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The Maternal Mortality Related To Pregnancy Assignment

The Maternal Mortality Related To Pregnancy Assignment

Two evidence-based article critiques will be submitted using the Johns Hopkins Evidence Based Research Appraisal Tool (Appendix E) for nursing approach following the enclosed rubric. Each student will submit documents available on the Brightspace course page. A clinical PICO (population, intervention, comparison, and outcome) question will be formulated, reflecting the student’s own clinical interest. The question and articles are selected by the individual student with input and guidance from the course instructor. A rubric is provided. Follow the rubric, identify, and address each of the required elements  The Maternal Mortality Related To Pregnancy Assignment

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Research Problem

The research problem covered in the selected article is the disproportionately poor maternal health outcomes, including the high rates of maternal mortality related to pregnancy and/or childbirth among lower-income and women of color. The study by Smith et al. (2020) sought to demonstrate the extent to which Black women in the South Carolina are more likely to experience adverse pregnancy outcomes and reproductive injustices, including the heightened risk of child and maternal mortality, and the greater need for a multi-tiered approach that brings together the patient, care providers and public health policy and practice.

Research Purpose

The main purpose of the reviewed article was to demonstrate the extent to which a working agenda for black mothers must be adopted with the core intention of improving their maternal health, and to address the current maternal health crisis in the America’s Black community. The research purpose of the article by Smith et al. (2020) was to highlight the America’s black maternal health crisis through a comprehensive review of empirical evidence to emphasize the fact that black women deserve the right to safe, accessible, high-quality and competent care that supports healthy pregnancies, births and motherhood/parenthood.  Smith et al. (2020) utilized a reproductive justice framework to capture the manner in which oppressive systems of power have unacceptably denied many low- and middle-income black and African-American women access to high-quality, patient-centered reproductive health. As a serious public health crisis, black maternal mortality is considered to be 4 times higher than the rates of maternal mortality in the White community, and hence the growing quest for reproductive justice The Maternal Mortality Related To Pregnancy Assignment.

 

Research Questions and/or Hypotheses

  1. How do South Carolina women’s social construction of identity based on race/ethnicity, age, ability, gender, immigration status and sexual orientation impact their perceptions of reproduction?
  2. How do South Carolina women understand their reproductive health within racial, political, social, historical and economic realms?

Hypotheses

  1. Black pregnant patients receive differential treatment when it comes to maternal health when compared to their white counterparts.
  2. The maternal health crisis and the entrenched health disparities threaten to widen the perceptions of systemic racism between the medical community and people of color.
  • The pursuit of reproductive justice in the United States is integral to addressing the greater disparities in reproductive health outcomes in black women, than do women nationally.

Variables

  • Independent variables (age, ethnicity/race, geographical location)
  • Dependent variables (pregnancy, maternal health service delivery, maternal health outcomes) The Maternal Mortality Related To Pregnancy Assignment

Literature Review Summary

The article by Smith et al. (2020) sought to reveal the huge disparities in maternal health care in the South Carolina women, and the extent to which evidence-based interventions must be developed and implemented to mitigate the growing rates of maternal mortality among low-income and women of color. The findings indicated that pregnancy-related mortality among black women is more than four times higher in comparison to the rate for white women, nationally. The findings indicated that the massive maternal health disparities as reported in racial/ethnic minority communities should be attributed to a plethora of factors including the prevalent economic and social inequalities, and the failure of the country’s health system to provide women of reproductive age from the black communities with affordable, high-quality and client-centered coverage and other healthcare services (Smith et al., 2020; Lister, 2019;

Uneke et al., 2017). Using a reproductive justice framework, the article also revealed that pregnant black women in both rural and urban environments are more likely to experience many of the adverse pregnancy outcomes than their white counterparts. Some of the negative maternal health outcomes and morbidities behind the high rates of black maternal mortality identified in the reviewed literature include: the increased risk of developing cardiovascular and cardiomyopathy conditions (e.g. pulmonary hypertension, coronary artery disease, asthma, vascular aneurysm, gestational diabetes, congenital valvular heart disease, placental disorders, vascular malformations, chronic hypertension, obesity, eclampsia, and preeclampsia, Marfan syndrome conduction abnormalities, among others)The Maternal Mortality Related To Pregnancy Assignment. Notwithstanding the onset of prenatal care, the risk of maternal deaths was more than three times for black women compared to whites, a clear indication of the greater need to improve the quality of care delivered to women and girls from the black communities (Smith et al., 2020; Laigo, 2021; Marill, 2022). The article advocated for a multi-tiered approach embed within the reproductive justice framework that seeks to ensure enhanced access to a continuum of high-quality, patient-centered and evidence-based health care, health coverage and other services before, during and after pregnancy, to black and African-American women.

