Our skin color should not determine the quality of your health care. But at the intersection of being Black and being a mother lies a grim question: Why are so many Black women in the U.S. dying from pregnancy-related causes? It is a question reverberating across the nation amid calls for serious investigations into finding the answers – and saving lives.
At the core, these discussions bring to the forefront the disproportionate disparities throughout health care that exist for Black people and other communities of color. Black mothers are not being heard and, in some cases, their complaints are not being taken seriously. They sometimes don’t have access to quality health care. They can suffer from pre-existing conditions that need to be carefully monitored, especially during and after pregnancy. And they need health care professionals who are committed to their wellness, which demands cultural awareness and the acknowledgment of bias – implicit or not.
These inequities are systemic and long-standing, something of which Chicago’s Dr. Lisa Green is acutely aware. “We’ve known these numbers for a while,” she says. “On a national level Black maternal health should be on the fore of platforms – not to be an afterthought, but to be a part of the process of what health care looks like in our community.”
When she saw that unexpected BFP, first-time mom Mya Morenzoni of Bellwood says she felt terrified. As a nurse and wellness blogger at MyaMorenzoni.com, she’s had her finger on the pulse of the Black maternal health crisis and she wanted to make sure she and her baby got the best care possible.
“I wanted to really be heard,” she says.
Moms are dying
Zero to Three’s State of Babies Yearbook 2020 recently reported that the national maternal mortality rate – 17 deaths per 100,000 live births nationally – is higher than those found in other industrialized countries. When broken down, maternal mortality among Black women is more than three times higher (40.8%) than among white women (13.2%) – a gap that has not decreased over multiple decades.
“Researchers have explored connections between health disparities and factors such as poverty caused by parents not earning a living wage, unemployment or underemployment; living in under-resourced neighborhoods; or low-educational attainment. Numerous studies reach the same conclusion: Even after considering the influence of these factors, race accounts for huge differences,” the study found.
ZERO to THREE’s mission is to ensure that all babies and toddlers have a strong start in life, and the institute just added maternal mortality as an indicator to its annual study.
In 2019, the Chicago Department of Public Health released its most recent Maternal Morbidity & Mortality In Chicago report. It found 527 Chicago women experienced severe maternal morbidity, a rate of 74.1 per 10,000 deliveries between the years 2016 and 2017.
Black women experienced it at a higher rate than all other ethnicity groups despite having similar birth rates. The study also revealed that despite having similar birth rates, Black women died during or within one year of pregnancy, almost six times more often than white women.
Jessica Davenport-Williams, co-founder of Black Girls Break Bread, a Chicago-based nonprofit that works to address health disparities to improve the life expectancy of Black Chicagoans, says her work at the local, state and federal levels is focused on preventing Chicago’s Black women from becoming part of those harrowing statistics.
“When I’m advocating, it’s about getting to the root cause,” Davenport-Williams says. “(Black women) didn’t create the systems and the structural racism that impact us. Being able to impact policy and legislation, even being able to impact the education pipeline is important. Being able to address maternal and infant mortality is a very critical movement.”
The education, Davenport-Williams says, is a critical process for health care workers to help alleviate cultural insensitivities that contribute to health care disparities.
Access is another contributing factor to health care disparities that impact Black mothers.
In Chicago, community members were vocal about the closure of several South Side hospitals that provided obstetrics care. In response, Green formed the South Side Obstetrics Synergistic Collaborative, a group of physicians with a mission to bring awareness to the issue on the South Side.
“The purpose is to impact policy change,” Green says. “How do we as a group of physicians create a level of voice that turns into action.”
The collaborative had an early win working with the Department of Health and Human Services to provide all pregnant women in Illinois with a blood pressure cuff, since a common risk factor for Black women is hypertension, which puts them at risk of cardiovascular disease.
Ditching the stereotypes
There are faces behind the data that show Black women are more at risk of maternal mortality or near-death experiences. Misconceptions about moms impacted by those risk factors too easily assume they are low-income or are uneducated. In reality, socioeconomic status, education and even having a family support system hasn’t provided protection for Black women against this crisis.
“I want to cut down on as much of this as possible, and that means looking at all the options. We have to do this now, the new reality,” Morenzoni says, adding that she had to explain to her mom all about the maternal health crisis and why she is going to greater lengths to assemble a team that would support and care for her.
Morenzoni says she understands the health care system is overwhelmed, under stress and workers are underpaid, particularly during the COVID-19 pandemic. But she also wants the best care possible for herself and other moms.
“Moms have power in asking questions and being informed and being an advocate,” she says.
Still, she says moms shouldn’t let the fears overtake the happiness of having a baby.
Even Black celebrities and higher profile moms aren’t immune.
Serena Williams, a multiple Grand Slam tennis champion, had life-threatening complications shortly after giving birth to her daughter in 2017. Initially her concerns weren’t treated with urgency.
Dr. Chaniece Wallace, a chief resident at Indiana University School of Medicine Pediatric Hospital with Indiana University Health Physicians, died last year after giving birth to her daughter and developing preeclampsia. Erica Garner, an outspoken activist about Black maternal health, suffered a heart attack after giving birth to her second child.
A national spotlight
Illinois Congresswoman Lauren Underwood and North Carolina Congresswoman Alma Adams co-founded the Black Maternal Health Caucus so that Black mothers are not alone in advocating for quality health care.
As co-chairs, they are leading the efforts to ensure health care is equitable by working to eliminate the Black maternal health crisis in the United States through the Black Maternal Health Momnibus Act. The act includes a series of 12 bills, sponsored by caucus members, to save lives and help end racial and ethnic disparities in maternal health outcomes.
Among the efforts, the bills will grow and diversify the perinatal workforce, provide funding to community-based organizations working to improve maternal health outcomes and promote equity, and support moms with maternal mental health conditions.
These efforts to remove barriers to unbiased medical care for Black women are a start, Green says.
“I’m grateful that we are now taking a serious look and approach to addressing these issues,” Green says. “I think we have come so far along with modern technology that if we really make this a priority and focus, we can do something about this.”
In April, Illinois became the first state to extend full Medicaid benefits – from 60 days to 12 months postpartum – to reduce maternal mortality.
Meanwhile, as the various legislation works through the systems, it is important that Black women become their own advocate.
Dr. Wendy Goodall McDonald, a board-certified obstetrician gynecologist raised on the South Side of Chicago, says forming that relationship is critical. “If you can’t have a conversation with your doctor – and have them understand your motivation and desires and have you understand theirs and the reason behind the care – it’s not a good relationship,” Goodall-McDonald says. “People of color have to advocate for ourselves.”
Something must be done to protect moms and their babies, says Myra Jones-Taylor, chief policy officer at ZERO TO THREE, in a news release.
“This is an unmitigated crisis that impacts babies and families in every single state in our country, and it has long-lasting impacts throughout our lives,” she says. “If we want to truly address the issues plaguing Black and Brown communities in the United States, we need to start by identifying disparities, addressing them with specific policies and budgets, and making the potential of every baby a national priority.”
Shocking stats
- In Chicago, Black women die during or within one year of pregnancy almost 6 times more often than non-Hispanic white women.
- Nationally Black women die at a 3 times higher rate than the rate of white women.
- 12.1 percent of Black women receive late or no prenatal care, above the national average of 9.9 percent.
- 55 percent of Black moms will experience preterm births and are two times as likely to have babies with low birth weight.
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