Black Maternal Health of New York City

Part: 2

NYC's High Maternal Deaths Defy Usual Explanations

Wednesday, March 16, 2011

New York's high rate of maternal mortality exposes glaring risks for black women. But a detailed 2010 city report eliminated many usual suspects for the maternal morality gap: poverty, obesity, pre-existing conditions. The first story of a series.



NEW YORK CITY (WOMENSENEWS)--A single question wakens Dr. William M. Callaghan in the middle of the night.

Why is pregnancy so much more dangerous for U.S. black women?

Callaghan is acting chief of the maternal and infant health branch of the Atlanta-based Centers for Disease Control and Prevention's division of reproductive health.

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He has published research that demonstrates that throughout the United States white and black women have similar levels of pre-existing conditions during their pregnancies.

Despite this, Callahan's research has found that black women for the past five decades have consistently suffered an almost four-times greater risk of death from pregnancy complications than have white women.

The higher risks, he wrote in a 2007 paper published in the American Journal of Public Health, are independent of age, the number of births or education.

"Why this is true," Callahan said in a recent telephone interview, "is what I ask myself when I wake up at 3 a.m. and am staring at the ceiling fan."

Pregnant black women in New York City face nearly double the national risk.

Akira Eady lived in New York City in 2007.

Eady died shortly after giving birth at Mount Sinai Medical Center, one of New York City's most prestigious hospitals. The official cause of death of the 21-year-old mother of three, as recorded by the New York City medical examiner, was heart failure after post-partum seizures.

Eady's aunt, Carole Eady, recounted recently that her niece, who was employed and had private medical insurance, bled heavily after receiving an epidural to ease the pain of labor. After giving birth, she complained of headaches. Nevertheless, the hospital released her. Two days after giving birth,  she had a seizure and then a heart attack.  She was brain dead four days after giving birth.

Carole Eady, now raising Akira's older daughter in her Harlem home, acknowledges that her niece's partner might have played a role in her death by hitting her on the morning of her seizure, but she feels strongly that the hospital staff did not properly administer the epidural or respond to her complaint of headaches.

Mount Sinai's press officer was unable to comment on Eady's death because of the state's privacy laws.

20 Deaths in 2007

Eady was one of the city's 20 African American new mothers who died in 2007 as a result of a pregnancy gone wrong. With the absolute numbers of African American births in New York city dropping, the city's Vital Statistics reports state African American women had a maternal mortality ratio of 68.7 (the number of deaths if 100,000 African American mothers had given birth) in 2007.

The following year, 22 African American women died in New York City from "pregnancy-related causes" for a maternal mortality ratio of 78.8.

Dr. Jo Ivey Bufford, president of the New York Academy of Medicine and a researcher in maternal mortality, estimates that 45 percent of these deaths are preventable.

In New York City that year, 2008, two white women died during pregnancy and childbirth, for a maternal mortality ratio of 5.1. The following year, four white women died for a maternal mortality rate of 10.4, according to the New York City Vital Statistics reports. (A chart detailing all ethnic groups' deaths and maternal mortality rates is featured in the accompanying video.)

Going beyond the data routinely gathered, New York's health department issued a report on maternal mortality in the city for the years 2001 to 2005 that provides an unprecedented level of detail about which women die and how.

The findings drew no conclusions about how to lower the high rate of maternal deaths in New York--among the highest in the nation--and among African Americans.

But the city's report does detail the high risk of C-sections. The New York study found that a whopping 79 percent of all mothers who died "from pregnancy-related causes" gave birth via Cesarean sections. In addition, other reports from New York City's health department indicate a consistent rise in Cesarean sections in the city, from 25.8 percent of all births in 1997 to 34.4 percent--more than a third--of all births in 2008.

The World Health Organization's recommendation is that no more than 15 percent of all births should be C-sections.

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Obesity is often linked to lack of routine exercise--even daily, moderate activity--and, of course, diet. I'll need to read some of Dr. Callaghan's research to learn if he has also included exercise and diet as factors that increase risk of death, or if Callaghan is seeking factors other than the usual suspects...

Women's enews events

BLACK MATERNAL HEALTH OF NEW YORK CITY SERIES

Part: 5

Embolism Stalks Black Moms With Lethal Bias

Part: 4

Study Details Causes of High Maternal Death Rates

Part: 3

Black Women's Maternal Risks Go Unquestioned

Part: 2

NYC's High Maternal Deaths Defy Usual Explanations

Part: 1

NYC's Rising Black Maternal Mortality Unexplained