It’s time to talk about the matter of maternity care as the world is facing an increasing healthcare crisis across all sectors. Maternal mortality has been on the rise in the United States.
A report from the Centers for Disease Control and Prevention (CDC) counted 1,205 women in the United States dead of maternal causes in 2021. This is a stark rise from 861 women in 2020 and 754 in 2019.
This statistic ranks the United States as the highest mortality rate of all high-income countries, at approximately 22 deaths per 100,000 live births. This statement is based on reports from the CDC as well as the Organisation for Economic Co-operation and Development (OECD).
Attending pregnant and postpartum patients will be common if you’re studying to work in healthcare, like online nurse practitioner programs. It’s important to understand why maternity mortality is on the rise and the maternal health disparity gap.
In particular, this article will explore the maternal health disparity gap in Chicago. Maternal mortality rates are higher there compared to other cities in the country. This is due to a variety of reasons, which has caused a “maternity care desert”.
What is a Maternity Care Desert?
Maternity care deserts refer to counties in the United States in which access to maternity care services is either limited or completely absent. This could either be due to a lack of services or barriers that exist that make it harder for women to access services within the county.
In areas where it is a maternity care desert due to lack of services, this means it is a county without any hospital or birth center offering obstetric care and without any obstetric providers. These providers aren’t just limited to obstetricians, but also family physicians and nurse midwives.
In a county that has a low access level of maternity care (also referred to as a maternity care desert), this describes when an area has one or fewer hospitals or birth centers providing obstetrics care. It would also have fewer than 60 obstetric providers per 10,000 births.
Maternity Care Desert Statistics
Statistics show that more than 2 million women of childbearing age are currently living in maternity care deserts. For context, there are 3,143 counties and equivalents in the country. 1,052 of those counties are classified as maternal care deserts.
In addition to those numbers, 3.5 million women of childbearing age live in counties with limited access to maternity care. Also, almost 130,000 babies were born in maternal care desert counties.
Maternity Care in Chicago
Obstetric and Gynecological (OB/GYN) facility closures are having a significant impact on the maternity care gap and maternal mortality in Chicago’s south and west sides. This information comes from a joint report from the American Medical Association (ADA) and Sinai Urban Health Institute.
The report, titled “From Facilities to Outcomes: A Neighborhood-Level Examination of Maternal and Infant Care Access in Chicago”, highlights the impacts of maternity care deserts, and measures the level of maternal care access within the City of Chicago.
According to the report, low, moderate, and full maternal care access is distributed unequally across Chicago. Most low-access maternal care access is located on the south and west sides of the city.
The pre-existing lack of maternal care in the south and west sides of the city, along with the recent closures of OB-GYN clinics have left these areas maternal care deserts. The growing concern regarding maternity care in Chicago goes beyond just the lack of clinics, too.
There’s also a massive divide between white pregnant people and their Black and Indigenous equivalents, according to the 2022 March of Dimes report.
Below, we’ve listed related statistics published by the City of Chicago for maternal care and mortality rates, including for demographic subgroups.
Severe Maternal Morbidity Statistics from 2016-2017:
- For the two years combined, 527 Chicago women experienced severe maternal morbidity. This is a rate of 74.1 per 10,000 deliveries.
- The severe maternal morbidity rate for non-Hispanic Black women was over 2.5 times higher than for non-Hispanic White women.
- Women living in communities with high economic hardship have the highest severe maternal morbidity rates in Chicago. The rate is 91.5 per 10,000 deliveries.
Pregnancy-Associated Mortality Statistics from 2011-2016:
- A total of 116 Chicago women died during or within a year of their pregnancy. This gives a pregnancy-associated mortality ratio of 48.6 per 100,000 births during those years.
- The pregnancy-associated mortality ratio was almost six times higher for non-Hispanic Black women compared to non-Hispanic White women. The rate is 98.8 per 100,000 births compared to 17.0 per 100,000 births respectively.
- Women living in communities with high economic hardship have the highest pregnancy-associated mortality ratio.
The Divide in Maternal Care
Statistics published by the City of Chicago and various health-related organizations report there is a clear problem with accessing maternal care, with rates being especially worse for Black women and those with lower socioeconomic status.
Between 1999 and 2019, Black people had the highest median mortality rate in the country, while Indigenous people had the largest increase in the median state maternal mortality rate.
While the disparity between Black and white maternal mortality rates has always been high across the United States, Chicago is higher than the national estimate.
A recent study from the City of Chicago’s Department of Public Health found Black Chicagoans were nearly six times more likely than white women to die during pregnancy, or a year after birth.
According to the same study, these birth mortality inequalities are not due to biological differences. The disparity comes from systemic injustices that prohibit Black and Indigenous women’s access to resources.
The prohibited access to resources isn’t just on an obstetrics provider level either. The restricted access also extends to other areas, like education, prenatal care, nutritionists, and insurance, contributing to pregnancy outcomes.
Bridging the Maternal Health Gap
Measures are being taken to bridge the maternal health care gap disparity in Chicago and across the country in maternal care deserts and for Black women. For instance, the Melanated Group Midwifery Care model received a $7.1 million grant from the Patient Centered Outcomes Research Institute.
The Melanated Group Midwifery Care model is designed to improve the birthing experience and patient outcomes for Black women from prenatal to postpartum care. As part of the program, it’ll also be creating jobs for Black people within healthcare.
There are many ways forward in which access could be increased for those living in maternal care deserts in Chicago. These include:
- Leveraging telehealth for pregnancy care to bridge the gap between in-person appointments.
- Expand pre-existing clinics in maternal care deserts to provide prenatal and postpartum care.
- Implement health literacy programs that can educate women about maternal health, prenatal care, and resources available in the area.
