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Developing Tools to Report Racism in Maternal Health for the CDC Maternal Mortality Review Information Application (MMRIA): Findings from the MMRIA Racism & Discrimination Working Group

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A Correction to this article was published on 18 February 2022

This article has been updated

Abstract

Purpose

The purpose of this report from the field is to describe the process by which an multidisciplinary workgroup, selected by the CDC Foundation in partnership with maternal health experts, developed a definition of racism that would be specifically appropriate for inclusion on the Maternal Mortality Review Information Application (MMRIA) form.

Description

In the United States Black women are nearly 4 times more likely to experience a pregnancy-related death. Recent evidence points to racism as a fundamental cause of this inequity. Furthermore, the CDC reports that 3 of 5 pregnancy related deaths are preventable. With these startling facts in mind, the CDC created the Maternal Mortality Review Information Application (MMRIA) for use by Maternal Mortality Review Committees (MMRC) to support standardized data abstraction, case narrative development, documentation of committee decisions, and analysis on maternal mortality to inform practices and policies for preventing maternal mortality.

Assessment

Charged with the task of defining racism and discrimination as contributors to pregnancy related mortality, the work group established four goals to define their efforts: (1) the desire to create a product that was inclusive of all forms of racism and discrimination experienced by birthing people; (2) an acknowledgement of the legacy of racism in the U.S. and the norms in health care delivery that perpetuate racist ideology; (3) an acknowledgement of the racist narratives surrounding the issue of maternal mortality and morbidity that often leads to victim blaming; and (4) that the product would be user friendly for MMRCs.

Conclusion

The working group developed three definitions and a list of recommendations for action to help MMRC members provide suggested interventions to adopt when discrimination or racism were contributing factors to a maternal death. The specification of these definitions will allow the systematic tracking of the contribution of racism to maternal mortality through the MMRIA and allow a greater standardization of its identification across participating jurisdictions with MMRCs that use the form.

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Funding

The work group to Use the Maternal Mortality Review Information Application (MMRIA) to Document Discrimination and Racism was supported through a partnership with the Centers for Disease Control and Prevention (CDC)’s Division of Reproductive Health and the CDC Foundation in 2019–2020.

Author information

Authors and Affiliations

  1. Center for Antiracism Research for Health Equity, Division of Health Policy Management, School of Public Health, University of Minnesota, 420 Delaware St SE MMC 729, Minneapolis, MN, 55455, USA

    Rachel R. Hardeman

  2. Tufts University School of Medicine, Boston, MA, USA

    Anna Kheyfets & Elizabeth A. Howell

  3. Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA

    Allison Bryant Mantha

  4. Association of Maternal &, Child Health Programs, Washington, DC, USA

    Andria Cornell

  5. National Birth Equity Collaborative, New Orleans, LA, USA

    Joia Crear-Perry

  6. Tennessee Maternal Fetal Medicine, PLCDivision of Perinatal Services, Baptist Hospital, Nashville, TN, USA

    Cornelia Graves

  7. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    William Grobman

  8. Yale School of Nursing, Yale University, New Haven, CT, USA

    Sascha James-Conterelli

  9. New York State Association of Licensed Midwives, New York, NY, USA

    Sascha James-Conterelli

  10. Morehouse School of Medicine, Atlanta, GA, USA

    Camara Jones

  11. Center for Reproductive Rights, Atlanta, GA, USA

    Breana Lipscomb

  12. Department of Obstetrics, Texas Children’s Hospital, Houston, TX, USA

    Carla Ortique

  13. Division of Maternal-Fetal MedicineSchool of Medicine, Department of Obstetrics and Gynecology, School of Medicine, Department of Maternal and Child HealthGillings School of Global Public Health, University of North Carolina Carolina Global Breastfeeding InstituteUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Alison Stuebe

  14. Georgia OBGyn Society, Atlanta, GA, USA

    Kaprice Welsh

  15. Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA

    Kaprice Welsh

  16. Department of Obstetrics and Gynecology in the Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

    Elizabeth A. Howell

Authors
  1. Rachel R. Hardeman
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  8. Sascha James-Conterelli
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  9. Camara Jones
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Correspondence to Rachel R. Hardeman.

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Hardeman, R.R., Kheyfets, A., Mantha, A.B. et al. Developing Tools to Report Racism in Maternal Health for the CDC Maternal Mortality Review Information Application (MMRIA): Findings from the MMRIA Racism & Discrimination Working Group. Matern Child Health J 26, 661–669 (2022). https://doi.org/10.1007/s10995-021-03284-3

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