Talk:Race and maternal health in the United States

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Some quick comments[edit]

This outline looks really solid, and you are off to a running start with the body text which is full of factual, clearly stated, relevant, and well-cited information in the parts that you have elaborated so far.

When I look at the lead, I feel like the included material makes up what should be the second paragraph of the lead, forming a list of authoritative evaluations of the subject by scholars (sentences 1-3), the World Health Organization, the US government ("Healthy People 2030"). The beginning of the lead should be more like that of Race and health in the United States, stating the existence of disparities first, as well as the domains where they occur. Consider editing this sentence into the opening one:

Race affects maternal health throughout the pregnancy continuum, beginning prior to conception and continuing through pregnancy (antepartum), during labor and childbirth (intrapartum), and after birth (postpartum).

Or inserting a sentence before it like this:

A variety of health outcomes related to pregnancy, childbirth, and infant health differ substantially by race in the United States. Race affects maternal health throughout the pregnancy continuum, beginning prior to conception and continuing through pregnancy (antepartum), during labor and childbirth (intrapartum), and after birth (postpartum).

With regard to the rest of the lead, the sentences on biological factors and social factors are good starts, and will likely evolve over time. The WHO sentence falls afoul of a technicality in how we write on Wikipedia. You are making the case that deficiencies in US maternal mortality by race are a human rights issue. While this is compelling, Wikipedians don't make such arguments in their own voice or cite third-party sources that don't refer to the topic of the article (it's called WP:SYNTH), but the encyclopedia can and does follow other sources that do so. In this case, you could attribute this conclusion to the American Public Health Association, which argues here that "maternal mortality is also a significant human rights issue" when specifically talking about the "large and persistent disparities in US maternal mortality by race/ethnicity." Relatedly, you should let readers know that Healthy People 2030 is an initiative of the Federal government (and what agency sponsors it).

Some useful general advice on tone from WP:BETTER: "The tone, however, should always remain formal, impersonal, and dispassionate. … It is not Wikipedia's role to try to convince the reader of anything, only to provide the salient facts as best they can be determined, and the reliable sources for them." So wherever possible, state facts rather than including evaluations in your summaries.

I'm eager to see how this article develops.--Carwil (talk) 21:55, 18 April 2021 (UTC)[reply]

I left my edits on the peer review page for your article! Cecilesaleh (talk) 22:22, 25 April 2021 (UTC)[reply]

Peer Review[edit]

This is a wide-ranging, detailed, organized, well-informed, and well-cited article, drawing on an impressive amount of research. Still, here I am to make lots of suggestions that I think will make it even better.

Conceptually, I feel like there are only two significant absences:

  • The staccato presentation of racial differences makes it hard for the reader to disentangle causes. Something that is often relevant is whether these differences are incident to differences in socioeconomic status. Where possible, it's helpful to hear… "This difference appears across education and income…" "This difference is largely a consequence of socioeconomic status / of prior health conditions / for the uninsured"
  • A clear summary of possible interventions to overcome disparities. See the ACOG article I mention later for a list of possible remedies.

A technicality you'll want to read first:

  • Put citation footnotes after punctuation, except for inside parentheses. See MOS:PUNCTFOOT.

Here are some places for wording improvement (mostly on the lead since the body paragraphs are largely fantastic):

  • The lead sentence must become boring and just identify the topic. Per Wikipedia:Manual of Style/Lead section: "The first sentence should tell the nonspecialist reader what, or who, the subject is. It should be in plain English." Consider something like "Maternal health care and the health outcomes of pregnancy and birth differ significantly by race in the United States."
  • Describe the timeline that structures the article (from pre-conception to postpartum) somewhere in the opening paragraph. Also, while you have two sentences on biological and social factors, I think three or four sentences summarizing available explanations, ranging from socioeconomic difference, access to care, accumulated stress and other consequences of racism, provider bias, and diagnostic lapses, would be useful in the lead.
  • "is sometimes referred to as being in crisis" constitutes a "weasel wording" that avoids attributing opinions to those who hold them. In the lead, look for a strong authoritative source that will convince unfamiliar readers. For example, The American College of Obstetricians and Gynecologists has found that, "Racial and ethnic disparities in obstetric and gynecologic outcomes and care are prevalent and persistent." (per this Committee Opinion)
  • Expand the lead a bit, and remove most signalling words like "In addition." It makes sense to at least break up the lead into two paragraphs, maybe three. Use one to introduce the issue, maybe another to summarize the information below, and a third that focuses on interventions.
  • Consider whether "methodological limitations may fail to distinguish the experiences of all racial groups" is a claim made by someone elsewhere. If so, cite it. If it's your insight, don't include it in the Wikipedia article.
  • A lay (=nonmedical) reader is unlikely to understand "Environment" as including racial stress. Consider the subhead.
  • Also in that environmental section, it would be helpful to follow the chain of publication / arguments leading to a belief in such causes, including the existence of negative outcomes among college-educated Black women, their absence among African-born immigrants, and research on accumulated stress impacts on racial minorities.
  • Re hypertension, I feel like an "of reproductive age" or "when pregnant" is missing in these quantitative comparisons.
  • "Geronimus": Use full names in the text.
  • Missing word or phrase here: "Historically, involuntary sterilization has targeted limiting the reproduction of minority women"

Two (possibly future) additions:

  • One day this article should have a history section. Not sure this is your work. Just noting.
  • Scholarly / public framings… Quote and cite scholars or public figures who situate the issue in relation to: the higher-than-its-peers rates of maternal and infant mortality in the United States, the cumulative impact of structural racism (e.g., Dana-Ain Davis), the treatment of Black and poor women (e.g., Khiara Bridges, Dorothy Roberts).

Great work so far, and good luck with where you take this. — Carwil (talk) 16:50, 3 May 2021 (UTC)[reply]

Wiki Education assignment: Race in America, sec 1[edit]

This article was the subject of a Wiki Education Foundation-supported course assignment, between 10 January 2024 and 24 April 2024. Further details are available on the course page. Student editor(s): PurplePhoneLaptop (article contribs). Peer reviewers: Puppyluver1234.

— Assignment last updated by PurplePhoneLaptop (talk) 15:23, 3 April 2024 (UTC)[reply]

Wiki Education assignment: Race in America, sec 2[edit]

This article was the subject of a Wiki Education Foundation-supported course assignment, between 10 January 2024 and 24 April 2024. Further details are available on the course page. Student editor(s): Bluecalypso (article contribs).

— Assignment last updated by Bluecalypso (talk) 02:23, 3 April 2024 (UTC)[reply]