A study led by UC Berkeley School of Public Health and Stanford University School of Medicine researchers found a correlation between hospital quality and severe maternal morbidity, or SMM, due to racial and ethnic differences.

SMM can be categorized into 21 adverse health complications that could occur during childbirth, including eclampsia, heart failure and aneurysm. Researchers collected information from more than three million birth records in California from 2007-2012 to see if disproportionate SMM outcomes in minorities could be explained by problems at the hospital level.

The study’s findings show that higher SMM rates for Black, American Indian/Alaska Native and multiracial women could be reduced with access to the same hospitals as non-Hispanic white women, according to a press release from the School of Public Health.

“Our model found that if Black women gave birth at the same distribution of hospitals as White women, this would have resulted in 156 fewer cases of SMM in Black women, representing a 7.8% reduction in the Black-White disparity,” said Mahasin Mujahid, lead researcher and UC Berkeley associate professor of epidemiology, in the press release.

According to the Centers for Disease Control and Prevention, SMM has increased by almost 200% between 1993 and 2014, with Black women experiencing it at two to three times the rate of white women. The study found that SMM rates for Black women, 2.1%, are highest overall and double that of white women, 1.1%.

With national data showing that Black women are more likely to deliver at hospitals with worse outcomes overall, the researchers have hypothesized that birth hospital, or the hospital where a mother has given birth, is an underlying, important contributor to these statistics, Mujahid said in the press release.

According to the study, investigations of birth hospital’s contribution to racial and ethnic differences remain limited. The study’s findings reveal a need to further explore structural racism’s role in health care, as well as the differing access to quality hospital care based on race and ethnicity, according to Mujahid. 

“We are in the midst of a national reckoning on the impacts of structural racism on Black Americans,” Mujahid said in the press release. “It is imperative that we include the health disparities experienced by historically marginalized women.”