In 2023, the most recent year for which данные is available, black mothers were три раза more likely to die during pregnancy or within six weeks of giving birth when compared to their white, Hispanic, and Asian peers. In 2022, the most recent year for which infant mortality rates are available, black babies were more than twice as likely to die in their first year of life compared to white babies.
Given these sobering statistics, it’s critical that we ask some hard questions: First, what’s killing pregnant and newly postpartum moms and their babies? Second: what programs or interventions are in place to help right the ship on maternal and infant mortality in the United States? In this article, we’ll give answers to both those questions.
What’s killing pregnant and newly postpartum moms and their babies?
A 2018 отчет based on research by the Nine Maternal Mortality Review Committees found that new mothers were more likely to die during the first six weeks postpartum (45%), compared to during pregnancy (37.6%) itself, or between six weeks and one year postpartum (17.5%). The top identified causes of death were tied between postpartum hemorrhage and cardiovascular or coronary conditions (14% each), followed by infection (10.7%), cardiomyopathy (heart muscle disease, 10.7%), amniotic fluid embolism (8.4%), преэклампсия and eclampsia (7.4%), and mental health conditions (7%). Not coincidentally, black mothers are also disproportionately more likely to have Cesarean sections, в том числе medically unnecessary C-sections, compared to their white peers.
As of 2022, the top five drivers of infant mortality (defined in the U.S. as death within the first year or life) were birth defects, preterm birth and/or low birth weight, sudden infant death syndrome (SIDS), accidents and unintentional injuries, and maternal pregnancy complications, according to the CDC.
Within the black community specifically, black babies were over three times more likely than white babies to die due to low birth weight, SIDS, or maternal pregnancy complications. Their mothers were also twice as likely as white mothers to receive late or no prenatal care.
Two innovative programs are proving that maternal mortality in the United States is largely preventable
While these numbers are disturbing, the good news is that the vast majority of maternal deaths, in particular, are предотвратимые, not inevitable. The CDC estimates that fully 80% of maternal deaths could be avoided “with reasonable changes to patient, family, provider, facility, system, and/or community factors.” Certainly, patient, family, provider, facility, system, and/or community factors represent a wide range of potential avenues to tackle unacceptably high maternal and infant mortality rates. Two innovative new programs, one in New Jersey and another founded in Missouri but with nationwide reach, capitalize on these areas of opportunity.
While these numbers are disturbing, the good news is that the vast majority of maternal deaths, in particular, are preventable, not inevitable.
Dads to Doulas shows empowered fathers protect moms and babies
Dads to Doulas, founded in St. Louis, Missouri, is an initiative of Dear Fathers, “The Premiere Media Platform dedicated to telling stories of black fathers from all angles. We ignite the power of fatherhood + culture.” Through the six-week Dads to Doulas program, which can be taken in person or virtually, black fathers are educated on all aspects of pregnancy through postpartum. The program intends to help black fathers advocate for their partners and children during labor and beyond.
The Dads to Doulas сайт states: “Dear Fathers recognizes the profound impact this can have on our community and strives to empower our families from the very start. Our one of a kind doula program is specifically designated to assist, encourage, support, de-stress, maintain, and educate black men and fathers in Maternal and Paternal care.” Upon completion of the program, which is completely free, fathers have the opportunity to go through a formal doula certification program.
Dads to Doulas is the brainchild of Brad Edwards, who lost his twin baby boys to stillbirth in 2017. Following that loss, and while his partner was pregnant with their daughter (born in 2020), Edwards reached out to long-time friend and doula Kyra Betts. Betts became the lead developer of what is now the Dads to Doulas program. In an interview on Сайт Jennifer Hudson Show, Edwards shared that since its inception in 2024, men in twenty-two states have participated in the Dads to Doulas program.
Doulas can make a real difference in driving down maternal mortality
There’s good reason to believe Dads to Doulas can make a real impact on maternal mortality rates (as well as infant mortality related to maternal pregnancy complications). Both the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine recognize что doula care—non-medical physical and emotional support from pregnancy through postpartum, and especially during the labor and birth process—improves outcomes for mothers and babies.
Doula care—non-medical physical and emotional support from pregnancy through postpartum, and especially during the labor and birth process—improves outcomes for mothers and babies.
As the two professional organizations noted in a 2014 joint заявление, “Published data indicate that one of the most effective tools to improve labor and delivery outcomes is the continuous presence of support personnel, such as a doula.” Specifically, research shows “that the presence of continuous one-on-one support during labor and delivery was associated with improved patient satisfaction and a statistically significant reduction in the rate of cesarean delivery [a major abdominal surgery with possible risks of hemorrhage, infection, and even death].” While a doula can benefit any woman during labor and delivery, as the population most at risk of maternal mortality, black mothers stand to gain the большинство from doula support.
Family Connects NJ bridges the gap between birth and six-week follow-up for moms и дети
While Dads to Doulas empowers black fathers to advocate for their partners and children, another program seeks to educate all members of the family in the home setting. Family Connects NJ is a free nurse home-visitor program helping bridge the crucial gap between birth and the traditional in-office six-week postpartum follow-up. (Importantly, while ACOG has for years рекомендовано a checkup for new moms at три weeks postpartum, in addition to the six-week visit, this is far from the norm).
Every baby born in the state of New Jersey, including adoptive and foster families and families who experience pregnancy or infant loss, is eligible for a Family Connects NJ visit during the first two weeks after birth. According to the Family Connects NJ сайт: “Specially trained registered nurses evaluate health, screen for potential complications, answer questions about welcoming a newborn, and address any unexpected changes families are experiencing.”
President & CEO of the Partnership for Maternal and Child Health of Northern NJ, Mariekarl Vilceus-Talty, explained during an интервью on PBS’ Think Tank with Steve Adubato, “It’s an evidence-based home visiting program with no eligibility restrictions, and it is so important because we know that [during] the two weeks after delivery, we need that support, we need that education, because that is when the majority of morbidity and mortality happens.” Vilceus-Talty’s statement dovetails with the data noted above about the first six weeks postpartum representing the highest risk for maternal mortality.
“…we know that [during] the two weeks after delivery, we need that support, we need that education, because that is when the majority of [maternal] morbidity and mortality happens."
Итоги
America’s high maternal and infant mortality rates are not unsolvable mysteries. Dads to Doulas and Family Connects NJ are two model programs that seek to make meaningful change for mothers and babies in practical, evidence-based ways. With greater investment in and expansion of these innovative programs (and others that prioritize support, empowerment, and education during pregnancy and postpartum) across the country, we may finally see our maternal and infant mortality numbers move in the right direction.
