Addressing Racial Disparities in Maternal Health: The Case for an Equity Birth Plan

Birth equity can be defined as “The assurance of the conditions of optimal births for all people with a willingness to address racial and social inequities in a sustained effort.” (Birth Equity |California Maternal Quality Care Collaborative, n.d.). Complex explanations exist for adverse maternal outcomes, but unequal health care, socioeconomic and racial inequalities pose risks to women and their babies (“Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” 2003). The data is clear: Maternal death rates have increased and are 3 to 4 times higher for black women than white women (Zaharatos et al., 2018). These disparities exist even for black women of higher socioeconomic status where issue of access and resources would presumably be eliminated. Current data are inadequate in addressing issues of access, fragmentation of care, systemic racism, and the differential treatment of women of color. Birth plans were developed in the 1980s and were aimed at addressing patient autonomy in male dominated health care systems; birth plans provided a vehicle for patients to communicate their birthing preferences (Penny Simkin, 2007) (Kaufman, 2007). A recent Google search for “birth plan template” resulted in over 9 million results- most of which were simply provided checklists. Most identified plans fail to explain birthing options and fail to address individualized risks.