“I was hurting so bad I didn\'t know what to do with myself,” remembers Tiffany, who was forced to labor for hours in a basement hallway of the public hospital in Jackson, Mississippi, where she had sought maternity care. Despite her sister’s pleas for the nurses’ attention, Tiffany was completely ignored until the baby started to crown.
Jamila reports a similar experience. She was made to wait 10 hours in extreme pain before being seen in a hallway of a hospital in Atlanta. She attributes much of the poor treatment she experienced that day to the staff’s perception of her as a single, low-income, uninsured woman of color.
Aaliyah’s doctor at the public hospital neglected routine prenatal care, and as a result her baby spent three weeks in the neonatal intensive care unit. LaKeisha developed a serious infection following her C-section due to inadequate follow-up care. When Kayla gave birth to a baby with several malformations to the hands and feet, doctors refused to let her hold her daughter and instead interrogated her about suspected drug use.
Such lapses in quality maternal care are all-too-familiar experiences for many women of color. Nationwide, black families are nearly four times more likely to face the loss of a new mother than white families and black women are twice as likely to suffer severe pregnancy complications such as heart attack, shock, blood clot, or hysterectomy.
While the Black Lives Matter movement grew out of responses to police violence perpetrated on black communities, it has led to increased scrutiny of a constellation of factors that put the bodies and lives of black men, women, and children at risk. One of these factors is lack of access to good-quality health care, which is both a symptom and a cause of deepening social inequality.
This past June, reproductive health and justice advocates organized a convening in Atlanta called “Black Mamas Matter” to better understand and address this glaring crisis. More than 20 experts working on maternal health came together to discuss current approaches and coordinate future action on black maternal health.
“There is a lot of discomfort in discussing these issues in terms of race, but there is not a lot of uncertainty that this is an issue rooted in racial inequality,” says writer and reproductive justice activist Elizabeth Dawes Gay, who co-organized the event along with Monica Simpson of SisterSong and Katrina Anderson of the Center for Reproductive Rights. “While the causes are multiple and complex, there is no question that women of color face alarming health disparities in the United States.”
These disparities are even starker in the American South, where barriers to reproductive services—including sex education, contraception, abortion, and prenatal care—are pervasive. In that region, residents are disproportionately impoverished and a number of states have rejected Medicaid expansion, leaving many low-income women without affordable health insurance.
In Jamila and LaKeisha’s hometown of Atlanta, known for having some of the top medical facilities in the country, African American women die in childbirth at a rate more than three times the national average. In nearby Mississippi, there are rural counties where black women die in childbirth at a rate higher than in sub-Saharan Africa.
“The U.S. spends vastly more on health care than any other country. So why has maternal mortality increased dramatically in the U.S. even while it’s fallen precipitously in the rest of the world? This domestic human rights crisis is a result of policy choices that fuel inequality and discrimination against black women and families,” notes Anderson, the Center’s senior human rights counsel. “When we talk about addressing systemic racism and social inequality, black maternal health must be a central part of that conversation.”
Meaningful responses must tackle the root causes of discrimination and inequality and address women’s comprehensive needs, starting before pregnancy—such as sex education that helps women plan healthy pregnancies—and continuing until after birth with paid parental leave and other policies to support families across the socio-economic spectrum.
Attendees at the June convening drew from a variety of disciplines. They included public health professionals, academics and researchers, policy experts and advocates, community activists, and service providers including OB/GYNs, midwives, doulas, and abortion providers. Participants affirmed the need for cross-disciplinary approaches, such as improved data collection to better understand how racial discrimination becomes a factor in maternal death as well as advocacy and messaging tools that can drive more meaningful policy solutions.
Appropriately, the landmark meeting was held in SisterSong’s historic Atlanta MotherHouse, the original home of the National Black Women's Health Project and a longstanding meeting place for black feminist thinkers and activists in the South.
“It was inspiring to see experts from such varied fields come together so enthusiastically to craft a holistic vision to address our maternal health and mortality crisis,” says Monica Simpson, executive director of SisterSong. “It is unacceptable for racism to limit the access of people of color seeking reproductive health care in this country. Black women are losing their lives in childbirth, our children are being killed in the street, black mothers are trying to provide for their families but only make 64 cents to every dollar that men make. This is not what justice looks like.”
As Simpson suggests, the pursuit of reproductive justice and the undertaking to improve black maternal health is directly related to the growing Black Lives Matter movement, which seeks to address the continued devaluation of black lives that results in state-sanctioned violence and pervasive discrimination.
Reproductive justice is a concept that reconsiders and broadens conventional notions of reproductive rights beyond the ability to decide when or whether to have a child. This includes securing the context into which that child is born and ensuring the conditions that allow all families to thrive.
“The withholding of resources from the black community—healthy food, critical social services, living wages, quality health care—is a violence of its own,” says Elizabeth Dawes Gay. “Add that to the chronic stress of what it is to be black in America, and you start to get a sense of the depth and breadth of the issue we are addressing by asserting that black mamas matter.”
The path to protecting and improving the lives of all black people in the United States may be as complex as the issue itself. But one thing is excruciatingly clear: Without healthy black mothers, there cannot be healthy black families and communities.