Registered nurses are healthcare heroes. These licensed professionals practice independently under the supervision of physicians or surgeons and offer patients real medical know-how and much needed comfort. Now a new study shows that diversifying the RN workforce can add another benefit — one that’s especially important for expectant mothers.
Racial and ethnic minorities are up to three times more likely to experience life-threatening complications during pregnancy, childbirth and the postpartum period than their white counterparts. The study shed light on not just the reason for this, but a way to keep these mothers-to-be and their babies safer.
To get a picture of the connection between nurse diversity and pregnancy outcomes, the researchers analyzed data from over 3.6 million 2017 U.S. birth certificates compiled from 50 states and the District of Columbia. They also gathered data on the proportions of registered nurses who were members of racial and ethnic minorities in each state using the American Community Survey, and categorized the state results regarding ethnic and racial diversity as low, intermediate and high.
A blood transfusion was the most frequent maternal complication recorded, followed by eclampsia — a condition in which a pregnant woman suffering from high blood pressure may have convulsions. Hysterectomy was the third most common complication of pregnancy.
States with the least ethnic and racial nurse diversity had the highest rate of complications.
The study found that states with the lowest ethnic and racial nurse diversity had the highest rate of complications, followed by those with intermediate diversity. On the other hand, women who gave birth in states with the highest nurse diversity had a reduced risk of adverse maternal outcome. “Until now, evidence linking healthcare workforce diversity to improved maternal health outcomes was scant,” said the study’s first author, Jean Guglielminotti, in a press statement.
“Structural racism in public policies, institutional practices, cultural representations, and other norms work to perpetuate racial group inequities and what we believe contributes to these disparities in severe maternal outcomes, independent of poverty and other social determinants of health,” Guglielminotti, a member of the department of Anesthesiology at Columbia University's Vagelos College of Physicians and Surgeons, explained.
Based on these findings, it seems clear that diversifying nursing staff should be a priority in order to ensure that all moms get the best care and the most positive outcome possible.
“Perinatal care is team work. Frontline nurses play a key role in ensuring the safety and wellbeing of mothers and their newborns” the study’s senior author, Guohua Li, a professor of epidemiology and anesthesiology at Columbia Mailman School of Public Health, said. Having a racially diverse workforce not only can reduce providers’ implicit biases, it can improve communications and trust between patients and clinicians — a win for mothers and babies.
Based on these findings, diversifying nursing staff is an important step towards reaching this goal. “Our study provides robust evidence to support the recommendation to diversify the heath care workforce as a strategy for addressing racial and ethnic disparities in maternal health outcomes,” Li added.
If you’re planning to have a baby, the following suggestions from the Centers for Disease Control will also help you have a healthier pregnancy:
- Take 400 micrograms of folic acid every day. This B vitamin can help prevent birth defects of the developing baby’s brain and spine.
- See your healthcare professional regularly. Start as soon as you think you’re pregnant.
- Avoid harmful substances like alcohol, cigarettes, marijuana and other recreational drugs.
- Strive to reach and maintain a healthy weight.
- Avoid overheating and treat any fever promptly.
- Reach out to other mothers-to-be, and speak with your healthcare provider about any concerns.
The study is published in The American Journal of Obstetrics &Gynecology MFM.