Why racial disparities in U.S. maternal health are so terrible, and what you can do about it

Editor’s Note: April is Black Women’s History Month. Throughout this month, Black Youth Project is celebrating Black women. This month is also National Minority Health Month, Autism Awareness Month, Sexual Assault Awareness Month, Child Abuse Prevention Month. We are interested in publishing works that address these topics and the things surrounding them.

This post is in partnership with City Bureau

By Caroline Olsen, City Bureau

It’s an “international embarrassment” that so many women in the U.S. die during childbirth, researchers say. And the gap between Black and white women in Illinois is even wider than the national average.

Maternal mortality is finally getting the national attention it deserves and requires. State lawmakers have introduced more than 80 bills this session to address the ongoing crisis. But how did the United States end up with the worst rate of maternal mortality among all high-income countries in the world, and become the only one with rates that have been rising since the ’90s?

In honor of Black Maternal Health Week, here’s a look at the racial gap in maternal mortality and why the U.S. has struggled to improve maternal health, as well as the different groups fighting to reverse the trend.

HOW DID THIS HAPPEN?

High maternal mortality rates in the U.S. are largely due to wide racial disparities in the statistics: In the U.S. Black women die at rates similar to women in lower income countries, while the mortality rate for white mothers is closer to rates in more affluent countries. According to the Centers for Disease Control and Prevention, Black women in the U.S. die at three to four times the rate of white women during childbirth, and Black babies die at twice the rate of white babies. Half of all pregnancy-related deaths in the U.S. are preventable.

WHERE DOES THE RACIAL GAP COME FROM?

Research suggests that it’s not just about education level or socioeconomic status: Black college-educated mothers are more likely to suffer pregnancy-related complications than women of other races who never graduated high school. Studies indicate that institutional racism plays a role, as does stress caused by the psychological effects of racism.

RELATED: Doctors refused to diagnose my chronic illness because this world ignores Black women’s pain

A recent study published in the Proceedings of the National Academy of Sciences shows that Black people are routinely undertreated for pain due to false beliefs that medical professionals still hold about biological differences between races. Another study found that some people assume Black people feel less physical pain in part because of the perception that they have faced more hardship than other races.

MEDIA COVERAGE IGNORES BLACK VOICES

Coverage also overlooks Black experts, Columbia Journalism Review reports. Journalists are taught to privilege the voices of doctors and researchers, but 77 percent of OB-GYNs are white. It’s rare that nurses, midwives or patients are treated as main sources, even though they might have deeper connections with the issue.

Nurses were identified as only 2 percent of sources in health news, according to a 2018 American Journal of Nursing study. “And [sources] are almost never social scientists or other thinkers in fields like critical race theory, which studies race and power,” says Monica McLemore, a nurse, assistant professor at the University of California San Francisco and a member of the Black Mamas Matter Alliance.

HOW HAS IT BEEN ADDRESSED?

In December 2018, the Preventing Maternal Deaths Act was signed into law to help collect data on maternal deaths across the nation, a crucial first step since U.S. maternal mortality data has been consistently underreported and inconsistent. Both the MOMMA’s Act and the MOMMIES Act are bills introduced in Congress this year to extend pregnancy-related Medicaid coverage for a year following birth, a significant factor since Medicaid finances half of births nationally. The MOMMIES Act also recommends Medicaid reimbursement for doula services, and a recent study of New York women from the Maternal and Child Health Journal found that doula services led to lower rates of low birthweight and mothers reported that they felt doula support gave them a greater voice.

RELATED: Black Mamas Matter Alliance launches first national Black maternal health week

California is the only U.S. state to reverse the national maternal mortality trend; its maternal mortality rate has decreased in recent years, in large part due to data collection on how each mother died in the state. Vox reported on the California Maternal Quality Care Collaborative, established in 2006, which implemented a data collection process for the state, reviewed the top preventable causes of maternal mortality and created free, downloadable toolkits for hospitals and health care providers. The collective also acts as a network for health care providers to share skills and motivation.

WHAT’S THE DEAL IN ILLINOIS?

In Illinois, the racial disparity around maternal health is even worse than the national average.  According to the Illinois Department of Public Health, Black women are six times as likely to die of pregnancy-related conditions compared to white women, and 70 percent of those deaths are preventable. The report lists the top three factors contributing to maternal mortality as obesity, mental health conditions and substance abuse, all of which are linked to environmental stress.

WHAT GRASSROOTS SOLUTIONS ARE OUT THERE?

Organizations like Chicago Birth Workers of Color, Chicago Volunteer Doulas, New Moms and Ounce of Prevention Doula services are working to offer home support to mothers outside of the traditional health care setting. These organizations are looking for volunteers, donations and help collecting information so they can share resources with others. Nationally, SisterSong and Black Mamas Matter Alliance are doing a wide range of work to analyze power systems and intersecting oppressions and collect community-based solutions and knowledge to organize for government accountability and policy change. You can follow their work and take part in their organizing efforts online and in person.

WANT MORE INFO ABOUT MATERNAL AND INFANT HEALTH?

“The Cord” is a free text-message service from City Bureau reporters about pregnancy and motherhood on the West Side. Get news, learn about resources and share your thoughts—sign up here.

This report was produced by City Bureau, a civic journalism lab based in Woodlawn. Learn more or get involved at www.citybureau.org.