With the new administration underway, there is great potential for change within the maternal care space. You may have heard of the Black Maternal Health Momnibus, a series of 12 bills addressing racial and ethnic disparities in maternal care. The act was originally introduced by Vice President Harris during her time as a senator and has been re-introduced by Senators Booker, Underwood, and Adams.
With this in mind, we asked Dr. Temeka Zore of Spring Fertility to hear her greatest hopes for the next four years when it comes to addressing disparities of care for women of color. Here’s what she had to say.
There is no question that this past year has brought about a social and racial awakening for many people in this country. Whereas the past may have lent itself to overlooking the issues of racism and disparities that exist, the recent events surrounding the murder of George Floyd, the Black Lives Matter Movement, and discrimination against Asian Americans have shone a new light on past issues. Additionally, this pandemic has also highlighted racial disparities in care that persist.
Racial disparities in care and racial disparities in medical outcomes exist in almost all fields of medicine, from higher rates of severe COVID infection and hospitalization in minority populations to higher rates of infertility in black women with an almost 50 percent lower likelihood of seeking care, to an almost 40 percent higher rate of breast cancer mortality in black women. These unfortunate statistics are likely driven by a variety of factors including access and affordability of care, weathering, implicit bias in the medical field, and a pervasive mistrust of the medical system in general.
When we focus on reproductive and maternal health care, my hope is that this new administration will make it a priority to address the maternal morbidity and mortality disparities in care that exist.
The Black Maternal Momnibus Act is one such step in the right direction. Introduced by Congresswoman Lauren Underwood, Congresswoman Alma Adams, Senator Cory Booker, and members of the Black Maternal Health Caucus, the Black Maternal Momnibus Act seeks to build on current legislation to comprehensively address the disparities in maternal morbidity and mortality in the US.
In the United States, black birthing people are dying at almost 3x the rate as white people and Native American/Alaskan Natives are dying at twice the rate of white people from pregnancy-related causes. The bill has identified several important areas for which our healthcare system can address the disparities in care that likely contribute to these staggering maternity disparities.
I hope over the next four years we are able to take direct action regarding the injustices that exist. It will take action and cooperation from state and federal agencies to ensure that all women have access to affordable and reliable preconception and first trimester obstetrical care to address the chronic medical conditions that tend to impact minority women at higher rates, thus potentially predisposing them to higher maternal morbidity and mortality. Additionally, it will take coordination among medical training programs to recognize and address implicit bias in the healthcare system and how best to incorporate competency training into our healthcare education system.
Our healthcare system will also need to address the differences between equal and equitable care. When we think of these terms in relation to healthcare, we have always sought equal access to healthcare and treatment. However, equity acknowledges that while everyone deserves equal access to care, that there may be other cultural, racial, and societal factors influencing the ability to access the care being provided, that not everyone is starting on an equal playing field when it comes to healthcare.
As healthcare providers, we all need to do our part to ensure we are providing culturally competent care to patients and to recognize any implicit biases we may possess and how we can learn and grow from those biases. As a healthcare system, we have to continually ask ourselves how we can expand care and ensure that we are meeting the needs of all of our patients and it will also take our government to continue to address, support, and fund legislation and research focused on minority health.
We’d love to hear in the comments—what are your hopes for the Biden/Harris administration when it comes to addressing racial and ethnic disparities in maternal care?