An Integrative Review of Structural Interventions to Address Inequity in the Maternal Mortality Crisis Among Black...

To review and evaluate the literature for upstream, structural interventions that seek to improve maternal mortality rates among Black birthing people in the United States.

Searches were conducted in PubMed, Embase, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Of the 883 articles returned, 623 abstracts were screened, and 7 articles met the criteria for inclusion. Articles were eligible for inclusion if they assessed the impact of structural interventions on maternal mortality, including among Black birthing people.

Data were extracted on study designs, intervention type, outcomes, and health equity implications using a standardized template.

Findings were synthesized thematically according to intervention type and included Access to reproductive health care and Social investment as effective maternal health policy. The findings revealed that maternal mortality is largely preventable and responsive to structural interventions. Interventions that addressed upstream determinants such as racism and social conditions demonstrated the greatest impact in reducing maternal mortality and improving equity.

Targeted policy and programmatic interventions that address social and structural determinants of maternal health are essential to mitigating the maternal mortality crisis. Efforts that extend health care access, invest in public health infrastructure, and promote reproductive justice are particularly effective in improving outcomes for Black birthing people.