Susan Carmichael

The US has the highest rate of maternal mortality of any high-income country and is the only one for which the rate is not declining. Severe maternal morbidity (SMM), which encompasses conditions that put pregnant people most at risk of dying, doubled in the last two decades. It disproportionately affects people from Black and Latinx populations. It is 100 times more common than maternal mortality, affecting 1-2% of births. The overarching goal of our team’s research is to understand causal pathways and mechanisms leading to SMM and its disparities, from macrosocial factors related to institutionalized racism, to targeted clinical causes like hypertensive disorders, and ultimately identify actionable, multi-level strategies to prevent SMM and promote maternal health equity.  Two critical gaps our team has identified in the study of SMM in the US are 1) limited understanding of people’s experiences of SMM and its impact on their families and their future health and well-being, and 2) lack of engagement of the highest-risk populations in setting research priorities.  Understanding the lived experience of SMM among the most affected groups through direct engagement and collaboration with individuals and their support networks is essential to promoting health equity and identifying the most promising interventions to prevent additional harm.

The objectives of this proposal are to begin to understand personal experiences of SMM among Black and Latinx people and to begin to integrate community-based and qualitative approaches into our team’s population-based research. Specifically, we will conduct interviews with Black and Latinx birthing people who have experienced SMM, and a support person they identify, and we will form and collaborate with a Community Advisory Board to support this research.  We aim to understand families’ experiences of SMM, challenges, and sources of resilience and strength, all of which provide foundations for building more informative research, better care, and prevention of severe childbirth complications.