Maternal mortality is increasing in America and Tennessee and cardiovascular causes are the most common reasons of pregnancy associated mortality. Blacks are three to four times more likely to die from pregnancy related causes than white mothers in Tennessee. To date, no consistent body of literature has shown that underlying biology is a causal link to racial disparity in adverse pregnancy outcomes. It is often reflexive first to blame patient factors such as lack of education, lower socioeconomic status and inadequate prenatal care. However, national data has demonstrated that while these factors contribute to maternal mortality overall, it does not entirely explain the observed disparities. Studies has demonstrated that players in the medical system have racial bias that impacts the delivery of healthcare. Previously, racism was thought of as a social issue separate and distinct from racial health disparities. In these unprecedented times during this Covid-19 pandemic and racial unrest, it clear that systemic racism steeped in the history of our nation has played a pivotal a role in propagating the health disparities including maternal and infant health. For this reason, we have a mandate to deliberately act to mitigate the casualties of racism in maternal/ infant health in Tennessee. While universal unconscious bias training will help in addressing the provider contribution to racial disparities, there remains a need to mitigate unequal access, treatment and adverse outcomes in maternal and infant health in measurable ways. Addressing racism, social determinants of health and recommending the consistent delivery of culturally sensitive health care is an important charge for TIPQC and its members and will promote health equity for Tennessee families.
Rolanda Lister, MD is a Maternal Fetal Medicine specialist at Vanderbilt University Medical Center and the Officer of Health Equity for the Tennessee Initiative for Perinatal Quality care