# Improving Health Outcomes and Equity by Targeting Postpartum Mothers at Highest Risk

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2021 · $1,274,899

## Abstract

Summary
 Racism is under scrutiny as a fundamental cause of racial-ethnic inequity in maternal morbidity and
mortality, and now, the COVID-19 pandemic is replicating existing structures of inequality and
disproportionately harming communities of color. Current evidence on racism in birthing people centers around
birth outcomes, with little known of its influence on maternal postpartum health, when racial-ethnic disparities in
maternal mortality are widest. Thus, it is urgent to investigate the influence of racism on postpartum maternal
morbidity during the COVID-19 pandemic. To fill this gap, we propose a prospective postpartum cohort
examining the influence of exposure to structural and interpersonal racism and the COVID-19 pandemic on
postpartum maternal health. This goal aligns with that of the parent R01, to identify high-risk women in the
postpartum period and design and implement a behavioral educational intervention to reduce inequity in
maternal mortality and morbidity. We will recruit a postpartum cohort of 400 multiethnic mothers in Philadelphia
and New York City. Our primary aim is to assess multiple levels of racism using contextual and self-reported
measures at delivery, then prospectively follow postpartum patients three months to assess blood pressure
(BP) trajectories, anxiety, depression, and quality of life among. Our second aim is to explore associations
between COVID-19 exposures, including infection or social and economic stress, and postpartum maternal
morbidity outcomes. Finally, we will test if individual or community resilience buffers associations between
racism and postpartum maternal morbidity. The proposed study will provide new evidence of the influence of
perceived and structural racism on postpartum maternal morbidity, with a focus on outcomes with strong ties to
maternal mortality. Our findings will be used to target exposure to racism as a driver of maternal morbidity and
resilience as a modifiable buffer in the design of a multilevel intervention to reduce maternal mortality.

## Key facts

- **NIH application ID:** 10392562
- **Project number:** 3R01MD016029-02S1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Elizabeth A Howell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,274,899
- **Award type:** 3
- **Project period:** 2020-09-18 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10392562

## Citation

> US National Institutes of Health, RePORTER application 10392562, Improving Health Outcomes and Equity by Targeting Postpartum Mothers at Highest Risk (3R01MD016029-02S1). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10392562. Licensed CC0.

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