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By Vernice Anthony, BSN, MPH, CEO, VDA Health Connect Consultant, SEMPQIC
Black women have been on the front lines, providing leadership and making sacrifices for every movement from civil rights to being the backbone of the black church, including the creation of the Black Lives Matter movement and assuring voting rights in Atlanta and across the country. Now is the time to prioritize the lives of black mothers and make certain they have the rights, respect and resources to thrive throughout their lives, including their reproductive lives and their childbirth journeys.
Black mothers in the US are dying in childbirth at greater rates than in many undeveloped countries. Covid-19 disparities in cases and deaths has certainly increased general awareness of the injustices in health care that has existed since slavery but hidden within all of this new data is the ugly truth that black families are losing their mothers at three times the rate of white families. Shockingly, the maternal death rate of black mothers has been increasing within this past decade.
According to the World Health Organization, maternal mortality is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or it’s management, but not from accidental or incidental causes”.
As we approach Mother’s Day and the closure of “Black Maternal Health Week”, it’s time to reflect and take action to reverse this awful trend. “Every mother and baby in Michigan should have the same opportunity to achieve optimal health and positive birth outcomes regardless of race, ethnicity, community or residence, insurance coverage or hospital of delivery…” according to Governor Whitmer in her proclamation in support of Black Maternal Health Week this year.
While we have spent many years blaming the victim: ”they” are too lazy to keep their appointments, “they” don’t care about their babies, “they” must be on drugs or uneducated.
The reality is that white mothers in rural and suburban communities use opioids more than black mothers in urban areas, like Detroit, and white women also have a higher rate of smoking. In fact, based on Michigan’s Vital Records we know that black mothers with a college education have more than 2 times the risk of dying, from giving birth, than a white mother with less than a high school education, even when insurance coverage or income is not a problem.
Data has documented the impacts of stress caused by daily life problems, including racist microaggressions in the workplace and police violence in communities. These stressors and anxieties are certainly exacerbated today, as we follow the news on the killing of Daunte Wright, George Floyd and many other unarmed black men, women and children. Stress related to poor quality healthcare, lack of childcare and financial worries also contributes to the poor health outcomes. Something as simple as being heard by health care professionals is actually a critical component in positive care outcomes. In fact, the 2018 Michigan Pregnancy Risk Assessment Monitoring System reported that mothers in the City of Detroit report feeling disrespected at their medical appointments, dissatisfied with the advice they receive and less satisfied with their birth experience more than mothers in other parts of the state.
We know that Social Determinants of Health (SDOH) such as education, housing, poverty, unsafe environment, including police shootings, all of which are rooted in systemic racism in our country, and within our healthcare delivery system, play a huge role in creating these disparities. We also know that the primary clinical causes of black maternal deaths are infections, heart damage, high blood pressure and hemorrhage. Health care professionals know what to do to prevent and treat the conditions that result in these devastating losses, but these lifesaving treatments are not applied equally to black women.
Reliable research has documented that healthcare providers often have internalized implicit biases against black patients that impacts the service they provide. While implicit bias may be unintentional, the outcomes are still the same. Particularly, in the perinatal system of care, implicit bias has resulted in black women often not being ‘listened to” by their providers. This type of disrespect, not being heard or listened to, is the cornerstone of the message from Serena Williams, a national tennis icon, who had severe birth complications that could have resulted in death. Charles Johnson, the husband of Kira Johnson, who died after childbirth, is traveling the country advocating to rectify maternal health policies and regulations to reduce maternal deaths. By the time staff responded to his calls for attention, Kira Johnson had been allowed to bleed internally for 10 hours, resulting in her tragic and unnecessary death.
Governor Whitmer’s executive order on requiring Implicit Bias Training in medical school curriculums and requirements for healthcare licensure is a definite step in the right direction, and some black women are seeking out alternative models of care through doulas, support partners and midwives, who empower them throughout their pregnancy and beyond. However, much more has to be done to improve outcomes for black mothers.
A call to action should include support for programs that empower black women, greater emphasis on providers to “listen & hear” black mothers, more black physicians, nurses and other providers, more mental health support and access to quality day care. However, for sustainable improvements, more programs would never be enough. We must speak up and become a force, along with other advocacy groups fighting for birth justice and to dismantle systemic racism wherever possible.
Specifically, call your congress person and voice your support for S.346 Black Maternal Health Momnibus Act of 2021, which is now in committee in the House. This bill makes critical investments in social determinants of health to comprehensively address every dimension of the black maternal health crisis in America.
We must accept that systemic racism has permeated our health care delivery system and is contributing to the disparities that we are all concerned about. Also, we must individually and collectively value all mothers and babies in a way that assures black mothers, too, have the opportunity for happy and healthy birth outcomes, making birth justice our mutual goal.
We invite everyone to join us for a FREE virtual screening of ‘TOXIC: A Black Woman’s Story’, a short film that addresses racism, toxic stress and birth outcomes and how are these things intertwined. A post-screening discussion will follow including a call to action.
Thursday, May 6 at 6:30 p.m.
Hosted by the Southeast Michigan Perinatal Quality Improvement Coalition (SEMPQIC)
Registration is required:
https://us06web.zoom.us/webinar/register/WN_Qj7V1nzLRpyYXeu0vm_MUg
In addition, you may visit www.MDHHS – Maternal & Infant Health (Michigan.gov) for information, resources and ways to take action and www.cdc.gov/HearHer to get access to the CDC campaign to empower women of color and increase provider awareness.
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