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A way forward in the maternal mortality crisis: addressing maternal health disparities and mental health

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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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Funding

Supported in part by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number 1R01MD016029-01. This work was also supported by the Blavatnik Family Women’s Health Research Institute.

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Authors and Affiliations

  1. Blavatnik Family Women’s Health Research Institute, New York, NY, USA

    Kimberly B. Glazer

  2. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA

    Kimberly B. Glazer

  3. Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA

    Kimberly B. Glazer

  4. Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Elizabeth A. Howell

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  1. Kimberly B. Glazer
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Correspondence to Kimberly B. Glazer.

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This article is part of the Topical Collection on 40th Anniversary of the International Marcé Society for Perinatal Mental Health: Innovations in Research Policy and Clinical Care Guest Editor: Lisa Segre

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Glazer, K.B., Howell, E.A. A way forward in the maternal mortality crisis: addressing maternal health disparities and mental health. Arch Womens Ment Health 24, 823–830 (2021). https://doi.org/10.1007/s00737-021-01161-0

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