Worcester Business Journal

12 Worcester Business Journal | May 13, 2024 | wbjournal.com BY MICA KANNER-MASCOLO WBJ Staff Writer M assachusetts is facing a mounting maternal morbidity crisis, the likes of which aren't slowing down. Rates of severe maternal morbidity in the state nearly doubled from 2011 to 2020, with Black birthing people among the most impacted by the unexpected negative outcomes of labor and delivery affecting short- and long- term health, according to a 2023 report from the Massachusetts Department of Public Health. "When a pregnant person dies, it means that something is profoundly wrong with the healthcare system," said Hafsatou Diop, DPH's inaugural assistant commissioner of health equity. "No one should be dying because they're pregnant, particularly in a rich country like the U.S., particularly Massachusetts, where you have the best hospitals in the whole world and the best of providers. at should not just happen." An increasing number of pregnancies in Mass. are resulting in severe complications, including death, as the greatest impact falls on the Black community IMAGE | ADOBESTOCK.COM; AI GENERATED Systemic failures Mitigating this rising problem in Central Massachusetts will take a multifaceted approach. e healthcare system needs to diversify its workforce and implement training on implicit bias and racism, communities need to be more culturally competent and supportive of women throughout all stages of pregnancy and postpartum, and those in positions of power need to prioritize funding qualitative research on the real-life experiences of pregnant and birthing people. "We recognize that racism is pervasive in society. It's in the water, it's in the air, it's woven through [the] health system, it's woven through education, housing, etc.," said Dr. Cherise Hamblin, OB/GYN and medical director of the UMass Memorial Health doula program. A systemic root cause Part of recognizing how deeply systemic racism affects the lives and birthing outcomes of Black women includes addressing social determinants of health, said Hamblin. Issues that precede a pregnancy, such as homelessness, stress, and obesity, can have substantial impacts on health outcomes when pregnant, and in order to reduce maternal morbidity, people need to enter pregnancy healthier. "If we say, once a person is pregnant, that's when we want to deploy the resources and say, 'Now you can have additional food benefits, and now you have vitamins, and now you have a little bit more money on your EBT card'…we've kind of missed a point," she said. In 2022, Worcester had an average preterm birth rate of 9.7%, according to data from the U.S. Centers for Disease Control and Prevention analyzed by the Virginia-based nonprofit March of Dimes. e city's highest preterm birth rate of 10.8% was among Black infants, which was more than 1 percentage point higher than the 2022 Mass. average of 9.1%. e health systems within Worcester aren't able to keep up with both the city's rapidly diversifying population and rising rates of homelessness, the latter of which disproportionately impacts people of color, said Love Odetola, visiting assistant professor at College of the Holy Cross in Worcester. e Central Massachusetts Housing Alliance reports that rates of homelessness in Worcester have risen 20% each year for the last two years. While rates of severe maternal morbidity rose across all races in Massachusetts, Black birthing people were more significantly impacted by the rapidly rising rates than their white counterparts. Black birthing people experienced a 10.1% average increase per year while white birthing people experienced an average 7.8% increase. Furthermore, rates of maternal mortality among Black people are 2.6 times the rate white people, as reported by the Centers for Disease Control and Prevention in 2021, when using the World Health Organization's definition of maternal mortality: deaths relating to pregnancy or its management occuring during pregnancy, birth, or within 42 days of the termination of a pregnancy. Racism in health care Social determinants of health affect people on a holistic level, and that includes maternal mental health. ough Massachusetts has done a lot of work to improve its mental healthcare system, the barrier to entry is still extremely high, especially for those utilizing public health insurance, said Nancy Byatt, perinatal psychiatrist Dr. Cherise Hamblin, OB/GYN and medical director of the UMass Memorial Health doula program Hafsatou Diop, DPH assistant commissioner of health equity

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