Creating a BOLD Future for Black Maternal Health

“Please do not kill me. If I say I’m sick, please believe me.” were the opening statements written in a birth plan of an expecting Black mom. Written in bold letters explicitly to her care team in hopes that her wishes during pregnancy and childbirth were honored and she would not become statistic.

It is unconscionable that the United States is still the most dangerous place to give birth in the world as a developed country. While we have known for decades that we have a maternal health crisis, the pandemic showed us that the bodies of Black and Brown people have kept the score. There are a number of complex factors that contribute to racial inequities and disparities in maternal health outcomes. Yet the ability to live a long and healthy life is predicated on access to a range of social and economic resources systematically denied African American families and communities.[1] A growing body of evidence cites negative health effects of ‘weathering’ and stress from institutional racism endured over the lifespan as significant drivers in Black maternal health outcomes.

In Missouri, Black women are 4 times more likely to die from pregnancy or childbirth as white women (87.6/21.9 per 100,00 live births) despite income and education levels, and experience 2 times the risk of severe maternal morbidity as white women.

It is these and other daunting maternal health statistics that serve as painful reminders of the dangers and risks pregnancy and childbirth present to Black women and birthing people.

“Statistics are the stories with tears wiped away.” Author Unknown

The terrifying and harrowing birthing experiences of Black women and birthing people often generate tremendous fear and anxiety, causing Black birthing people to question their desire to give birth.

“If I go into surgery to have a baby, will I make it out alive?”

Are the dreams of a healthy pregnancy and joyful birthing experience dreams deferred?

Let’s end the maternal health crisis and create a BOLD future where race and zip code no longer determine health outcomes. Collectively, we can dismantle racist care practices and systems, create space so those most impacted can elevate their voices, and co-design equitable pathways to safe, affordable, and respectful care.

At Generate Health, we believe that when we center Black women and birthing people with lived experience, we will be able to collectively create systems where Black moms, babies, and their families thrive. Our approach is to support the leadership of those with lived experience – from FLOURISH’s Community Leaders Cabinet leading a change project to uplift Black maternal mental health to the Black women-led Momnibus steering committee crafting a package of policy recommendations for the Missouri State Legislature. In the words of Angela Davis, our goal is to transform current health care conditions into “Health systems that meet Black bodies with deep love, utmost standards in care, deep interest and presence.”

THE VISION elevated by the FLOURISH Community Leaders Cabinet (Powered by Generate Health) is a region where birth and pregnancy is a marked moment to celebrate. Black women and birthing people have access to holistic care that is culturally congruent to their needs, and they are informed, listened
to, respected, and supported in having the healthy pregnancy and birth that they desire.

Improving Black maternal health outcomes demands a multi-faceted, holistic approach that addresses Black women and birthing people’s health across the lifespan, improves access to quality health care, addresses social determinants of health (improving family and community conditions), and provides greater economic security.[2]

  • Provide patient-centered care that is responsive to the needs of Black women and birthing people
    What’s missing from the care of Black women and birthing people is their centered voice, validation of experience, and freedom to choose and be informed. Black women and birthing people need respectful care that is free of implicit and explicit bias. (“Setting the Standard for
    Holistic Care of and for Black Women”, 2018)
  • Eradicate cultural biases and discrimination in medical practice and medical education
    Who’s in the room matters. Increase provider diversity to reflect patients served and how providers and institutions account for unbiased, high-quality, evidence-based care.
  • Expand and protect access to trusted community providers
    Doulas and community health workers play an essential role in providing Black women and birthing people with important supports before, during and after childbirth. Integrate doulas as part of the care team and advocate for insurance reimbursement for their services.
  • Expand access to quality, patient-centered and comprehensive reproductive health care
    Policymakers must work to ensure that Black women and birthing people are able to plan their families in the way that feels best for them.
  • Address the social determinants of health (conditions under which people live, work, and play)
    Advocate for policies that raise incomes and build wealth; provide access to clean, safe, and affordable housing; improve the quality of education; prioritize reliable public transportation and transport for medical and other essential appointments; and increase the availability of healthy, affordable food.
  • Expand and maintain access to health coverage
    Support policies like Medicaid expansion that would improve maternal outcomes for Black women and birthing people by providing better access to care and reduce financial instability.
  • Expand paid family and medical leave
    Paid family and medical leave allow workers to earn a portion of their pay while taking time off from work to care for themselves or their families.
  • Invest in health care safety and quality improvement initiatives
    Maternal mortality review committees increase understanding of the underlying and contributing causes of pregnancy-related deaths. Hospitals and medical practices shall participate in quality improvement efforts known to improve maternal health.[2]

What can you do?

Join Generate Health’s network of diverse advocates as we work together to center the voices of those most impacted by maternal health disparities and accelerate positive change for our community.

  • Learn how you can get involved in one of the community-driven priorities by reaching out to Leah Moser, Director of Planning & Partnerships,
  • Share your vision for ways to transform Black maternal health by reaching out to Lora Gulley, Director of Community Mobilization & Advocacy,
  • Share your personal story of hope, joy, dignity and respectful care you experienced during pregnancy and/or childbirth journey by messaging us on Facebook or Twitter
  • Sign up to receive advocacy alerts for the latest information on actions you can take to help advance Black maternal health
  • Follow us on social media: Facebook : Twitter
Generate Health
5501 Delmar Blvd, #B240
St. Louis, MO 63112
phone: (314) 880-5719
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