The statistics are shocking. And completely unacceptable. The United States has the highest maternal mortality rate than any other developed country. Furthermore, black women are twice as likely to die during childbirth than any other ethnicity. Their chances of survival during childbirth are likened to women in developing countries.

How is this possible? This month’s LOG we explore this issue and highlight women and organizations that strive to end this frightening issue. We also feature stories, some tragic, of black women, who at the hands of our current health systems’ biases, lost their lives while bringing new lives into the world. Charles Johnson, founded 4Kira4Moms after losing his wife Kira when she was left to bleed internally for ten hours after a ‘routine’ C-section. Charles strives to see this never happen again to another woman or family. He created the organization to honor her and fight for better maternal care in this country. Get to know this organization and their crucial efforts, in the name of a young, brilliant black woman the world lost far too soon.

We further feature organizations like Black Mamas Matter Alliance, who grapple with the root causes of black women’s issues with receiving quality maternal care - from changing policy to addressing cultural biases to empowering women who lack adequate resources and access to health care. Led by black mothers, Black Mamas Matter are aligning with various other organizations to combat this issue in an impactful, sustainable way. We outline articles and research that break down this tragic issue and show how women are resorting to alternate methodologies, including doulas, to protect themselves from the problems they face in traditional settings when giving birth. We also provide information to let you know how to support efforts to address this issue in our nation.

Last month we looked at women empowering women, with organizations like mothers2mothers creating paths for new mothers by other mothers who have learnt how to navigate new motherhood while HIV positive. This month we continue to see how women are creating their own solutions to issues that plague them. Specifically around maternal health, as the issue of black women and other women of color dying at childbirth in this nation continues to persist at such shocking numbers. It is on us to bring awareness and participate in solutions. Women deserve equal and capable care when it comes to what should be the most beautiful moment in their lives, in the richest nation in the world. We can do better and we must. For Kira.

Kira Johnson tragically lost her life after a routine c-section at Cedars Sinai. Kira was allowed to bleed internally for more than 10 hours before the medical staff at Cedars Sinai took action. 

We fight to make sure this never happens to another mother. More women die in the United states each year than in any other civilized country in the world.

4Kira4Moms

4Kira4Moms was founded with the mission to advocate for improved maternal health policies and regulations, to educate the public about the impact of maternal mortality in communities, provide peer support to the victim's family, friends, and promote the idea that maternal mortality should be viewed,and discussed as a human rights issue. 

4Kira4Moms is currently calling on Congress to pass H.R.1318. That legislation will support States in their work to save and sustain the health of mothers during pregnancy, childbirth, and in the postpartum period, to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve health care quality and health outcomes for mothers. Join the Fight!

HOW YOU CAN GET INVOLVED

We have numerous ways you can get involved and join the cause. Your help and support is greatly appreciated.

DONATE

Help 4Kira4Moms reach our fundraising goal by donating today.

Support the campaign

SIGN OUR PETITION

Sign our petition today to help new legislation get passed and ensure improved maternal health policies in the future.

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SPREAD THE WORD

Support 4Kira4Moms by spreading the word to your family, friends and colleagues via social media.

Join the discussion

Our Mission

Black Mamas Matter Alliance is a Black women-led cross-sectoral alliance. We center Black mamas to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice.

Our Vision

We envision a world where Black mamas have the rights, respect, and resources to thrive before, during, and after pregnancy.

Our Goals

• Change Policy: Introduce and advance policy grounded in the human rights framework that addresses Black maternal health inequity and improves Black maternal health outcomes
• Cultivate Research: Leverage the talent and knowledge that exists in Black communities and cultivate innovative research methods to inform the policy agenda to improve Black maternal health
• Advance Care for Black Mamas: Explore, introduce, and enhance holistic and comprehensive approaches to Black mamas’ care
• Shift Culture: Redirect and reframe the conversation on Black maternal health and amplify the voices of Black mamas

Our Story

The Black Mamas Matter Alliance was sparked by a partnership project between the Center for Reproductive Rights (CRR) and SisterSong Women of Color Reproductive Justice Collective (SisterSong) that began in 2013. The two organizations collaborated on story collection on the obstacles that Southern Black women face in accessing maternal health care, leading to poor maternal health outcomes and persistent racial disparities. These findings were included in a joint report – “Reproductive Injustice: Gender and Racial Discrimination in U.S. Health Care” – submitted to the UN Committee on the Elimination of Racial Discrimination (CERD).

