Uprooting Racism: The Role of Nurses in Cultivating Improved Maternal Outcomes for Black and African American Women

After controlling for education, socioeconomic status, and genetic factors, Black and African American patients in the United States are three to four times more likely to die in childbirth than are White patients. The literature is replete with strategies to improve maternal outcomes for Black and African American patients. Existing strategies focus on addressing poverty and individual risk factors to reduce maternal mortality, yet maternal outcomes are not improving for these patients in the United States. Recent literature suggests that a nuanced approach that considers the effects of individual and structural racism could improve maternal outcomes, especially for Black and African American patients. As nurses comprise the largest component of the health-care system, their collective power and influence can provide a powerful tool for dismantling structural racism. Some important concepts to consider regarding the care of the Black and African American population are cultural intelligence (CQ), allostatic load, and humanitarian ethos. By developing CQ and consistently including the four CQ capabilities (drive/motivation, knowledge/cognition, strategy/metacognition, and behavior/action) in all aspects of practice, nurses can help to uproot racism and cultivate experience to improve maternal health outcomes for Black and African American patients.