Black moms work to improve health care
Data shows disparities remain in mortality rates
CINCINNATI – Latosha Shelton, 28 weeks pregnant and hyperventilating, shoved aside her midwife’s advice to “wait it out,” gripped the steering wheel and headed for the hospital, screaming.
She’d spent weeks experiencing frightening symptoms – swelling feet, swelling face, headaches, stomach pains – and hearing doctors tell her that she was overreacting, these symptoms were just first pregnancy woes.
“I wasn’t listened to,” she said. “I felt like I had to be like, ‘Am I being dramatic?’ It let me ignore myself.”
Not this time. She awoke around 3 a.m. in agonizing pain and realized she had not felt her baby move all day. A midwife suggested by phone she try some sugar, then wait an hour to see if the baby was stimulated.
Shelton arrived at the emergency department with critically high blood pressure. Her platelets would not clot. Her placenta had no amniotic fluid. She had a rare syndrome called HELLP, a type of preeclampsia that causes elevated liver enzymes and a low platelet count.
“My organs were shutting down.” Kendall Rose was delivered by cesarean section at 1 pound, 13 ounces, and her mother was stabilized.
The ordeal, Shelton said, “changed my life forever.”
The U.S. medical system has a history of implicit racial bias that can include ignoring Black women’s pain and lead to disparities in treatment and outcomes – including high rates of deaths of pregnant and new Black mothers and their infants.
Black mothers and babies in the United States are more than twice as likely to die during pregnancy, at birth or shortly thereafter than white moms and infants. The crisis started in slavery times. Now, the United States has one of the highest disparities in these mortality rates in the world’s developed countries.
The disparities exist across the nation. Black babies were nearly three times more likely to die in Hamilton County, Ohio, in 2022, “regardless of their parents’ socioeconomic status or health behaviors,” according to Cradle Cincinnati.
Shelton wanted change for Black women. First she became a doula, a caregiver supporting other Black mothers through pregnancy and birth, in 2020. Then she joined a core group of Black mothers in Cincinnati who are working to turn around a centurieslong crisis in Black infant deaths, and now, maternal deaths.
They are members of Queens Village, a team of more than 3,000 Black women in the Cincinnati region. The group began in 2017, when four mothers and their children joined for dinner. They were hosted by Meredith Shockley-Smith, executive director of the nonprofit Cradle Cincinnati, a collaborative formed in 2013 to confront Hamilton County’s high Black infant mortality rates.
The “queens” are an essential part of Cradle Cincinnati, Shockley-Smith said. They’re also a partnership for each other and other Black women and their fampartnership
ilies.
“I feel like this is where God called me to be,” Shelton said.
Black mothers were more than 2.5 times as likely to die during pregnancy, while giving birth or shortly after pregnancy than white women in the United States, state and national maternal mortality records for from 2014-2021 show. The latest data, released May 2 by the National Center for Health Statistics, shows a drop in maternal death rates overall – but the gap between Black and white maternal deaths is about the same.
Queens Village is working with the four major birthing hospital systems to create a website, MamaCertified.org, which makes public hospital reports detailing maternal and infant health data and equity improvement plans.
The hospital systems have embraced the plan, the women say. The Mama Certified website was launched in February and continues to develop its content. The effort is funded by foundation bi3, Anthem Blue Cross and Blue Shield Foundation and CareSource.
“Accountability and trust are key,” MamaCertified.org announces to those who visit. “Together, we are working in with hospitals to hold them accountable for how they care for Black people who give birth.”
The site has ratings of hospitals’ overall care of Black moms and their babies. It includes newborns’ breastfeeding rates, outlines the hospitals’ safesleep strategies and community outreach programs. It shares hospital data on newborn complications and shows how each hospital’s rate compares to that of the county and state. The hospitals are asked to provide annual updates for recertification.
Mama Certified also is getting national attention, Shockley-Smith said.
The U.S. Department of Health and Human Services invited her to Washington, D.C., last year and this year to discuss the work happening in Cincinnati, including Mama Certified. Shockley-Smith was also invited to Vice President Kamala Harris’ office in 2023 to brief her team on Mama Certified work.
Other cities have reached out to discuss Mama Certified as an option for their communities, Cradle Cincinnati spokeswoman Jessica Seeberger said.
Now, Mama Certified lists all the hospitals’ postpartum maternal care services – including mental health.
The women deliver personal and passionate expertise that health care professionals do not have, said Lauren Bartoszek, director of community health strategies for the Health Collaborative. Efforts to improve health care for marginalized people need to include people who are most affected by the disparities, research shows.
“Queens Village reminds all of us that those closest to problems are closest to the solutions,” said Kate Schroder, president and CEO of Interact for Health, a nonprofit working for equity in health. “They know their community – and what will work – and they are trusted to lead.”
Queens Village advisory board members Shelton and Mia Crockett said the website is a symbol of hope for Black mothers now and a long-range vehicle for change for mothers and their babies’ outcomes.
“We are looking for change for the future,” Shelton said. “Not only for our generation.”