Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI.
Am J Obstet Gynecol MFM. 2020 Feb;2(1):100047. doi: 10.1016/j.ajogmf.2019.100047. Epub 2019 Sep 27.
Maternal deaths, particularly racial disparities in maternal deaths, represent a deeper problem than their medicalized solutions reflect-one deeply rooted in the devaluation of women's well-being, institutional inequality, and racism. Most policy solutions for addressing maternal mortality involve actionable goals within the purview of healthcare providers, medical institutions, and insurance providers. Although we should continue studying the causes of maternal mortality through maternal mortality review committees, reducing racism in medicine with implicit bias training, and standardizing pregnancy care, there is a pressing need to challenge the processes and institutions that lead to health inequities. A woman's income level, insurance status, housing stability, country of origin, gender identity, or skin color should not dictate how likely she is to die from a pregnancy-related cause.
孕产妇死亡,尤其是孕产妇死亡中的种族差异,反映出一个比其医疗解决方案所反映的更深层次的问题——这一问题深深植根于对妇女福祉、制度不平等和种族主义的轻视。解决孕产妇死亡率问题的大多数政策解决方案都涉及医疗保健提供者、医疗机构和保险公司职权范围内的可操作目标。虽然我们应该继续通过孕产妇死亡率审查委员会研究孕产妇死亡率的原因,通过隐性偏见培训减少医学中的种族主义,并规范妊娠护理,但当务之急是要挑战导致健康不平等的过程和制度。一个女性的收入水平、保险状况、住房稳定性、原籍国、性别认同或肤色不应决定她因与妊娠相关的原因而死亡的可能性。