Ensuring Quality Maternal Healthcare for Women in the US: A Systematic Issue - Essay Sample

Introduction

In the United States, like other parts of the world, every woman deserves quality healthcare. Before and after pregnancy, all women should get maternal healthcare to ensure that their lives and those of the child are not at risk. Unfortunately, system-based issues and many social factors have been putting many women at risk of maternal mortality. A high number has lost lives when delivering or after birth, and the causes are different. Such cases are a great disappointment given the value that a human life carries. Therefore, it is essential to examine the issue in detail while identifying the underlying causes and possible solutions.

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Contextual Information on Maternal Mortality

Based on where they live, African Africans are highly disadvantaged as far as quality healthcare is concerned. They have been racially discriminated, and have not yet reached the same recognition level as the whites. According to Howell (2018), the rate of maternal mortality in African American women is three to four times higher compared to whites. Also, the quality of care they get from preconception through postpartum has been an issue for long. As Prather (2016) further mentions, racism has affected the position of African American women as far as maternal healthcare is concerned. Many live in conditions that usually do not allow them to access the same facilities as whites.

Overall, African American women are a somewhat disadvantaged group. According to Howell, Egorova, Balbierz, Zeitlin, and Hebert (2016), most of their deliveries occur in the concentrated set of hospitals where the rate of severe morbidity rates is high too. Given this, a majority of these women get pregnant and carry the pregnancy in unpleasant conditions and end up giving birth under depressing circumstances. It is the same case that makes black infants in America to record higher death rates (twice) than their white counterparts (Villarosa, 2018). Overall, maternal mortality depends on several factors that come together at a disadvantage of African American women.

Concept Selection

Concept selection is always the first step in concept analysis. It is a description of the concept to be analyzed in detail while giving the necessary explanation of items. The concept of maternal mortality among African Americans is the main focus of this analysis. It has been chosen due to its criticality, given its dynamics and how it affects the entire American populace. Also, it shows the problems facing healthcare equity, equality, and access in the United States.

To a significant extent, maternal mortality is a pressing issue that requires a lot of attention in nursing and healthcare at large. As a way of improving the current situation, a concerted effort is vital at the individual, community, and national levels. The various initiatives put in place to promote equality in healthcare do not bring the intended due to problems such as racial discrimination. Also, as Prather (2016) highlights, African American women are economically disadvantaged since they are the ones prone to high poverty and unemployment levels. Besides that, they lack the same education as whites, which also increase health disparities. As a broad concept, it is crucial to understand it precisely.

Aims of the Concept

The second step of maternal mortality analysis is the purpose determination. The primary objective of this concept analysis is to clarify the meaning of mortality rate (as a concept). This meaning can further bring a shared understanding of the concept that the healthcare community and future nursing research can use to improve practice. Upon getting a detailed analysis of the issue, it would be possible to heighten its understanding to the extent where the healthcare fraternity and policymakers can put relevant measures in place to reduce maternal mortality among African American women.

Presently, there are a lot of grey areas surrounding the issue. Indeed, it has been normalized, but the fact remains that it is mostly the black community that is disadvantaged. The issue of race seems to affect maternal healthcare, but African Americans have been blamed for their lack of initiative to reduce the problem. Due to the broad spectrum and changing paradigm of the concept, a common articulation is necessary. It is only through such efforts that the problem will be understood better and solved appropriately.

Identifying the Uses of the Concept

From Walker and Avant's steps, the third part of maternal mortality involves the various uses of the concept in healthcare literature. Dictionary and general meanings of the concept are available, and there is a lot of healthcare literature that explains maternal mortality more professionally. The concept is two-worded, and it is essential to examine their meanings independently. The consulted sources are literature materials that define the concept in more detail.

Maternal: this word is all about something relating to mother. The dictionary and general meaning of the word is anything happening during pregnancy and immediately after a child is born. For instance, Creanga et al. (2014) discuss maternal mortality in light of an issue affecting women only. Despite men being part of the problem by extension, they have been excluded.

Mortality: overall, this word means being subjected to death. Accordingly, the rate of mortality in any setting is the number of deaths in a given population against its size. As a result, Creanga et al. (2014) demonstrate maternal mortality in light of deaths that stem from pregnancy complications or childbirth.

