In countries where the economy is good, access to proper healthcare, and there is the presence of modern technology, the postpartum mortality rate is low, whether it is days or week after delivery. However, there is a minority population who is discriminated against when it comes to healthcare; therefore, the rate of deaths after childbirth is usually very high. For example, the World Health Organization found out that 830 women die every day and around 99% of them are those who live in poor and less developed countries where they do not have access to healthcare, and the technology available is not of much help. The sad fact about postpartum deaths is that they can be prevented (Singer, 2019). The purpose of this paper is to discuss the reasons for the rise of postpartum maternal mortality rate while identifying what can be done to solve the issue especially on the minority population which consists of the African Americans, Latino and Hispanic Americans in the United States.
Importance
The problem is essential to the health of the mothers after delivery in the minority population because if addressed it could help reduce postpartum maternal mortality rate giving the mothers a chance to bring up their children while taking care of them. The death of women after delivery is sometimes associated with some complications which could have developed during pregnancy but were not treated or prevented. Other problems could have been present even before pregnancy and after pregnancy, but they worsened after delivery, therefore the importance of this problem is that it leads to the nations and organizations being alarmed about the rates of death of mothers after delivery enabling them to come up with measures to control the rate by ensuring that the women in those areas where healthcare is limited, and the technology is not advanced are guaranteed to have minimal complications but providing health services.
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The effect of not solving this problem is that it leads to increased infant mortality rate, which arises from the death of the mothers after death. Most of the time after birth, the baby requires the mother's care, which lack of it could lead to the end of the baby. Most of the complications which arise after a mother delivers are closely related and tied to infant deaths equally. This could also lead to the reduced population due to the increased deaths of mothers after delivery and the infants consequently.
Patient Population
Most women from the minority population are least likely to access adequate healthcare primarily because in the areas in which they reside there are less skilled healthcare workers meaning that most of the births by this kind of population is usually not attended to by a doctor, nurse or even a midwife. The women in these areas rarely participate in antenatal clinics where they can receive care from skilled health workers both during the pregnancy and after delivery, which leads to increased deaths after delivery.
In such a population, women faced with poverty such that they do not afford better care and they are discriminated against on the basis of race in the United States by being treated with less respect and dignity, and they are provided with low-quality health care services. They also lack information since they are discriminated against; therefore, they are not educated on matters regarding postpartum maternal care. They have little or no information on the causes of postpartum maternal mortality and what they can do to prevent it. Cultural practices in such areas also aggravate the problem with most women from minority populations being so staunch in preserving their cultures such that if the norms and beliefs of the society prohibit women from seeking medical attention, they tend not to seek health care even if their lives are at risk.
Given that cultural values, practices, customs, and beliefs greatly influence the behavior of women in minority population during the postnatal period leading to increased postpartum mortality rate through harmful acts, use of healthcare, social status, and inaction, understanding the specifics of how the cultural values of the minority population contributes to the postpartum maternal mortality could help the health workers, nurses and even midwives in provision of health care and programs which are culturally competent to reduce the rate of postpartum deaths. Most designed interventions which do not account for the cultural factors are less effective in reducing postpartum maternal mortality.
Proposed Solution
Improving maternal health before and during pregnancy should be one of the main priorities that should be handled to help solve the problem of postpartum maternal mortality. Postpartum maternal mortality can be reduced through the increase of clinical guidance, the setting of global standards, and technical support to health service providers in areas with the minority population. This ensures that the women in these areas receive and have access to treatments that are effective and affordable, and the health workers are supported with guidelines and training materials. The behavior and norms of the individuals, community, and households should be improved by providing them with adequate knowledge on during pregnancy and postpartum healthcare ( Das, 2018) . This information should entail engaging in healthy behaviors while pregnant and after delivery through seeking health care during delivery and after delivery.
Examples of support programs meant to improve healthy maternal behaviors include seeking care for both complicated and uncomplicated pregnancies to reduce postpartum deaths to prompt treatment and to create awareness of postpartum health. Community mobilization should also be done in efforts to build the capacity of families, women, communities, and groups who can engage with each other, with the healthcare providers and with some government policymakers to help improve and provide quality health services and to hold the accountability of health systems.
