Women’s Health Care Physicians.

Women’s Health Care Physicians.

American College of Obstetrics and Gynecology (ACOG). (2015). Women’s Health Care Physicians. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Racial-and-Ethnic-Disparities-in-Obstetrics-and-Gynecology

Centers for Disease Control (CDC). (2019). Pregnancy-Related Deaths | CDC. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm

Cox, R. G., Zhang, L., Zotti, M. E., & Graham, J. (2011). Prenatal care utilization in mississippi: Racial disparities and implications for unfavorable birth outcomes.Maternal and Child Health Journal, 15(7), 931-42. doi:http://dx.doi.org/10.1007/s10995-009-0542-6

Reply Gina

Given the United States’ climate of racial inequality and health disparities, our patient, which is an African American woman is more likely to be exposed to stress and complications such as preterm labor, preeclampsia, depression, fetal demise or fetal growth restriction during the pregnancy. A healthy environment, financial stability, healthcare, education, and social community context are essential during pregnancy (Mohamed et al., 2014). In this case study, the patient is a 32-years-old, African American single mother, has three children from previous relationships, is financially unstable, overweight, with preexisting conditions such as hypertension and at risk for gestational diabetes. She has two jobs that probably does not offer benefits or insurance coverage. The patient is more likely to experience hypertensive disorders of pregnancy that may be attributable to pre-pregnancy hypertension. Her BMI is already elevated, which may lead to complications, including preterm birth, fetal death, macrosomia, gestational diabetes, and cesarean delivery.

According to Mohamed et al. (2014), women of color are less likely to have access to vital reproductive health services including screening for sexually transmitted infections and cervical cancer, family planning; and abortion, when compared with non-Hispanic white women. Although socioeconomic status is considered the main leading factor in health disparities, factors at the patient, practitioner, and health care system levels contribute to existing and evolving disparities in women’s health outcomes (Mohamed et al., 2014). In this case, I would inquire on factors that contributed to her delay in OB care and lack of follow-up visits. What determined the patient to have all this gap in care? Was it the lack of financial resources or other factors such as domestic violence? Based on the screening results, the patient should be screened for domestic violence and guided in the process of care based on her needs and beliefs.

Unfortunately, African American women receive lower-quality health care related to inequities in income, housing, education and job opportunities, which results in higher risk for mortality across the life span for this population (Bryant, 2010). This contributes to racial disparities in pregnancy-related risk factors such as hypertension, anemia, gestational diabetes, and obesity and other conditions such as heart disease, HIV, AIDS, and cancer (Bryant, 2010).