Partnering to Save Lives: Lowering Black Maternal and Infant Death in Chicago

By: Shawn M. Smith
May 07, 2024

I have over twenty years of experience working in the Neonatal Intensive Care Unit at Lurie Children’s and the Labor and Delivery unit at Northwestern Medicine Prentice Women’s Hospital. I am also a leader in health equity and advocacy. In these capacities, I stay up to date on evidence-based research on how we can improve maternal and infant health.

Looking at recent public health data, it is clear that Black women have a right to be petrified while pregnant and after delivering a baby. National rates of maternal morbidity (health conditions that arise during pregnancy, childbirth, or during the postpartum period) and mortality are alarmingly high, with Black women and infants disproportionately impacted. Black women face a risk of severe maternal morbidity twice that of white women, with mortality rates three times higher. 

In Illinois, an average of 88 women die each year from pregnancy-related causes, the majority of which were potentially preventable. One in every 115 deliveries was complicated by severe maternal morbidity, the most common cause being excessive bleeding. Discrimination in healthcare is present in 40% of deaths among Black women; for example, Black mothers are significantly more likely to have C-sections than white women, making them more susceptible to postpartum hemorrhage. They are also less likely to be screened and treated for anemia. Black women are also at higher risk for maternal mental health disorders due to higher levels of trauma exposure throughout their lifetime, such as through racism, discrimination and inequities in the maternity care system.

These unacceptable disparities are not rooted in differences in biology or genetics; they stem from a complex web of social and systemic factors. Focusing on the dignity of Black women, listening to Black women, respecting Black women, recognizing Black women’s pain, acknowledging cultural humility and understanding the historical past and inequities will improve care and save lives.

It is not only our mothers who are at risk: Black infants are twice as likely to die before their first birthday than are white infants. A top contributor to infant morbidity and mortality is preterm birth. According to the March of Dimes, the 2023 Chicago preterm birth grade is a D+, and risk factors include maternal high blood pressure, diabetes and obesity. Chicago’s poor score is indicative of the unequal distribution of resources in our city – social influencers of health that impact quality of education, health literacy, access to nutritious foods, access to quality healthcare, and much more. These inequities, combined with the lived everyday experiences of individuals, deeply affect a woman’s ability to thrive and be healthy.

Future direction

In 2020, the Illinois Perinatal Quality Collaborative (ILPQC) launched a Birth Equity Initiative for birthing hospitals to address bias, racism, and social factors influencing maternal health. Illinois has created a solid foundation for improvement by implementing Medicaid expansion to a broader population, extending postpartum coverage for a full year after delivery. However, more must and can be done. A 2020 study recommends that hospitals and health care organizations diversify their workforce and build awareness of these disparities and their root causes. Hospitals must also collaborate more with community-based programs to help address social influencers of health.

What We Are Doing Now

Chicago’s West Side exemplifies the urgency of this work. For example, Garfield Park’s rates of low birth weight are nearly three times those of the more affluent Lakeview on the North Side. Chicago’s infant mortality rate between 2017-2021 was highest in Austin, which experienced 58 deaths compared to 5 deaths over the same time period in Lakeview.

To address these critical maternal and infant health disparities, West Side United (WSU) and Lurie Children's have partnered to launch the West Side Healthy Parents and Babies program. The program provides expectant and new parents with free support from pregnancy to the first year postpartum, connecting them to resources such as doula or lactation consultant services to help with navigating the healthcare system. This partnership represents a significant step forward in our collective efforts to address systemic health disparities. By addressing social determinants of health and providing comprehensive support to new and expectant parents, we can improve the health of parents, children and entire communities, bringing us one step closer to ensuring that every family receives the care and support they deserve.