The DC Mayor’s Maternal & Infant Health Summit

By Jessica Bowers

I recently attended the DC Mayor’s Maternal & Infant Health Summit in Washington, DC. The turnout at the summit and the variety and level of stakeholders demonstrated the magnitude of this issue and how many people want to create change. There were about 800 attendees, predominantly African-American, standing-room only.

The reason for the summit was clear: While the United States overall has a serious maternal health problem (we are the only industrialized nation with a rising maternal mortality rate), Washington, DC has it twofold. Marked by tremendous inequality, Washington DC’s maternal mortality ratio is nearly double the national average and the highest maternal mortality ratio in the nation, yet at the same time their non-Hispanic white patients have the lowest maternal mortality mortality ratio in the U.S.

Many women in the District of Columbia do not access care until late in their pregnancies, or not at all. The maternity care deserts that exist in rural areas across the country (shortages of providers and facilities nearby) exist in urban areas as well. The last two hospital maternity wards that served the poorest areas of the city closed in the last two years. The District has identified this crisis and recently ordered the creation of a mortality review committee.

The summit’s panels featured U.S. mayors (from Baltimore; Flint, MI; Gary, IN; Rochester, NY), local community-based organizations (CBOs) (Mary’s Center, Community of Hope), national organizations (March of Dimes, Campaign to Prevent Teen Pregnancy), DC government officials, private health sector leaders (MedStar Washington, CareFirst, Kaiser Permanente) who came ready to examine the trends and discuss and learn about solutions.

Some of the most informed and insightful remarks came from the leaders of community-based organizations and others who have been working to advocate for and implement maternal and newborn health solutions for people living at the margins for decades. The call was clear: the only way we will make progress is to engage and involve the community, and work through and with community organizations and leaders.

Some of my favorite quotes from the day illustrate a few of the key takeaways from the summit:

“To really affect pregnancy outcomes you need to start early, and to start early you need to engage the community.” — Dr. Hugh Mighty, Howard U. College of Medicine. Alternative forms of care that are located at the community level (doulas, other community-based care workers, etc.) tend to be more accessible and provide women with a bridge to better access formal health services. Meet women where they are, even if it’s locating services and providing information through churches and other community spaces.

“We need to stop acting like mental health is different from physical health.” — Mayor Karen Freeman-Wilson, Gary, IN. Going beyond just physical care and looking at the whole woman is critical for positive mom/baby outcomes: mental health resources and wraparound support systems are invaluable and should be part of any maternal health care package.

“We need to deal with implicit bias and make sure all providers are treating women equally.” — Stacey Davis Stuart, President, March of Dimes. Structural and systemic racism is a significant and harmful barrier. Training and educating providers early should be part of their training, and building the pipeline of providers of color is an important investment.

“If women have a good experience, they will tell all their friends, if they have a bad experience they’ll tell EVERYONE!” — Cherie Craft, CEO/Founding Executive Director, Smart From the Start. We need to consider the importance of customer service — if people are treated badly, they are unlikely to want to return for care — it’s that simple.

The solutions aren’t simple, but they are out there. Plenty of great programs and organizations out there are doing incredible work — they just need support, resources, and a seat at the table to be able to scale and continue doing what they are doing. As one panelist said, we need to build on what already exists in the communities.