In the United States, NICUs are disproportionately populated by non-Hispanic black infants because of high preterm birth rates among black women. Inequities persist despite increases in coverage of essential maternal and newborn care interventions, with considerable evidence that social determinants influence outcomes. Inequities may result from discrimination or differential treatment at the point of care or from patients delaying care due to fear of discrimination. Inequities also result from other barriers to accessing care or quality care such as direct and indirect costs, influence of others on decision making, transportation and access to care. Wealth-based inequities have been shown in access to maternal, newborn, and child health interventions, particularly presence of a skilled attendant at birth. Additionally, structural factors such as staff awareness of bias and privilege, trauma informed care and women’s empowerment or decision-making power, is also associated with use of maternal health services, including skilled delivery services.
OBJECTIVES:
Discuss the inequities in the neonatal population.
Describe opportunities for improvement in regard to equities in the neonatal population.
Summarize strategies to improve equities in the neonatal population.
TARGET AUDIENCE
Perinatal specialty physicians, nurses, nurse midwives, residents, fellows, lactation consultants, social workers
