Morehouse School of Medicine and Emory University have been awarded a grant by the National Institutes of Health to establish a research center focused on reducing maternal mortality and advancing maternal health equity.

The grant is part of a $24 million national initiative — Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE). It is expected to last seven years and cost $168 million.

Through the IMPROVE grant, Morehouse’s Center for Maternal Health Equity will team up with Emory professors to form the Center to Advance Reproductive Justice and Behavioral Health among Black Pregnant/Postpartum Women and Birthing People (CORAL). Dr. Natalie Hernandez-Green, executive director of the Morehouse center, will lead the effort. According to Hernandez-Green, CORAL will receive $10.3 million over seven years to operate the center.

“The magnitude and persistence of maternal health disparities in the United States underscore the need for research to identify evidence-based solutions to promote health equity and improve outcomes nationwide,” said Dr. Diana W. Bianchi, NICHD director, in a press release.

“Through collaborations with community partners and others, the Maternal Health Research Centers of Excellence will generate critical scientific evidence to help guide clinical care and reduce health disparities during and after pregnancy,” she added.

Georgia’s Maternal Mortality Review Committee has cited behavioral health conditions, such as anxiety, depression and birth-related PTSD as leading and growing causes of maternal death. These conditions affect 1 in 5 women, with Black women experiencing a disproportionate burden. Helping Black women survive and thrive through pregnancy and postpartum is CORAL’s mission.

Morehouse is one of two HBCUs, along with Jackson State University, something that Hernandez-Green lauded as “huge.”

“We normally don’t get the street cred for what we do and the work that we do in the community,” she said. “Sometimes, in research, community is not looked at as a strong component, and I think that’s where solutions have been inadequate.”

In collaboration, the 12 institutions, including 10 research centers, a data hub and implementation hub, will collaborate on research projects on factors that affect pregnancy-related complications and deaths. They will focus on racial and ethnic minorities, people with disabilities, underserved rural areas and other communities that experience health disparities.

“We’re hoping that the type of research that we uncover with this center, that we can move it back to the community, that it can be useful for the community,” Hernandez-Green said. " We know that there’s a dearth of people that look like the community that are conducting research with the community.


MATERNAL MORTALITY

Maternal mortality is measured as a ratio: the number of maternal deaths per 100,000 live births. This is Georgia’s maternal mortality rate over time. Data for maternal mortality is usually poor, but these numbers were determined by intensive investigation into case files by a state committee of experts. Experts caution that if investigative tools improve, the data may rise for that reason.

The majority of pregnancy-related deaths don’t happen in childbirth; they happen in the weeks and months after the patient gives birth.

Georgia’s Maternal Mortality Ratio

2012-2015: 28

2015-2017: 25.1

2018-2020: 30.2

Maternal Mortality in Racial/Ethnic groups

Non-Hispanic white: 23.3

Non-Hispanic Black: 48.6

Source: Georgia Department of Public Health


LEADING CAUSES OF MATERNAL DEATH

The state Department of Public Health has released some initial findings from the review of Georgia’s maternal deaths between 2018 and 2020 by the Maternal Mortality Review Committee. These were the top ways in which the committee found pregnancy contributed to the death of someone who was pregnant or had given birth in the previous year.

16 deaths: Hemorrhage. All preventable.

15 deaths: Mental health conditions. All preventable.

13 deaths: Cardiomyopathy (a condition that affects how the heart pumps blood). All preventable.

12 deaths: Cardiovascular and coronary conditions. All preventable.

12 deaths: Embolism (an obstruction in an artery or a blood clot). Ten were preventable.

10 deaths: Preeclampsia and eclampsia. All preventable.


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