Maternal mortality: this involves risks associated with each pregnancy and death being the outcome. According to the Center for Disease Control and Prevention (CDC), reproductive health in the United States faces many challenges that cause variations in the rate of mortality rate across populations (Creanga, 2014). The standard deduction is that there is no guarantee for life after pregnancy. Depending on where these women live, risks and perceptions of issues differ. For instance, CDC reports that some women are highly vulnerable to high blood pressure and cardiovascular diseases, which increase the rate of maternal death (Villarosa, 2018). It is a broad issue whose dynamics change according to the populations of interest and the type of healthcare services they receive.

Defining Attributes

From a Walker and Avant approach, the fourth step in the concept analysis of maternal mortality among African American women if defining the attributes. In this case, attributes involve the elements of the issue that repeatedly appear in the literature. They are the most frequently associated with the concept such that it is impossible to miss them when one comes into sight with it. Thus, maternal mortality involves the following defining attributes:

• A case where women do not get the attention they deserve during or after pregnancy
• A scenario where there is a disproportionate lack of the necessary resources to take care of pregnant women
• A declined capacity for healthcare providers to deal with emergencies during delivery leading to death

Identifying a Model

This is another important step in the analysis of maternal mortality. The construction of a model case involves coming up with a real illustration of the concept with all the mentioned attributes being evident. It is a scenario where the real-world application of the concept is described. Below is an example of a real-world model.

Two weeks before her estimated date of delivery, Debbie started feeling abnormal contractions and expansions in the womb. As usual, she thought it was an ordinary sign since her delivery date was almost due. However, the pain persisted and had to seek help at a healthcare facility. She lived in a remote setting in Jacksonville and decided not to visit an up-to-date health facility since she believed that there was no way she could deliver that day. After arriving at the facility, Debbie was given reasonable first aid and told to relax a bit as the nurses attended other patients. She pleaded with them, and her opening of the cervix was checked. It had not opened, but due to persistent pain, scans were done that confirmed that she was in labor.

Since her cervix was not opening as required, the nurses attending her told her that induction was inevitable. She was induced and told to wait as the reaction took place. However, no major changes were happening in her body, and the discomfort heightened. Due to remoteness of the place, and the fact that the facility served mainly African Americans, the doctor to lead her operation was to be called since the case had turned to an emergency. She was referred to a cesarean section, but her baby did not come out alive. She had lied in a discomfort position for long as the decision to operate her was not made quickly.

This model case is a perfect illustration of the outlined attributes of maternal mortality. Debbie's case shows how African American women do not get the attention they get when pregnant or during delivery. The fact that the doctor to lead her operation was called shows inadequacy of resources to take care of pregnant women. Her case took long to determine- this is a reflection of a declined capacity for healthcare providers to deal with emergencies.

Identifying Borderline and Contrary Cases

This step involves making up borderline and contrary cases. From the Walker and Avant steps, the borderline part is where some attributes are present but not all as in the model. On the other hand, a contrary case represents an idea that does not represent the current concept. With the two cases, it becomes possible to check out the attributes that fit the definition of maternal mortality in African Americans the best.

Borderline case: over the past week, the maternity has been receiving several complications from women who their dates are not due. In most cases, their complaint is prolonged pains, but they are warned against taking painkillers. With the maternity being always full, some were referred to a private facility in a nearby location for quick attention. Although some conditions were critical, it was impossible to give even first aid.

This case shows the presence of two or the three critical attributes of maternal mortality. The fact that women with complications are referred to a nearby facility without even getting first aid shows how the victims do not get the medical attention they deserve during pregnancy. Maternity being full signifies a lack of necessary resources to take care of pregnant women. This setback increases the rate of maternal mortality. However, since no death occurs, the third attribute of maternal mortality is ruled out.

Contrary Case: Debbie loves visiting the healthcare facility, albeit not having an illness. She decides to accompany her pregnant friend Essie for a routine checkup. They are received calmly and scans made. Essie is advised on how to eat, exercise, and stay safe. No complication or a need for an emergency is required, and they go back home safely and contented.

This example has none of the three attributes earlier mentioned. The nurse attending Essie shows a willingness to give this woman the attention she deserves during pregnancy. Scans take place, which shows that resources are available to take care of pregnant women in the facility. No deaths or an emergency leading to the same is identified.

Identification of Antecedents and Consequences

Some events need to occur before the concept manifests itself. These events are the antecedents. In this case, there must be some factors triggering the cause of maternal mortality. On the other hand, as illustrated in the seventh step of the concept analysis, there are consequences. Typi...