Black women across the country and in New York confront a staggering and persistent threat to their lives: the decision to have a family. Indeed, black women in New York are nearly four times more likely to die because of pregnancy or childbirth than white women.
And while a black woman’s higher socio-economic status is no protection from a higher maternal mortality rate, poor black women are at an even greater risk. In our state, 67 percent of maternal deaths from 2012 to 2013 were among women insured through the Medicaid program.
What’s more, the disparities in maternal health outcomes aren’t just a New York problem. The U.S. is one of only 13 countries in the world where the maternal mortality rate is worse now than it was 25 years ago, according to the New York Times.
The U.S. also ranks 32 out of the 35 wealthiest nations in infant mortality. Black infants are now more than twice as likely to die as white infants, a disparity that is wider now than it was in 1850, before the end of slavery.
And the disparity in health outcomes exists even when a person’s education level, income and prenatal care are taken into account. A 2016 study showed that in New York City, black, college-educated mothers who gave birth in local hospitals were more likely to suffer severe complications of pregnancy or childbirth than white women without a high school diploma. As Rewire reported in April, “black women who live in affluent neighborhoods, receive prenatal care in the first trimester, are normal weight, and have advanced degrees are still more likely to die or have their baby die than white women in poor neighborhoods, with no prenatal care, who are obese, and don’t have a high school diploma.”
In other words, these disparities are a reflection of a broken health care system embedded with systemic racism where medical care is treated as a luxury instead of a right. And this is deeply shameful in a rich nation with the financial resources to help tackle the problem.
On a fundamental level, our health care system does not value black women as much as it values their white counterparts. For example, black women regularly report that medical staff underestimate and under-treat their pain. And medical staff are not usually trained in how to recognize and address racial bias in how patients are treated.
New York ranks 30th in the nation in its maternal death rate. It is past time we turn our attention to this matter in order to gain a better understanding of the gaps in care that lead to maternal mortality.
These disparities are a reflection of a broken health care system embedded with systemic racism where medical care is treated as a luxury instead of a right.
With a nod to this urgent need, in April Gov. Cuomo announced the creation of a taskforce to address maternal mortality and disparate racial outcomes. The taskforce will provide policy recommendations for reducing racial and economic disparities as well as bringing down the rate of maternal mortality and morbidity overall.
This is a positive step, but more must be done and it will require state lawmakers to act. A bill (A-10346A/S-8907) that passed out of the State Assembly Health Committee this week would create a maternal mortality review board to review every maternal death in the state and develop strategies to prevent them.
The aim of the board, in part, is to bring together a diverse group of experts from a number of different disciplines and from medically underserved parts of the state. These stakeholders will then scrutinize each maternal death case, identify patterns and come up with specific ways in which more can be done to prevent maternal deaths. This type of scrutiny is necessary to inform larger policy solutions and track accountability.
And this is all the more crucial given President Trump’s barrage of attacks on women’s health care. The Trump administration has made it easier for employers to deny women insurance coverage for contraception for example. And the administration’s proposed domestic gag rule, would force any organization that receives federal funding for reproductive health care to avoid providing abortion or even telling patients that abortion is an option for them. The rule would put abortion care further out of the reach of many women, especially poor women. Denying access to reproductive health care will only further exacerbate the very conditions that lead to women dying from pregnancy and childbirth-related causes.
In the face of this national threat, New York must step up and lead the way forward. New York lawmakers must act swiftly and pass legislation establishing a maternal mortality review board. Women’s lives depend on it.