WASHINGTON — When U.S. Rep. Cori Bush of Missouri was pregnant with her first child, Zion, she saw a sign in her doctor’s office encouraging her to speak up about anything unusual she was feeling.
She did so, telling her physician that she was having severe pains, but her concerns were swiftly dismissed. The doctor told Bush, who is African American, that she was fine and sent her home — and one week later, Bush went into early labor.
“At 23 weeks, my son was born, one pound, three ounces,” Bush told a congressional hearing Thursday on Black maternal mortality. “His ears were still in his head. His eyes were still fused shut. His fingers were smaller than rice, and his skin was translucent, a Black baby, translucent.”
Bush recalled that the doctor who delivered her son apologized for not listening to her.
But when she was pregnant with her second child, she faced the same situation. She again went into early labor, and a different doctor refused to help her, telling Bush in a clear reference to her race: “You can get pregnant again, because that’s what you people do.”
Her story is far from unusual.
Mothers, spouses and loved ones of Black people who have died as a result of childbirth complications described their experiences to the House Oversight and Reform Committee in heartbreaking detail.
Black birthing people are three times more likely to experience pregnancy-related death when compared to their white counterparts, according to the Centers for Disease Control and Prevention. They also experience higher rates of pregnancy complications, infant loss, and miscarriage.
Affluent Black Americans also are disproportionately affected: a Black person with a college degree is twice as likely to experience a severe physical or mental complication from childbirth than a white woman without a high school degree, said Dr. Veronica Gillispie-Bell, medical director for the Louisiana Perinatal Quality Collaborative.
Gillispie-Bell and other medical experts said race and the country’s long history of racism are at the root of why childbirth has a greater likelihood of turning fatal for those who are Black.
False medical beliefs about Black people — including that they have thicker skin or a greater tolerance for pain — have contributed to health care providers being less likely to listen to and act upon health concerns raised by Black patients, studies have found.
One study found Black patients who undergo a cesarean section are less likely to receive the same anesthesia treatment as white patients who have the same surgery, said Dr. Joia Adele Crear-Perry, of the D.C.-based National Birth Equity Collaborative. She completed her medical degree at Louisiana State University and her residency and in obstetrics and gynecology at Tulane University’s School of Medicine.
After the doctor refused to help Bush, 44, now a freshman Democrat in Congress, stop her preterm labor in her second pregnancy, her infuriated sister threw a chair down the hallway.
The nurses who responded called Bush’s original doctor — the one from her first pregnancy who apologized for not listening — and the physician was able to place a surgical stitch to keep her cervix closed, allowing Bush to continue carrying her daughter to a healthy birth.
“Every day, Black women die because the system denies our humanity,” Bush said. She did not name the doctors or the health care facility where the incidents occurred.
When Charles Johnson went to the hospital with his wife, Kira, for the delivery of their second son, complications were far from his mind after a healthy pregnancy for both Kira and the baby.
But after her C-section, he grew alarmed when her catheter began to turn pink due to internal bleeding. For hours, he sought help, but a scan that was scheduled to be performed “stat” was delayed.
At one point in his pleading, a nurse told him flatly that his wife was “not a priority.”
When she finally was taken for surgery 10 hours later, three-and-a-half liters of blood had filled her abdomen, and Kira died.
Johnson, who founded an advocacy group on maternal mortality, said that even in her most vulnerable state, his wife urged him to stay calm. She feared that if he raised his voice as a Black man, he would have been seen as a threat and kicked out of the hospital.
“It haunts me. Should I have yelled?” Johnson asked. “But the reality of the situation, as a Black man, I did not have the same autonomy to raise my voice, scream, that a Caucasian father would.”
Johnson said he would like to see Congress take bipartisan steps to make childbirth safer. But he also expressed some resignation about the limits of federal powers. “You cannot legislate compassion,” he said, attributing his wife’s death to a lack of concern and humanity.
Democratic lawmakers have introduced a range of bills seeking to address disparities in the U.S. health care system that make childbirth more dangerous for Black Americans.
Cosponsored by Reps. Alma Adams (D-N.C.) and Lauren Underwood (D-Ill.), a package of legislation dubbed the Black Maternal Health “Momnibus” Act — using a pun based on the term for legislation covering wide-ranging issues — would seek to collect more data on the causes of the maternal health crisis; provide more money to community groups and telehealth services to support care during pregnancy; and aim to grow and diversify the country’s birth workers, including doulas and midwives.
“It doesn’t matter what side of the aisle you’re on: Either you have a mother, or you are a mother or you know women who are moms,” said Adams, co-chair of the Black Maternal Health Caucus.
House Oversight Chairwoman Carolyn B. Maloney, a New York Democrat, also said after the hearing that she has requested three new Government Accountability Office reports on the public health crisis.
One change that advocates urged lawmakers to support: making permanent a provision in the latest stimulus package that temporarily allows states to extend Medicaid coverage for pregnant people for a year after giving birth, instead of just 60 days.
Medicaid pays for nearly half of all births in the U.S., and the longer length of health care benefits is viewed as pivotal in ensuring those who are pregnant receive proper postpartum care for their physical and mental recovery.
Michigan’s largest city reports ‘historic’ drop in infant mortality rate
Relatedly, Detroit Mayor Mike Duggan and Dr. Joneigh Khaldun, Michigan’s top health official, on Wednesday announced during a news conference what they described as an “historic” drop in Detroit’s infant mortality rate. The rate of babies born in Michigan’s largest city who do not live to see their 1st birthday is the lowest it has been in decades, according to state data. It represents the steepest drop in more than 20 years, they said.
Detroit’s infant mortality rate plunged from 16.7 deaths per 1,000 live births in 2018 to 11 per 1,000 live births in 2019, representing a one-third rate reduction, according to the Michigan Department of Health and Human Services. The data represents a significant closing of the disparity between Black babies and white babies dying before their 1st birthday. In 2018 the rate was 18.9 for Black babies compared to 6.4 for white babies. In 2019, that gap closed dramatically with a rate of 12.3 for Black babies and 9.7 for white babies. Detroit is 79% Black.
Duggan and Khaldun credited a community-wide effort among a wide group of government, private health care and nonprofit organizations that have worked for years – in some cases decades – to improve the odds of survival for babies born in Detroit. In recent years, the city has funded rides for pregnant mothers to their prenatal appointments.
“We won’t know for certain all of the factors that led to the reduction in infant mortality in 2019, but want to make sure all Detroit moms-to-be get transportation,” Duggan said.