Rachel R Hardeman1, Anna Kheyfets2, Allison Bryant Mantha3, Andria Cornell4, Joia Crear-Perry5, Cornelia Graves6, William Grobman7, Sascha James-Conterelli8,9, Camara Jones10, Breana Lipscomb11, Carla Ortique12, Alison Stuebe13, Kaprice Welsh14,15, Elizabeth A Howell2,16. 1. Center for Antiracism Research for Health Equity, Division of Health Policy Management, School of Public Health, University of Minnesota, 420 Delaware St SE MMC 729, Minneapolis, MN, 55455, USA. Hard0222@umn.edu. 2. Tufts University School of Medicine, Boston, MA, USA. 3. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA. 4. Association of Maternal &, Child Health Programs, Washington, DC, USA. 5. National Birth Equity Collaborative, New Orleans, LA, USA. 6. Tennessee Maternal Fetal Medicine, PLCDivision of Perinatal Services, Baptist Hospital, Nashville, TN, USA. 7. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 8. Yale School of Nursing, Yale University, New Haven, CT, USA. 9. New York State Association of Licensed Midwives, New York, NY, USA. 10. Morehouse School of Medicine, Atlanta, GA, USA. 11. Center for Reproductive Rights, Atlanta, GA, USA. 12. Department of Obstetrics, Texas Children's Hospital, Houston, TX, USA. 13. Division of Maternal-Fetal MedicineSchool of Medicine, Department of Obstetrics and Gynecology, School of Medicine, Department of Maternal and Child HealthGillings School of Global Public Health, University of North Carolina Carolina Global Breastfeeding InstituteUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 14. Georgia OBGyn Society, Atlanta, GA, USA. 15. Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA. 16. Department of Obstetrics and Gynecology in the Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Abstract
PURPOSE: The purpose of this report from the field is to describe the process by which an multidisciplinary workgroup, selected by the CDC Foundation in partnership with maternal health experts, developed a definition of racism that would be specifically appropriate for inclusion on the Maternal Mortality Review Information Application (MMRIA) form. DESCRIPTION: In the United States Black women are nearly 4 times more likely to experience a pregnancy-related death. Recent evidence points to racism as a fundamental cause of this inequity. Furthermore, the CDC reports that 3 of 5 pregnancy related deaths are preventable. With these startling facts in mind, the CDC created the Maternal Mortality Review Information Application (MMRIA) for use by Maternal Mortality Review Committees (MMRC) to support standardized data abstraction, case narrative development, documentation of committee decisions, and analysis on maternal mortality to inform practices and policies for preventing maternal mortality. ASSESSMENT: Charged with the task of defining racism and discrimination as contributors to pregnancy related mortality, the work group established four goals to define their efforts: (1) the desire to create a product that was inclusive of all forms of racism and discrimination experienced by birthing people; (2) an acknowledgement of the legacy of racism in the U.S. and the norms in health care delivery that perpetuate racist ideology; (3) an acknowledgement of the racist narratives surrounding the issue of maternal mortality and morbidity that often leads to victim blaming; and (4) that the product would be user friendly for MMRCs. CONCLUSION: The working group developed three definitions and a list of recommendations for action to help MMRC members provide suggested interventions to adopt when discrimination or racism were contributing factors to a maternal death. The specification of these definitions will allow the systematic tracking of the contribution of racism to maternal mortality through the MMRIA and allow a greater standardization of its identification across participating jurisdictions with MMRCs that use the form.
PURPOSE: The purpose of this report from the field is to describe the process by which an multidisciplinary workgroup, selected by the CDC Foundation in partnership with maternal health experts, developed a definition of racism that would be specifically appropriate for inclusion on the Maternal Mortality Review Information Application (MMRIA) form. DESCRIPTION: In the United States Black women are nearly 4 times more likely to experience a pregnancy-related death. Recent evidence points to racism as a fundamental cause of this inequity. Furthermore, the CDC reports that 3 of 5 pregnancy related deaths are preventable. With these startling facts in mind, the CDC created the Maternal Mortality Review Information Application (MMRIA) for use by Maternal Mortality Review Committees (MMRC) to support standardized data abstraction, case narrative development, documentation of committee decisions, and analysis on maternal mortality to inform practices and policies for preventing maternal mortality. ASSESSMENT: Charged with the task of defining racism and discrimination as contributors to pregnancy related mortality, the work group established four goals to define their efforts: (1) the desire to create a product that was inclusive of all forms of racism and discrimination experienced by birthing people; (2) an acknowledgement of the legacy of racism in the U.S. and the norms in health care delivery that perpetuate racist ideology; (3) an acknowledgement of the racist narratives surrounding the issue of maternal mortality and morbidity that often leads to victim blaming; and (4) that the product would be user friendly for MMRCs. CONCLUSION: The working group developed three definitions and a list of recommendations for action to help MMRC members provide suggested interventions to adopt when discrimination or racism were contributing factors to a maternal death. The specification of these definitions will allow the systematic tracking of the contribution of racism to maternal mortality through the MMRIA and allow a greater standardization of its identification across participating jurisdictions with MMRCs that use the form.