Many individuals within the Black community carry deeply impactful narratives surrounding their experiences with childbirth – whether they’re mothers whose pain was dismissed in the delivery room, fathers who lost their wives during childbirth, individuals who witnessed their sisters unnecessarily suffer during labor, or neighbors who cared for someone experiencing postpartum PTSD.
Black maternal health extends far beyond the labor and delivery room. It is a critical issue that – if addressed effectively – will save lives, improve the wellness of families, strengthen communities, and overall lead to the transformation of healthcare in the United States.
According to the Health Resources and Services Administration, at least 80 percent of pregnancy related deaths are preventable. The mortality rate for Black women is over three times higher than for white women – a disparity that exists across all income levels, with even celebrities like Serena Williams having a near brush with death after being ignored and dismissed by medical professionals.
In response to this glaring racial disparity in birth, the California Dignity in Pregnancy and Childbirth Act (SB464) was passed in 2019. This law requires physicians to regularly complete implicit bias training, and for hospitals to let patients know their rights to be treated without discrimination and how to file a complaint if this right is violated.
While SB464 was a win for Black maternal health that we should continue to strengthen, the legislation’s main function is addressing what boils down to interpersonal racism. There are systemic factors that we must be countering at the same time.
Stress is a huge factor in the medical issues that Black women face – in fact, studies show the stresses of racism and misogynoir can age Black women by up to ten years. In pregnancy, this stress can translate into things like an increased risk of preeclampsia and gestational diabetes.
One clear next step in addressing Black maternal health is to strengthen parental leave across the board – for mothers, fathers, and all parents. Right now, parental leave in California is unnecessarily complicated. Unless you happen to work for a company with extraordinarily generous benefits, most people have to puzzle piece different programs together just to get a couple months of 60-70 percent paid leave. Some professions, like teachers and other school employees, do not receive paid pregnancy disability leave at all. Parenthood is inevitably challenging in many ways, but we must work to ensure that finances are not the root or sole cause of those challenges.
More paid leave would reduce maternal stress, leading to better birth experiences and outcomes. It would allow more space to treat postpartum depression and complications that may have arisen during birth. And it would allow a financial cushion that would improve familial dynamics as new parents get used to caring for a tiny human being.
Additionally, Black maternal health needs to include comprehensive primary care, dental care, mental health treatment, interventions for and solutions to domestic violence, guaranteed access to nutritious food, and reassurance that moms will have support and child care once they give birth.
At St. John’s Community Health, we saw a desperate need for more support for Black moms in Los Angeles. That’s why we launched Committed to Black Wellness and Health (CBWH) last year, a program led by Black doctors and staff that provides intensive case management, behavioral healthcare, pre and post natal healthcare, weekly group sessions, and free supplies such as diapers and carseats.
The program treats racism as a public health issue, providing mothers with skilled advocates and a community of women who understand each others’ experiences. The mothers are building the program from the ground up, ensuring that the solutions to the Black maternal health crisis are centered around the needs of Black moms.
One of the moms came to the program after being continuously dismissed by local urgent care facilities. Through CBWH, she not only found a healthcare provider she could trust, but also gained the knowledge and confidence to advocate for herself effectively. This self-advocacy ultimately led to a life-saving intervention for her and her baby.
It’s an honor to see our moms finding much needed resources, community, and empowerment through the program. But at the end of the day, interventions like CBWH shouldn’t be needed. We are working towards a world where Black women have the same quality of care as everyone else.
Black moms dying pregnancy-related deaths leaves infants without a primary caretaker, fuels cycles of immense grief and fear, and leaves the rest of the family with an unexpected and fragile responsibility. Black moms, and Black communities at large, deserve so much better.
Fixing the systems fueling the Black maternal health crisis will not only allow moms to thrive – it will lead to stronger families and communities.