Monica Simpson of SisterSong, Katrina Anderson of CRR, and Elizabeth Dawes Gay co-organized a convening in Atlanta in June 2015 that brought together experts, activists, and stakeholders from a variety of sectors who were concerned about Black maternal health. “Black Mamas Matter” was an outcome of this meeting, along with a call to action to produce toolkits for activists in the South working to improve maternal health. Over the course of the next year, CRR, in collaboration with members of BMM, created the Black Mamas Matter Toolkit.

Recognizing the need for the BMM project to become its own entity, CRR and SisterSong initiated a process to create a Steering Committee to guide BMM into its next phase. In November 2016, BMM hosted its first Steering Committee retreat. At this two-day meeting, the group decided on the “alliance” structure, and crafted a vision, mission, values, goals, and work plan for the upcoming year. 

In June 2018, Angela Doyinsola Aina and Elizabeth Dawes Gay became co-directors of the Alliance; expanded the alliance to include over 18 Black women-led organizations; implemented the first ever Black Maternal Health Week National Campaign; and the first Black Maternal Health Conference and Training Institute, all in 2018. The rest is Herstory!!

Going beyond statistics to end life-threatening racism in maternal care

In July 2019, Erica Chidi called a friend, Stanford obstetrician Erica Cahill, MD, to ask for her help with an important project.

Chidi, a sexual and reproductive health educator, aimed to help other Black women who feared for their health in childbirth. Today, the United States is the riskiest wealthy nation in which to give birth, with Black women facing especially heightened risks of death and devastating complications.

The overall U.S. rate of maternal deaths is more than triple what’s seen in other wealthy countries and three times higher among Black than white women. Severe birth complications are rising, affecting more than 1 in every 100 births, with race playing a big role in who is most vulnerable.

“I was pretty frustrated because all I was seeing around the issue was statistical, situational reporting. There weren’t any interventions being coupled with the reporting,” said Los Angeles-based Chidi, who is the CEO of an online women’s health education startup, LOOM, and a former doula, or support person for women in labor.

The New York Times had recently given her the go-ahead to write a guide for how pregnant Black women could work with their doctors to lower their risk of complications.

“Erica and I talked,” said Cahill, clinical assistant professor of obstetrics and gynecology at the Stanford School of Medicine, and Chidi told her, “I have friends and colleagues coming up to me, saying, ‘We see all this very terrifying data; what do we do about it?’ I have nothing to give them.”

Danger giving birth

The United States trails every other rich country in keeping birthing women safe, and race is a key factor: Black and Native American women are about three times more likely than all other groups of women in the country to die from childbirth, facing risks similar to those of birthing women in many developing countries.

But the risks don’t end there. All nonwhite mothers — including Asian women and Latinas — are also more likely to experience life-threatening complications of birth.

Though not fatal, complicated deliveries cause short- and long-term physical harms — from hemorrhage and seizures to heart problems, kidney failure and emergency hysterectomies — as well as emotional trauma, and lasting effects on women’s health and finances.

“Birth equity is where a whole life starts,” said Stanford neonatologist Jochen Profit, MD, associate professor of pediatrics, noting that babies born to nonwhite women are more likely to be born so dangerously early that they need intensive care.

“Birth is a particularly vulnerable time for families and for babies. Any suboptimal care we deliver can have lifelong ramifications.”

Today, several Stanford experts are working hand in hand with maternity care leaders, California health agencies and 40 other organizations to end maternal deaths, reduce severe health complications, and take on racial health disparities that hamper those efforts. At the same time, Profit and other neonatologists are tackling racial inequities for babies hospitalized in neonatal intensive care units

Black women in the U.S. are more likely to die in childbirth than other races.

By using a doula -- a trained professional who provides support to moms before, during and after childbirth -- Naomi is part of a growing trend of Black women who see having a doula, particularly a Black doula, as a potentially lifesaving advocate during birth.

