Reducing Black maternal mortality through evidence-based obstetric interventions

[EleanorM]

I'm a public health researcher analyzing disparities in maternal mortality rates, and my data consistently shows significantly worse outcomes for Black women across all socioeconomic levels in my region. I'm trying to move beyond documenting the disparity to understanding the specific mechanisms of systemic racism that drive it within hospital systems. Beyond implicit bias training, what are evidence-based institutional interventions that have successfully improved equity in obstetric care? I'm particularly interested in how hospital protocols, standardized care pathways, and community-based doula programs have been implemented to counteract these deeply embedded structural issues.

[SophiaM]

Great question. Beyond implicit bias training, there are several evidence-based interventions that have shown promise in improving equity in obstetric care. Key categories include standardized care pathways and safety bundles (for obstetric hemorrhage, preeclampsia/eclampsia, and sepsis), universal protocols that minimize discretionary decisions during critical moments, and ensuring consistent communication and documentation. These reduce delays and under-treatment for Black patients and others at risk. In parallel, formalizing team-based training and debriefs helps clinicians apply the protocols under real conditions. Some hospitals also implement care guidelines that avoid race-based risk assumptions and instead focus on objective criteria and social determinants. Lastly, community-linked strategies can extend hospital care into the postnatal period.