California Gov. Gavin Newsom in October signed landmark legislation introduced by Sen. Holly J. Mitchell that addresses the inequities in maternal care for black mothers and infants.
Senate Bill 464, the Dignity in Pregnancy and Childbirth Act, requires implicit bias training for perinatal providers involved in services at hospitals and birth centers. It also requires the state Department of Public Health to track and publish data on maternal mortality rates and pregnancy-related conditions.
“Now's the time for the health care delivery system to acknowledge implicit bias and the impact it has on their ability to provide adequate, appropriate (and) equal health care services for all,” said Mitchell, who represents parts of downtown L.A., South L.A., Culver City and the westside.
According to the Centers for Disease Control and Prevention, about 700 women die as a result of pregnancy or delivery complications every year in the U.S. In addition to reported deaths, more than 50,000 women a year suffer from various pregnancy related complications.
American women are dying at a higher rate than women in any other developed country, and CDC studies show that black and American Indian/Alaska Native women are about three times as likely to die from a pregnancy-related cause as white women.
“We've come to believe that it's a race-based bias because it's women at all ends of the socioeconomic spectrum who are having this disproportionate negative experience with the health care delivery system,” Mitchell explained.
Research done for the 2018 California Pregnancy-Associated Mortality Review showed black women are only 5% of the state’s birthing population but make up 21% of pregnancy-related deaths in the state.
Between 2006 to 2013, California’s rate of maternal mortality has decreased 55%.
Lawmakers and health professionals continue to work together to lower the number of maternal deaths.
“The key is collaboration,” explained Dr. Stephen H. Lockhart, Sutter Health's chief medical officer. “When we think about how we can be most useful and have the greatest impact in our communities, it's only through partnerships."
“As far as I understand it, particularly in California, but I believe in other areas too, African American women are bearing the brunt of this issue,” MedShare Western Regional Director Eric Talbert explained. “It’s a structural violence that perpetuates itself through generations. And so, anything we can do within California to help bring awareness to that issue will help raise those voices to make sure that they're getting the attention that they need so they get the care that they deserve.”
Lawmakers, health care providers and health organizations use storytelling as a big tool when it comes to understanding and bringing awareness to the issue of maternal mortality — especially within the black community.
“What is so sobering to me is everybody has a story. Everybody has a story of their own, of a woman in their family, of someone they know. And that's frightening to me, but also lets me know that we're on the right track,” Mitchell explained. “While California's numbers are better than most, they still are not proportional to our sheer numbers in the population. And so we've got to talk about why that is.”
On a national level, federal lawmakers are hoping to lower preventable maternal mortality rates with bills like the Modernizing Obstetric Medicine Standards Act of 2019; Mothers and Offspring Mortality and Morbidity Awareness Act; and Excellence in Maternal Health Act of 2019.