group synthesis

Hogan, Saavedra-Avendano, Darney, Torres-Palacious, Rhenals-Osorio, Vázquez Sierra and Lozano performed a research study to reclassify and identify maternal deaths, both indirectly and directly related (Hogan, et al. p. 362). This study was accomplished to properly identify and label the reason for death within the maternal health field, and put their findings into one process called the BRIMM, having a main point to find the reasons for maternal deaths the researchers hoped would help to reduce and catch these causes before they lead to death (Hogan, et al. p. 362). The population of interest in this study are all deaths in women of reproductive ages (10-54 years) (Hogan, et al. p. 362). The way these researchers chose to do this research was to look at all the death records, autopsy reports and medical records to properly see why these women died and if the directly related to maternal causes; looking at suspicious deaths, incomplete death codes, complicated deaths without a known cause, all deaths with a prenatal box checked and care related information on maternal death (Hogan, et al. p. 363). Before the researchers performed the review there were only 7829 deaths that were coded as maternal deaths. After the review the researchers recoded 1214 (13.4%) to maternal deaths. There was an increase in maternal death from 192 to 628 a 4.8% increase. There was also an increase of 6.8% and 11.4% in indirect and direct related deaths, respectively (Hogan, et al. p. 363). This study shows that there is still more to understand with the causes of deaths related to maternal deaths and properly identifying them to avoid deaths that can be treated while allowing for a single point of data where other medical profession can check against for the causes of deaths and how to treat maternal patients adequately.

Synthesis

These eight articles relate to health care disparities within maternal, children and minorities. All of these articles coincided with each other in agreeance that there is health care professional lacking in protecting their patients. There were no contradictions within these eight articles that showed any form of disagreement to show that minorities receive the same care as those that are financially, higher education and the color of their skin receive the same care as those that are of a lesser class, education and minority.

Limitations

These findings of this study propel the advancement of healthcare awareness of a pressing issue of low birth weights and contributing factors. The overwhelming disparity and the poor outcomes of black infants and mothers has always been evident however, without substantial cause or reason why this is occurring. This article sheds light on the fact that there are additional underlying issues other than the perceived notion that black women’s health behaviors are a contributing factor in this phenomenon.

This study reinforces the ideologies that institutionalized factors embedded in the laws, perceptions of care, insurance, bias in care and employment (discrimination) is the main cause of this gap. These implications are important because with an increase in awareness and acknowledgement of these key factors, changes can be made in handling of pregnant women and take special care of pregnant black women. Being more aware as a health care provider of unconscious discrimination and be more attentive to black women’s needs all together will help this disparity by decreasing the mortality rate of black infants.

It is important in conducting other research studies to explore the structural levels of discrimination, how it effects the people groups such as Black women and White women. In addition, how discrimination affects them on an individual level. If institutionalized racism is the key factor as to why black pregnant women have such high rates of low birth weight outcomes, further research is needed to determine how healthcare providers perpetuate this problem in their quality of care.

Finally, the last instillation of this group synthesis is entitled, “Increased risk of premature death following teenage abortion and childbirth- a longitudinal study”.

In this study, independently of social background, premature death especially by suicide, violence, ischemic heart disease, cervical and lung cancer appears to be more common among women with a history of teenage childbirth than women without teenage pregnancy.” (Jalanko, Leppalahti, Heikinheimo & Gissler. p.845-846)

From 1986- 1987 to 2013 more women with a lower educational level, living in urban areas in Finland that had teenage pregnancies, died due to suicide, injury, poisoning and other external causes including alcohol related deaths. More so, than women that had higher education and did not have teenage pregnancies.

Discussions

Questions and areas for further studies

Questions that remain unanswered, Will qualitative research design give more details about the variations in visit rates? What are the underlying factors for poor access by African- American women to the postpartum services? Does the issue of risk aversion influence the utilization of postpartum services among women? 

The third contributing study of the group synthesis is entitled,” Black/White disparities in pregnant women in the United States: An examination of risk factors associated with Black/White racial identity”. The risk factors associated with Black/White racial identity”, is the outstanding difference between the adverse pregnancy outcomes such as low birth weights in Black pregnant women compared to White pregnant women. 

Though there have been laws, to help bridge the gap between the disparities such as, legislative act H.R.45171, this law only improves the overall health of children by raising the awareness of infant mortality rates. However, the article calls out the need to pin point the issue in the disparity of care in the black women. Furthermore, the article will explore the factors associated with low birth weights in Black and White pregnant women. In turn, this article will also gather information on how institutionalized racism contributes to adverse pregnancy outcomes, looking at health behaviors and various factors to see if they’re different between the people groups.