Addressing the issue of inequalities in access to quality maternal, postpartum, and deliver health services by ensuring that there is available universal health care to the women in minority populations can reduce postpartum maternal mortality rate ( Bowen, 2016) . Improvement of postpartum maternal health strengthens the community and family of the mothers as well and just the mother only. Addressing the drivers to inequality, women will benefit from the increase in access to quality information, goods, and health care along with the barriers which put mothers at risk of deaths after delivery being removed.
Advanced quality healthcare can be achieved through the integration of maternal postpartum services, diagnosing, preventing, and treating the causes of postpartum mortality and increasing focus on addressing and averting postpartum maternal mortality. Provision of quality health services can be achieved through the support of transformation of cultural and social norms to access maternal health care through programs and initiatives that are community –based, Reduction of financial, geographical, cultural and social barriers to safe deliveries, and through catalyzing the government's actions to increase the budget allocations for postpartum health services ( Evans, 2013) .
The needs of women and girls of the minority population can be responded through the strengthening of the health systems to accommodate women of all status and race. This can be done by promoting data collection to identify the intensity of the problem, for decision making and accountability, and through the promotion of innovation and thorough research for programs and policies.
In handling this problem, ethical considerations such as ensuring there are no racial disparities in postpartum maternal mortality should be considered. In ensuring that the plan to solve this problem is executed health practitioners and providers should ensure that they do not discriminate against the women in the minority population while providing services. In the United States, the survival rate of mothers who are African American is high, especially because of their race and ethnicity. Most disparities are associated with racism since social services, and health care services, which are of poor quality are offered to African Americans unlike that which is offered to the white women ( Bowen, 2016) . Women from the minority population are provided health services with less respect and dignity; therefore, in developing a plan to resolve this problem, equality irrespective of race and ethnicity of the women should be ensured.
Goals
Postpartum Maternal Mortality Rate can be addressed in multiple ways when focusing on the causing factors. In the short term, nurses can help pregnant women get access to health care and education. Factors such as financial problems and marginalization expose women from minority groups to Postpartum Maternal Mortality ( Firoz et al., 2018) . In the short run, the focus is to educate the women on factors that may lead to postpartum maternal mortality. Access to health care during the prenatal period, delivery and postnatal will help the pregnant women acquire the necessary care and knowledge to reduce postpartum mortality. Early access to healthcare gives the nurses a chance to know the pre-existing conditions.
The plan to execute the short term goal is to have groups of nurses get into the community to educate and mobilize pregnant women to get health services from close health facilities. Thus, planning for community visits in the community and educating women on productive health and providing services. The goal can be measured through the record of women accessed during the community visit and the number of pregnant women willing to acquire health services.
The long term goal is to have health care follow up for all women from minority groups with the aim of reducing the postpartum maternal mortality rate. Medical follow during and after the delivery can help detect possible causes of death occurring after birth ( Oyerinde, 2013) . Women who give birth in the traditional setting can also be followed up to make sure that the best care is offered. Thus, no matter the place of birth, nurses should work to ensure that expectant and newborn mothers get the best of follow-up care that reduces the imminent risk of death. The long-term goal can be measured by comparing clinical data on postpartum maternal mortality over a period of three to five years. If the percentage rate decreases, it means that the goal is successful.
Barriers
Lack of finances is one of the barriers to executing the plans for reducing postpartum maternal mortality. Provision of health services that are accessible to all the women in need, modern technology, and even programs to educate the women and communities is expensive and requires a lot of resources starting with the skilled health care workers, the equipment, and materials. The minority population is allocated the least amount of funds while the government budgets leaving very little amount of money for the provision of all services that the people require, including health care. Training programs and acquiring information to offer to the mothers are also expensive to finance. This barrier can be overcome through the equal allocation of resources, and those who are less fortunate should be allocated more resources given their numerous needs. The Government should ensure that the health facilities are equipped with the necessary equipment required for the care of women during and after delivery.
Poverty is also another barrier. Getting to achieve the goal where every woman gets a just and fair opportunity to be healthy postpartum is faced by poverty as a barrier to care. Women of the minority population have limited resources which they can use to pay for health services leading them to not seeking quality health care even if the prices are standardized in such a way that the providers assume it is affordable to everyone hence it is a barrier to achieving the success of the plan. This problem can be overcome through ensuring that all women have adequate health insurance such that even if they do not have real cash on them, they are still able to access health services.
