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Why Giving Birth Is Deadly for Black Women ... and Why It Might Get Worse

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Mothers dying during pregnancy and childbirth is a crisis most Americans believe impacts only countries experiencing extreme poverty with shortages of food, health care providers, medicine, water and housing.

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Most people think of developing or war-torn nations where there are inadequate hospitals and little government infrastructure. But when it comes to maternal health and mortality in the United States, we need to think again.

This deadly reality unfolds in the apartheidlike health outcomes experienced by black women, in which the difference between life and death for a mother and her newborn is too often determined by the color of her skin. The maternal mortality rates among black women in the United States are simply terrifying: Black women are between three and four times more likely (pdf) to die from pregnancy-related causes than white women.

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Shockingly, these numbers hold true across all education levels, even after controlling for differences in socioeconomic status. It is this disproportionate risk that black women face during pregnancy and childbirth that drives the maternal mortality crisis in the United States, in which black mothers and their babies experience rates of death and disease virtually nonexistent in most developed nations.

Across race, the maternal mortality rates in the United States are already at alarming levels: According to the World Health Organization, the U.S. is one of only 13 countries in the world where pregnancy-related deaths are actually on the rise, and it has the worst rate of maternal deaths in the developed world. In fact, American women are more likely to die from pregnancy-related complications than women in 45 other countries, including the United Kingdom and much poorer nations like Libya and Kazakhstan.

The crisis in this country is getting worse: Both the likelihood of experiencing a severe pregnancy complication and dying from it are on the rise (pdf).

If the state of maternal care in the U.S. is abysmal for America’s women, the health care system fails black mothers and their babies the most. Our nation’s enduring legacy of systematic racism against black people has deep roots in virtually every sector of society—including health.

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Racial health disparities are as wide as they were in the 1930s, and let us not forget this country’s history of using and abusing black female bodies at the expense of their reproductive health. From a brutal system of slavery and segregation that robbed black women the chance of healthy motherhood to Jim Crow-era forced sterilization and inhumane gynecological medical experimentation, black mothers’ human right to have access to quality health care has always been under threat.

It comes as no surprise that a study from as recent as 2016 showed that a disturbing number of medical professionals polled held wildly racist views about their black patients, such as the false beliefs that black people feel less pain than whites and that their blood coagulates faster—resulting in lack of proper treatment and care.

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Every mother has the right to quality and equitable maternal health care. Fundamental human rights protections, such as those enshrined in the International Covenant on Economic, Social and Cultural Rights—signed by virtually every country on the globe—ensure that women’s experiences of pregnancy and childbirth care are rooted in principles of equality and nondiscrimination.

Even the international community has raised concern over the maternal mortality rate of black women in America. In September 2014, a United Nations committee (pdf), troubled by the persistently high rates of maternal mortality among black women, called on the United States to eliminate racial disparities in health in order to fulfill its international human rights obligations.

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Medicaid covers nearly half of births in the U.S. And while its imminent gutting has been halted, Medicaid is still in the crosshairs. The conditions that enable black women in this country to support healthy pregnancy and childbirth are almost impenetrable, and the ongoing Republican health care agenda’s proposed slashes to health services would very likely increase the body count of black mothers and their newborns. 

Let’s be clear: Black Moms Matter, which is why MomsRising members and mothers across the nation are fighting back as our elected officials attempt to gut the health care system and worsen our nation’s already abysmal track record on maternal health. Now is the time to expand health access—not cut it. Until black mothers are able to achieve their best health, access to quality care is not just a health issue, but also a racial-justice one.

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Monifa Bandele is a vice president at MomsRising and leader of the Healthy Kids Programs. She was previously the director of organizing for the Urban Homesteading Assistance Board, a national field director for the Brennan Center for Justice, a director of development and communications for the People’s Hurricane Relief Fund, and a senior programs manager at the National Coalition on Black Civic Participation. Bandele has been interviewed by several major media outlets, including MSNBC, CNN, Essence magazine and TV One. She currently sits on the board of the Brooklyn Movement Center. 

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DISCUSSION

rockoutwithyourbockout
rockoutwithyourbockout

I’m not a medical professional or medical researcher but I do participate in the health policy research community and currently write a blog on family issues. I did a serious on maternal health and found a lot of people had *no* idea that there were racial disparities. I did another one on Medicaid expansion and, again, surprised people with the overlap between states without Medicaid expansion and maternal health in black women. This trend appalls me. However, as a white lady, when I talked to my friend who is an MD and happens to be a black lady, I was told “while you know this about moms and babies, I can tell you my person experience with rotations shows me it is EVERYWHERE.” She now specializes in psych and talks relentlessly about how mental health for black people is just so different and complicated.

The research shows this. My recent research is smacking me in the face with racial disparities right now. My recommendation will be to target certain populations. In another health area, our research shows that with a certain program our state has implemented this as improved outcomes for black subjects MARKEDLY if they were targeted with specific services and equaled their results for white participants. Prior to these changes and in other states where there haven’t been these changes, there are huge disparities. Of course, no matter what we do or how loud ALL of us talk, it seems to be ignored. I am not sure what the solution is but I want to listen.

 How can we as researchers studying policy assist moms and others with these issues? I’m at a loss but I’m listening and trying. Personally, too, I’m lobbying for change by demanding Medicaid expansion in our state and providing targeted programs to black moms who are most at-risk. But one person can only do so much. And there are a lot of nice white ladies I know who are more concerned with having their damn birth pool and treating that like it is the end of the world than with racial disparities in maternal mortality. I don’t want to be one of those ladies.