While Black Maternal Health Week has ended, the work continues. The week of action and exploration provided an opportunity for advocates, mamas and medical practitioners to share the abundance of thought and the possibility of building better systems that consider the experiences of Black mothers.
Beyond discussing the stark disparity in maternal mortality between Black and white women, there is an opportunity to explore alternatives in medical care and bridge the gap in care.
Breana Lipscomb, senior advisor for Maternal Health & Rights at the Center for Reproductive Rights, said the space created by Black Maternal Health Week provides an opportunity to highlight the work of phenomenal doulas, midwives, researchers and advocates fighting on behalf of Black mamas.
Black midwives, doulas, and lactation consultants all play a crucial role in improving Black mothers’ care. According to Lipscomb, research shows that having a doula present or birthing with a midwife improves birth outcomes.
“Black women face disrespect, abuse, and mistreatment in facility-based settings like hospitals, at a much higher rate than other people of color, particularly, more so than white women,” Lipscomb shared. “We have to make sure that they are receiving safe and respectful care when they walk into a hospital.”
The Center for Reproductive Rights has three policy priorities: improving data quality, access to care and addressing racism both within and outside the health care system. Enhancing data quality involves having a better representation of midwives, doulas, lactation consultants and other community-based providers participating in maternal mortality review committees.
Lipscomb said that improving access to care involved adjusting the Medicaid rules to create a standard for postpartum care beyond the 60 days of postpartum coverage that previously served as the baseline.
“At the state and federal levels, we’re working on extending Medicaid coverage in the postpartum period to one year,” she explained. “Just two years ago, no states had extended coverage. We’re almost at 20 plus states that have extended Medicaid coverage to one year, and that number is rising.”
Lipscomb said that changing the standard for postpartum care at the federal level would prevent the piecemeal approach of having states apply for extensions to provide up to one year of care. A tracker managed by the Kaiser Family Foundation explained that Medicaid covered approximately 40 percent of births. As of April 14, 2022, more than 25 states and Washington D.C. had either implemented a 12-month extension or planned to do so.
“It should be permanent and mandatory that every state provide coverage for one year postpartum,” she said. “We’re kind of working on a state and federal strategy to get that done. So that there’s consistent care available to women across the country.”
It’s estimated that 52 percent of maternal deaths occur after delivery. Despite claiming to be pro-life and pro-family, it’s been a fight in several states to pass policies that benefit maternal health.
“We struggle to get the same state legislatures to pass proactive policies like paid leave, Medicaid extension to one-year postpartum, policies like covering doula care or expanding access to midwifery care or even making childcare affordable,” Lipscomb said. “We’re seeing a lot of hypocrisy when it comes to what supporting families really look like.”
Lipscomb said state legislators need to evaluate their record and consider what It means to support families.
And part of having state legislators and other elected officials who truly support families is electing individuals that share those values. Amanda Brown Lierman, executive director of Supermajority, said that making a change starts by connecting real people through dialogue.
“Sometimes it’s not a politician who’s going to convince you that your voice matters,” Lierman said. “But instead, it’s a friend. It’s an auntie. It is a grandma helping you understand how your lived experience and the values that you have, in terms of how the world should be operating, how that’s connected to real political conversation and dialogue, and decisions around us.”
Working across several political campaigns, policy spaces, and issue-based advocacy organizations, Lierman always understood the need to invest in building powerful coalitions. With the rise of women, especially Black women, as a force to behold, Supermajority provides pathways for women to enter the political realm.
“One of the saddest truths of our democracy is just that we have so many people who just feel like their voices don’t matter,” she said. “If we are able to come together, vote together, be the multiracial coalition of women and show up to the polls as the most powerful voting bloc that there is, we can change how decisions are being made.”
Lierman connected the political organizing of groups like Supermajority with the policy efforts spearheaded by the Black Mamas Matter Alliance and other affiliated groups pushing for changes that directly impact the health of Black mothers. A mother of three, Lierman said becoming a mom and going through pregnancy as a Black woman was a wake-up call to how the world is not set up to support women as mothers.
“From my own experience, I had so much fear as a Black woman, particularly a Black woman giving birth in the DC area,” Lierman shared. “I started having babies about five years ago, at the time that this conversation was being elevated.”
Lierman said she recognized her privilege in being able to curate a birthing experience complete with a Black midwife and other supports. Shortly after becoming a first-time mom, Lierman said she started her journey as a doula. That advocacy and experience directly connect to her broader work building a multiracial democracy.
“It felt like a thing that I could do to help other women and to be there for other women and provide that emotional, physical and mental support to try to curate more of an empowering experience for people, which is something that I was able to do for myself,” she explained. “To be empowered during pregnancy, and certainly during labor, it requires a fair amount of activism, advocacy, and education. And the same is true for how we should be engaging in our elections.
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