Medical terms like hemorrhaging, preeclampsia and toxemia began to circulate the internet in major fashion and consumer publications. Readers baffled at how something like this could happen to two of pop culture’s biggest names.
“If this can happen to Serena Williams, can you imagine what happens to every other black woman during and after birth,” one Twitter user wrote.
According to a report for the Center for Disease Control, black mothers in the United States are three to four times more likely to die than white mothers during or after pregnancy or childbirth. The rates of black maternal deaths far exceed those of other racial groups, with the United States average for all racial groups being 71 percent higher than that of other developed countries.
The nation’s capital is consistent with these statistics, having been declared “one of the worst places in America to be another” by Newsweek in 2015. Disparities in maternal care are exacerbated by a lack of hospitals and maternal health clinics, with none currently standing in Ward 8 east of the Anacostia River and Providence Hospital and United Medical Center recently closed in Ward 5. Both of these Wards are predominantly black.
A documentary by The Atlantic shares the experiences of one Ward 8 mother, who details long drives and long waiting times in order to be seen by a doctor during her second pregnancy.
The obstacles women face to receive maternal health care have almost become overwhelming without many identifiable solutions. Many healthcare professionals have attributed socioeconomic status, education, access to healthcare and health as to why black women still face grimmer outcomes in childbirth but these variable have all proven to be insignificant when controlled, according to the Center for American Progress.
“I feel like now we’re having the conversation of systematic and institutionalized racism both and how that shapes not only how black women survive and live in this country, but their interactions with health systems,” said Ebony Marcelle, Director of Midwifery at Community of Hope DC.
Marcelle has activated an ideal model of care and most hopeful solution for black women. Community of Hope serves 25 to 30 “dues” or women about to give birth in a given month. Roughly 95 percent of those women are African American.
Themes persistent in black women’s testimonies include racism, lack of trust and often a disregard for black women’s lives when they mention possible red flags. In this model of care, Marcelle hopes to combat.
“My struggle is...even though a lot of healthcare providers are very well-intended, there’s this way of wanting to not acknowledge the historical past,” Marcelle said.
“If we don’t acknowledge this historical past we’re not going to be able to move forward correctly and I think that’s part of the hurdle-- people don’t want to talk about why black women don’t want to breastfeed and how black women were wet nurses back in the days of slavery. We don’t want to talk about all the experiments from Henrietta Lacks to the Mississippi Project [and] all the ways we know African Americans have been affected or have been treated in the healthcare system.”
Marcelle and Community of Hope has worked to establish trust between healthcare providers and patients, by bringing more women of color on staff and easing up on traditionally strict healthcare practices to create a more friendly and nurturing environment.
This, Marcelle says, midwives can sometimes be a determining factor in decreasing negative outcomes for black mothers.
“There’s research showing that states that have less restrictive practice regulation on midwives do better. And the states that are the most restrictive with midwifery and also with abortion access have the worst outcomes.”
Reevaluating policies around maternal healthcare has been the next step to reverse the damage as well. DC Health Director LaQuandra Nesbitt spearheaded the “Perinatal Health and Infant Mortality Report” which shed light on maternal health care practices for DC women in all stages of maternal care. In 2017 DC Councilmembers proposed the Maternal Mortality Review Committee, of which Marcelle is a member set to be sworn in early December.
“When we investigate the cause of death, there’s things that we can figure out to then change the systems going forward,” Marcelle said. These include continuity of care and family health history.
Understanding the deeply-embedded practices maintained by medical institutions and addressing them early in medical education and supporting women of color striving to be midwives is what Marcelle believes could be the solution to black maternal mortality and “near misses.”
“I need folks to rally and support the growth and development of more midwives of color and also more midwives, period. I think we need to support and listen to black women, because Black women are going to give you the answer to this problem, so #ListentoBlackWomen.”