Race Isn't Really a Factor in Maternal Mortality

Alabama researchers suspected when they dug into the records at the state’s largest hospital that they would confirm the national data that women who died during childbirth were more likely to be African American.

After all, in the United States, African American women are nearly 4 times more likely to die during childbirth than white women.

So when the researchers set out to review pregnancy-related deaths at the University of Alabama at Birmingham (UAB), they hoped to better understand the patient characteristics that would explain the racial disparity.

What they didn’t count on finding was a lack of racial disparity.

But that is exactly what they discovered after combing through all maternal deaths at UAB Hospital from January 1990 through December 2010. For a comparison, the researchers matched 2:1 each death with women who delivered at a time that most closely coincided with the time of death. In fact, the study revealed African American women accounted for 57% of the maternal death group and 61% of surviving women.

What they did discover, however, was a need to better understand the barriers that women face in accessing health care and those effects on maternal death. That’s because the hospital records indicated that, among the women who died, the average distance to the hospital was 90 miles, compared with only 24 miles for the comparison group.

"Overall, longer distance was associated with more frequent mortality," according to the authors. And, after adjusting for distance traveled, the relationship between race and mortality was still nonsignificant.

“We suggest that the next step toward understanding racial differences in maternal deaths reported in the United States should be directed at the health care delivery outside the tertiary care hospital setting, particularly at eliminating access barriers to health care for all women,” the researchers concluded.

The study appears in the November issue of Anesthesia & Analgesia.