Advocating for Black Maternal Health

Black Moms Are Dying…What Are We Doing About It?

In the richest nation on earth Black moms in the U.S are dying during and after childbirth at 3 to 4 times the rate of their white counterparts. The United States lags behind many other countries in this area and the Centers for Disease Control and Prevention (CDC) estimates that about 60% of maternal deaths in the U.S. are preventable¹. There are a multitude of contributing factors which have been linked to maternal mortality, some of which include:

1. Black women having higher rates of chronic conditions (e.g., heart disease, diabetes, and hypertension) and experiencing poorer preconception health than white women. ^2,3
2. Implicit bias – the attitudes or stereotypes that affect an individual’s understanding, action, and decisions in an unconscious manner – on the part of health care professionals resulting in unfair treatment of patients based on race, gender, age, or appearance.

More than 1 in 5 pregnant black women have been the victims of racial

discrimination during obstetric care⁴. Experiencing racial discrimination is not only stressful but can deter women from going to postnatal visits and also influence the recommendation of procedures such as Cesarean sections, which were more common among black women than white women.⁵

To address this crisis Representatives Lauren Underwood & Alma Adams, Senator Cory Booker, and Members of the Black Maternal Health Caucus have introduced the Black Maternal Health Momnibus Act of 2021 which will address the black maternal health crisis. This comprehensive act will:

BILL SUMMARY

1. Make critical investments in social determinants of health that influence maternal health outcomes, like housing, transportation, and nutrition.
2. Provide funding to community-based organizations that are working to improve maternal health outcomes and promote equity.
3. Comprehensively study the unique maternal health risks facing pregnant and postpartum veterans and support VA maternity care coordination programs.
4. Grow and diversify the perinatal workforce to ensure that every mom in America receives culturally congruent maternity care and support.
5. Improve data collection processes and quality measures to better understand the causes of the maternal health crisis in the United States and inform solutions to address it.
6. Support moms with maternal mental health conditions and substance use disorders.
7. Improve maternal health care and support for incarcerated moms.
8. Invest in digital tools like telehealth to improve maternal health outcomes in underserved areas.
9. Promote innovative payment models to incentivize high-quality maternity care and continuity of insurance coverage from pregnancy through labor and delivery and up to 1 year postpartum.
10. Invest in federal programs to address the unique risks for and effects of COVID-19 during and after pregnancy and to advance respectful maternity care in future public health emergencies.
11. Invest in community-based initiatives to reduce levels of and exposure to climate change-related risks for moms and babies.
12. Promote maternal vaccinations to protect the health and safety of moms and babies.

Passing this legislation will be a move in the right direction to protect our black mothers, but no matter what the work will continue, and we need to be prepared to advocate for our own health in light of biases, racism and other factors which can lead to maternal mortality and other complications. To follow this legislation, go to Congress.gov and search for S.346 – Black Maternal Health Momnibus Act of 2021.

To learn more about what you can do to advocate for yourself and others check out the new CDC “Hear Her” campaign, which focuses on raising awareness of potentially life-threatening warning signs during and after pregnancy and improving communication between patients and their healthcare providers.

SOURCES

Petersen EE, Davis NL, Goodman D, Cox S, Mayes N, Johnston E, et al. Vital signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017. Morb Mortal Wkly Rep. 2019;68(18):423–9.

Louis JM, Menard MK, Gee RE. Racial and ethnic disparities in maternal morbidity and mortality. Obstet Gynecol. 2015;125(3):690–4.

Sakala C, Declercq ER, Turon JM, Corry MP. Listening to mothers in California: a population-based survey of women’s childbearing experiences. 2018. https://www.chcf.org/wp-content/uploads/2018/09/ListeningMothersCAFullSurveyReport2018.pdf. Accessed 9 Apr 2020.

Attanasio L, Kozhimannil KB. Health care engagement and follow-up after perceived discrimination in maternity care. Med Care. 2017;55(9):830–3.

Roth LM, Henley MM. Unequal motherhood: racial–ethnic and socioeconomic disparities in cesarean sections in the United States. Soc Probl. 2012;59(2):207–27.

Featured Photo Cred: Mateus Campos