MAC is thrilled to learn that our research faculty Dr. Maeve Wallace has been awarded two 5-year R01 grants from the National Institute of Health for work that aims to identify reasons why the US has the highest maternal mortality rate in the developed world despite spending more on health care than any other country. A central concern of both grants is understanding the persistence of a vast racial inequity in maternal mortality: black women are 3 to 4 times more like to die from complications of pregnancy, childbirth, or postpartum than white women.

Decades of research, improvements in obstetric care safety and quality, and interventions that target individual behaviors have failed to close the racial gap.  Dr. Wallace and her team – Dr. Theall, MAC’s Director, Dr. Emily Harville, Epidemiology Department, Dr. Charles Stoecker, Health Policy and Management, and Dr. Joia Crear-Perry, National Birth Equity Collaborative – will analyze data on every birth and death occurring in the US since 2005.  They hope to identify aspects of the social environment in which women live and work that place them at greater risk of death during pregnancy or postpartum, including structural racism, racial and economic segregation, income inequality, and violence.  They also aim to explore how these same factors increase risk for homicide, a leading cause of death among pregnant and postpartum women in Louisiana.

“It is our hope that studying these deaths in context will increase our understanding of how to develop population-wide strategies, programs, and policies that ensure equal access to health-promoting resources so that if and when they become pregnant, all women have and equal chance to experience healthy reproduction, raise a healthy infant, and continue happy and productive lives.”

A related project will explore state-level policies in relation to maternal and infant mortality in each state. These include polices intended to support health and remove barriers to care – such as paid family leave and expanded income eligibility for Medicare – and those that limit women’s reproductive rights by restricting access to abortion services.

“Across the US legislators are passing women’s health policy at an unprecedented rate, often without any information about how the policy may impact maternal and child health.  It is critical that we understand how policies can support or harm the health of the population so that we can hold policymakers accountable for addressing the maternal mortality crisis in this country and eliminating racial inequity.”