Disproportionate Access to Maternal and Perinatal Health Care: An evaluation, outcomes and Proposed Interventions

This study examines persistent inequities among African American Birthing Individuals (AA BI), revealing that socio-economic factors alone do not mitigate negative pregnancy-related outcomes. A literature review and data analysis highlighted high infant mortality rates among this group despite existing programs. The Perinatal Equity Initiative (PEI) offers community-based resources, yet disparities persist regardless of income, education, or maternal age. National and city-level comparisons consistently show higher infant mortality rates among AA BI, primarily due to preterm deaths. Recommendations include expanding PEI by increasing doula services, implementing a multi-step community-based intervention, and enhancing partnerships to conduct root cause analyses addressing social determinants of health. A 2024 needs assessment by SFDPH identified perinatal and maternal health needs, such as access to care and economic support, underscoring the importance of addressing these issues. Future research should focus on understanding and tackling the root causes of disparities, along with stronger implementation of implicit bias training among clinicians. Keywords: inequities, African American birthing individuals (AA BI), social determinants of health (SDOH), Perinatal Equity Initiative (PEI), racial disparities, implicit bias, obstetrics, infant mortality, root causes.