Racial Discrimination and Economic Obstacles Contribute to Dramatically Elevated Maternal Death Rates for Women of Color in the United States, Says a New Amnesty International Report

A new report from Amnesty International reveals that
African-American women are nearly four times more likely to die of
pregnancy-related complications than white women. In high-risk
pregnancies, the disparities are even greater; African-American women are five
and a half times more likely to die than white women.

The report, Deadly
Delivery: the Maternal Health Care Crisis in the USA, faults
discrimination, a lack of nationally enforced standards and barriers to
adequate maternal care as contributing to the high death rate among women of
color giving birth. Women living in poverty and those who speak little or no
English face additional barriers to quality maternal care, resulting in missed
opportunities to save women's lives and reduce complications.

Inamarie Stith-Rouse, 33, who was African-American,
died in a Boston hospital after delivering a healthy baby girl
following an emergency c-section. Her husband Andre said he tried telling staff
that his wife was in distress and struggling to breathe after surgery, but he
said he was told it was "no big deal" and the couple was "too
emotional." Hours went by before appropriate tests showed she was
hemorrhaging. It was too late. Inamarie went into a coma and died four
days later. Andre Rouse felt race played a part in the hospital staff's immediate
lack of response.

Two to three women die every day in the United States from pregnancy-related
complications, according to the Centers for Disease Control, and half of these
deaths are preventable.
More than 34,000 women nearly die
each year due to flaws and shocking disparities in maternal health care. These
severe pregnancy-related complications that nearly cause death have increased
by 25 percent since 1998.
Authorities concede that haphazard reporting means maternal death statistics
could be twice as high as officially reported.

"This country's extraordinary record of medical
advancement makes its haphazard approach to maternal care all the more
scandalous and disgraceful," said Larry Cox, executive director of
Amnesty International USA. "Women should not die in the richest country on earth from preventable
complications and emergencies."

Maternity care advocates and practitioners confirm the
findings in AI's report. "In the 20 years I've been in this country,
the racial disparity has not improved. I cannot comprehend how such a stark
racial disparity could even exist in a country like this," said Jennie
Joseph, a U.K.-trained midwife who founded the Easy Access Prenatal Care
Clinic, an outreach maternity clinic in West Orlando, FL; the outreach clinic
clientele is 50 to 60% African American.

The report
includes these key findings:

• l Women of color account for 32
  percent of all women in the United States but more than half (51 percent) of uninsured women;
  this means they are more likely to go into pregnancy with less than optimum
  health or untreated medical problems. (State data available.)
• l Women who do not receive any
  prenatal care are three to four times more likely to die than women who do.
  African-American and Latina
  women are two and a half times and Native American women are three and a half
  times more likely than white women to receive late or no prenatal care. (State
  data available.)
• Burdensome
  bureaucratic procedures in Medicaid enrollment delay access to prenatal
  care. Twenty-one states do not currently allow pregnant women to
  temporarily access medical care while their permanent application for Medicaid
  is pending.
• l In rural areas and inner cities
  there is a critical shortage of health care professionals. In 2008, 64 million
  people were living in "shortage areas" for primary care, but
  federally-supported community health centers-a critical safety
  net-were available in only 20 percent of these areas. (State data available.)
• Caesarian sections make up nearly
  one-third of all deliveries in the United States-twice as high as recommended by the World Health
  Organization. African American women have the highest c-section rate of any
  group. The risk of death following c-sections is more than three times higher
  than for vaginal births.

Comprehensive, Consistent Approach Needed
to Maternal Care

The Amnesty International report calls for a coordinated,
comprehensive and consistent approach to maternal care, from family planning to
post-partum care, to fix a system that is failing so many women.

Because there is no systematic, robust government response
to this critical problem, Amnesty International is urging the government to
establish a single office within the Department of Health and Human Services
responsible for ensuring that all women receive quality maternal care.

Other recommendations include:

• l An increase in support for
  federally qualified health centers by 2011 to expand the number of women who
  can access affordable maternal health care
• l Vigorous enforcement of federal
  non-discrimination laws
• l Ensure access to timely prenatal
  care for all women
• l Encouraging home care visits during the first weeks
  following birth
• l Protocols to prevent and respond to the leading
  complications that cause pregnancy-related death

Respect for human rights requires the recognition that everyone
has the right to live in dignity, and the right to food, shelter, water, basic
health care and education. For more information about Amnesty International's
"Demand Dignity" campaign, please visit: https://www.amnestyusa.org/demand-dignity/