Nursing Theoretical Framework

The culture care theory is widely applied as the nursing theoretical framework for demonstrating the importance of offering culturally-congruent, safe, beneficial, just and sensitive maternal health care to individuals or patients of similar or diverse cultures (Smith et al., 2020). Taylor (2020) explained that the theory of culture care recognizes the centrality of the cultural intelligence and cultural respect in promoting reproductive justice and reducing health disparities, including maternal health disparities through strong emphasis on the provision of responsive, holistic, high-quality and evidence-driven healthcare that is respectful of the distinct needs, expectations and healthcare concerns of diverse patients The Maternal Mortality Related To Pregnancy Assignment.

Design of the Research Problem

The exploratory research design was used in the article to investigate black maternal mortality as a complex phenomenon that requires the attention of policymakers, government officials, advocacy groups, healthcare providers, researchers and academics, communities and the public at large.

Legal and Ethical Issues

Some of the legal and ethical issues touched on the use of human subjects and hence a set of ethical principles including informed consent, beneficence, non-maleficence and accountability were exercised when conducting the research included in the article.

Sample

The study recruited 70 women, aged between 19 and 78 years. Whilst one-third of the participants were identified as Black, at least half self-identified as White and 8.7% were Latina). Other key variables considered in coming up with the sample included immigration status, marriage status, level of education and employment status (Smith et al., 2020).

Procedures

Data collection was done using semi-structured interview guides that were distributed and collected by the research team. In terms of data analysis, an inductive analytic approach was adopted to help in coding of the results based on the personal voices and experiences of each respondent. The qualitative data analysis software (namely: HyperRESEARCH 3.7.5.)  was utilized enhance the coding and organization of the transcripts (Smith et al., 2020)The Maternal Mortality Related To Pregnancy Assignment.

Summary of Results

Using the reproductive justice framework, the results in the article indicated that black women experience a myriad of structural barriers to high-quality reproductive health care. A number of factors including the inequitable distribution of power, racial and historical oppression, lower socio-economic status, and the dysfunctional health system undermined the realization of reproductive justice in South Carolina and the greater America (Smith et al., 2020; Taylor, 2020)The Maternal Mortality Related To Pregnancy Assignment. Equally, the results indicated the need for implementation of empowerment initiatives and efforts aimed at improving the lived experiences of black women and enabling them to access high-quality, holistic and evidence-based healthcare, including maternal health.

Validity of the Research

The findings in the study are valid, credible and up-to-date. This is because the authors employed a wide set of qualitative and quantitative data and information to resolve the research question, and to create a better understanding of the case of black maternal mortality as a public health crisis in the United States.

Implication on Future Nursing Practice

The findings of the research attempted to provide some of the working solutions to enhancing black maternal health. With the rise in maternal mortality rates, adoption of evidence-based pharmacological and non-pharmacological interventions in the nursing practice is urgently need to mitigate the growing cases of adverse maternal health outcomes including the increased risk of morbidity and mortality in pregnant black patients (Smith et al., 2020; Taylor, 2020; Lister, 2019)The Maternal Mortality Related To Pregnancy Assignment.

Current Nursing Practice

In my current nursing practice, the results from the research are highly insightful and useful in terms of how they shed more light on the black maternal health crisis as a top priority issue that must be addressed to attain equitable and high-quality health care. As a result, the centrality of evidence-based best practices and policies in addressing the high rates of maternal mortality in at-risk communities is informed by my current interest in learning how to deliver culturally-congruent and client-centered care to patients, irrespective of any identifiable differences (Smith et al., 2020).

PICOT Question

Among Black and African-American Women (P), the implementation of evidence-based, culturally-congruent maternal health care (I), can help to reduce the high maternal mortality rates (O) compared to the standard care (C) within the peri and pre-conception periods? The Maternal Mortality Related To Pregnancy Assignment

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References

Laigo, S. (2021). Addressing maternal mortality rates of Black women in the US: California’s example. https://doi.org/10.33015/dominican.edu/2021.hcs.st.03

Lister, R. L. (2019). Black maternal mortality-the elephant in the room. World Journal of Gynecology & Womens Health, 3(1). https://doi.org/10.33552/wjgwh.2019.03.000555

Marill, M. C. (2022). Raising the stakes to advance equity in Black maternal health. Health Affairs, 41(3), 324-330. https://doi.org/10.1377/hlthaff.2022.00036

Smith, E., Sundstrom, B., & Delay, C. (2020). Listening to women: Understanding and challenging systems of power to achieve reproductive justice in South Carolina. Journal of Social Issues, 76(2), 363-390. https://doi.org/10.1111/josi.12378

Taylor, J. K. (2020). Structural racism and maternal health among Black women. Journal of Law, Medicine & Ethics, 48(3), 506-517. https://doi.org/10.1177/1073110520958875

Uneke, C. J., Sombie, I., Keita, N., Lokossou, V., Johnson, E., & Ongolo-Zogo, P. (2017). Improving maternal and child health policymaking processes in Nigeria: An assessment of policymakers’ needs, barriers and facilitators of evidence-informed policymaking. Health Research Policy and Systems, 15(S1). https://doi.org/10.1186/s12961-017-0217-5 The Maternal Mortality Related To Pregnancy Assignment