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Every year between 50,000 and 60,000 women in the U.S. suffer severe maternal morbidities such as kidney failure, eclampsia or other unexpected outcomes from labor and delivery that cause short- or long-term consequences to a womanʻs health.

A new University of Hawaiʻi at Mānoa study will investigate the severe maternal morbidity and the maternity care experiences of Native Hawaiians and Pacific Islanders. The study, led by researcher Rebecca Delafield of the Department of Native Hawaiian Health at the John A. Burns School of Medicine, was awarded a $762,720, five-year National Institutes of Health research training and career development grant from the National Institute on Minority Health and Health Disparities. She hopes her research will lead to helping reduce the detrimental outcomes.

Filling health research void

Rebecca Delafield headshot
Rebecca Delafield

While both maternal mortality and morbidity are relatively rare, they are largely preventable and there are documented disparities by race and ethnicity. When Delafield wrote her grant proposal, there was no federal report of maternal mortality among Native Hawaiian and Pacific Islanders.

“The fact that we didn’t have this major statistic available for our Native Hawaiian and Pacific Islander population, one of the five federally recognized race categories, was shocking,” she said. Then, in May, while her grant was under review, the CDC published data showing that non-Hispanic Native Hawaiian and Pacific Islanders had the highest pregnancy-related mortality ratio relative to any other racial/ethnic group.

Native Hawaiian and Pacific Islander major maternal health outcomes have been largely invisible to the public due, in part, to aggregation of data with the Asian race category.

I think it’s not just about access to care, it’s about the relationship with health care.

“Unfortunately, often when data is disaggregated, results suggest that Native Hawaiians and Pacific Islanders have risk factors for potential adverse events during pregnancy,” she said. “For example, Native Hawaiians and Pacific Islanders, compared to other racial groups, are the least likely to enter prenatal care early in their pregnancy, and they’re most likely to get no prenatal care.”

“I think it’s not just about access to care, it’s about the relationship with health care.”

As part of the study, Delafield will survey 300 Native Hawaiian and Pacific Islander women about their experiences with health care during their pregnancy and delivery.

“We’re trying to understand that relationship better, in order to find ways to improve it.”

Delivering research that makes an impact

She will work with community partners to disseminate her findings and receive additional training on research communication to help her effectively and appropriately share her research.

“I don’t want community members to have to search or just read it in a scientific journal. Part of the grant is focused on learning how to convey my research in a digestible way,” Delafield said. “I want my research to touch them and have it mean something because that’s how we’re going to initiate change.”

Read more on the JABSOM website.

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