Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle

Abstract

Racial and ethnic disparities exist in both perinatal outcomes and health care quality. For example, black women are 3 to 4 times more likely to die from pregnancy-related causes and have more than a 2-fold greater risk of severe maternal morbidity than white women. In an effort to achieve health equity in maternal morbidity and mortality, a multidisciplinary workgroup of the National Partnership for Maternal Safety, within the Council on Patient Safety in Women's Health Care, developed a concept article for the bundle on reduction of peripartum disparities. We aimed to provide health care providers and health systems with insight into racial and ethnic disparities in maternal outcomes, the etiologies that are modifiable within a health care system, and resources that can be used to address these etiologies and achieve the desired end of safe and equitable health care for all childbearing women.

Barriers and Facilitators to Recurrent Preterm Birth Prevention among Low-Income Women: A Qualitative Study

“…21,25,26 A recent Consensus Statement by the National Partnership for Maternal Safety highlighted patient navigation as a potential approach to achieve high-quality and equitable care for all women and to reduce racial and ethnic disparities. 27,28 Patient navigation has improved attendance at postpartum visits compared with a historical cohort who did not receive navigation, suggesting applicability to obstetrics, such as for pregnant women who are recommended 17P. 20,29 Additionally, as comprehensive postpartum care represents an ideal opportunity to optimize postpartum health and educate patients about subsequent risks and preventive care, patient navigation for postpartum women with a PTB may be an opportunity to leverage identified facilitators and address barriers to future PTB prevention.…”

Updates from the Literature, November/December 2019

“…There is a growing body of scholarly literature that has underscored and drawn attention to existing racial and ethnic disparities in maternal mortality and other health measures. It is now well recognized that racism negatively affects multiple health outcomes . In this commentary, Ghidei, Murray, and Singer acknowledge that medicine has contributed to propagating myths and falsehoods about differences in race that occur daily in clinical practice.…”

Addressing Maternal Deaths in North Carolina

“…One of the bundles rarely highlighted is the Health Disparities Reduction bundle. This bundle addresses steps individuals, providers, and systems can adopt to reduce ethnic and racial disparities in maternal mortality [8]. This bundle attempts to reduce the individual risks for any woman who encounters a health care provider or system.…”