As pregnancy-related deaths continue to rise, so do the disparities between Black mothers and their white counterparts nationwide and in Connecticut.
According to the Robert Wood Johnson Foundation, the number of pregnancy-related deaths in 2021 was nearly 80% higher than in 2018. The national maternal death rate for non-Hispanic Black women was nearly three times higher than that for non-Hispanic women in 2020, reported National Center for Health Statistics.
In Connecticut, the state Department of Public Health reported that babies born to Black mothers are significantly more likely to die before their first birthday than babies born to white women in 2017. Black babies are also twice as likely as white babies to have be born under six pounds, which can lead to severe health and development issues.
In May, U.S. Sen. Richard Blumenthal co-sponsored the Black Maternal “Momnibus” Act, a series of bills to address various obstacles underserved mothers face when accessing prenatal and postnatal care.
If passed, the bill would allocate funds for community-based organizations to bolster their maternal healthcare resources. It would also provide funds for research studies analyzing the root causes of the maternal death disparities among women of color.
“Those statistics are a searing indictment of our health care systems,” said Blumenthal, D-Connecticut. “More broadly, it’s not just the healthcare system. It’s also environmental issues; it’s transportation and housing. They’re a combination of different issues that are really problematic for women of color when they encounter pregnancy-related problems.”
Congresswoman Jahana Hayes, D-5th, didn’t know the extent of maternal mortality and its impact on Black pregnant women until she joined Black Maternal Health Caucus in 2019. She learned about the data documenting the widespread disparities between mothers of color and white mothers.
For example, although Connecticut has the country’s fourth-lowest maternal mortality rate, Black pregnant residents are still at the highest risk for death, Hayes explained.
Social determinants of health play significant roles in access to healthcare during and after pregnancy. This can include addressing environmental problems, transportation, childcare and nutrition. Hayes explained that Black women may face more than one social determinant that makes access healthcare a low priority or inaccessible.
“When you see how Black women are affected more by all of those things, they have jobs where they don’t get time off to heal after pregnancy, have kids who are close together, don’t have access to preventative care or checkups,” Hayes said.
More than 80% of pregnancy-related or adjacent deaths were preventable, according to the Centers for Disease Control and Prevention.
However, Hayes said that even when all these social determinants and health care barriers are addressed, Black women may still die during childbirth.
One of the most recent examples is the death of Tori Bowie, a Black Olympian sprinter, who died at 32 years old while in labor in May. Hayes explained that although Bowie was extremely fit and healthy, she died from respiratory distress and eclampsia and her daughter was stillborn.
“It doesn’t matter your income status, doesn’t matter where you live,” Hayes said. “When Black women are not taken seriously when they go to a doctor and complain or say ‘this feels different’ or ‘this is happening,’ the care and attention that they get is very different.”
The Black Maternal Health Momnibus Act was introduced in May 2023 and involved 13 individual bills that analyze the problem of maternal mortality and address the specific needs of communities of color.
The bills address specific social determinants and hope to expand eligibility for the Special Supplemental Nutrition Program for Women, Infants and Children. It also seeks to improve maternal healthcare for veterans, expand mental health services, boost comprehensive pregnancy care for incarcerated women, diversify the maternal care workforce and promote maternal vaccines for mothers and babies.
There are also a handful of bills to fund community-based organizations, provide investments in telehealth, update payment models for maternity care and non-clinical support during or after pregnancy. Other bills would also promote community initiatives to address climate change-related risks for moms and babies.
Blumenthal hopes the act will have a federal hearing by September. However, he predicts that financing would be the biggest obstacle before the Momnibus Act could become a law.
“It really is just this multifaceted, multi-pronged approach that really looks at every aspect from community-based supports to healthcare providers, to social determinants,” Blumenthal said. “All the things we need to do in order to make the maternal experience better and safer for pregnant moms.”
Hayes’ bill, the Social Determinants for Moms Act, establishes a task force to address the health crisis. It also establishes a maternal health fund to help community-based organizations and public health departments address social determinants.
She explained that, in general, the Momnibus Act is addressing “all of the intersections [of maternal health], so not just what happens in the delivery room, but preventative medicine and care leading up before women are even pregnant.”
Program Director of Maternal Health Equity at Hartford Hospital Daileann Hemmings said that implicit bias and microaggressions often come into play when administering healthcare care.
Hemmings said that the Momnibus emphasis on mental health and access could help destigmatize the postpartum depression a mother may experience after birth.
National studies found that postpartum mental health issues impact low-income and minority families at higher rates. The Center for Law and Social Policy reported that more than half of poor infants live with a mother who experiences depressive symptoms. Similarly, suicidal ideation and intentional self-harm significantly increased among Black women from 2006 to 2017 during their pregnancy or up to one year after, according to JAMA Psychiatry.
“We know that [mental health] is an issue that lasts not only during the pregnancy or within that six weeks after [birth],” Hemmings said. “Some of these deaths… related to pregnancy are occurring up to a year after and mental health is one of the leading causes of that happening.”
Hemmings added that the inclusion and funding of community-based organizations or data collections can help isolate and identify areas of improvement and specific needs. She explained that building these relationships with community-based organizations is important due to their trusted connection to the community.
“Working with community-based organizations is huge because they are right there on the ground, people who have relationships and have trust with the community. That’s primarily who you want to be sure has the information and having trusted people be able to share ways to improve their health is really important.”
However, Hayes noted that the money needs to be distributed equitably. She explained that low-income patients often need extra financial support to address their needs, compared to higher-income neighborhoods.
“What I don’t want to see is pushing for funding to come to the state of Connecticut that is equally dispersed in every community. We all know that some communities need it more than others because the impact, the problems and challenges for maternal mortality in those communities are greater,” Hayes said. “So, really finding out where the problems are and then deploying the resources to help in those communities.”
Although Hemmings considers the Momnibus Act a “significant bill,” there is still a lot of work to be done since passing the act doesn’t always equate to enforcement.
Addressing the maternal health crisis among mothers of color is a multi-level, collaborative effort from the community-based organizations, government agencies and healthcare providers. Hemmings said that these groups have to be intentional and look at the greater systemic issues in healthcare through data collection and listening to community members.
“My hope is that we will get to the place where a person will not need to feel fear because they are wanting to grow their families. They can be confident in living here and knowing that they will be able to get the support that they need to be able to have a healthy pregnancy, where they’re not thinking that they may not survive it.”
Health Equity reporter Cris Villalonga-Vivoni is a corps member with Report for America, a national service program that places journalists in local newsrooms. They can be reached at cvillalonga@record-journal.com and 203-317-2448. Support RFA reporters at the Record-Journal through a donation at https://bit.ly/3Pdb0re. To learn more about RFA, visit www.reportforamerica.org.