The Star Malaysia - Star2
Keeping black mums alive
LAWMAKERS pushing to address America’s rising maternal death rate – particularly among Black women – heard testimony recently on what Congress can do to address the problem
The rate of pregnancy-related deaths in the United States is the worst of any industrialised country, and the number of such deaths has steadily risen over the last 30 years, according to the Centers for Disease Control and Prevention (CDC).
In 2019, the most recent year for which data is available, the maternal mortality rate in the US was 20.1 per 100,000 live births, according to the CDC’S National Center for Health Statistics.
But wide racial and ethnic disparities exist.
The rate for Black women was 44 deaths per 100,000 live births, for non-hispanic white women it was 17.9 deaths per 100,000 live births, and for Hispanic women it was 12.6 deaths per 100,000 live births.
The Centers for Disease Control estimates that three in five of those deaths are preventable.
“How does one of the most medically advanced nations in the world continue to fail Black birthing people at such high rates?” Oversight and Government Affairs Committee Chairwoman Carolyn Maloney, said.
“To understand, we have to take the blinders off our history and acknowledge that our health care system – including reproductive health care – was built on a legacy of systemic racism and the mistreatment of Black people, and that this legacy continues today,” she said.
Democrats are hoping to include a package of bills focused on maternal health in President Joe Biden’s massive infrastructure and tax bill, one of the major pieces of legislation expected to pass this year.
Vice President Kamala Harris was one of the lead sponsors of the package last year when she was a senator.
House speaker Nancy Pelosi, said last month that passing the maternal health bills is a priority.
The package invests in increasing maternal vaccinations and in training more doulas, midwives and obstetricians and gynaecologists.
It also includes improving access to maternal mental health care, telehealth and community health centers, and providing more funding for racial bias and health care disparity training.
There is also the allocation for extra funding for additional data collection to help the government understand the causes of the high death rate.
Until January, the CDC was not receiving standardised data from all 50 states.
And because of this the rate of maternal deaths has long been based on estimates rather than exact figures.
Advocates who testified recently also urged Congress to make permanent a provision passed in the most recent economic aid package that temporarily allows and encourages states to extend postpartum Medicaid coverage for a year rather than the current 60-day limit.
Low-income pregnant women who make too much to qualify for Medicaid can apply to have the programme cover the cost of their delivery.
Medicaid paid for 43% of all US births in 2018, according to Congress’ Medicaid and CHIP Payment and Access Commission.
Advocates argue that not every state will choose to make the change.
They want to require the states to extend the coverage permanently.
The Centers for Disease Control and Prevention estimates one-third of women who die because of childbirth do so during pregnancy.
About one-third die during delivery or in the week after; and onethird die because of complications in the year after birth.
“The year after birth is a crucial, critical time,” said Dr Veronica Gillispie who is the medical director of the Louisiana Perinatal Quality Collaborative.
“Even with those incentives, not all states will choose to extend Medicaid,” she said.
Along with the statistics and anecdotes from medical professionals and advocacy groups, the testimonies included wrenching personal stories from both witnesses as well as some members of Congress.
“There is no statistic that can quantify what it’s like to tell an 18-month-old that his mommy is never coming home,” said Charles Johnson.
Johnson created an advocacy group after his wife, Kira Johnson, died hours after giving birth to their second son in Los Angeles.
Meanwhile, representative Cori Bush, recounted her story.
She shared how when she complained to her obstetricians and gynaecologist about severe nausea and sharp pains during her first pregnancy the doctor told her she was fine and that she should go home.
A week later she went into preterm labour, delivering her son Zion at 23 weeks.
He weighed 600g, and spent four months in neonatal intensive care.
Bush said she went back to the same clinic when she got pregnant again.
This time, a doctor told her she was in pre-term labour again and should go home.
He told her that the baby would probably not survive.
Her sister angrily threw a chair down a hallway in response, prompting nurses to call a different doctor.
This time, the doctor agreed to place a temporary cervical cerclage, a surgical stitch that keeps the cervix closed, which allowed Bush to carry her daughter, Angel, to term.
“This is what desperation looks like. That chair flying down a hallway.
“This is what being your own advocate looks like,” Bush said. – dpa