How Medical Bias Causes High Maternal Deaths in POC

Conscious and unconscious medical biases are very dangerous. This is especially true in pregnancy as they have led to higher mortality rates in pregnant POC.

Implicit Bias

According to the Perception Institute, implicit bias is “when we have attitudes towards people or associate stereotypes with them without our conscious knowledge.” This type of bias can be harmful and difficult to deal with as it is unconscious. T. 

Implicit medical bias can have many detrimental effects but is directly linked to higher maternal mortality rates for POC. POC are also at a higher risk of suffering complications during birth and pregnancy.

Maternal Mortality Rates

According to the Center of Disease Control, approximately 700 women in the US die each year due to pregnancy or pregnancy complications. A 2018 article from the National Library of Medicine states, “black women are three to four times more likely to die a pregnancy-related death as compared with white women.” The CDC found that per 100,000 births in the US, 40.8 black women, 29.7 Indigenous women, and 12.7 white women died from pregnancy-related causes.

A 2020 KFF article identified multiple causes of pregnancy-related death, including pulmonary embolism, high blood pressure, hemorrhage, and hypertensive disorders. In all of these cases, white people had a lower chance of dying from these complications than POC. According to the CDC, most pregnancy-related deaths are preventable.

Infant mortality rates follow a similar pattern as maternal mortality rates, according to the same KFF article. With non-white infants dying at a higher rate than their white counterparts. The infant mortality rates shows 10.8 black infants, 4.9 Hispanic infants, 8.2 Indigenous infants, and 4.6 white infants per 1,000 births.

The Correlation

Implicit bias often manifests as poorer treatment by healthcare workers due to unconscious and conscious stereotyping. A 2021 article from the Journal of Women’s Health explored how this bias correlated to higher maternal mortality rates. One of the main correlations is health care providers’ tendency to take the pain of POC less seriously, leading to several issues not being addressed

This bias can often lead to mistreatment by healthcare providers. The same article from the Journal of Women’s Health stated that 30% of Black and Hispanic women that delivered in hospitals reported mistreatment by the provider, compared to 21% of white women. This mistreatment can lead to improper treatment, which can explain the higher maternal mortality rate of POC. 

The same article from the Journal of Women’s Health cited a study by the Society for Maternal Fetal Medicine that showed that while many healthcare workers agreed that bias exists in their line of work, they fail to acknowledge it in themselves. “84% of respondents agreed that disparities affect their practice, but only 29% believed that personal biases influenced their ability to care for patients.” Without acknowledging and working to correct their bias, harm will continue to be done to POC in the healthcare system.

What Can be Done

Due to the unconscious nature of implicit bias, it can be hard to address. To be effectively dealt with, a person must confront their own internalized biases resulting from societal influences. This bias is reflected in many areas across our society and is only a part of a more significant problem. Unfortunately, the solutions for implicit medical bias fall on the healthcare workers that have them. But there are ways that the healthcare system can help its workers become more diverse and inclusive. There are resources available to help healthcare workers address their own biases and learn how not to let them interfere with their work. This includes training simulations and seminars. One of these resources is the AAMC. They offer many resources, including webinars. On the patient’s end, there is less that can be done to prevent implicit bias on the end of healthcare workers. One of the best things they can do is self-advocate and insist on a second opinion.