Reviews | Why is it so dangerous to be pregnant in America?


Compared to its peers, the United States’ trajectory in maternal health has been a shame. Addressing this growing problem requires looking not only at the quality of care a woman receives, but the entire environment around her, from her access to health care to the availability of food in the home. his community.

The Maternal Vulnerability Index uses a range of maternal health and community data – six categories in total – giving a more complete picture of what is behind the risk of poor maternal health outcomes in counties. across America.

Data shows that a woman’s chances of having a healthy pregnancy vary widely depending on where she lives, depending on factors such as her high school diploma, her exposure to poverty, her access to obstetricians-gynecologists and midwives, and its access to abortion clinics.

How at risk are women in your country and why? Find your county to find out. (Higher scores indicate higher risk.)

Overall maternal risk in New York County, New York State
is moo.

Source: Surgo Ventures.·Notes: Maternal risk is on a scale of 0 to 100, with a higher score signifying a higher risk. WRA stands for “women of childbearing age”. Air pollution is determined by the concentration of particles (PM2.5). The quality of ambulatory care is based on the United States Department of Health and Human Services Prevention Quality Indicators.

One of the most striking findings is that a woman’s risk of poor maternal health varies widely by race, and these racial differences vary widely by region.

For example, there are large differences in risk for black women compared to white women in the Midwest and Northeast.

For Native American and Native Alaskan mothers, the risk deviations from white mothers are greatest in the West and Midwest, especially in states with Native American reservations like Montana, South Dakota and New Mexico, suggesting that women of childbearing age living on American Indian reservations may die at higher rates and have riskier pregnancies.






Maternal risk associated with

physical environment

Racial disparities in crime,

access to housing and transport

Maternal risk related to the physical environment

Racial disparities in crime, housing and access to transport

Maternal risk related to the physical environment

Racial disparities in crime, housing and access to transport

Maternal risk related to the physical environment

Racial disparities in crime, housing and access to transport


Source: Surgo Ventures.

What contributes to the big gap between white and black women?

In almost all states, three types of factors play a disproportionate role. White women are more likely to live in good physical environments: less polluted communities, less violent crime, and better access to high-quality housing and transportation options. They are also more likely to be in good physical health, to have access to treatment and prevention strategies for sexually transmitted infections and non-communicable diseases. And they face fewer socio-economic barriers: they are more likely to have access to educational opportunities, financial resources, and healthy food options, and are less likely to face language barriers.

But there are a few exceptions – in Wisconsin, for example, the state with the highest risk gap between black and white women. Mental health and addiction play an important role in addition to the factors described above. This includes general stress levels, mental illnesses like depression, access to mental health care, and substance use like nicotine and street drugs.


social capital more often than white women do.”>





Maternal risk associated with

Socioeconomic status

Racial disparities in education,

poverty and social capital

Maternal risk linked to socio-economic status

Racial disparities in education, poverty and social capital

Maternal risk linked to socio-economic status

Racial disparities in education, poverty and social capital

Maternal risk linked to socio-economic status

Racial disparities in education, poverty and social capital


Source: Surgo Ventures.

Over the past two decades, maternal mortality has increased by almost 60 percent. The United States is the only other Group of 7 country outside of Canada to experience such a drastic decline in maternal health. (Canada has seen a slight increase in pregnancy-related deaths.)

President Biden has invested funds in various programs to improve maternal health, such as extending Medicaid coverage to 12 months after childbirth, implicit bias training for health care providers and committees. state level maternal mortality review.

Passing the Black Maternal Health Momnibus Act, which includes a set of transformative policies for maternal health, is the next important step in tackling this complicated problem. It is the most comprehensive and evidence-based legislative approach to remove barriers to good maternal health for women of color.






Maternal deaths per 100,000 live births

Maternal deaths per 100,000 live births

Maternal deaths per 100,000 live births


Source: The World Bank.

These general federal policies, however, cannot solve the problem on their own. We also need a much more focused local action, in the form of a specific set of solutions tailored to the problems that each community faces, as the reasons for maternal risk may vary from county to county.

Consider two counties where pregnancies are particularly risky: Georgetown County, South Carolina, and Webb County, Texas.

In Georgetown County, local leaders could focus on non-communicable diseases and increase screening for sexually transmitted infections, providing low-cost transportation options to help women get to their medical appointments, or by providing more affordable, high-quality housing where pregnant women do not. have to worry about the black mold growing in their rooms.

But in Webb County the risks are linked to factors such as fluency in English, whether a woman has a high school diploma, whether she is living in poverty or food insecurity, access to obstetricians-gynecologists and midwives and access to abortion clinics. Policymakers there should focus on a different set of solutions, such as expanding access to nutrition programs such as WIC and SNAP, and increasing access to midwives, doulas and family planning services.

While the Vulnerability Index shows the range of issues facing lawmakers, it does not fully explain racial disparities. This suggests that other causes are at play. Black women face implicit biases that lead to worse treatment and must experience other manifestations of racism, such as residential segregation at the neighborhood level.

Addressing racial disparities in maternal health outcomes is not just the responsibility of those working in health care. Housing authorities can help low-income women find better living conditions; urban planners can increase access to healthy food options in underserved communities; and educators and school administrators can offer mothers flexible GED or higher degree options, potentially including free or low-cost child care.

It is high time the United States tackled the devastating racial maternal health gap. Policymakers, researchers, community health organizations and advocates from all sectors must come together to provide a better future for all who give birth.

Comments are closed.