Black babies, too, are three times as likely as white babies to die in infancy. Despite this information, elected officials haven’t prioritized solving this problem that affects millions of Americans. That is, until now. Just ahead of Black Maternal Health Week, the Biden administration has announced health equity initiatives that specifically target the maternal mortality rate. In a proclamation released this week, the president and vice president announced an action plan that would allocate funds to potentially close the mortality gap. This was the first time any presidential administration has publicly acknowledged the issue of Black Maternal health.
Proposed Measures
A few major measures put forth by the Biden Administration include:
$200 million towards implicit bias training for healthcare providers, at-home prenatal programs, Maternal Mortality Review Committees, expansion of the Rural Maternity and Obstetrics Management Strategies (RMOMS) program; and placement of early child development experts in pediatrician offices with a high percentage of Medicaid and Children’s Health Insurance Program patients. Increasing funding to the Title X Family Planning program, which will provide access to preventative servicesIncreasing funding for the Health and Human Service Office for Civil RightsExtend postpartum coverage to women on MedicaidAdding an additional $6 billion in funding to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) for families in need
The Importance of These Initiatives
60% of maternal deaths could have been prevented, and according to the CDC, some of these causes are access to care, missed or delayed diagnoses, and not recognizing—or perhaps ignoring—warning signs. These deaths occur during childbirth, and before the baby turns one. It is already known that gender bias exists in medicine. For instance, on average, women wait 16 minutes longer than men to receive pain medicines. This disparity in care changes greatly once race is taken into account. That is because studies show that Black people are less likely to receive proper pain management because of pervasive myths that Black people have thicker skin and feel less pain. While 60% of maternal deaths are preventable nationwide, in states like Louisiana, an alarming 59% of Black maternal deaths are could be stopped, compared to 9% of white deaths. One acknowledged cause of the disparity is implicit bias. With the disparities being more pronounced in certain areas, initiatives are being implemented on local levels that cater to the unique needs of the area. Quantrilla Ard, PhD, MPH, MPhil expresses that these initiatives are long overdue and that Black maternal health can’t afford to continue to decline while we “figure it out.” She says that despite the lives already lost, the program is a start. “We have to begin somewhere. Programs and interventions that reduce and eliminate maternal health disparities require funding, and that’s a good place to start."
How States Are Getting Involved
New Jersey already has initiatives in place that are being implemented, and it has been the first state to map out a plan to change the trajectory for Black mothers at the state level. First Lady Tammy Murphy announced the state’s plans in January. According to Murphy, “Here in New Jersey, we are 47 out of 50, which is shocking, given our wealth and the sophistication of our healthcare across the state.” What she is referring to is the overall high cost of living in New Jersey, and how New Jersey is ranked 4th out of 50 states for its quality healthcare. Murphy points out, “Black women in New Jersey are seven times more likely than white women to die from maternity-related complications and black babies are three times more likely than white babies to die before their first birthday, which is shocking. We are determined to fix that, and we’re well on our way to making New Jersey the safest and most equitable state in the nation to deliver a baby.” But this point juxtaposes with the fact that Black women have unnecessarily died during and after childbirth, regardless of their socioeconomic status or education level. In New Jersey, the infant mortality rate is 4.5 per 1,000 live births. For Black babies, that rate in New Jersey is an alarming 9.4 per 1,000, compared to 2.7 for white babies. Murphy is painfully aware of the reality that Black women face, but not more than Black women themselves. That is why Ard believes that Black women need to be directly involved in these initiatives. According to Ard, “Black women need to be seated at the tables where decisions about Black women are being made to control the narrative about Black women.” New Jersey’s 11 person advisory team is made up of mostly Black and Latina women, and Murphy gives them credit for the comprehensive plan. Murphy explains, “By the end of the year, we’ll be rolling out implicit bias training at our 49 FQHC (federally qualified health centers). I honestly think that we’ve created an incredibly thoughtful strategic plan, with the help of 11 consultants from across the country.” What’s more, on Monday, April 12th, Illinois became the first state to implement a portion of the new American Rescue Plan by expanding postpartum Medicaid coverage from 60 days to a full year.
The Bottom Line
Ard expresses that whether it’s New Jersey officials or the White House, Black women need to have input. “Black women need to be seated at the tables where decisions about Black women are being made to control the narrative about Black women. Black women don’t need people to speak for them, they can and do speak for themselves. They need the opportunity and platform to speak for themselves.”She says that with Black women present, their complexities and various circumstances can be properly centered. “Black women are not a monolith. Any initiatives geared toward enhancing and elevating their quality of life and health requires a multi-faceted and multi-disciplinary approach.” Just as important as the initiatives is the need to begin to earn the trust of Black families. For this to happen, Ard suggests allowing Black families to publicly share their stories so that they can influence policies that would directly affect them. She explains, “It is important to engage Black families, especially those who have been harmed, immediately and thoroughly to actively listen to and address their experiences and concerns. Establish a culture of compassionate follow up. Never allow any Black family who has been harmed to feel as if they have been forgotten or as if they are a check on a list just to close a loop.” The question will always be for me, ‘How do we measure the success or failure of these initiatives, and how do we hold people accountable?’”
