Women who deliver at hospitals serving predominately Black mothers are much more likely to suffer serious complications, including birth-related embolisms and infections, according to a recent investigative study by ProPublica.
After examining two years of inpatient discharge stats from Florida, Illinois [and] New York, researchers found a racialized pattern in women’s hospital care similar to that uncovered in previous studies. For one, women who hemorrhage while giving birth at what the research calls “Black-serving hospitals” are at higher risk of experiencing complications from post–birth emergency hysterectomies, which are directly related to hemorrhaging.
It’s now common knowledge that African–American mothers fare worse during pregnancy and child birth compare to their white peers, dying at nearly three times the rate, Centers for Disease Control data shows. Part of the racial disparity can be linked to factors such as poverty and limited access to healthcare, yet, some stats also points to the quality of care administered at hospitals where a disproportionate amount of Black women are seen. It is often these same hospitals that are located in racially segregated communities, according to previous research.
The ProPublica report took a deeper look at the racialized disparities, allowing researchers to identify individual hospitals with higher complication rates, find out what protocols they have in place to deal with said complications, and then review exactly what went wrong in certain cases. For example, their report found that on average, 34 percent of women who experience a hemorrhage at New York hospitals go on to develop serious complications. At SUNY Downstate Medical Center in Brooklyn, the rate for complications was a whopping 62 percent.
Between 700 and 900 women die from pregnancy and childbirth-related causes each year, however, the disproportionate outcomes for African-American women has sent health care experts scrambling to pin down what’s fueling the disparity. The answer could lie individual hospital care.
ProPublica researchers pored over pages of inpatient hospital discharge data, examining all obstetric cases that were coded as involving hemorrhages (about 67,000 cases total) from Florida, Illinois and New York between 2014 and 2015. They then grouped the hospitals by the bulk of Black patients they served, labeling the facilities as low, medium or high Black-serving.
Only a handful of low Black-serving hospitals had high complication rates, according the analysis, but the outcomes at facilities serving predominately Black patients were still far worse. For example, high-Black serving hospitals across New York had complication rates 21 percentage points higher than the low-Black serving hospitals. This pattern was echoed in Florida and Illinois, where the complication rates at high-Black serving facilities were 11 percent higher, on average.
Even among women of average birthing age (25 to 32 years old) with no history of chronic health conditions, the pattern persisted, supporting the notion that differences in care could be to blame for the disparity.