Cultural barriers. Most cultural norms and values of the women from the minority population prohibit women from seeking medical care. While trying to make sure that programs to educate the women on the importance of seeking medical care and making sure that women receive quality health care to prevent postpartum maternal mortality culture can be one factor that could prohibit that. Some societies believe in traditional was of treatment such as the use of herbal medicines and they, therefore, do not believe in seeking medical services from the hospital while some conditions that occur after delivery may require advanced medical care which could lead to death if left unattended. To overcome this barrier, the health providers, nurses and even policies implemented to solve the problem of postpartum maternal mortality should ensure that the health programs and services are culturally competent and the designed interventions account for the cultural factors.
Benefits
From implementing the proposed solution and goals of the postpartum maternal mortality challenge among women in the minority groups, both these women and nurses will benefit. The women from minority groups will benefit by accessing education and care necessary to improve productive health with the aim of reducing the risk of death after delivery. Thus the women will eliminate the risk of death or life-threatening conditions after birth. Through education, women learn of potential risks and how to deal with them. Through access to healthcare, women get the necessary medical help that increases the survival rate after delivery. Medical follow up will benefit both the mother and the child in the detection of any medical risk that might occur after birth ( Firoz et al., 2018) .
The nurses will benefit by being able to offer their services to the needy in society. Caregiving is a calling, and job satisfaction is being able to serve the community. The nurses will, therefore, feel be satisfied if the proposed solution and goals work by reducing the postpartum maternal mortality rate. Thus, the nurses will be able to document their approach to reducing the postpartum maternal mortality rate among women in minority groups by their approach and thus can be used as evidence.
Participants and Interdisciplinary Approach
The participants in the implementation of this plan include nursing administration, practitioners, community administration, doctors, community health volunteers, and women from minority groups in the community ( Firoz et al., 2018) . Nursing administration is key for the approval for the implementation of the proposed plan and policies. Nursing administration also plays a role in the allocation of necessary resources to help with the implementation of the plan. The nursing administration team also connect with community administration to ask for permission to carry out the plan. The nurse practitioners are the implementers of the proposed solutions and goals. The nurses are the ones to interact with the target population and get to know the challenges of the group and how they can help.
The community administration role is to give the go-ahead for the caregivers to provide their services in the community. Permission from this group help in security issues that may come in handy with such services. A doctor in each group is key for possible diagnosis needed. Doctors are also to help in answering questions pertaining to pregnancy and reproductive health. Community health volunteers have a connection with the members of the community and also have vital information on the target population ( Firoz et al., 2018) . The community health volunteers connect better with the community members. Women from minority group cooperation will help in achieving the proposed plan.
Conclusion
Resolving the problem of postpartum maternal mortality it is required that all women from the minority groups are provided with health care services that are accessible and affordable. In ensuring that women access quality health care to prevent deaths upon delivery, there is a need to come up with a plan which incorporates a variety of actions. These actions include programs and policies to educate women and the society in general on the importance of seeking medical care during pregnancy or before getting pregnant to reduce the complications that could lead to postpartum mortality. The purpose of this plan is to ensure that even the issues that result from the problem are also prevented and that the number of women who die after delivery is reduced by handling the complications that are treatable and preventable. Addressing this problem prevents infant mortality, which is tied to postpartum maternal mortality. This is not only important to the mother and the child, but it is also important to the society and families of such women since women are homemakers. It is important to the economy, especially those women from the minority groups since they are involved in money-making activities that contribute to economic growth.
References
Bowen, R. M. (2016). Reduce Maternal and Infant Mortality. Family Capital and the SDGs , 60.
Das, S. (2018). Maternal health, human rights, and the politics of state accountability: Lessons from the Millennium Development Goals and implications for the Sustainable Development Goals. Journal of Human Rights , 17 (5), 550-567.
Evans, E. C. (2013). A review of cultural influence on maternal mortality in the developing world. Midwifery , 29 (5), 490-496.
Firoz, T., McCaw ‐ Binns, A., Filippi, V., Magee, L. A., Costa, M. L., Cecatti, J. G., ... & members of the WHO Maternal Morbidity Working Group (MMWG). (2018). A framework for healthcare interventions to address maternal morbidity. International Journal of Gynecology & Obstetrics , 141 , 61-68.
Oyerinde, K. (2013). Can antenatal care result in significant maternal mortality reduction in developing countries? J Community Med Health Educ , 3 (2), 2-3.
Singer, K. MSN, RNRN. (2019) 2019 NCLEX-RN®Test Plan Overview. Test Development Associate, Examinations
