The United States is in the midst of a maternal and infant health crisis. Every 12 hours a woman dies due to complications resulting from pregnancy and every two hours, we lose a baby.
Women of color reading this post won’t be surprised to learn this problem doesn’t affect all American women equally. For black and brown women who are 30 years or older, the number of pregnancy-related deaths per 100,000 live births is approximately 4 to 5 times that of white women. Black women also have a preterm birth rate that’s 50 percent higher than that of white women.
I so often hear members of the black community talk about a baby that “came a bit early.” Prematurity is a problem so common among black women that we’ve normalized how we talk about it. And for black women, our income, education or level of access to prenatal care doesn’t make a difference when it comes to pregnancy complications — as we’ve seen in the recent experiences of Beyoncé and Serena Williams. The disparities persist regardless of any of that.
At times, to be honest, I struggle with sharing facts like these about moms and babies. The last thing in the world I want to do is to make any woman afraid to have a baby or to think it’s unsafe to have a baby.
But, if we aren’t honest with ourselves, we will never dismantle the systemic racism that puts the lives of black moms and babies at risk.
We have to be honest not only about the poor health outcomes black women face, but also about the roots of those problems. African American women have long been blamed for our own poor health, but in fact we’re still dealing with the legacy of slavery and segregation. Modern researchers such as Dr. Fleda Mask Jackson have pulled back the curtain, showing how stress and the social determinants of health — housing, health care access, employment, transportation, education — influence black women’s maternity outcomes.
Even decades past the victories of the Civil Rights movement, we face discrimination on all of those fronts, and we are less healthy because of it. And so are our children.
But I have hope that we can reverse the disturbing trends in maternal and child health by addressing inequity head on. Here are four things we can do as black women:
- Build awareness of the dangers. We can surface the facts about maternal and infant mortality and use them to force change. Greater awareness in our community will empower and embolden black women to fight systemic inequities, build support for solutions and take charge of their own health.
- Advocate for state and federal policies that protect the health of moms and babies. At the state level, I’m talking about important steps like implementing Maternal Mortality Review Committees that can collect data, design interventions and hopefully save lives. You can learn whether your state has one here.
On a national level, we have to encourage our representatives to support policies and legislation that improve data collection, aim to end provider bias toward women of color, improve access to health care in places where there are few maternity care providers, and extend Medicaid coverage to women for a year after pregnancy.
- Put equity front and center in the fight for the health of all moms and babies. For example, my organization, the March of Dimes, is pushing back against systemic bias and stigma by launching implicit bias training for health care providers. We know that group prenatal care program has shown to be particularly effective for women of color. It’s one reason why we launched our own program, known as Supportive Pregnancy Care. The program, which provides prenatal health care and education in a group setting with other moms-to-be of similar gestational ages, is expanding across the country. We think if more practices and clinics use it, more women will get the prenatal care they need, fewer babies will be born to soon and less women will face dangerous high-risk pregnancies.
- Advocate for ourselves, even when doing so seems difficult. It’s a burden to feel that we have to push back against a medical establishment that often dismisses us. But it’s your health care providers’ jobs to take care of you. Speak up and ask questions if you’re not confident that they are listening to you or acting in your best interest.
When I look back at my parents’ generation, in many respects, it’s clear we’ve come a long way. There have been many civil rights wins, many health wins, many new discoveries in science. But that doesn’t diminish the challenges black women face today. It just underscores the power we have to make the world a better place for all of us.
Stacey D. Stewart is president and CEO of March of Dimes, which promotes the health of all mothers and babies through research, education and advocacy.