Correcting Course: From Race-Based to Race-Conscious Practice in Maternal-Infant Health

A contextual understanding of how neonatal and infant health inequities have developed is crucial to dismantle the harmful effects of race-based medicine and transition to a race-conscious, trauma-informed approach. Past and present laws and policies influence not only the sociocultural context within which people live but also the accessibility and quality of health care delivered to birth people and infants. Race-based medicine operationalizes race as a proxy for presumed biology in medical risk and treatment algorithms. Many examples of this exist within Obstetrics and Neonatal-Perinatal Medicine and have contributed to health care-generated inequities. Transitioning to a race-conscious, trauma-informed approach requires acknowledging racism, not race, as a driver of outcome disparities and intentionally directing efforts toward mitigating and eliminating these inequities. This involves considering barriers that some families face outside of and within the neonatal intensive care unit, applying a culturally attuned and personalized approach, revising outdated policy and practice, diversifying the workforce, including key stakeholders in decision-making, and improving transparency in research design and evaluation. This supplement explores the inequities that become amplified or compounded across the perinatal life continuum from birth person to infant, relevant policies or interventions to mitigate and eliminate the inequities, and associated outcomes. The perinatal, neonatal, and pediatric community must continue to critically assess policy and research, recognizing the impact of racism on health inequities, medical education, and patient care.