All Black and American Indian UCare members carry their pregnancies to term
Rate of Full-term Pregnancies by Race - Black or African American
Current Value
90%
Definition
Full-term pregnancy - 37+ weeks gestation
2021 data through June
Story Behind the Curve
Limiting/Negative Factors (Factors pushing the trend down)
- Racism
- Black bodies age faster due to structural racism and discrimination (physical weathering)
- Based on preliminary data from 2011-2017, the maternal mortality rate for non-Hispanic Black people is 2.3 times higher when compared to white people.
- Voices of Black people aren’t being valued equally in healthcare
- The Ob/Gyn history is rooted in brutal research experiments on enslaved Black people that didn’t include anesthesia out of a belief that Black people were uniquely constituted to endure pain.
- Current medical school students (60%) don’t believe Black people feel pain in the same way.308 Black skin is thicker than white skin. Black people who experience pain receive less pain medication.
- Police violence and the corresponding stress results in low birth weight and preterm babies
- Limited access to healthcare clinic and providers representative of the women’s background
Positive Factors (Factors pushing the trend up)
- Education – awareness – understand the value
- Equitable care is Respectful Care: provide services through 1). Respect for Patient’s Preference; 2). Coordination and integration of care; 3). Information and education; 4). Physical comfort; 5). Emotional Support; 6). Involvement of family and friends; 7). Continuity and transition; and 8). Access to care.
- Co-creation of programs with community leaders and members
Factors creating disparities
- Lower rate of access to early and adequate number of prenatal care services
- Higher rate of preventable disease and chronic conditions including diabetes, hypertension and cardiovascular disease
- Increase need to bridge to community resources to meet the economic stability, safe neighborhood, education, food security, community and social needs, and access to health insurance and health care of pregnant women
Priority Factors
- Increase educational opportunities and trainings
- Legislative action
- Match culturally congruent maternal health workers with pregnant UCare members
Partners
- MN State Legislature
- Hennepin HealthCare African American Virtual Doula Project
- African American Babies Coalition (AABC)
- Maternal and Child Health Advisory Task Force
- Ramsey County Birth Equity Community council (RC-BECC)
- Minnesota Medical Association
What Works
- Invest in social determinants of health
- Fund community-based, Black led organizations
- Grow and diversify the perinatal and healthcare workforce
- Improve and mandate data collection and quality measures
- Support innovative care models and payment models
- Medicaid coverage up to 1 year postpartum
- Implicit bias training
- Anti-racism training
- Grow cultural sensitivity and maternal and child health training for staff – moving to a Respectful Care model with pregnant individuals
Strategy
| Organization | Potential Strategy |
| UCare |
Convene community-based maternal health organizations Collaborate to identify and support innovative strategies to advance maternal health |
| African American Babies Coalition |
Initial training and coaching of UCare leadership and staff Expanded pregnancy and family parenting education, support, and resources; and Co-create the development of a community support group pilot. |
| Hennepin HealthCare African American Virtual Doula Project |
Match US Born Black American pregnant mothers to culturally congruent doula services. |
| Maternal and Child Health Advisory Task Force | Advise the Commissioner of Health on the health care serves/needs of maternal and child health populations in Minnesota. |
| Ramsey County Birth Equity Community council | Bring community partners and stakeholders together to proactively address infant mortality, low birth weight, and prematurity in Hennepin and Ramsey County with communities with the highest prevalence. |
| Minnesota State Legislature |
Adopt legislation to create more equitable policy in support of maternal health.
House File 660 Dignity in Pregnancy and Childbirth Bill: Look at medical systems can control for all the factors leading to these high morbidity factors. Requires annual anti-racism and implicit bias training in clinics and hospitals. Extend mortality review to include morbidity to understand the near misses. Create a model curriculum working with Dr. Rachel Hardeman at the U of M.
House File 1268 African American Babies Coalition: Black infants in MN are twice as likely to die before their first birthday when compared to white infants. Mortality rate was cut in half by infants cared for by Black doctors. Representation matters at every level in all systems. Bill provides education on infant mortality and creates pathways for more diverse healthcare providers.
House File 2136 Wrap Around Services for Black Moms Black Babies and Black Communities: Reducing the number of women who experience pre-term birth or deliver babies with low birth rates.
House File 1200 Family Medical Leave (Rep. Winkler/Hortman): States with family medical leave see a reduction in the rate of pre-term birth and reduction of births of low-birth weight babies. |
| Minnesota Medical Association |
Create implicit bias and anti-racism training materials for providers Deliver implicit bias and anti-racism training to care workers Enable the sharing of equity-focused ideas and practices across organizations Develop metrics for accountability |
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