The Equity Equation: Advocates discuss solutions to improve Black maternal health

By the time the hospital team realized Krystal Oriadha was crowning, she had already been in active labor and extreme pain for 10 hours.?

“I had a horrible birthing experience,” said Oriadha. “I was a Black woman at the mercy of the health care system. And in my situation, they didn’t believe me.”?

Fortunately, Oriadha’s baby was born healthy but the episode inspired the Prince George’s County councilmember to advocate for change.??

Oriadha joined Dr. Tamara Henry, Ed.D. with the George Washington University Milken Institute School of Public Health and Virginia Senator Angelia Williams Graves for a discussion on the Black maternal health crisis and what’s being done to improve outcomes during IPHI’s second Equity Equation webinar in April.??

Watch Power in Policy: Driving Change for Black Maternal Health and read a recap below.?

Understanding the Black maternal health Crisis?

While examining maternal health is complex, a new study suggests the U.S. maternal mortality rate is 10 deaths per 100,000 births.??

Yet more than 80% of pregnancy-related deaths are preventable according to the CDC. And alarming disparities exist: Black moms are three times more likely to die from pregnancy-related causes than white women.?

Dr. Henry encouraged attendees to first consider social determinants of health and systems when examining Black maternal health.??

“We cannot continue to just put the onus on individual health behaviors,” said Dr. Henry. “We should consider asking the right questions around what is going on in the lives of Black women who are giving birth, and what some of these root causes may look like.”?

Where a person lives can impact birth outcomes, thanks to confluence of health care access and structural inequities.??

For example, a report from the District of Columbia's Maternal Mortality Review Committee shows that while Black people accounted for half of the births in D.C., they suffered 90 percent of birth-related deaths.??

Dr. Henry noted the ripple effects of maternity and food deserts within Wards 7 and 8.?

“We’re seeing concentrated levels of poverty in certain places that are further exasperating our quality of life for women giving birth in the district,” she said.???

Data from 2015-2019 shows the mortality rate for Black mothers is nearly four times that of white mothers in Maryland.??

In Virginia, the mortality rate for Black women is twice the rate of white women.??

“This is not happening by happenstance,” explained Dr. Henry. “We have a system that is not working.”?

Policy focus: Expanding post-partum care?

More than half of maternal mortality happens during post-pregnancy, up to one year after giving birth. Dr. Henry noted post-partum hemorrhages and various cardiac issues as some of the causes.??

She sees expanding post-partum care as an important policy solution.??

Dr. Henry also highlighted how addressing racism, training medical professionals on biases and disparities, launching peer-to-peer models and eliminating maternity care deserts as important steps to achieving better health outcomes.??

“We’re going to need a holistic approach to address this, as well as a systemic approach,” said Dr. Henry.??

The Virginia Black Maternal Health Caucus launches??

Senator Graves helped form the Virginia Black Maternal Health Caucus this year, a group of Black women lawmakers in the Virginia General Assembly who are committed to addressing maternal health inequities. The Caucus meets periodically to discuss Black maternal health and is looking for organizations to partner with to create legislative solutions.?

“One of the things I’m very proud of is the space the Black Maternal Health Caucus gives us to have these conversations, not only with each other as Black women, but also with our white counterparts, and also with our male counterparts,” said Senator Graves. “It gives us an opportunity to have these conversations with them to help dispel misnomers and some of the biases that may come into those patient settings.”?

This year, Virginia’s governor signed a resolution to designate April 11-17 as Black Maternal Health Week. The Caucus plans to use the annual observance – and the time in between – to bring awareness to Black maternal health, as well as looking for ongoing policy opportunities.??

The Caucus also successfully advocated for bills to expand the state’s Maternal Mortality Review Team and a law to require health insurers to provide coverage for doula services in Virginia.?

Maryland policies address Black maternal health outcomes?

Oriadha is using her experiences as a new mom to drive change in her community.?

She helped create a pilot program called “Team Birth,” a program to improve communication between patients and the medical team at the hospital where she gave birth.??

Oriadha also successfully passed a Black Maternal Health Fund to support doulas, a childcare incentive program for local businesses and a maternal healthcare audit for Prince George’s County. She is also working on legislation to require lactation rooms in county buildings and expanding parental leave.??

To support expectant and new moms, she recently published “A Black Mother’s Guide” with tips and resources.??

“We have to do everything when it comes to addressing Black maternal health,” said Oriadha. “We have to address every aspect: mental health, the ability to work, access to care, systemic racism.?

“It’s going to be way bigger than a week. What we have to do is to make sure this is not a moment – that this is a movement and it doesn’t stop,” added Oriadha.???

The next Equity Equation conversation will take place in late summer. Updates will be posted on the IPHI website.??

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