Black Maternal Health: The Disparity in Outcomes, Insights From Our Listening Work, and How We Can Find Solutions
By Annie Yu, Jennifer DeYoung & Dr. Venice Haynes
“I wrote my doctor a note like a letter explaining what I wanted, how I expected it and I was just straight up honest with him. I was basically saying to him ‘I need to get home to my kids.’ I was really nervous with him and I’m like I need to get home with my kids. I need you to make sure that I’m okay, so I wrote that in my letter to him.”
-Black Woman, New Jersey
Each year, thousands of Black women die from complications stemming from childbirth — not just while giving birth, but up to a year after, and while efforts and significant resources are rightly put towards addressing this problem, the maternal mortality rate for Black women continues to climb. According to the latest CDC report, the mortality rate among Black women skyrocketed to almost three times that of White women. With a bipartisan majority of Americans supporting improvements in maternal and newborn care and a robust advocacy network highlighting the impact this inequity has on our communities, the question remains — why has our health care system failed Black women so severely?
At United States of Care (USofCare), we know that finding solutions to persistent health care problems requires creating change differently and that starts with listening to people. Through our listening work, we know that people want their health care to be more affordable, dependable, personalized, and easy to understand. With this growing disparity in maternal health outcomes in mind, we lean in on maternal health specifically and listen deeply to understand people’s birthing experiences and the challenges they face. Most recently, we spoke with 20 Black, Hispanic, and Asian-American women across the nation, and asked about their birthing experiences, including the resources and support they wanted and needed during their pregnancy and postpartum periods. Additionally, we asked what a world would be like if they had all of the resources and support they needed during their pregnancy journey. What we learned was sobering, and highlighted how many inequities exist in maternal health for women of color, and Black women in particular.
One of the biggest insights among these discussions was that the Black women we spoke with were keenly aware of and concerned about the racism and racial disparities of maternal and child health in our health care system, and the potential negative health outcomes for them and their children. From times when their providers didn’t believe them when they said they were in pain to times when they felt they needed to verify and do personal research about the care they were receiving due to concerns about medical racism, the Black women in these groups shared a number of experiences that speak to the barriers Black women face when seeking care during and after childbirth.
“I was very, very aware of what was happening with maternal health. Black women were a lot more likely to die in childbirth for not being listened to.”
-Black Woman, Wisconsin
Additionally, high out-of-pocket pregnancy and postpartum health care costs remained top-of-mind and incredibly prohibitive for Black women. This comes as no surprise, as the average cumulative cost of pregnancy, childbirth, and postpartum care averaged a total of $18,865 between 2018 and 2020, with average out-of-pocket costs reaching $2,854 for women enrolled in large-group plans. Compounded with the confusion over what services are covered by insurance and what is left to pay out-of-pocket, the experiences of the Black women we spoke with highlighted how the significant cost of care is made worse by the inequalities faced — all just to have a baby.
“Once I decide to have kids again, I want to have the best coverage because you can get anything, and it may not cover everything, and then you end up paying higher. I didn’t realize when I was younger that you are paying a hospital bill, but you are also paying — they have like a private entity in-fee that they go through, so just making sure you are fully covered all the way around.”
-Black Woman, Georgia
Over the next year, USofCare will dig in deeper on these issues and what Black women have to say about their pregnancy experience in order to identify where the inequities are occurring along the pregnancy to postpartum trajectory. Using these insights to fuel our efforts, we will create change through collaboration with policymakers, private sector leaders, health care leaders, innovators, and everyday people to build a more equitable health care system where Black women are not more likely to die from childbirth than their white counterparts.
Annie Yu is our Policy Innovation Manager.
Jennifer DeYoung is our Senior Director of Policy & Innovation.
Dr. Venice Haynes is our Director of Research & Community Engagement.
About United States of Care:
United States of Care is a nonpartisan organization committed to ensuring that everyone has access to quality, affordable health care.
Disclaimer:
This article is part of United States of Care’s Medium publication, representing the individual views of the author(s). It does not necessarily reflect the beliefs or positions held organizationally by United States of Care or its board of directors. As a non-profit organization dedicated to ensuring that everyone has access to quality, affordable health care, United States of Care values and seeks out a diverse range of perspectives. We believe in the power of different voices to enhance understanding, empathy, and dialogue about critical health care issues.
Visit: UnitedStatesofCare.org
Follow: X
View: Instagram
Like: Facebook
Learn: LinkedIn
