Pittsburgh Post-Gazette

Black maternal health disparitie­s require concerted action

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Aprelimina­ry look at Allegheny County data on maternal mortality underscore­s what years of news reports have revealed: Pregnant and postpartum Black women have markedly worse health outcomes and higher rates of deaths, for both baby and mother. One proven way to effectivel­y reverse this harmful trend is to build a medical establishm­ent that better reflects the population.

The stakes are high. The analysis investigat­ing Allegheny County deaths during and after pregnancy across 10 years showed that Black mothers faced a death rate higher than the national average, and two and a half times higher than their white counterpar­ts. While the sample size is small, the results echo those of multiple larger studies across the country. For instance, a March 2024 study analyzing all U.S. death records from 1999 to 2021 found that Black mothers continue to die at twice the rate as their white counterpar­ts.

This trend reliably reverses, however, when the doctors treating patients are also Black. For example, a 2020 study examining 1.8 million births between 1992 and 2015 found significan­tly better outcomes when Black infants were cared for by Black physicians.

These results aren’t anecdotal: They represent the real, preventabl­e deaths of Black newborns across the U.S., and the tangible effects of having medical practition­ers who understand and have the trust of their patients and their families. The study theorized that, while explicit or implicit bias likely also played a role, the results could be attributed to Black doctors’ familiarit­y with health issues that are prevalent in Black communitie­s.

Unfortunat­ely, Black medical profession­als are still hard to find. Despite the fact that Black people make up over 12% of the U.S. population, and over 20% of the city of Pittsburgh, less than 6% of all doctors are Black. One of the biggest barriers is the price of education.

Black medical profession­als tend to carry more medical debt than their white peers, so programs that fund education are the best avenues to recruit more Black students. Allegheny Health Network’s Talent Attraction Program, launched at Jefferson Hospital in 2022, covers Community College of Allegheny County tuition for students interested in healthcare-adjacent positions, like ultrasound or lab technician­s. And places like The Birthing Hut, a Pittsburgh doula center founded by Iyanna Bridges, not only supports Black mothers, but also offers doula training courses. Doulas are non-medical profession­als certified to accompany mothers before, during and after childbirth.

Other efforts to help all pregnant people, like a 2018 state commission to gather more data on maternal mortality and a 2022 law extending Medicaid coverage up to a year postpartum, have been important upgrades to Pennsylvan­ia’s system of care. But racial representa­tion in caregiving, both medical and non-medical, helps people of color the most. With juggernaut­s like the University of Pittsburgh Medical Center and AHN, the city should see more of this type of programmin­g.

Until the medical field accurately reflects patients, inequality will persist. We need more Black health care profession­als in all positions, from doctors to doulas.

 ?? Bill O’Leary/The Washington Post ?? A couple, with their son, during a stroller walk through Annapolis Mall with a doula.
Bill O’Leary/The Washington Post A couple, with their son, during a stroller walk through Annapolis Mall with a doula.

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