Everyone should have the safe, respectful, and dignified care and treatment they need to have healthy pregnancies and healthy babies.
Allyson Felix (illustrated above)—the most decorated American track and field athlete in Olympic history—considers motherhood the most special job she’s ever had.
The birth of a child should be a time of joy for every family. All parents deserve a beautiful, positive birthing experience that aligns with their values and needs. But this is not the case for many women in the United States—and especially for Black women. If we work together, we can make sure that all who give birth get the chance to have healthy pregnancies and healthy babies.
In this blog post, two powerful Black women—an Olympic gold medalist, and the other a nationally recognized physician on a mission to improve maternal outcomes—reflect on motherhood, maternal care, and how to shape a brighter future for Black birthing people and babies. Both women are featured in the new documentary, BIRTHING JUSTICE (supported in part through funding by RWJF), premiering nationally April 10 on PBS, kicking off Black Maternal Health Week.
Elevating Black mothers’ experiences
Eleven-time Olympic medalist Allyson Felix considers motherhood the most special job she’s ever had. But her birth story is indicative of a wider Black maternal health crisis.
As an Olympic athlete who stayed fit throughout my pregnancy, I never expected to have a complicated pregnancy or birth. Then at 32 weeks, my doctor discovered that I had severe preeclampsia during a routine prenatal visit. Fortunately, my doctor acted quickly and likely saved my life and my daughter’s. But not all Black women—even those with the resources I have—are fortunate enough to get the care they need and deserve to have a joyful birth experience.
Far too frequently, a Black person’s pain or suffering is dismissed because of discrimination or implicit bias in our healthcare system. It cannot go on that way. For Black women and their infants to thrive, it’s crucial that doctors, nurses, and other medical professionals value and respect every birthing person’s experiences.
Restructuring our healthcare system
For Dr. Elaine Batchlor, a physician and chief executive officer of MLK Community Healthcare, access to quality, diverse healthcare is foundational to achieving birth justice.
My personal experiences as a Black woman shape my commitment to quality care in my health system. Access to the best possible care is a fundamental right. Offering it can be an act of social justice.
That means access to care at every stage of our lives. Women’s health during pregnancy is deeply connected to their health before and in between pregnancies. If you live in a community with limited access to medical care and are unable to see a doctor regularly, you are entering into pregnancy with increased risk. Women need comprehensive reproductive healthcare, from primary care through postpartum support, for healthy outcomes. We deserve to receive this care from providers who understand our needs. We deserve to enter pregnancy with anticipation, not trepidation.
America is the most dangerous place to give birth in the developed world—and pregnancy-related deaths are on the rise. The toll is not equally distributed: Black women are three times more likely to die of pregnancy-related causes than White women.
The Black maternal health crisis is rooted in systemic racism and its impacts—not individual choices on the part of the mother or family. Data from the CDC’s Maternity Mortality Review Committee found that a shocking 80% of pregnancy-related deaths were preventable in 2017-2019, with the constellation of inadequate primary and specialty care, lack of access to services, and implicit bias and discrimination among healthcare providers contributing factors to this loss. Disparities exist across income and education lines.
As a physician one thing is clear to me: quality reproductive healthcare is fundamental to providing a healthy birth. Adequate provider payment will attract doctors to serve in communities like mine. Recruitment and training of a diverse healthcare workforce, from physicians to community-based perinatal support professionals, will ensure that all mothers are treated and cared for by someone who looks like them, understands their unique experiences, and prioritizes their preferences. It works for our babies too—physician-patient racial concordance improves health outcomes for both mothers and their infants.
Joining together to advance solutions to the Black maternal health crisis
We all deserve to have our voices respected and valued when giving birth. Policymakers, funders, and hospital administrators must learn new lessons by listening to those most impacted by this crisis. But listening alone won’t be sufficient—we must act together. When healthcare systems, community partners and parents collaborate on solutions, prioritizing evidence and weighing and respecting community voice, we will be better equipped to make lasting change for birth equity.
Birth justice-focused organizations are advancing policies and practices that address the impact of structural racism on maternal and infant health outcomes. Communities on the front lines of this crisis are advocating to increase the number of birth support people demonstrated to improve birth outcomes—and expand insurance coverage to include their care. These efforts are vital to reducing disparities.
Lastly, our policymakers must invest in making birth equity a reality in our country. Medicaid expansion, on the rise in some states, is associated with reduced rates of maternal death, particularly for Black women. In order to address the Black maternal health crisis, however, we must not only expand and enhance Medicaid coverage, but also ensure that providers receive adequate payment. Without both expanded Medicaid and fair reimbursement, Black women will not be able to access the healthcare they need.
There is additional action our policymakers can take, from providing families with a living wage and paid family and medical leave to access to quality and affordable childcare, safe, affordable housing and nutritious food. These combined solutions could dramatically improve equity in Black maternal and infant health. For every family to experience the joy of a healthy birth, they must be put into action.
We’re already seeing a powerful shift in awareness. Let’s continue to act on the evidence, listen and respond to the voices of those giving birth, celebrate Black excellence in healthcare professionals, advocates and birth workers, and change failed systems and policies so every expecting parent can envision a birth story as the loving, joyful and healthy experience it should be.
Visit birthingjustice.com to watch a documentary on how Black women are navigating pregnancy and working to improve maternal and infant health.>>
About the Authors
Allyson Felix is a retired Olympian and executive producer of Birthing Justice.
Elaine Batchlor, MD, MPH, is a physician and the chief executive officer of MLK Community Healthcare in South Los Angeles.