Shalya Giles, RN, DNP, CRNA

DNP Nurse Anesthesia 

Increased Maternal Mortality for African American vs. Caucasian Women: An Integrative Literature Review

Project Category: Evidence Synthesis

Project Team: Shalya Giles, DNP, CRNA, Chardae French, DNP, CRNA Pamela Chambers, DNP, EJD, MSN, CRNA (Advisor)

Abstract

Background: The maternal mortality rate has risen dramatically in the United States over the last several decades; however, the rate is steeper for African-American women. Current literature suggests that these differences stem from physician and patient knowledge deficits, socioeconomic differences, and a lack of resources in the African-American community. According to the Centers for Disease Control and Prevention (CDC, 2019), 60% of maternal deaths are preventable. This integrative review aims to determine the top contributing factors that have led to a higher maternal mortality rate and what implementations can help decrease this rate.

Methods: An integrative review was conducted using a systematic search of PubMed, Ovid, and CINAHL. Data from six studies were grouped by the top complications contributing to the increase in maternal mortality rate: preeclampsia, hemorrhage, and socioeconomic status. Four epidemiological studies were also analyzed to determine the trends. The risk of bias was assessed using the JBI critical appraisal tool. 

Results: Data suggests contributing factors for increased maternal mortality include a lack of physician and patient knowledge, as well as insufficient preventative measures and treatment delay. Although data is limited on preventative care for parturients, interventions in the literature were geared toward preventing the worsening of outcomes related to preeclampsia, hemorrhage, and socioeconomic factors that lead to maternal mortality.

Conclusion: This research should be continued but with each category reviewed separately. This will allow for a deeper understanding of how to indefinitely decrease the maternal mortality rate.

Full Manuscript