Having more Black doctors and midwives could be the key to reducing Black maternal mortality rates

Becoming a mother is an amazing experience for so many, but for Black moms in the United States, the safety of the experience depends a great deal on the doctors and medical staff involved. Black women in the United States are 3 to 4 times more likely than white women to die from pregnancy or childbirth-related causes. There is also a stark racial contrast when it comes to newborn baby mortality rates.

A study published in 2020 in the “Proceedings of the National Academy of Sciences” found Black babies are less likely to die if they are cared for by Black doctors.

According to the study, Black babies are 2 to 3 times more likely to die than white babies when white doctors are in charge of their care. Being cared for by a Black doctor almost cut the number of deaths in half.

To gather data for the study, researchers examined almost 2 million birth records in the state of Florida from 1992 to 2015. Taking into account the race of the doctor in each instance, they were able to determine the developing pattern of mortality rates for Black babies. Interestingly, the race of the doctor did not affect the outcome of the survival of white newborns. The death rate for white babies was almost 300 per 100,000 births; for Black children, it was almost 800 deaths.

The United States struggles with high infant mortality rates. According to the Centers for Disease Control (CDC), 19,582 babies nationwide died prior to their first birthday in 2020. With 5.41 infant deaths per 1,000 births, the U.S. outpaces infant mortality rates in several countries, including Canada, France, United Kingdom, Belgium, Switzerland and the Netherlands. Singapore, Japan and Monaco are among those with the lowest infant mortality rates. Health System Tracker states that the United States’ rate is 71% higher than the comparable country average.

What accounts for the huge disparity?

Along with the race of the doctor caring for the baby, other external factors can include social and economic disadvantages, environmental stress and even unconscious racism some white doctors may have towards Black mothers and their children.

“The healthcare system in the United States has to grapple with a lot of issues throughout our history related to racism that have had an impact on the trust that people have when they’re interacting with the healthcare system,” study co-author Dr. Rachel Hardeman tells CBC News.

The physician workforce is disproportionately white

Given these stats, it makes sense that some Black moms would seek out Black doctors for their birth, but Black mothers don’t always have an easy time finding a Black physician to deliver their babies. When examining diversity in medicine in 2018, the Association of American Medical Colleges found that only 5% of doctors are Black.

The role of Black midwives

Dr. Hardeman is currently researching health outcomes at a Black-owned birthing center and says infant mortality rates “are not reflecting the disparities that we see in the rest of the state and across the country.”

“What we see is that people who received care from a Black midwife in this particular research study were more likely to report being satisfied with that care, feeling like they were a partner in that care, feeling respected, feeling heard,” she tells CBC.

Bottom line: Things need to change

The study notes that the “results underscore the need for research into drivers of differences between high and low performing physicians, and why Black physicians systemically outperform their colleagues when caring for Black newborns.”

According to Dr. Hardeman, patients should not be afraid to ask questions of their OB-GYN or birthing center, and medical professionals should be dedicated to “listening to Black birthing people and hearing—really hearing—what they need and what they want, and centering that and allowing that to be what drives any of these efforts in any of this work forward,” she explains.

A version of this post originally appeared on Aug. 24, 2020. It has been updated.