Improving health equity through clinical innovation

Despite having the most expensive system of maternity care in the world, outcomes for birthing people in the USA are worse than other high-income nations. Critically, US outcomes also reflect deep and<br />persistent racial and ethnic health disparities. The maternal mortality rate (deaths occurring within 42 days of pregnancy per 100 000 live births) in the USA was 23.8 in 2020, the highest of all comparable countries. Non-Hispanic black (NHB) and Native American individuals are two to three times more likely to die during or after childbirth compared with those who are non-Hispanic white (NHW). In contrast, maternal mortality outcomes for Hispanic and Asian/Pacific Islanders are generally comparable with those of NHW individuals, though some research findings suggest health disparities among specific subgroups. NHB and Native Americans also experience higher rates of severe maternal morbidity (SMM), resulting in significant short-term or long-term consequences to their health. While mortality rates among industrialised countries are highest in the USA, racial and ethnic disparities in outcomes have also been noted in Brazil, Canada, the Netherlands and the UK.