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Black and Pregnant: A Higher-Risk Combination

Reasons Why and How to Overcome Them

Black women are three times more likely to die from a pregnancy-related cause than white women.

"There are societal, structural and institutional reasons for health disparities like this," explains Janelle R. Bolden, MD, a Northwestern Medicine maternal-fetal medicine physician. "But it all comes down to the way Black women receive health care."

Social determinants of health (SDOH) refer to conditions that impact health, functioning and quality-of-life outcomes and risks. Black women are more likely to be born, live and engage in communities with fewer resources, which can present barriers to economic, physical and emotional health.

Overcoming Barriers to Health

Dr. Bolden shares advice for patients who may have SDOH impacting their ability to get proper medical care:

  • Use the resources available to you. Ask your physician's office if they have a patient representative, patient navigator or patient advocate. These people can help guide you through the care process and make sure your needs are not overlooked.
  • Advocate for yourself. In every encounter with medical staff, be honest about how you are feeling and what you are concerned about. You are there to get the care that you need, and your care team is there to provide it. So, be open and ask questions, particularly if you do not understand something or are not comfortable with your treatment plan. Consider asking:
    • "Could you explain that a different way?"
    • "Are there alternatives to this treatment?"
    • "Can I walk you through all of my concerns?"
  • Use your support system. Consider bringing a partner, family member or friend to your appointment. You may feel more comfortable having someone there to validate your concerns and to mention anything that you might miss.

If you are looking to promote equity beyond patient and physician interactions, Dr. Bolden says one thing is key: Speak up and spread awareness.

"If people are aware that disparities exist, they can begin to combat them," she explains. "When we have clinicians who look like and understand our patients, it helps provide better health outcomes."

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Janelle R. Bolden, MD
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