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 * DOT-MOM  //  GUEST CONTRIBUTOR
   
   
   MATERNAL HEALTH: HOW RACIAL AND GENDER DISCRIMINATION DRIVE MATERNAL
   MORTALITY RATES
   
   March 20, 2024 By Patricia Da Silva
   
   The International Day of the Elimination of Racial Discrimination on March 21
   offers a significant opportunity to reflect on a key issue in maternal
   health: despite global progress over the past 20 years, maternal deaths are
   rising across the Americas. Why?
   
   To find the answer, simply examine who is being hardest hit by this
   preventable epidemic: women and girls of African descent.
   
   Afrodescendent women and girls are more likely to die during childbirth than
   almost every other racial and ethnic group in the Americas due to systematic
   neglect and mistreatment by society and healthcare systems, according to a
   recent analysis from UNFPA, the United Nations sexual and reproductive health
   agency, Maternal Health of Women and Girls of African Descent in the
   Americas. Black women and girls in the United States, for example, are three
   times more likely to die while giving birth or within six weeks of giving
   birth compared to non-Afrodescendent and non-Hispanic women. The rate is 2.5
   times higher in Suriname, while Brazil and Colombia see figures 1.6 times
   higher.
   
   “When a woman of African descent dies during childbirth, it is still too
   often put down to her own poor life decisions or her predisposition to
   certain medical conditions; then, the world moves on,” said Dr. Natalia
   Kanem, Executive Director of UNFPA at a press conference launching the
   analysis. “Justice and equality will only be possible when our health-care
   systems see these women and provide them with respectful, compassionate
   care.”
   
   
   INTERSECTING CHALLENGES
   
   How did UNFPA isolate the role of racism and sexism in maternal health?
   
   In their  July 2023 analysis UNFPA revealed how disparities in health
   outcomes for Afrodescedent women and girls persisted even when controlling
   for educational levels and income.      
   
   The analysis found that higher income or levels of schooling also offer
   little protection for mothers. Maternal deaths among African American college
   graduates in the United States, for instance, were 1.6 times higher than
   among white women who had not achieved a high school diploma. Thus,
   Afrodescendent women and girls’ worst maternal health outcomes could not be
   fully explained by the social determinants of health.
   
   Instead, structural problems like racism and sexism play a major role in
   outcomes. These systemic issues result in Afrodescendent women and girls
   being denied quality care, or being refused pain relief based on racist
   beliefs dating back to the era of enslavement that they are less sensitive to
   pain. They are also subjected to verbal and physical abuse in hospitals.
   
   Their mistreatment and the low-quality services these women receive can have
   deadly consequences, as they lead to increased complications and delayed
   interventions.
   
   
   
   
   REVEALING THE INVISIBLE
   
   Lack of available data is also an issue. Only 11 out of the 35 countries in
   the Americas collect maternal health data broken down by race. A mere four
   countries with comparable data count the number of Black women who die during
   childbirth. This data gap renders the challenges Afrodescendent women and
   girls face invisible.
   
   The alarming rate of maternal deaths among women and girls of African descent
   is a human rights crisis that is largely ignored and overlooked by
   decision-makers. Out of the population of more than 1 billion people in the
   Americas, 209 million are of African descent. However, only one-third of the
   32 national health plans surveyed by UNFPA as part of its research identified
   Afrodescendents as a population that experiences barriers to health.
   
   
   SAVING LIVES
   
   The vast majority of maternal deaths among Afrodescendent women and girls are
   preventable—but they can only be averted when their voices are heard, and
   their problems are made visible. They must be at the table as maternal health
   policies are developed, and their ideas and concerns must be addressed. 
   
   Racist misconceptions rooted in enslavement-era beliefs about people of
   African descent have no place in medical education, training curricula,
   hospitals, or doctors’ offices. Obtaining improved data is a critical
   priority, as is providing services that acknowledge and fulfill
   Afrodescendent communities’ right to health. This care should reflect
   preferences defined by women and girls of African descent and integrate
   culturally appropriate healthcare practices.
   
   Realizing the sexual and reproductive health and rights of Afrodescendant
   women and girls requires addressing the main barriers they face in finding
   such care. National governments, international organizations, and healthcare
   providers in the region can meet the maternal, sexual, and reproductive
   health needs of Afrodescendent women and girls by addressing the root causes
   of structural racism, sexism, and discrimination.
   
   UNFPA is committed to zero preventable maternal health by 2030. It plays a
   leading global role in improving health care and achieving justice and
   development for people of African descent, especially women and girls. Its
   chief goal is to accelerate data improvements so countries can take urgent
   corrective actions to address these challenges.
   
   Author: Patricia Da Silva is the Program Adviser for the Initiative for
   People of African Descent and coordinated the UNFPA’s Maternal Health of
   Women and Girls of African Descent Analysis.
   
   About UNFPA: UNFPA is the United Nations sexual and reproductive health
   agency. UNFPA’s mission is to deliver a world where every pregnancy is
   wanted, every childbirth is safe, and every young person’s potential is
   fulfilled. UNFPA calls for the realization of reproductive rights for all and
   supports access to a wide range of sexual and reproductive health services,
   including voluntary family planning, quality maternal health care, and
   comprehensive sexuality education.
   
   Sources: PAHO, United Nations, UNFPA.
   
   Photo Credit: A pregnant woman in Haiti. Elena Heatherwick, UNFPA Haiti,
   2018.
   
   Topics: Dot-Mom, gender, global health, Guest Contributor, maternal health,
   sexual and reproductive health
   
   

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