It's Time to Step Up for Black Mothers
I started my day today (ironically Martin Luther King Day) reading yet another tragic story about a young black mother who hemorrhaged to death after giving birth in a poor Southern Hospital. In fact 30% of black women reported neglect or mistreatment during their pregnancies according a survey from CDC Vital Signs report.
The maternal death rate increased 53% from 2018 to 2021. Women of color had even worse numbers with the maternal mortality rate among black women increasing from 37 per 100,000 in 2018 to 70 per 100,000 in 2021. That's almost 3X the rate for white women. These numbers are staggering. In case you think that is within the realm of normal...the US maternal death rate is more than 10 times that of other
high income countries. Australia, Japan, Israel, Spain and Austria hovered between 2-3 deaths/100,000.
Why do black mothers have such dismal experiences and mortality? Variations in healthcare, funding of health care, underlying chronic conditions, RACISM, and implicit bias are all contributors. Social and economic disparities are real and deadly. Health insurance coverage may play a big role. Economic instability and the food choices women can access are not as good. Poor communication with health care providers and clinics is a factor. Lack of providers and midwives of color plays a huge role in communication, trust, believing women and addressing their concerns. I could go on and on. Let's quit analyzing the problems and get to some fixes.
We in healthcare need to acknowledge that we have a problem and commit to change.
The repeal of Roe v. Wade is making this worse. Rise up
Hospitals should formulate pregnancy support groups, led by a midwife for women of color so they can discuss concerns and share experiences
Insurers and Medicaid need to provide postpartum home visits and PT/OT universally for women. A new mom's life and body has completely changed and problems like postpartum depression, pelvic floor issues, breast feeding, infection, hemorrhage can be addressed before they take a life. More than 1/2 of all maternal deaths take place after delivery.
The US must provide paid maternity leave. Attention: Women work! Women support their families! More than 120 nations provide paid maternity leave. The USA doesn't.
Health systems must recognize and address what affects maternal death rate for black women:
Immediately develop training and funding for physicians and midwives of color. Get this! Only 5.7% of physicians in the US are Black. More than 90% of all midwives are white. Racism and financial pressures are faced by midwives in training. Getting preceptorships often requires moving to get the training and financial support is not provided. Out of 4,000 midwife students, only 22 received scholarships and less than 400 were awarded loan repayment support.
Affirmative action was overturned by the Supreme Court in 2023. California was a test case on how this will turn out as prop 209 outlawed it in 1996. Undergrad enrollment of unrepresented minorities fell 40% at UCLA and Berkeley. In 2021 only 3% of the States physicians were black, despite the California medical schools initiating other socioeconomic admission criteria to increase diversity. When you look at the health care priorities we have, its not a surprise that we have a BIG Problem.
We can do better.
If you have read this far, please stay educated, vote progressively. We owe our Black mothers more. We owe our society more. We owe ourselves more.
