Racial disparities in maternal care have been an issue for decades—and for decades, many politicians were content with ignoring the issue or made decisions that actively exacerbated inequality. But in recent years, there has been a sea change nationwide as more elected officials at every level of government have committed themselves to addressing black maternal care. Not surprisingly, the driving force behind this newfound political will are black women.
Congressional Reps. Lauren Underwood (D-Ill.) and Alma Adams (D-N.C.) founded the Black Maternal Health Caucus last year to elevate the issue of maternal disparities on Capitol Hill. According to the most recent statistics, black mothers will die from pregnancy-related causes at 2.5 times the rate of white women. This is actually an improvement over the preceding decade, where black mothers died at 3 to 4 times the rate of white mothers—the largest gap between all races and ethnicities in the U.S.
The Black Maternal Health Caucus created a coalition of representatives eager to track the racial disparities and develop evidence-based, community-focused policy solutions to improve maternal health outcomes among black parents. As the Caucus recently announced, in just one year it has added more than 100 congresspeople from both sides of the aisle to its cause.
Last month, the caucus, led by Reps. Underwood and Adams, alongside Rep. Ayanna Pressley (D-Mass.), and Sen. Kamala Harris (D-Calif.), unveiled a groundbreaking set of proposals designed to “comprehensively improve” health outcomes for black parents and their infants.
The legislation comprises nine individual bills with distinct goals and populations. Among them are providing funding to community-based organizations working to improve maternal health outcomes, especially for black women; growing and diversifying the perinatal workforce (meaning, making sure people of all backgrounds are represented in medical care, as well as birth care—which includes doulas and midwives); extending and improving maternal care for people who are incarcerated; and improving data collection so the maternal health crisis can be properly tracked.
“The Momnibus provides a new roadmap to ensure our healthcare systems, providers, and society truly make black maternal and infant health a priority. This legislation says, unequivocally, that black moms matter,” Rep. Adams said at the time. Despite the novel coronavirus dominating much of the news cycle this week, the caucus recently hosted a teleconference to mark Black Maternal Health Week and discuss the progress it has made on ensuring fair, equitable care.
There has also been substantial movement on maternal care at the state and local level. At a gathering of progressive elected officials held earlier last year, a number of black women listed the maternal health gap as a key concern of theirs. One of them, Maryland State Rep. Jheanelle Wilkins, successfully passed two bills last year that track maternal mortality more robustly than in years prior: requiring pregnancy-related deaths to be broken down by race in all reporting, requiring oversight programs to deliver recommendations for reducing the number of maternal deaths, and allowing counties to build local teams to further study pregnancy-related deaths in their area.
This is a necessary response to an onslaught of legislation that has placed black families—and black mothers in particular—at risk, like the ongoing erosion of programs like Medicaid, nutrition assistance, or Temporary Assistance for Needy Families. Because of economic policies that have stifled the economic growth of black families for generations, black households are overrepresented in terms of relying on these programs to stay healthy.
But maternal care is an issue that cuts across class and education levels. And as Sen. Harris recently pointed out in her op-ed series for Essence, the same chronic conditions that make COVID-19, the disease caused by the coronavirus, more deadly for African Americans, also make childbirth more risky. Black patients of all backgrounds also have to confront medical bias when they are seeking out care.
“We must acknowledge that there are two problems when it comes to black maternal mortality: ongoing systematic disparities and implicit bias. And we need solutions to address both,” Harris wrote.
The California senator reintroduced her Maternal CARE Act to the Senate last year. The bill includes $25 million in direct funding to medical schools, nursing schools, and other health professional training programs that implement evidence-based implicit bias training, so health care providers can better treat black parents. Bills like these are more urgent than ever, Harris implores.
“Black women can’t afford not to be heard when their lives and babies are on the line, but they especially can’t afford to be shut out when we are going through a pandemic,” wrote Harris.
Systemic problems require bold, visionary changes. As of last year, the U.S. was one of only 13 countries in the world where maternal mortality rates were worse than they were 25 years ago. Making healthcare kinder and safer for black parents means ensuring the health and safety of black children; and the kinds of policies and resources that make this possible are the very same solutions that make Americans of all backgrounds healthier. Thanks to a growing crop of black women in leadership, we finally have a real shot at reversing the tide.