Sen. Elizabeth Warren unveiled a new plan on Wednesday to address the crisis of women dying during childbirth in the United States, an issue which disproportionately impacts Black women. Research has shown the nation has the highest maternal mortality rate in the industrialized world, and most of these deaths are completely preventable.
"You can measure a country’s values by how it treats its mamas and babies — and America is failing. We need to call it out: Black moms are dying in and around childbirth at rates three to four times higher than white moms because of structural racism," Warren told Refinery29. "Medical providers should pay for the high rates of Black maternal mortality in our country — and keep paying until they fix it."
Warren was one of several 2020 presidential contenders who participated in the She the People conference in Houston, TX, on Wednesday. Monifa Bandele, senior vice president and head of maternal justice campaigns at MomsRising, asked the Massachusetts senator about this issue. "I got a plan," Warren said. She said hospitals would be rewarded with a "bonus" fund for reducing their maternal morbidity and mortality rates. "And if they don't," Warren said, "then they're going to have money taken away from them. I want to see the hospitals see it as their responsibility to address this problem head-on and make it a first priority. The best way to do that is to use money to make it happen, because we gotta have change and we gotta have change now."
Black moms in our country are dying from childbirth-related causes 3-4 times more often than white moms. Any meaningful solution to our maternal mortality crisis must address structural racism as a root cause of this problem. My new idea would tackle this crisis head on. pic.twitter.com/1YcaVNTedz— Elizabeth Warren (@ewarren) April 24, 2019
Statistics show Black women face mortality and morbidity at disproportionately high rates, even after adjustments for income and education. Last year, Serena Williams opened up about the life-threatening complications she faced after giving birth to her daughter. The star athlete said she knew something was not right with her body and believed she was suffering from blood clotting, but her doctors dismissed her concerns. Her condition was confirmed via a CT scan, but only after she persistently asked. If it had not been detected, she could have died. Williams' story is not uncommon: Between 700 and 900 women die from pregnancy or childbirth-related causes every year in the U.S., while 65,000 nearly die, according to a 2017 report from NPR and ProPublica.
One of the main reasons Black women specifically are so impacted by this crisis are the "racialized ideas around the impact of trauma and pain," Bandele told Refinery29 in an interview. To this day, many physicians and other health providers still believe that Black people, including Black women, have a higher threshold for pain — a notion that has no scientific basis. When combined with the stress of racism and the subsequent dismissal of their symptoms, Black women are more vulnerable to facing life-threatening conditions or death during childbirth.
This is why Bandele believes the 2020 presidential candidates need to address maternal mortality. "I was very impressed that she had thought a lot about the issue," she said of Warren's response. (That the Massachusetts senator has a plan should not come as a surprise, since she has introduced policy proposals on issues ranging from child care and Big Tech to reparations for slavery and student loan debt.) "There has to be a multifaceted approach to bringing down the maternal mortality rate, from expanding Medicaid so it covers doulas and people have access to nontraditional support, and one that also includes hospital accountability," Bandele said. "That is one lever in addressing this crisis. I liked that [Warren] was coming at it from an accountability framework. Money is a way to hold institutions accountable."
Bandele added that one of the cons of the plan is women in hospitals with limited resources are already vulnerable, and cutting down funding could further endanger them. But she said Warren's proposal is worth exploring. "It's good that candidates are thinking about it," she said. "When it comes time to put a plan in place, we need moms, doulas, midwives, doctors, and researchers all together with our policy-makers."
Bandele said that three years ago, when she started working on this issue, not a lot of people considered maternal mortality a crisis. That has since changed. For example, Sens. Kirsten Gillibrand and Kamala Harris, both 2020 presidential candidates, have taken the lead on this issue in the Senate. Last year, Gillibrand and Harris introduced legislation targeting hospital negligence and fixing the racial disparity in care that can lead to women of color dying before, during, or after giving birth. The bills, called Modernizing Obstetric Medicine Standards (MOMS) and Maternal Care Access and Reducing Emergencies (CARE), were meant to complement each other.
"The movement began under the umbrella organization, the Black Mamas Matter Alliance," Bandele said, adding that organizers and activists have been raising public awareness all along. "It's a from-the-ground-up victory in bringing this issue to the forefront."