The American Academy of Nursing (Academy) President-Elect Eileen Sullivan-Marx, PhD, RN, FAAN, spoke recently at the House of Representatives Black Maternal Health Caucus’s Stakeholder Summit on black maternal care along with other national policy and advocacy organizations.
The Academy announced its continued commitment to addressing the causes, consequences, and solutions to combat two prominent issues related to maternal and infant health (MIH): Increased rates of maternal mortality and morbidity as well as preterm births (PTBs) within the U.S. and especially among African American mothers.
Racial disparities within MIH are significant as African American women are 3.2 times more likely to die during pregnancy or childbirth than Caucasian women and research shows that impoverished, marginalized, and under-represented women are most vulnerable to PTBs.
The Black Maternal Health Caucus, co-chaired by Representatives Alma Adams (D-NC) and Lauren Underwood (D-IL), was launched this spring to improve black maternal health outcomes, noting that even as advancements are made in MIH, the U.S. lags behind other developed countries on these important maternal and infant health issues. Maternal mortality rates have doubled since the 1990s and, despite a steady decline from 2007 – 2014, PTBs peaked at 9.93 percent in 2017.
The Academy’s Maternal and Infant Health Expert Panel recently published a policy brief on African American mothers’ persistent excessive maternal death rates, in which the Academy calls for:
· The collection of more comprehensive and consistent data on African American mothers across all states, as well as additional funding to make this possible
· Equitable healthcare insurance coverage and access to care for all women and mothers, especially during the childbearing period
· The requirement of coterminous mortality and morbidity review boards in all states, with county-level data on pregnancy mortality available to the public
· The appointment of a special task force by the CDC to launch a sustained media campaign on the prenatal, pregnancy, and postpartum care of mothers.
Sullivan-Marx additionally highlighted two of the Academy’s Edge Runner models. Academy Edge Runners are innovative, nurse-designed models of care that demonstrate improved health quality while reducing cost. Both of the following programs have proven effective because they are partnering and engaging with the community in practical ways to ensure mothers and families have voice and agency in their health:
· The 11th Street Family Health Services, of Drexel University, is a nurse-managed, transdisciplinary health center delivering care, promoting health, and reducing health disparities among underserved populations in Philadelphia. Notably, the 11th Street center reduced pre-term births to 2.5 percent in African American patients, compared to 15.6 percent in Philadelphia broadly.
· Recent efforts to improve MIH and to address the health and racial disparities in this area remain insufficient. African American mothers remain the primary group at risk of both maternal and infant mortality as well as PTBs. These statistics will only improve significantly when better access to quality healthcare is achieved.
Most critically, the Academy calls for heightened data collection and research on maternal mortality and PTBs to better healthcare professionals’ understanding of significant contributing factors.
