Landmark Legislation Seeks to Reduce Black Maternal Health Risks

The Black Maternal Health Caucus unveiled a package of bills this week that aims to comprehensively improve health outcomes for Black mothers.

Sekesa Berry knows firsthand how significant the disparities are between Black and white mothers in the delivery room. As the director and founder of the Atlanta Doula Collective, Berry, who has worked as a doula since 2006, supports every mother in her care, but has had to work harder for Black moms. 

“I think what stands out the most to me, in my line of work, is the difference I see in care for white women and Black women,” she told COURIER. “I certainly have to advocate more for Black moms and their birth plans in most circumstances. Over the years, I’ve learned through working with white women that they’re offered actual choices—and those choices are accommodated, like whether they want the hepatitis B vaccine, azithromycin in the newborn’s eyes, and what they want to do with the placenta—that were denied to Black mothers.”

The United States is the most dangerous place to give birth among developed nations, and, for Black mothers in particular, statistics are especially bleak. After wrestling with this horrifying reality for several years now, lawmakers have introduced a sweeping new set of bills this week to address the Black maternal health crisis.

On Tuesday, Reps. Lauren Underwood (D-IL), Ayanna Pressley (D-MA), Alma Adams (D-NC), Sen. Kamala Harris (D-CA), and members of the Black Maternal Health Caucus unveiled the “Black Maternal Health Momnibus Act of 2020.” Through nine separate bills, the legislation aims to comprehensively improve maternal health outcomes and close racial disparities in outcomes.

“The Black Maternal Health Momnibus is a historic piece of legislation that not only fills existing gaps in maternal health care, but also works to address pervasive maternal health disparities through solutions that are culturally-congruent and proven effective,” said Rep. Adams, co-founder and co-chair of the Black Maternal Health Caucus, in a statement. “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.”

In 2019, the National Center for Health Statistics released numbers for the national mortality rate. Based on data from 2018, the research shows that deaths caused or aggravated by pregnancy were estimated at 17 maternal deaths per 100,000 live births, after an estimated 658 women died. The same data shows that Black women fared the worst in terms of the national maternal death rate, dying 2.5 times more often than white women—at 37 deaths per 100,000 births. 

Historically, Black women have had the highest maternal mortality rates of any race or ethnicity. Many variables contribute to these statistics, such as institutional racism and implicit bias in the health care system, lack of access to quality prenatal care, and Black women’s increased susceptibility to certain health conditions like hypertension. 

The Momnibus Act aims to help prevent cases like that of Shalon Irving, an epidemiologist at the Centers for Disease Control and Prevention, lieutenant commander for the Commissioned Corps of the U.S. Public Health Service, and a single mother living in Atlanta.

Irving gave birth to her daughter Soleil in January 2017. In the weeks after her delivery, Irving suffered multiple complications—a painful infection that caused lumps to develop along her C-section incision, spikes in her blood pressure, chronic pain, persistent headaches, and swelling in her legs, according to media reports. 

Because she suffered from a blood-clotting disorder and her health history included fertility struggles and a surgery to treat fibroid tumors in her uterus, Irving likely needed more in-depth follow-up care and monitoring after Soleil’s birth. Within three weeks, however, Irving collapsed from cardiac arrest and was rushed to the hospital, where she later died from complications of high blood pressure. 

“There’s no manual for overcoming the death of a child, especially when you know that her death could have been prevented if her complaints had been heard,” her mother Wanda Irving said during a symposium held at the Johns Hopkins Bloomberg School of Public Health last year.

A summary of the Momnibus Act outlines nine key areas the legislation seeks to address. For example, social determinants such as housing, transportation, food and childcare all impact health, and addressing barriers to these issues could have a profound effect on Black women. As such, the lawmakers want to establish a “Housing for Moms” task force in the Department of Housing and Urban Development; expand the eligibility period of WIC (the federal assistance program that helps low-income pregnant women, breastfeeding women, and children under the age of five have access to nutritious food); and create a program that lets women drop their kids off for free childcare services whenever they have a prenatal or postpartum doctor appointment. 

Another bill in the package seeks to provide funding to community-based organizations that directly work to improve maternal health outcomes for Black women while also working to diversify the perinatal workforce so all American mothers can receive maternity care and support from people they trust.

“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.”

Reforming maternal healthcare for incarcerated women and veterans are also on the list of priorities, as well as investing in mental healthcare and substance abuse disorder treatments for mothers.

Importantly, the Momnibus Act also calls for bias training for all providers and staff who work in a maternal healthcare setting. The American College of Obstetricians and Gynecologists said in a 2017 statement of policy that maternal health disparities “cannot be reversed without addressing racial bias” and the “structural institutional racism that contributes to and exacerbates these biases.” 

The landmark legislation is endorsed by 93 maternal health and healthcare organizations, including the March of Dimes, Center for Reproductive Rights, the Black Mamas Matter Alliance, and the American College of Obstetricians and Gynecologists.

 “Black women are dying at higher rates than all other races, which is unacceptable,” said March of Dimes President and CEO Stacey D. Stewart in an emailed statement. “Almost two-thirds of maternal deaths are preventable. Now is the time to enact policies that will eliminate disparities and improve health outcomes for women of color.”

The Atlanta Doula Collective also endorses the proposed policies. “This legislation is the most comprehensive effort yet to address the crisis of Black maternal mortality in the U.S,” Berry said. “It will grant women in our community greater access to a more diverse spectrum of better quality perinatal care, which will evaluate need assessments and offer applicable resources such as doulas, midwives and mental health therapists.” 

“The Black Maternal Health Momnibus Act,” she added, “is … long overdue.”