Bills to Fix NC’s Black Maternal Health Crisis Haven’t Received Votes

Wide-ranging legislation in North Carolina languishes as more women die unnecessarily from pregnancy-related complications.

More women in the United States die unnecessarily from pregnancy-related complications than in any other wealthy country in the world—and the problem is even worse in North Carolina. 

The US maternal mortality rate is 45.5 deaths per 100,000 live births. In North Carolina, it’s 68.1, a News and Observer analysis showed last month.

The dangers, however, are not uniform. Black women are three-to-five times more likely to die in or soon after childbirth than white women, regardless of income level, insurance, or college degree. 

There are several reasons for the disparity, but one of the biggest is that Black women are less likely to be taken seriously by their doctors in an emergency. 

In 2018, Tomeka Isaac almost became part of the statistic. 

‘The Medical System We Trusted Failed Us’

Isaac, a native of Kenansville, told her story during a Black maternal health panel last year. 

“At 35 weeks I was into what I thought was an amazing, normal pregnancy,” Isaac said of her pregnancy with her son, Jace. 

She lost consciousness at home and was rushed to the hospital. Jace no longer had a fetal heartbeat.

Doctors told her Jace had died in utero and that she had a dangerous form of preeclampsia. A blood or urine test could have told her much earlier in her pregnancy that she was at risk, but her doctors never ordered them, she said. 

“Jace died because I had not received quality, routine, prenatal care. I almost died because for more than three hours, the hospital failed to give me a CT scan which would have shown I was bleeding internally,” Isaac said.

She had seven surgeries in 45 days. She could not attend Jace’s funeral.

“I have two masters’ degrees and over a decade of professional experience,” Isaac said. “I had private insurance, never missed a prenatal appointment and had no preexisting conditions, but none of that protected me or my baby.”

She added: “The medical system we trusted failed us.”

Some Success in Congress

The issue receives annual coverage in the news media, including last month in a deeply reported series by The News and Observer, and last year by Cardinal & Pine.

North Carolina Democrats are among those trying to solve the problem.

US Rep. Alma Adams, who represents Mecklenburg County, helped lead a summit in Washington DC on Tuesday to highlight the problem and the solutions waiting to be deployed. 

Adams, Sen. Cory Booker of New Jersey and others co-sponsored the 2021 Momnibus Acts, a collection of bills in the House and Senate that would make huge investments to bring the death rates down.

While the package has not gotten a vote as a whole, many of the individual pieces have passed the House and languished in the Senate, and some measures passed both chambers and were signed into law.

Though no Republicans co-sponsored momnibus acts overall, there was bipartisan support for increasing maternal health care for veterans, so the House and Senate put those provisions in a separate bill which passed and was signed into law by President Biden in 2021.

Both chambers also passed a spending bill last year for Fiscal Year 2023 that included some other Momnibus priorities, like funding for increased maternal mental health services and for community groups.

NC’s Efforts Have Stalled

There has been less movement in the state legislature.

Democratic state Senators Natalie Murdock, Sydney Batch and Gladys Robinson, introduced similar legislation in the General Assembly, but it too has not been taken up by leadership.

While some provisions to address maternal health were included in the state’s new 12-week abortion ban, they are nowhere near enough, state Democrats say.

“Fund Black maternal health support because mothers and babies are dying,” Murdock said at an abortion rights rally in May. “Fund paid family leave so Black people don’t lose their jobs simply because they are sick. Provide access to contraceptives so that people can have full control over if and when they have children. Don’t hide it in a monster abortion bill. Do it because we should do it and should have done it a long time ago.”

Here’s a look at the Momnibus Acts and the status of each provision.

Federal:

• Invests in fixing areas that contribute to high death rates, like inadequate housing, transportation, and nutrition services. (Has not become law)
• Extends eligibility for postpartum women who get benefits from the Women, Infants, and Children (WIC) food assistance program. (Has not become law)
• Funds community-based organizations working to improve maternal health outcomes. (Passed into law in 2022 as part of a larger spending bill)
  
• Increases funding for veterans’ maternal health care. (Passed into law in 2021 as the Protecting Moms who Served Act)
• Improves data collection and access to digital health options in rural areas. (Has not become law)

State:

• Creates a state-funded grant program to expand organizations working to prevent maternal deaths among Black women. (Has not become law)
• Helps communities access the grants program. (Has not become law)
• Improves parental access to lactation services, child care, and wellness-programs. (Has not become law)
• Establishes implicit-bias training for physicians. (Has not become law)
• Extends Medicaid coverage to pay for doulas to better advise and advocate for mothers. (Has not become law)

[An earlier version of this article referred incorrectly to the status of the US Momnibus Act in Congress. While the overall package has not gotten a vote, some individual provisions have passed the House and/or Senate in separate bills.]