Written by Amber Rogers

Black Maternal Health Week, initiated by Black Mamas Matter Alliance, Inc. (BMMA), is an annual event held this year from April 11-17, to raise awareness and address racial disparities in maternal health outcomes. By fostering activism and community engagement, BMMA advocates for maternal health initiatives, prioritizing Black reproductive health and birth-justice movements. The Centers for Disease Control and Prevention (CDC) and John Hopkins Bloomberg School of Public Health[1] (John Hopkins) report that Black women face disproportionate risk of pregnancy-related complications, with data showing they are two to three times more likely to die from such issues than white women. As the National Bureau of Economic Research[2] emphasizes, these deaths occur across all income and education levels and most are preventable.

Lantana is proud to partner with government and commercial agencies to lead initiatives that enhance data quality, leading to improved outcomes. In this blog, we highlight both community and legislative efforts addressing these disparities.

Community organizations and alliances are a key element to amplifying voices for research, justice, and legislative changes in Black maternal health. Oshun Family Center, recognizing the racial inequalities in health care, adopted holistic approaches to cultivate change. Oshun is a community organization focused on achieving “optimal physical wellness through psychotherapy and holistic healing and birthing methods such as doula and lactation support.”[3] John Hopkins reports that the assistance of doulas and midwives during pregnancy and birth lessens the frequency of preterm birth, C-sections, complications, and low birth weight for infants. Oshun embraces an overall healing journey of mind, body and soul that improves the well-being of mother and child.

John Hopkins reports that 65% of Black birthing individuals in the U.S. rely on Medicaid for pregnancy and postpartum care, compared to 42% of all mothers nationwide. Advocates have pushed for extending postpartum Medicaid benefits to a full year to address nearly half of maternal deaths occurring within the first postpartum year. Several states have expanded Medicaid coverage, resulting in lower maternal death rates. However, returning to work soon after birth remains a challenge, as the U.S. lacks national paid parental leave policies. Job-protected paid parental leave contributes to healthy maternal and infant outcomes, yet Black women have less access to it due to pregnancy discrimination and bias in employment, increasing their risk of poor maternal health outcomes.[4]

Telehealth services offer remote access to healthcare professionals, which is shown to decrease racial disparities in postpartum care attendance. The John Hopkins article notes that the CARES Act and the 2022 Omnibus Appropriations spending bill support the adoption of telehealth policies. The Black Maternal Health Momnibus Act of 2021, introduced by the Black Maternal Health Caucus, proposes comprehensive changes through 12 standalone bills addressing socioeconomic factors affecting pregnancy, including investments in social determinants of health, diversifying the perinatal workforce, and enhancing data collection.

Recognizing the need to improve maternal outcomes, the United States Core Data for Interoperability (USCDI+) initiative supports the development of domain-specific data element lists as an extension of USCDI. Provided as a service by the Office of the National Coordinator for Health Information Technology (ONC), USCDI+ extensions are built from the same USCDI foundation and align data standards across programs and use cases. USCDI+ Maternal Health defines a core set of data essential for quality care, equitable outcomes, and maternal health research. These data elements capture the impact of maternal health on outcomes for both mothers and children.[5]

Lantana, in collaboration with CDC, is at the forefront of assessing pregnancy data elements for inclusion in the next iteration of USCDI+. Accurate data elements enhance clinical systems’ ability to accurately record pregnancy outcomes, ultimately improving measurement and treatment, and addressing adverse consequences in maternal health.

Lantana’s commitment to improving maternal health outcomes also extends to the development, maintenance, reevaluation, and support of electronic measures related to maternal and child health. Funded by the Assistant Secretary for Planning and Evaluation (ASPE) Patient-Centered Outcomes Research Trust Fund (PCOR-TF) and under the guidance of the National Institutes of Health (NIH), CDC, and ONC leadership, Lantana developed the Longitudinal Maternal & Infant Health Information for Research Fast Healthcare Interoperability Resources (FHIR) implementation guide (IG).[6] This IG provides data access, extraction, transformation, and validation tooling that fully populate maternal health records.

As we continue our collective journey towards achieving health equity for all, it is imperative that we remain vigilant in addressing the root causes of disparities and advocating for policies and interventions that promote justice and equity in maternal healthcare. Together, we can create a future where every birthing individual receives the care and support they need to thrive, regardless of their race or socioeconomic status.

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References

[1] John Hopkins Bloomberg School of Public Health, How Can We Solve the Black Maternal Health Crisis? https://publichealth.jhu.edu/2023/solving-the-black-maternal-health-crisis (accessed March 2024)

[2] Kennedy-Moulton K, Miller S, Persson P, Rossin-Slater M, Wherry L, Aldana, G. Maternal and Infant Health Inequality: New Evidence from Linked Administrative Data. NBER Working Paper Series 2022 Nov rev. 2023 Sept; Working Paper 30693: 5-6.

[3] Oshun Family Center. https://oshunfamilycenter.org/ (accessed March 2024)

[4] John Hopkins Bloomberg School of Public Health, How Can We Solve the Black Maternal Health Crisis? https://publichealth.jhu.edu/2023/solving-the-black-maternal-health-crisis (accessed March 2024)

[5] HealthIT.gov, USDI+. https://www.healthit.gov/topic/interoperability/uscdi-plus (accessed March 2024)

[6] Item of Interest: NICHD-Developed Guide Sets Framework to Link Maternal, Infant Health Data, NIH. https://www.nichd.nih.gov/newsroom/news/062623-maternal-guide (accessed April 2024)

Oshun logo provided courtesy of oshunfamilycenter.org