"I know the intensity of what's happening can lead to a lot of complications," Naomi, who asked that only her first name be used, told "Good Morning America." "When you're tapped out because you're having contractions that take your breath away, you want someone who can step in and knows what to do and knows what you want."

As a Black woman in the U.S. -- which continues to have the highest rate of maternal mortality among developed nations -- Naomi is more than twice as likely to die during childbirth or in the months after than white, Asian or Latina women, according to the U.S. Centers for Disease Control and Prevention (CDC).

Black women like Naomi are also more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.

Naomi said she only learned about doulas eight years ago, when she was pregnant with her sixth child and needed someone to be a support person in the delivery room. She was able to access a doula free of cost thanks to a local nonprofit organization, Black Parent Initiative (BPI), that matches Black women with Black doulas in hopes of improving their odds during pregnancy and delivery.

How doulas can help Black pregnant women 

Why Black women die at a higher rate than any other race during childbirth is the result of a web of factors, experts say.

Pregnancy-related deaths are defined as the death of a woman during pregnancy or within a year of the end of pregnancy from pregnancy complications, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiological effects of pregnancy, according to the CDC.

One reason for the disparity is that more Black women of childbearing age have chronic diseases, such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the CDC.

But there are socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions, data shows. And Black women often have inadequate access to care throughout pregnancy which can further complicate their conditions, according to a 2013 study published in the American Journal of Obstetrics and Gynecology.

"I cannot have another Black patient come to me and say, 'I'm scared I'm going to die having this baby,'" said Saint Jean, the OBGYN in New York. "It breaks my heart that in 2021 we still have women in the United States afraid that they will die in childbirth."

 Collage by Yunuen Bonaparte. Photos from left to right by Michelle Leman, Klaus Nielsen, and Tima Miroshnichenko. 

What it looks like when racism affects healthcare — and how we must do better.

In 2014, while in graduate school in Chicago, I underwent treatment for a serious illness. After spending an intense month in the hospital, I was finally transferred to outpatient treatment with weekly doctor appointments. One night, kept awake by insomnia, nausea, and with my hair inexplicably falling out, I wondered if I should page my doctor to ask for a medication adjustment or if I should wait 5 days until my next appointment. 

I was a foreigner from the Caribbean and had only been in the United States a few months, so I was still unsure of how to navigate the U.S. healthcare system. I texted two American friends to ask: a white friend from the East Coast, and a Black Midwesterner.

The first said to page him, that’s what doctors were there for.

The second told me not to bother, that it wouldn’t work and doctors would think I was a difficult patient if I asked for anything outside of hours.

What I perceived as a personality difference at the time, I later realized reflected different realities in the medical system in the United States.

With the murder of George Floyd and the rise of the Black Lives Matter movement, the American public has been awakened to what many have known for years: Racism affects every aspect of daily life. 

Healthcare is no exception.

One disturbing recurring finding is that patients of color are less likely to be prescribed pain medication.

Pain medication is distributed at a doctor’s discretion, and depends on their assessment of a patient’s pain levels. An analysis of 21 studies spanning 20 years in the journal Pain Medicine showed that race clearly impacts this, and Black patients were most affected, with the risk for undertreatment as high as 41 percent. The discrepancy in treatment may not be conscious discrimination, but implicit bias might associate patients of color with drug-seeking behavior or an assumption that they have a higher pain tolerance. 

This is a phenomenon that Micheal Cohen, a 43-year-old Black resident from Washington, D.C., has experienced firsthand. After undergoing a few painful dental procedures with little or no pain medication, Cohen began speaking to others about their experiences and was shocked to learn these incidents were not the norm; that his non-Black friends indeed received pain medication during dental visits. He immediately switched dentists and began to insist on receiving pain treatment during serious procedures.

Cohen described other unjust instances. In one, surgery on his finger took place with an insufficient anesthetic, allowing him to feel every incision. And in another — treatment discrimination not limited to pain medication — a practitioner offered to pray with him instead of give him prophylactic medication to prevent HIV after he was concerned about exposure.

