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Perinatal Mortality Among Black Women and Birthing People in the US,…

- - - - Depression
      - Mood disorders
    - - active
      - Exhaustion from stress
        
        Sedentary
      - Obesity - chronic health condition, stress related, increases risk of maternal mortality**
      - Age
    - - first birth
      - previous live births
        
        Relationship between proportion of births to Black women and maternal mortality rates
        
        Higher c-section rates
      - miscarriage
      - Reproductive Health
  - - - Cardiovascular disease
        
        Significant differences in mortality rates between Black and White women
        
        Cardiomyopathy mortality ratios higher in Black Women
        
        Hypertension
        
        Coronary artery disease
        
        Arteries experience damage that causes inflammation & plaque build up. Fat & cholesterol stick together & narrow blood vessels
      - HIV status
      - Inherited Conditions
        
        Sicle cell disease
        
        hemophilia
        
        cystic fibrosis
      - Chronic liver disease
      - chronic renal disease
      - Weakened immune system
        
        Reduced healing time
        
        increased susceptibility to illness
        
        Antiphospholipid Syndrome
        
        Extremely difficult to diagnose clotting disorder
      - The body normally stores excess nutrients to be used later. During stress, excess blood sugar circulates in blood which contributes to diabetes and cardiovascular disease
      - Metabolic Diseases
- - - - Language barriers make communication with healthcare providers difficult and result in misinformation on practices needed to prevent poor health outcomes
    - - lower attainment
        
        Not completing high school associated with higher rates of maternal mortality
  - - - Pregnancy intent & wontedness
    - - Racial & Ethnic Disparities
        
        Clinical Care
        
        Social
        
        Medical
        
        Health System
  - - - Violence in neighborhoods increases likelihood of domestic violence, which leads to physical, emotional, and psychological stress & injury
      - Living in proximity to harmful environmental exposures
    - - Living in urban areas with high traffic, noise, violence, etc. increases stress levels and makes it difficult to rest/sleep. Sleep deprivation further adds psychological & physical stress on the body
  - - - Lack of access of to prenatal care
      - Disrespectful, dismissive, and inadequate care due to staff shortages and insufficient time spent with patients
    - - Uninsurance rates
    - - Black women are more likely to be dismissed by medical providers when vocalizing concerns over their health, especially during pregnancy. This causes women to feel hopeless in expressing their concerns and advocating for themselves. Even if they are experiencing abnormal symptoms that need to be addressed, not speaking up about them due to intimidation and frequent dismissal prolongs diagnoses and ultimately actions needed to prevent poor health outcomes.
  - - - Due to systematic barriers, Black women are more likely to hold jobs with lower wages & income to support families. They are forced to continue working throughout pregnancy, thus increasing psychological stress & physical stress on the body. This also leaves less time available for prenatal appointments. Fear of losing employment due to taking time off for appointments contributes to increased stress and decreased willingness to seek care.
    - - Mother's of low-income may have difficulty allocating money for prenatal care as it would reduce funds for basic life necessities, such as food. A lack of adequate nutrition not only adds psychological stress (e.g mother worried about baby getting enough nutrients), but also puts physiological stress on mother's body.
  - - - smoking
      - alcohol
      - drug use
      - diet
      - physical activity
      - hygiene