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The Daily Tar Heel

Editorial: We can’t ignore gaps in Black maternal health care

Rep. Alma Adams (D-N.C.) at Mayfield Memorial Missionary Baptist Church on July 10, 2017, to discuss health care in Charlotte, N.C. Photo courtesy of Siner/Charlotte Observer/TNS.

The U.S. health care system is plagued with racial inequities that affect people of color and marginalized groups. In particular, maternal health care suffers from these flaws.

According to The Century Foundation, these inequalities include gaps in health insurance coverage, unequal access to health services and poor health outcomes in certain populations. 

For example, Black women in the United States experience unacceptably poor maternal health outcomes, including exceptionally high rates of pregnancy-related death and childbearing issues. Black women are faced with structural racism, discrimination and sexism in a health care system not designed to support them.

According to the Centers for Disease Control and Prevention, Black women are three times more likely to experience a pregnancy-related death than white women. Moreover, Black women are more likely to die from pregnancy or childbirth than women of any other race. 

From 2019 to 2020, the maternal mortality rate for Black women increased by just over 25 percent, while the rate for white women did not increase significantly, a February 2022 report from the National Center for Health Statistics found.

Most of the deaths among Black women who were seeking maternal health care were preventable and avoidable. For any woman who chooses to become a parent or wishes to increase the size of their family, proper health care is critical for both child and mother. 

There are many ways to support Black health. But at its root, structural changes must be made to address disparities that exist within the health care system.

It is crucial to encourage and support Black and Latinx young adults in pursuing medical careers. The first step in improving Black health is to have medical providers that look like patient populations. This allows certain barriers to be broken and help patients relate to their medical teams. It also puts patient advocates in the system.

Additionally, medical providers must work to meet patients where they are. Physically meeting patients in their communities is imperative, as access to proper health care can be an obstacle for certain groups.

But as Black women’s mortality rates rise due to pregnancies and childbearing, legal action must also be taken. 

In 2019, U.S. Representatives Lauren Underwood and Alma Adams formed a Black Maternal Health Caucus to assist in developing policies that combat the shockingly high Black maternal death rate. Underwood had said that the caucus will come up with "creative" and "strategic" solutions to elevate Black maternal health.

Since then, the caucus has grown to one of the largest bipartisan caucuses in Congress, with over 100 members in January 2020.

In 2021, Underwood and the caucus spearheaded the Black Maternal Health Momnibus Act, that increased research and data collection on maternal morbidity and mortality. The legislation required the Department of Health and Human Services to address the social determinants of maternal health and maternal health issues related to COVID-19.

This month, the caucus celebrated multiple priorities being included in the Fiscal Year 2022 omnibus appropriations package. This included funding for the CDC's Safe Motherhood/Infant Health Programs, the NIH's Maternal Health and Pregnancy Outcomes Vision for Everyone program, and the Maternal and Child Health Block Grant, among others.

The total funding attributed to improved maternal health care reached almost $1 billion. This is the type of legislation that can fuel outreach efforts, encourage personnel development and support the next generation of minority health care professionals — all things necessary for the reform of maternal health care.

In addition to politicians advocating for change, several independent organizations and groups have also paved the way for equity in health care.

Black Mamas Matter Alliance is an organization led by Black women that aims to "advocate, drive research, build power and shift culture for Black maternal health, rights, and justice."

Since its founding in 2016, the alliance has been expanded to include over 18 Black women-led organizations, and has implemented the first Black Maternal Health Week National Campaign and the Black Maternal Health Conference and Training Institute. 

BMMA has endorsed various legislation by political leaders, such as Underwood's Helping MOMS Act in 2019. Introduced in the House in 2021, the act allows states to provide one year of postpartum coverage under Medicaid.

Legislation like this is only the beginning. Reform is necessary on every level of the health care system for maternal health. Change the conversation and do your part to help support Black mothers, whether through donations, volunteering or raising awareness on the maternal health crisis.

Equitable maternal health care across marginalized communities should be a right — not a privilege.

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@dthopinion |