Racial gaps persist in pregnancy- and childbirth-related deaths across Kentucky, and advocates say solutions to the problem lie beyond the doctor's office.
According to the latest state data, 50% of maternal deaths were pregnancy-related in 2017, and 46% involved a substance-use disorder. Nearly 80% of cases were deemed to be preventable.
Obstetrician & Gynecologist and President and CEO of Physicians for Reproductive Health Dr. Jamila Perritt said maternal mortality is a key indicator of a state's health and has a long-term impact on other community health factors.
"Black and indigenous women have an increased risk of dying during pregnancy and in the postpartum period, as compared to white women," said Perritt, "even when you control for things like education and economic status."
Death certificates show maternal deaths appear to be higher among Black women in the two largest urban areas in Kentucky, Lexington and Louisville.
Perritt noted the White House has issued the first presidential proclamation marking this week Black Maternal Health Week.
"The U.S. Department of Health and Human Services marked this week by announcing actions to expand access for maternal health more broadly," said Perritt, "to improve outcomes."
The nation's maternal mortality rate continues to be highest in the developed world. Perritt said a holistic approach involving community groups, food and housing advocates, and social scientists is needed to tackle the crisis.
"So when we look at solutions, the solutions really have to be focused on addressing those root causes," said Perritt. "And often that leads right back to how we shape our systems and structures so that there aren't disparities in access to care."
Black, American Indian and Alaska Native women are two to three times more likely to die from pregnancy-related causes than are white women, and Black infants die at more than twice the rate of white infants, according to the Centers for Disease Control and Prevention.