Each year in the United States, about 700 women die from complications related to pregnancy or childbirth. According to the federal Centers for Disease Control, the risk of pregnancy-related death for black women is three to four times higher than it is for white women.
Researchers have pointed to several reasons for this disparity, including lack of prenatal care and systemic racism in health care.
In Charlotte, Johnson C. Smith University is working to help address the problem of maternal deaths among black women. Dr. Antonia Mead chairs the school’s Department of Health and Human Performance. She spoke with "All Things Considered" host Mark Rumsey.
Mark Rumsey: You have referred to this issue of maternal deaths among African-American women as a crisis. Can you describe that crisis?
Dr. Antonia Mead: It's a crisis because the health of our nation is linked to our babies. If we have babies dying, that's a red flag. Well, our babies are not able to get here without their mothers. So we have mothers dying. We have a crisis that we're not talking about.
Rumsey: And just to examine more closely, the Centers for Disease Control reports that the pregnancy-related death rate for black women is three to four times higher than for white women. What do we know about what's the cause of that?
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Mead: One of the things that you will read about in research or you'll hear different people talk about is how stress plays a part in pregnancy outcomes. That's a major problem for African-American women because African-American women deal with stress maybe from family, they deal stress from work and they deal with stress from the environment because you have that hidden racism that occurs and you're internalizing that.
All those stress hormones are building up over time and your baby is exposed to that. So that has an impact on those outcomes.
Rumsey: So what is Johnson C. Smith University doing to help address this problem? To try to reduce maternal deaths among black women?
Mead: Johnson C. Smith has ventured into the world of maternal and child health. We ventured into it in 2010. In 2010, we started a program called the Preconception Peer Educators, which is college students reaching out to their peers about being healthy before they ever start thinking about trying to have a child. That program has led us to it to where we are today.
Rumsey: Briefly explain what is a doula?
Mead: You could think of a doula as a birth companion. They provide services such as advocacy support [and] emotional support. [They] also [provide] physical support. They understand the process of childbirth and what the woman will be going through — and so they're there from start to finish. And when I say start I mean before they are in labor — so months leading up to labor and then they can be there postpartum after they've had the baby.
Rumsey: And why is that kind of support important for helping to address this issue of maternal health and maternal death?
Mead: It's so important because sometimes some women are very fearful of the health care system. They may be afraid to ask questions. And that's one thing that the doula is able to do — [doulas] help them to empower themselves. They may be afraid to ask their health professionals some questions but they would be able to ask a doula, who can do research and get their information back to them.
Then afterward — whether you are a new mom or moms who are doing this for the second or fourth time — may need the extra support that only someone who understands this process can give.
And if we look at it from a historical context, Doulas have been around for years, they just didn't have the name Doula. If we go back to slavery times or Jim Crow times, you know, you had the community coming together.
Rumsey: And Dr. Meade, you've said that there is a need among African-American women to have birth assistance from someone who looks like them. Can you elaborate on that?
Mead: Like what I said earlier, sometimes you're afraid of the medical system. And so when you have someone that looks like you — who understands your culture, who understands you — they've been possibly where you've been. You feel peace. You're more comfortable. And so when you have someone that is part of your culture, it becomes a little bit easier.
Rumsey: Antonia Mead chairs the Department of Health and Human Performance at Johnson C. Smith University in Charlotte. The school will be hosting a doula training program in February. Dr. Mead thanks for talking with us.
Mead: You're welcome.
