North Carolina

Deadly Disparity: Black Mothers Dying in Childbirth at Alarming Rate

Vanessa Miot loves playing with her adorable two-year-old daughter Sage. She ultimately experienced a beautiful pregnancy with her daughter, but her first encounter with her obstetrician was anything but fairytale-like. Vanessa says she felt disconnected from the doctor.

"It was very alarming!" Vanessa recalled. "I was taken aback because the visits were so short, questions were very short. [I] felt like I needed to find another healthcare provider who would give me that attention."

That experience led Vanessa to a midwife because she says she knew midwives had once been a tradition in the Black community. She says she found the nurturing she needed with midwife and activist Jamarah Amani.

"The way that medicine is taught and the way people are trained, there is an implicit bias in how Black folks are treated – and that has a long history," explained Jamarah.

As a pregnancy advocate, Jamarah believes a shift in mindset must occur in what she calls the double jeopardy of racism and sexism.

"We need more doctors saying 'Black mamas matter,'" Jamarah said. "We need more people believing that, supporting that and listening to their clients."

Jamarah's concern is shared by about a dozen U.S. lawmakers who introduced the first ever Black Maternal Health Caucus, one day before the start of Black Maternal Health Week. The week runs April 11-17.

"We are truly in the midst of a national public health crisis," U.S. Rep. Alma Adams of North Carolina exclaimed outside the State Capitol Thursday.

Nationally, African American women are four times more likely to die during childbirth, according to the Centers for Disease Control and Prevention. As a result, maternal morbidity rates for Black women in the U.S. are the highest in the developed world, equal to that of Haiti and countries in West Africa. In Florida, non-Hispanic Black women were two times as likely to die compared to non-Hispanic White women, according to the Florida Department of Health.

The newly launched caucus will work to combat the deadly disparity. U.S. Rep. Lauren Underwood of Illinois leads the caucus.

"What we need to do is direct research to really dig into what's causing this disparity," explained Rep. Underwood.

The caucus partnered with Black Mamas Matter Alliance. Jamarah is an active member of the group and traveled to the nation's capital to push for legislation targeting Black maternal health.

"I feel like Black women, by and large, feel like our concerns are dismissed," said Jamarah.

Advocates who echo Jamarah's sentiments say the Black mothers who are dying range from rich and poor.

"The disparity is multi-factorial," Rep. Underwood said. "The data has shown that the protective factors that help other women avoid death in childbirth, whether it's access to care…having a high-income level, being college educated, living in a clean, safe middle-class neighborhood…those things don't protect Black women."

Grammy award-winning singer Beyoncé and tennis titan Serena Williams are two high-profile Black mothers who shared their near-death experiences during childbirth. In an HBO docu-series "Being Serena", the 23-time Grand Slam champion revealed a battle more daunting than any she had faced on the court.

"I told the nurse I can't breathe," Williams said in the series. "I said 'listen I need you to run a C-scan with dye. I have a pulmonary embolism in my lungs'. I know my body." Tests later confirmed Williams' concerned: she had blood clots in her lungs.

Dr. Gene Burkett is an obstetrician/gynecologist at Jackson Memorial Hospital who serves on the board of Florida's Pregnancy-Associated Mortality Review. He believes genetics may play a role in increasing problems, such as hypertension and diabetes, among Black pregnant women. He says a key to helping women is knowing the risks.

"If they know and understand what their risks are and they know and understand how to mitigate those risks then I think you may change the outcomes dramatically," explained Dr. Burkett.

In 2016, non-Hispanic Black women made up nearly 42% of the pregnancy-related deaths in Florida, according to the Pregnancy-Associated Mortality Review.

"I think the most important thing is patient education. Until a patient understands the severity or the potential severity of a disorder then she may not take care of herself properly," Dr. Burkett said.

Florida's goal for 2020 is to reduce the rate of maternal mortality to 11.4 deaths per 100,000 live births. Currently, the rate is 18.1 deaths per 100,000 live births.

Florida's health department has partnered with the Florida Perinatal Quality Collaborative and the March of Dimes to lead an effort in educating pregnant women. In recent years, the department also contracted FPQC to implement Hypertension in Pregnancy and Promoting Vaginal Deliveries initiatives.

The review lists recommendations to combat these issues and the steps the department has taken to address maternal mortality. Read the entire review here.

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