The night before she had her first child in March of 2013, Jacqueline Carr-Martinez went to a hospital in Connecticut because she was cramping and in pain.
Carr-Martinez, now a Greensboro resident, was 23 years old and living in Connecticut when she was pregnant for the first time. She identifies as African American, Indian and Guyanese. Carr-Martinez said she was examined by a white doctor who didn’t warn her of the pain she’d experience while he checked her cervix.
“I just remember completely being in shock for how bad the pain was,” Carr-Martinez said. “And then finally he was like, ‘Oh you can just put your hands under your back if you’re in pain.’”
After that interaction, Carr-Martinez said she was scared to go back to the hospital the next day, even as she went into active labor and counted the time between contractions.
Research from recent years suggests that Carr-Martinez’s fear was not unfounded. Black women in the state have a maternal mortality rate nearly double that of white women, according to a 2014-15 Morbidity and Mortality Weekly Report cited by the North Carolina Medical Journal in January 2020.
Organizations, activists and lawmakers, including Rep. Alma Adams of North Carolina’s 12th Congressional District, have been pushing for action to address the country’s maternal health crisis.
A new bill in the U.S. House
On Feb. 8, U.S. Rep. Alma Adams, D–N.C., alongside U.S. Rep. Lauren Underwood, D–I.L., U.S. Sen. Cory Booker, D–N.J., and members of the Black Maternal Health Caucus, introduced the Black Maternal Health Momnibus Act of 2021.
Made up of 12 bills total, the Black Maternal Health Momnibus is intended to comprehensively address America’s maternal health crisis.
"The hour for bold action has arrived and bold action is what the Momnibus represents," Underwood said in a February press conference introducing it.
Adams co-founded the Black Maternal Health Caucus, a group within the House of Representatives focused on improving maternal health for Black women.
“The time to end preventable maternal mortality and close racial and ethnic disparities in outcomes is long overdue,” Adams’ website reads.
When Carr-Martinez arrived at the hospital in labor, the same doctor came to help her. Despite urging from nurses, she refused to push until another doctor arrived.
“All I kept thinking was I didn’t want this person to bring my child into the world,” Carr-Martinez said.
Mothers of color, particularly Black mothers, nationwide die at a higher rate than white mothers, according to research between 2007 and 2016 from the Centers for Disease Control and Prevention. Additionally, they face other health issues and discrimination during and post-pregnancy.
“I definitely think all doctors should be completely knowledgeable on the culture of their patients, no matter what culture or background they have,” Carr-Martinez said.
The objective of the fourth bill in the Black Maternal Health Momnibus Act of 2021 is to grow and diversify the professionals who support women immediately before and after birth so they can receive “culturally congruent maternity care and support.”
Additionally, the fifth bill of the Momnibus targets data collection processes and quality measures to better understand causes of the U.S. maternal health crisis and inform appropriate solutions.
The Momnibus also addresses maternal vaccinations, payment models for maternity care and maternal health care and support for incarcerated moms.
Local advocacy for change
In tandem with the Momnibus, grassroots organization Action NC is working to improve Black maternal health, reproductive health access and education in the state.
Action NC’s movement, called the Race and Gender Equity Initiative (RAGE), aims to uplift women of color and create momentum for policy change.
For Gloria De Los Santos, director of Action NC’s Durham office, the work to improve maternal health outcomes brings back memories of her own experiences as a mother.
De Los Santos had her second daughter at a hospital in North Carolina in 2009. A few hours after she’d given birth, she looked down to find herself bleeding out onto the hospital bed. A nurse came into the room to help and De Los Santos’ husband ran out to find a doctor.
Women of Asian and Hispanic background are more likely to experience postpartum hemorrhage than others, according to Stanford Medicine. Research published in 2017 by the clinical journal American Family Physician states that postpartum hemorrhaging causes 12 percent of maternal deaths in the U.S.
Though racial and ethnic disparities in pregnancy-related deaths have persisted through time, most of them are preventable, according to the CDC. De Los Santos recovered, but she said she’s heard one story after another from friends and women she’s worked with through Action NC that are more dire.
“Those are the stories that are impactful,” she said. “They need to be told.”
Action NC works with women to advocate for overall improvement to maternal health outcomes in addition to providing education and support for women of color.
This aspect of Action NC’s movement, De Los Santos said, is important because it directly empowers women of color, helping them understand how to advocate for themselves.
“It’s not just about policy,” De Los Santos said. “It’s about treating us as human beings.”
Though Action NC's RAGE Initiative began in 2019 to address the disparities women of color face, De Los Santos said the decision to also focus on maternal health became clear as more research emerged and leaders like Adams advocated for mothers of color at a national level.
"This has been going on far too long to just sit back and say, 'Well, things will get better,'" De Los Santos said.
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