Systemic Institutional Racism In American Healthcare is Killing Black Expectant Mothers

Maternal death is an unrelenting health crisis that requires national attention

Photos: Twitter

Although racial health disparities have been widely-recognized throughout the COVID-19 pandemic, Black women have shouldered the brunt of systemic inequities in health care for centuries.

As highlighted during this month’s Black Maternal Health Week — a campaign established four years ago by the Black Mamas Matter Alliance — Black women in the United States have disproportionately suffered poor maternal health outcomes, including death and other physical trauma for at least 100 years.

“Maternal death is an unrelenting health crisis that requires national attention, a community driven approach, research, and Black-led efforts,” said Pilar Whitaker, counsel at the Lawyers’ Committee for Civil Rights Under Law. “Although everyone is looking towards the end of the pandemic, it’s even more important that we continue to uplift this issue and support the work of Black women and other leaders who are trying to abate this centuries-long crisis.”

As of 2019, Black women in the United States were 2.5 times more likely to die as a result of pregnancy-related complications than non-Hispanic white women. This discrepancy persists even when differences in education and socioeconomic status are taken into account. A CDC study found that pregnancy-related deaths per 100,000 live births for college-educated Black women was over five times higher than college-educated white women, and 1.6 times higher than white women without a high school diploma.

Many factors account for these disparate outcomes, including racial bias on the part of health professionals. Racial disparities in healthcare access, unequal quality of care, the psychological toll of systemic racism and sexism, and higher rates of pre-existing health conditions results from these factors. In short, racism kills Black mothers.

The COVID-19 pandemic has exacerbated these long-standing systemic issues for Black and other pregnant people of color. Communities of color face higher infection, hospitalization, and death rates than their white counterparts. Pregnancy also increases a person’s risk for a severe COVID-19 infection and adverse pregnancy outcomes, including preterm birth. For Black women, the intersection of race, pregnancy, and COVID-19 is, as Representative Alma Adams has stressed, “a crisis within a crisis.”

However, recent legislative efforts and action taken by the Executive branch are encouraging. Just this week, President Biden issued the first-ever Proclamation on Black Maternal Health Week, 2021, highlighting how systemic racism contributes to maternal health disparities and the need for improved data to better understand this longstanding crisis.

In addition, Representatives Lauren Underwood and Alma Adams, Senator Corey Booker, and members of the Black Maternal Health Caucus recently reintroduced the Black Maternal Health Momnibus Act. The legislation, consisting of 12 independent bills, calls for investments in the social determinants of health and funding for community-based organizations working on maternal health equity. One of the “Momnibus” bills, the Maternal Health Pandemic Response Act of 2020, seeks to improve research and data collection regarding COVID-19’s impact on pregnant women — women of color, in particular.

Indeed, robust demographic pregnancy data is critical to addressing the maternal health crisis, especially during the pandemic. However, existing CDC data on the incidence of COVID-19 among pregnant women is woefully incomplete. Roughly two thirds of case report forms do not include information on pregnancy status. Further, the lack of disaggregated race and ethnicity data obscures the impact of COVID-19 on pregnant people of color. More thorough data collection is necessary. Because of this, the Lawyers’ Committee has advocated for the collection and publication of equitable demographic data during the pandemic, including for pregnant people of color.

Reader note: Though we use the terms “woman” and “women” in this post (because available data only reflects this population) we acknowledge that these terms do not encompass all people who can become pregnant or give birth, many of whom face increased risk of adverse maternal health outcomes.

Written by Natasha Mundkur of the Lawyers’ Committee for Civil Rights Under Law

The Lawyers’ Committee for Civil Rights Under Law (Lawyers’ Committee), a nonpartisan, nonprofit organization, was formed in 1963 at the request of President John F. Kennedy to involve the private bar in providing legal services to address racial discrimination. The principal mission of the Lawyers’ Committee for Civil Rights Under Law is to secure, through the rule of law, equal justice for all, particularly in the areas of voting rights, criminal justice, fair housing and community development, economic justice, educational opportunities, and hate crimes.

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