COMMENTARY: Celebrating and Saving the Lives of Black Mothers!

The disparities between Black and White maternal death rates are significant and unacceptable. Black mothers were 2.8 times more likely to die from pregnancy related causes in 2015-19 than White mothers. During the COVID-19 epidemic Black people were hospitalized and died at higher rates than White people and Black pregnant women were 3.4 times more likely to have a COVID-19 complication compared to White pregnant mothers.

Maternal mortality is defined as mothers who die from child-birth related causes that occur during pregnancy, during delivery or up to one year after birth.

These deaths are not just numbers or statistics in our communities. They are painful and harsh losses resulting in long term impact on Black families and our communities.

In 2021 a young black physician, first pregnancy, died of heart disease and her newborn died shortly after her.

In 2022, a Black mother of four died about 10 days after delivery, even though she had made a trip back to her provider after birth, because of her concerns about blood clots.

Also in 2022, a Black mother of 12, died from bleeding following a C-section, leaving her own aging mother to raise her children.

We know that over 60% of these deaths are preventable, based on clinical interventions and needed behavior changes on the part of health care providers. The major clinical causes of

maternal deaths are bleeding, infection, hypertension & heart disease.  Many deaths resulting from these conditions can be prevented by hospitals implementing a proven set of procedures and protocols on all deliveries equitably. We know this is not the case today.

 In the State of Michigan and metro Detroit significant progress has been made in implementing strategies that are proven to make a difference.  The State has expanded Medicaid coverage for up to one year after birth for the mother, expanded Doula services and provided Medicaid coverage for doula services, and refocused all state supported maternal child health programs to include equity strategies.  Much of this progress is due to the collective impact of Regional Quality Collaboratives statewide and especially the work of the Southeast Michigan Perinatal Quality Improvement Collaborative. (SEMPQIC).  In addition, SEMPQIC, with funding from the Merck Foundation’s, Project Detroit: Voices for Life, has brought together a partnership with Henry Ford Health System, Black Mothers Breast Feeding Association, Focus: HOPE and the Detroit Health Department to give voice to over 100 Black women and their perinatal journey, to create an Implicit Bias Training for healthcare providers, and to expand community Doulas. Doula’s and midwives have proven to be effective in reducing Black maternal deaths and severe maternal illnesses.

 Also, with funding from the Kellogg Foundation, SEMPQIC has created a Detroit Health Equity Resource to provide education & resources to those who want to reduce inequities and disparities in healthcare delivery for mothers, babies and families.  

In addition, SEMPQIC and the State of Michigan provides leadership in supporting birthing hospitals in measuring and reporting their progress in executing the necessary protocols and procedures to reduce preventable deaths of delivering mothers. More recently, we provided funding to add a requirement that strategies to reduce bias and inequities must be integrated into other life saving protocols.

However, there are some solutions that can be put in place through public policy, additional resources and most importantly recognition of the root causes of health care disparities.  The social determinants of health, such as educational levels, housing inadequacy, lack of reliable transportation and lack of access to quality health care are all the result of systems, policies and decisions based on historical and intrinsic racism woven into the fabric of our country. Redlining neighborhoods, underfunding urban education and limiting access to voting rights are just a few of the many examples illustrating this fact.

Where do we go from here? Governor Whitmer’s proposed 2024 “Healthy Mom’s Healthy Babies” budget is a very strong next step. Governor Whitmer has proposed an increased investment of $68.3 million for continued and expanded maternal-infant services and programs.  These funds would improve Medicaid access, support the re-implementation of the Plan First family planning benefit, expand Centering Pregnancy sites that are providing supportive prenatal care, continuing the Michigan Perinatal Quality Collaboratives, such as SEMPQIC, as well as supporting birthing hospitals across the state.   This is a much-needed shot in the arm that will reduce infant and maternal mortality statewide, while also reducing the disparities that plague our black families.  

This budget should be supported and passed by the Michigan Legislators!

Another significant barrier to access to quality perinatal care is the perception that providers frequently do not listen or respect Black women.  In fact, studies have shown that often the response is to brush off their concerns and not provide treatment for pain or other symptoms.  This is viewed as lack compassion and concern for the individual, resulting in mothers not returning for prenatal visits. Even Serena Williams, the iconic Black tennis player, experienced this lack of concern for her symptoms during her delivery experience! This finding provided the basis for the Governor’s Executive Order that requires the Michigan Department of Licensing and Regulatory Affairs to require implicit bias training for physicians and other healthcare professionals for licensure.

This trend of increasing maternal deaths, disparities and inequities in our health care systems is unacceptable, based on our values and rich resources in the United States.  Reversing this awful trend requires both leadership and community action, including all sectors, businesses, government, nonprofits, healthcare providers all working together and listening to those who have the lived experience of the impacts of racism and inequities in healthcare.

We must celebrate and save the lives of Black mothers.

Vernice Anthony BSN MPH

Lead Consultant, Southeast Michigan Perinatal Quality Improvement Collaborative (SEMPQIC)

Alethia Carr RD MBA

Co-Lead SEMPQIC

Iris Taylor RN PhD

Co-Lead SEMPQIC