Biden campaign hosts roundtable on Black maternal health

Black women account for 43% of pregnancy-related deaths in North Carolina. In Durham this week, a group of healthcare advocates and elected officials discussed the growing crisis of Black maternal mortality. 

The Biden campaign hosted a roundtable focused on Black maternal health in Durham on Wednesday to commemorate Black Maternal Health Week. 

The event was attended by elected officials and experts in the field of maternal health, and moderated by State Rep. Renée Price, a Democrat who represents parts of Orange and Caswell counties.

Attendees included Tomeka Isaac, who founded Jace’s Journey, a nonprofit whose mission is to address racial disparities in maternal health; Nimasheena Burns, the Vice Chair of the Durham County Board of Commissioners; Joy Spencer, the Executive Director of Equity Before Birth; Tina Sherman, the National Director of Moms Rising, and a birth doula; and Maya Jackson, a community doula and Black maternal health advocate.

Support for Black maternal health

In North Carolina, Black women disproportionately die as a result of pregnancy. 

“Despite Black people comprising only 22% of North Carolina’s population, Black women accounted for 43% of pregnancy related deaths between 2020 and 2022,” Rep. Price said.

The Centers for Disease Control and Prevention (CDC) says that 80% of pregnancy related deaths are preventable, and 53% of postpartum deaths occur within the first year after birth.

Jackson said that a lack of health insurance or postpartum treatment leads to pregnancy complications occurring under the radar, with some women even developing diseases and serious medical issues. 

“Increased hypertension, diabetes. Depending on how your delivery went, you’ve probably developed obstruction in your abdomen, pelvic floor issues…with these issues a lot of times people didn’t have insurance.”

When Vice President Kamala Harris visited Raleigh in March, she touched on the racial disparities in postpartum deaths. 

“Black women are three times as likely to die in connection with pregnancy, Native women twice as likely to die in connection with pregnancy, rural women one and a half more times as likely to die,” Harris said.

The Biden administration has made addressing the disparities in maternal health a key priority and invested in efforts to improve maternal health and Black maternal health outcomes. 

One step the administration took was pushing states to expand postpartum care for Medicaid recipients from 60 days to 12 months a move the Biden administration projects will impact roughly 65% of Black births. So far, 45 states have taken this step, including North Carolina.

North Carolina’s expansion of Medicaid has increased healthcare enrollment by over 400,000 people, providing many with a lifeline to medical treatment. 

“I think it’s amazing… postpartum is a very tricky period. A lot of maternal deaths happen in postpartum. To have that six week visit, and that be it, is very dangerous,” Isaac said.

“That year, 365 days postpartum, is when most maternal deaths occur. So we know in having that care, we are going to reap the benefits over and over and over again,” Sheman added.

She believes this expansion of care for Medicaid recipients could have a particular benefit in North Carolina.

“Medicaid covers almost 50% of births in this state,” Sherman explained.

How the overturning of Roe v. Wade impacts women’s health

In the two years since Roe was overturned by the US Supreme Court, abortion rights have been restricted across the country. In North Carolina, the state legislature passed a law last May that banned abortions after 12 weeks, with exceptions for cases of rape and incest up to 20 weeks, for fetal anomalies up to 24 weeks, and to preserve the life of the mother throughout pregnancy. 

These bans not only impact women seeking abortions, but exacerbate maternal mortality issues by reducing healthcare access for women who want to give birth. 

The University of Colorado estimates that if all abortions in the United States were banned, maternal deaths would increase by 24% nationwide, and that figure would be 39% higher for Black women. 

Jackson says these restrictions have forced women to leave the state to seek abortion care.

“Now we get phone calls with families who are now traveling to Pennsylvania and other states because they have now found out that the child is either at the point of demise, or not going to be viable once they come out of the womb. Because of the period of time that is continuing to decrease, a lot of our families are scrambling to find options, and are leaving out of the state to seek medical care,” she said. 

In the month after the state’s abortion restrictions took effect, the number of abortions performed in North Carolina declined 31%. 

Sherman has heard from providers who worry about their ability to continue practicing medicine in the state, potentially leading to further issues for patients and worsening the state’s maternal mortality crisis. 

“We can’t afford to lose any more providers. In fact, we need to have more providers that meet the needs of these families,” she said. 

Racial disparities in healthcare

The women noted that a consistent issue Black women face when dealing with doctors and healthcare providers is not being listened to, and misconceptions about Black women persisting. This has led some Black women feeling unsafe when dealing with doctors and healthcare providers.

“We’ve gotten calls at Equity before that say, ‘look, I’m having this baby at home, can you come and catch this baby? I refuse to step into the hospital,’ and that’s not safe. That’s not okay, but they are terrified. They’d rather sit at home and take the risk than even try to enter into a hospital setting, and we really have to change that,” Spencer said.

For people seeking to have a home birth, it isn’t always easy. 

“We only have 10 midwives who can practice across the state of North Carolina. So, there’s a lot of people who want to home birth, but they can’t get access to it since we don’t have enough providers,” Jackson said. 

In fact, until last year, midwives in North Carolina weren’t allowed to practice without the supervision of a physician.

Commissioner Burns recalled her own experiences with physicians where preconceived notions were expressed.

Burns, who needed fibroids removed, sought out the best surgeon to perform the procedure. When she explained her situation to one, and they replied saying, “‘You’re female, you’re Black, you’re big, it’s southeastern North Carolina, honey you drew the short end of the stick,” she remembers them telling her.

Jackson says that racism has played a major role in the lack of healthcare access in parts of Eastern North Carolina, and that all people in these communities lack sufficient resources as a result.

“Everytime there’s some type of policy that is going to be anti-Black, it then creates an exclusion for every other group. When you think about how the grand midwives were drastically removed from the south, that drastically disrupted birthing for not Black people, but also white people,” she said.

“There should be no reason why folks in Hoke County, or in Columbus County have to drive almost two hours just to be able to give birth. Same with the northeastern part of the state. All these rural healthcare gaps, these deserts, it’s because of these policies that were anti-Black, that trying to put restrictions on the movement of Black bodies, it’s now creating a ripple effect.”