Advancing maternal justice on both sides of the Atlantic – Harvard Health Blog

Positive pregnancy and birthing experiences go beyond merely having a healthy mother and baby — so, too, does maternal justice, a term that encompasses broad goals.

Affordable, timely, high-quality, equitable, and dignified care during and after pregnancy is essential for all birthing people. Maternal justice is a model of culturally sensitive care that aims to dismantle inequities in maternity care and maximize maternal health and well-being. It rests on human rights and requires us to chip away at racism entrenched in health systems.

How do race and ethnicity affect pregnancy and birth?

Globally, Black, indigenous, and people of color (BIPOC) have significantly worse maternal outcomes during and after pregnancy and childbirth. These unjust differences persist even after accounting for risk factors such as maternal age, medical conditions, and socioeconomic status. Additionally, differences in risk extend to the next generation. Babies born to BIPOC mothers are more likely to be stillborn or born premature, and to be admitted to the neonatal intensive care unit. Consider the following statistics from two sides of the Atlantic.

In the US:

In the UK:

What else affects outcomes for birthing people and newborns?

The health care systems in the UK and US differ primarily in payment structure, access, and midwifery model of care. The UK National Health Service (NHS) is a universal health care system largely provided free at the point of need since 1948. The US health system is a patchwork of insurance plans, which leaves millions without adequate coverage. Midwives deliver most pregnancy care in the UK, collaborating with obstetricians and other specialists as needed, which differs from the current US system of pregnancy care.

Yet in both countries, those who are BIPOC are more likely to experience discrimination, microaggression, mistreatment, and substandard maternal care.

So, while access to

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