Texas researchers plan to take a closer look at the disproportionate number of women of color who die during pregnancy and in the year after birth, including those who died by homicide.
Patti Hamilton, professor emeritus of nursing at Texas Woman's University, said women who've died by violence during pregnancy or in the year after giving birth could have been saved, so she categorizes their deaths using the term "failure to rescue." She feels that someone — or many people — failed these women.
This term is usually used to describe preventable deaths that happen in a hospital, but Hamilton thinks it applies here. She said it's just more difficult to determine who's responsible when you're talking about maternal mortality.
"In a surgical suite, you're pretty much in a controlled environment, but a woman who goes home with a new baby, or is pregnant, is living in the community, (and) is not confined to a bed on a particular unit in a hospital,” Hamilton said. “It's much more complex to decide who failed this woman. Was it her family? Was it providers? Was it the system? Was it the state? Was it the insurance company?”
Hamilton has researched Texas maternal mortality statistics from 2015, and her preliminary findings show women of color are, by far, at the greatest risk of dying by violence during this time.
"Of the women who were assaulted and died in the year following pregnancy, 100 percent of those assaults while the woman was pregnant were women of color,” Hamilton said. “They were Hispanic or black — 100 percent of the assaults during the six weeks following delivery were black.”
Hamilton’s preliminary research concluded: Of the 49 death certificates from 2015 for which pregnancy status was recorded, 42 (84 percent) were marked "not pregnant within one year" and seven (14.3 percent) had died from assault within one year of the end of pregnancy.
For those seven women who had been pregnant within one year of their death by assault, race appeared to be associated:
- Of the four women who were pregnant at the time of death, one was Hispanic and three were black.
- One woman died from assault during the 42-day postpartum period and she was black.
- Two white women died from assault 43 to 365 days following the end of pregnancy.
Hamilton’s findings, supported by years of research, concludes whatever supports are in place for pregnant women of color — pregnant black women, in particular — aren't working. She says it's time to find a new approach.
"We've got experts who are working diligently to describe the situation and derive some sense of the evidence to act on,” she said, “but I think a big missing piece is what the women who are at risk would tell us that they needed, and I think we'll do well to involve them more actively in taking the next step."
Hamilton plans to present her findings to the state's Task Force on Maternal Mortality and Morbidity in Austin this month.
Bonnie Petrie can be reached at firstname.lastname@example.org or on Twitter @kbonniepetrie