The U.S. has the highest maternal mortality rate in the industrialized world, and most of the deaths are completely preventable. On top of that, Black women die at up to four times the rate of white women due to racism in the healthcare industry.
This week, Sens. Kirsten Gillibrand and Kamala Harris introduced a pair of bills aimed at preventing negligence in hospitals that results in deaths and medical complications, and fixing the tragic racial disparity in how many women die before, during, and after childbirth. The bills, called Modernizing Obstetric Medicine Standards (MOMS) and Maternal Care Access and Reducing Emergencies (CARE), are meant to complement each other.
"Hospitals have struggled under a lack of funding for a long time and the MOMS Act helps them because it would provide funding and get the data so we can understand the depth of the problem," Sen. Gillibrand told Refinery29 in an interview.
According to the Centers for Disease Control and Prevention (CDC), an estimated 50,000 of women experience severe complications during childbirth, and about 60% of deaths and complications are preventable. And for every woman who dies in childbirth in the U.S., there are 70 who nearly avert death, an NPR and ProPublica report found.
Sen. Gillibrand's MOMS Act, cosponsored by Sens. Harris and Cory Booker, would allocate $40 million each year for five years, to be used by hospitals to develop and standardize safety best practices. Prioritizing hospitals serving low-income, at-risk, and rural populations, it would fund crucially needed hiring, training, and equipment.
According to a new USA Today investigation, the U.S. is "the most dangerous place to give birth in the developed world." The three states with the highest maternal death rates are Louisiana (58.1 deaths per 100,000 births, studied from 2012 to 2016), Georgia (48.4), and Indiana (43.6).
One of the leading causes of maternal deaths is excessive bleeding, said Sen. Gillibrand, recalling a woman whose bladder doctors accidentally sliced open during a C-section and who then complained of weakness and fatigue. Had doctors listened to her, they would done a scan sooner and discovered that her abdomen was full of blood. Another major cause is severe hypertension, according to USA Today. To assess these conditions, healthcare providers need to pay attention to a woman's blood pressure and accurately measure levels of blood loss — which the report found hospitals are often "eye-balling."
"We're finding that doctors and nurses sometimes aren't listening to patients — they're not following up with the patient" when she describes her symptoms, Sen. Gillibrand said, which results in women dying of preventable, but potentially fatal conditions.
We're finding that doctors and nurses sometimes aren't listening to patients — they're not following up with the patient.
Sen. Kirsten Gillibrand
These types of policies have worked in states like California, which has seen its maternal mortality rates decline by 55% (from 16.9 to 7.3 deaths per 100,000 births) between 2006 and 2013. California, according to USA Today, followed by Massachusetts and Nevada, now has the lowest maternal mortality rate in the country. At the same time, the overall U.S. maternal mortality rate has continued to rise.
Women of color are particularly vulnerable to dying as a result of childbirth-related complications. "Because of racism and institutional biases in medicine, they don't believe Black women when they say, 'I don't feel right.' ... She's doubly dismissed. Her feelings are not regarded, not responded to or followed up on," said Sen. Gillibrand.
This is what Sen. Harris aims to address with the CARE Act, which is co-sponsored by Sen. Gillibrand and 12 other Democrats.
"Health equity for Black women can only happen if we recognize and address persistent biases in our health system," Sen. Harris said in a statement provided to Refinery29. "This bill is a step towards ensuring that all women have access to culturally competent, holistic care, and to address the implicit biases in our system."
The CARE Act would create two new grant programs focusing on reducing racial disparities in maternal health. One would address implicit bias, a key reason Black women receive subpar healthcare, with trainings in facilities such as medical and nursing schools. The other would establish "pregnancy medical home" programs, which connect high-risk women with case managers who coordinate health and social services, modeled on a successful program in North Carolina.
"We applaud Sen. Harris on putting forward this critical legislation and appreciate her commitment to ending racial disparities in maternal health care and outcomes," Elizabeth Gay, MPH, co-director of the Black Mamas Matter Alliance, said in a statement. "Addressing racial discrimination and implicit bias is an important but often overlooked part of improving maternal health in the United States."