Reflecting on Black maternal health

In honor of Black History Month, Maven is examining the Black maternal health crisis and celebrating the people focused on finding solutions for the Black community. 

The Black maternal health crisis

Though there have been advances in advocacy over the past few years, the trends and statistics of maternal healthcare continue to be disturbing. Black women are more than three times more likely to die of pregnancy-related complications than white women, and the Black infant mortality rate is more than two times that of white infants. But in the face of these ongoing disparities, leaders in the public and private sectors are coming together to address the social determinants of health, and dismantle the systemic barriers to equitable outcomes for Black birthing people and their families. 

Acknowledging how far we’ve come

The maternal health crisis facing Black mothers and families is severe—but it’s important to also recognize the progress that has been made. “I wish more people talked about the positive things that are happening in Black communities regarding Black maternal health and well being,” says Nikia Grayson, a reproductive justice informed public health activist and family nurse-midwife. 

As racial disparities in maternal health outcomes have persisted, the roles of non-traditional providers like childbirth educators, doulas, and lactation consultants have become more widely accepted. “I think the focus on the tragedies and poor outcomes has overshadowed some amazing and innovative grassroots efforts that are being made,” says Grayson. “There are more Black midwives, doulas, and birth workers who are working in the community to address these issues. There are answers in the community—listen to Black birth workers.” 

Research shows that birth workers like doulas help reduce the rate of cesarean surgeries, which are higher among Black women than other groups. Doulas advocate for pregnant people and make sure they can ask questions and be heard, helping avoid an all too common experience of Black pregnant people having their concerns dismissed or ignored by their doctors. 

“There are answers in the community—listen to Black birth workers.” 

More and more providers now understand the importance of care matching— the process of matching patients with doctors who share or implicitly understand their unique lived experience, through race, ethnicity, or sexual identity. When patients see providers who understand them and empathize with them, they’re more likely to spend more time with their providers and take part in shared decision-making. Mounting evidence suggests that patients who see providers that share their background or come from their community face less bias and experience better health outcomes. “We have research and evidence that can prove [that] Black maternal wellbeing is dependent on autonomy, joy, culture, power, safety, and trust,” explains Sevonna Brown, a certified doula and Co-Executive Director at Black Women’s Blueprint. “I wish more folks would not just talk about it but trust the evidence of it so we could integrate it into comprehensive maternal health care globally.” 

A new awareness of the Black maternal healthcare crisis

Over the past few years, there’s been an increase in coverage and conversations around Black maternal mortality and the crisis facing Black mothers and families. Both the COVID-19 pandemic and the nationwide reckoning after the murder of George Floyd highlighted the structural biases contributing to gaps in care and how maternal health divides along racial lines. There is now more recognition of racial prejudice in healthcare on an institutional level. Both the CDC and the AMA have identified racism as a public health issue, and a growing number of medical schools are working to add anti-racism education into their curriculum. 

Awareness may seem like a small step, but spotlighting this crisis is an essential part of engendering change. A significant proportion of maternal morbidity and mortality events are preventable, and the implementation of anti-racist protocols and training can improve care for Black women. Conversations with providers and patients around racial disparities in maternal outcomes, cultural competency, and implicit bias are proven to be important steps to addressing disparities in care. 

Black maternal health in legislation 

Although historically progress has been unacceptably slow, there are a number of initiatives and legislation geared towards addressing Black maternal health. In 2021, a coalition of Black leaders in Congress reintroduced the Black Maternal Health Momnibus Act, a comprehensive package of 12 bills seeking to close the racial gaps in maternal and infant mortality rates in America. At the end of last year, President Biden signed the first bill of the Momnibus into law and signed a proclamation marking Black Maternal Health Week, followed by a historic summit hosted by Vice President Harris to mark the first White House Maternal Health Day of Action. “These policies can absolutely transform maternal health for our country for the better,” says Brown. “It also provides key financial investments to the many grassroots organizations in our country that support birthing people and their families in their immediate communities.” 

Alongside these federal advances, many state and local governments are taking action as well.  For example, a bill in New Jersey aims to make prenatal care more equitable and a bill in Georgia is expanding Medicaid coverage for new mothers. This progress signifies that there is momentum in the fight for improving maternal health outcomes for Black women and families.  

Recommendations for HR managers to empower employees:

While change may be slow to come on an institutional level, HR teams are uniquely positioned to make an impact on an individual level by updating policies, adding benefits and changing company culture to be more inclusive. HR managers and leaders can provide crucial work support to people on their family-building journey that reduces stress and helps them navigate the complexity of Black maternal healthcare. Here are some ways HR managers can empower their employees.  

• Add benefits that include access to culturally humble care: Offer a diverse network of care providers and have the option to match members to providers of the same background. 
• Ensure employees have access to a supportive community: Data suggests that supportive coworkers and supervisors reduce stress for pregnant employees. Make sure there are opportunities for employees to share their experiences, whether it’s a designated internal communications channel, an Employee Resource Group, or a virtual class like Maven’s virtual classes with 25 rotating topics from breastfeeding to toddler nutrition.
• Learn more about Black maternal healthcare: Stay up to date on current statistics and news about family planning and share with your team as necessary. With clear information about risk factors and options, Black women can more easily navigate systems that often dismiss their valid concerns about their health.