Birth/Maternity

What Is Known

Environmental and social factors influence maternal health behaviors and health status. These factors include access to health care and subsequent developmental screening/early intervention services, education, employment, economic opportunities, social support, and availability of resources to meet daily needs. The factors that influence maternal health also affect pregnancy outcomes and infant and child health. Racial and ethnic disparities exist in maternal, infant and child mortality and can be partly attributed to disparities in social determinants of health. Children’s health status varies by both race and ethnicity, as well as by family income and related factors, including educational attainment among household members and health insurance coverage. Other factors related to child health status include access to high-quality health care and maternity care practices that promote breastfeeding and safe sleep environments. The cognitive and physical development of infants and children are influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood.

Who Is at Risk

Many factors affect pregnancy and childbirth, including:

• Preconception health status
• Maternal age
• Access to appropriate preconception and interconception health care
• Poverty

Infant and child health are similarly influenced by sociodemographic factors, such as family income, but are also linked to the physical and mental health of parents and caregivers.

There are racial and ethnic disparities in mortality and morbidity for mothers and children. These differences are likely the result of many factors.

Social Determinants of Maternal Health
These include pre-pregnancy health behaviors and health status, which are influenced by a variety of environmental and social factors such as access to health care and chronic stress.

Physical Determinants of Maternal Health
Common barriers to a healthy pregnancy and birth include lack of access to appropriate health care before and during pregnancy. In addition, environmental factors can shape a woman’s overall health status before, during, and after pregnancy by:

• Affecting her health directly
• Affecting her ability to engage in healthy behaviors

Social Determinants of Infant and Child Health
The social determinants that influence maternal health also affect pregnancy outcomes and infant health. Racial and ethnic disparities in infant mortality exist, particularly for African American infants. Child health status varies by both race and ethnicity, as well as by family income and related factors, including educational attainment among household members and health insurance coverage.

Physical Determinants of Infant and Child Health
The cognitive and physical development of infants and children is influenced by the health, nutrition, and behaviors of their mothers during pregnancy and early childhood. Breast milk is widely acknowledged to be the most complete form of nutrition for most infants, with a range of benefits for their health, growth, immunity, and development. Also, children reared in safe and nurturing families and neighborhoods, free from maltreatment and other social adversities, are more likely to have better outcomes as adults.

Emerging Issues in Maternal, Infant, and Child Health
Recent efforts to address persistent disparities in maternal, infant, and child health use a “life course” perspective to health promotion and disease prevention. Fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of public health concerns. In response, preconception health initiatives focus on improving the health of a woman before she becomes pregnant through a variety of evidence-based interventions.

The life course perspective also supports the examination of quality of life, including the challenges of male and female fertility. An estimated 7.3 million American women ages 15 to 44 received infertility services (including counseling and diagnosis) in their lifetime. Infertility is an area where health disparities are large and may only continue to increase as childbearing practices change over time.

How To Reduce Risk

The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality care preconception (before pregnancy), during pregnancy, after the baby arrives, and interconception (between pregnancies).

• Health care before pregnancy can assist future parents in obtaining optimal health before conception.
• During the pregnancy, health care allows adequate monitoring of the infant and mother’s health and reduces the risk of developmental issues. Health care providers can provide needed vaccinations, order blood tests, monitor blood pressure and blood sugar to check for gestational diabetes, screen for HIV and other services to assure optimal health for mother and baby. Mothers can support their pregnancies by taking folic acid, eating a healthy diet, getting appropriate exercise, controlling their weight gain, avoiding exposure to certain chemicals and radiation, and abstaining from tobacco, alcohol, and other drugs.¹
• Post-pregnancy, health care providers can screen and monitor the health conditions of the infant and mother.² Practices such as breastfeeding, sleep positioning, and use of child safety seats are important ways parents can safeguard their baby’s health.

Page last updated July 29, 2022.