Cohen’s experiences, while jarring, are, again, not unusual. Longitudinal studies have shown that even with diversity training for medical staff and published research, disparities still exist. Cohen stated that to get the treatment he needs, he has to act as a firm advocate for himself.

In 2020, one of the most chaotic strings of events in US history occurred in just a matter of months. As the coronavirus pandemic ravaged homes and hospitals, and as communities and businesses began to feel unprecedented economic pressure, and as a contentious presidential election loomed, and as the push for racial justice in America intensified, the cracks in the country’s foundation grew wider and more visible.

As one online commentator put it, “Imagine living through the Spanish Flu, the Great Depression, and the Civil Rights Movement… all at once.”

During the mass demonstrations that followed the police killing of George Floyd, politicians and TV pundits voiced concerns that large gatherings of mostly unmasked people could lead to further outbreaks of the coronavirus. Health experts like Dr. Anthony Fauci, one of the nation’s leading immunologists, agreed: “When you get congregations like we saw with the demonstrations, that’s taking a risk.” Even the World Health Organization weighed in, supporting the protests while asking demonstrators to exercise caution by wearing masks.

There was, in that moment, a strange convergence of seemingly unrelated events: A global pandemic, which was affecting the health of millions of people, was suddenly sharing airtime with protests against the unequal treatment of African Americans. And as the two biggest storylines of 2020 briefly overlapped, one of the greatest medical threats to human life at the time was being ignored.

The connective tissue, which bound the pandemic with the protests, was institutional racism. Contrary to what commentators chose to discuss, marches against inequality did not threaten the African American community’s health nearly as much as the inequality that already existed in US medicine. Consider the disparities of the disease in question. African Americans comprise 13 percent of the US population but accounted for a quarter of the country’s COVID-19 deaths, according to the CDC. In fact, when corrected for discrepancies in age, the mortality rate for Black people was more than double that of their white counterparts.

Present this data to doctors, and their first response is to blame socioeconomic factors like income and education, elements that exist outside of their offices and medical practices. No doubt, social and economic undercurrents help explain higher rates of coronavirus deaths among African Americans. Racial minority groups are more likely to work essential (frontline) jobs, live in more congested neighborhoods, and have unequal health insurance coverage. Indeed, all of these factors contribute to poorer health outcomes.

Dive a level deeper, however, and it becomes clear that Black patients also suffer higher rates of prejudice and mistreatment in US hospitals, clinics, and physician offices, driving up their risk of death. As an example, billing data showed that African American patients who came to the emergency room with symptoms of COVID-19 (including cough and fever) were far less likely to be tested than white patients with similar symptoms. This doesn’t make any sense. With Black patients twice as likely to die from the disease, the logical response would be for doctors to test African American individuals more, not less. But when faced with a shortage of COVID-19 testing kits, a disproportionate number was used on white patients.

Childbirth is another example. Black mothers die at four times the rate of white mothers, according to the CDC, while the mortality rates for their unborn children are twice as high. Doctors view this as a systemic failure, but the research contradicts this conclusion. When the treating physician is African American, not white, this discrepancy evaporates.

Stand With Breonna

Saturday. March 13th, 2021 marked one year since police killed Breonna Taylor during a botched raid. Her family and millions of others continue their demand for justice. 

Breonna was asleep at home when a rogue task-force of the Louisville police broke down her door in the middle of the night and murdered her. They were attempting an illegal drug raid in the wrong neighborhood for a suspect that they'd already arrested earlier that day.

The police officers have yet to be arrested or charged. Breonna's family saw no progress in their fight for justice, so they reached out to our team at the Action PAC. We need all hands on deck!!!

Add your name: We’re calling on the Louisville Metro Police Department to terminate the police involved, and for a special prosecutor to be appointed to bring forward charges against the officers and oversee all parts of this case. We’re demanding that the Louisville Metro Council pass new rules banning the use of no-knock raids like the one used to break into Breonna’s home.

Since the launch of this petition, Commonwealth Attorney Tom Wine has recused himself from the investigation into the LMPD conduct that night, the FBI is now investigating the killing of Breonna Taylor, the LMPD Police Chief, Steve Conrad, announced his retirement, and all charges have been dropped against Breonna’s boyfriend, Kenny Walker, but our work is not done.