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Feature Racism in Medicine

Ethnic disparities in maternal care

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m442 (Published 12 February 2020) Cite this as: BMJ 2020;368:m442

Read all of the articles in our special issue on Racism in Medicine

  1. Lilian Anekwe, assistant news editor
  1. New Scientist, London
  1. lilian_anekwe{at}hotmail.com

Black and ethnic minority women are paying with their lives for the lack of action on racial bias, reports Lilian Anekwe

Maternal health—or lack of it—is one of the starkest examples of racial health inequalities in the United Kingdom and in the United States. Work in the UK by University of Oxford researchers found that between 2014 and 2016 the rate of maternal death in pregnancy was 8 in 100 000 white women, compared with 15 in 100 000 Asian women and 40 in 100 000 black women (box 1).1 It’s a similar picture in the US, where African-American, Native American, and Alaska native women die of pregnancy related causes at a rate three times that of white women, according to a May 2019 report by the Centers for Disease Control.2

Box 1

Problems in maternal care

  • In 2015-17, 209 women died during or up to six weeks after pregnancy in the UK, from causes associated with their pregnancy, giving a mortality rate of 9.2 women per 100 000

  • The overall maternal death rate in the UK did not fall significantly between 2012-14 and 2015-17

  • Assessors judged that 44% of women who died had good care, but that better care might have made a difference to the outcome in 29% of women who died

  • Thrombosis and thromboembolism were the leading direct causes of death, followed by maternal suicide

  • Cardiac disease remains the largest single cause …

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