A way forward in the maternal mortality crisis: addressing maternal health disparities and mental health
Abstract
Our objective was to review the role of maternal health disparities and mental health in the maternal mortality crisis in the USA, and discuss how perinatal care quality improvement in these areas is a critical lever for reducing maternal death. This paper summarizes content from a plenary talk delivered at the 2020 Biennial Meeting of the International Marcé Society for Perinatal Mental Health, in commemoration of the Society's 40th anniversary. The talk synthesized literature on two characteristics of the maternal mortality crisis in the US: (1) wide racial and ethnic disparities in maternal mortality and severe morbidity and (2) the impact of mental health and substance use disorders on maternal death, and introduced a framework for how health care quality gaps contribute to both of these issues. The US remains an outlier among similar nations in its alarmingly high rates of maternal mortality. Achieving significant progress on this measure will require confronting longstanding racial and ethnic disparities that exist throughout the pregnancy-postpartum continuum, as well as addressing the under-reported issue of maternal self-harm. Suicide and overdose are leading but under-recognized causes of death among pregnant and postpartum women in some states. Health care delivery failures, including inadequate risk assessment, care coordination, and communication, are identified in the literature on drivers of maternal health disparities and self-harm. Many of the same steps to improve quality of perinatal care can help to reduce health disparities and address the essential role of mental health in maternal well-being.
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There is growing recognition that exposure to racism rather than race itself is a risk factor for adverse maternal health outcomes.
“There is a growing recognition that exposure to racism rather than race itself is a risk factor for adverse maternal health outcomes.85”
From The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact (2022) · cites this paper as [85]
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The transition to parenthood in obstetrics: enhancing prenatal care for 2-generation impact
Monk, C., Dimidjian, S., Galinsky, E., Gregory, K. D., Hoffman, M. C., Howell, E. A., Miller, E. S., Osborne, C., Rogers, C. E., Saxbe, D. E., et al. (2022) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2022.100678 · Cited by 19 · see citing works
Self-citation
- Authors
- Glazer, K. B., & Howell, E. A.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- University of Pennsylvania (US)
- Corresponding author
- Glazer, Kimberly B.
- Venue
- Archives of Women's Mental Health
- Published
- 2021-08-24
- Volume
- 24
- Issue
- 5
- Pages
- 823-830
- ISSN
- 1434-1816 (ISSN-L)
- 1435-1102
- OpenAlex
- W3194529551
- Cited by
- 53
- References
- 54
- Citations by year
- 2026: 16 · 2025: 12 · 2024: 11 · 2023: 10 · 2022: 4
- FWCI
- 6.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Women s Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- maternal mortality, maternal health disparities, racial and ethnic disparities, perinatal mental health, substance use disorders, maternal suicide, care coordination, risk assessment, United States
- MeSH terms
- Maternal Health, Ethnicity, Female, Humans, Maternal Mortality, Mental Health, Pregnancy, United States, Racial Groups, Health Status Disparities
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