Black women and babies are 3-6 times more like to die in childbirth in the United States.

According to the DCist, Apr 28, 11:15 am story, Black People (women) Accounted For 90% Of Pregnancy-Related Deaths In D.C., Study Finds

“While Non-Hispanic Black birthing people made up 90% of the city’s pregnancy-related deaths, white residents (women) reported no pregnancy-related deaths, despite comprising 30% of all births in the city. Wards 7 and 8 residents comprised 70% of pregnancy associated deaths, while residents of wards 2 and 3 reported no pregnancy-associated deaths in the reporting period.”

The high mortality rates of black women and babies has been in the media for over a decade and during Black Lives Matter it finally became commonly known. Everyone is saying it, but where is the change?

“So, what is the way forward? How do we dismantle the myth of the default human and what will it take to build new standards in education, provision of care, research, policies, public health praxis, and workforce development, and ultimately improve Black maternal health outcomes? First, we must acknowledge that the people most impacted by health disparities are best positioned to determine the solutions. This means that Black communities and Black women specifically need to be centered and prioritized in discussions and decisions about Black maternal health.” Demolishing the Myth of the Default Human That Is Killing Black Mothers, Stephanie R. M. Bray1 and Monica R. McLemore.

”The U.S. has an overall shortage of maternity care providers relative to the number of births.” - Common Wealth Fund

More medical care is not the answer

The news is full of articles - for years - about how the US spends the most money on maternal health care and the US has worst outcomes of any industrialized nation for all women. For the many survivors of traumatic birth, the impact on these mothers, babies, families, and culture is collectively ignored while the US for-profit pathology-based, disease-based medicalized obstetric system has no intention of teaching, providing or supporting physiologic, natural, or home birth. Obstetric medicine is a profit-driven business that is not required by law nor customers to practice the evidence-based science about physiologic birth.

A recent report from The Commonwealth Fund concluded:

“Among 11 developed countries, the United States has the highest maternal mortality rate, a relative undersupply of maternity care providers, and is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period, a recent report from The Commonwealth Fund concluded. Compared with any other wealthy nation, the United States also spends the highest percentage of its gross domestic product on health care.

Maternal deaths have been increasing in the United States since 2000, and although 700 pregnancy-related deaths occur each year, two-thirds of these deaths are considered to be preventable.”

“Midwives in many countries are key care providers trained to provide a wide range of services. Among these are helping to manage a normal pregnancy, assisting with childbirth, and providing care during the postpartum period. Placing a priority on natural reproduction processes and relationship-building, midwives also can help address the social and personal needs of mother, baby, and family.8 Ob-gyns, meanwhile, are physicians trained to identify and intervene in abnormal conditions that come up before, during, and after pregnancy. They typically provide care in hospital-based settings.”

Midwifery-led care models have been shown to provide care that is comparable to, or sometimes even better than, that provided by obstetrician-gynecologists, or ob-gyns (see box).9

The U.S. and Canada have the lowest overall supply of midwives and ob-gyns — 12 and 15 providers per 1,000 live births, respectively (Exhibit 3). All other countries have a supply that is between two and six times greater.”

Common Wealth Fund

At the center of the crisis is The American College of Obstetricians and Gynecologists (ACOG), (not to be confused with Advanced Combat Optical Gunsight). ACOG is “a professional association of physicians specializing in obstetrics and gynecology in the United States….. The College as a 501(c)(3) focuses on education (with limited political work), whereas the Congress as a 501(c)(6) is allowed to advocate for members' interests in terms of the business of medicine (BOM) through lobbying and other political work.[3] Their main advocacy focuses on women's reproductive health, specifically opposing political interference in abortion access.”

ACOG is presented as the authority on women’s bodies, health, and birth, but it is a lobby group, not a research institution. It is a political group. It serves primarily it’s members. As such, it has been emboldened to dominate over women’s rights to truly informed choice in hospitals and to natural, physiologic birth with midwives at out-of-hospital birth. ACOG blocks all efforts to have midwifery care in the US, while it is common and doctors around the world work in partnership with midwives.

The recent trend in last few years of ”allowing” midwives and doulas in the hospitals is an effort to block midwifery, natural birth, and homebirth. Midwives and doulas have been weaponized. Again.

The American Medical Association (AMA) was formed in 1847. Men who formed it knew nothing about birth and women's bodies and they pushed through criminalizing abortion, giving them, the AMA - and later ACOG in 1951 - control over women's bodies and birth.

It’s not ironic or by mistake, it is the evolution of their systemic control and their main advocacy today is abortion rights, “specifically opposing political interference in abortion access.” But not the safety of women and babies at birth, especially black women and babies.

Birth, abortion, and racism are politically, religiously, and medically enmeshed. Neither birth nor abortion should have ever been criminalized or taken from the midwives who were the true experts on women’s bodies and birth.

“But in 1857, Professor Reagan writes, the newly founded American Medical Association “initiated a crusade to make abortion at every stage of pregnancy illegal.” The organization was driven not only by concern for fetal life but also by the desire to take control from midwives. And some members expressed concern that middle-class “Anglo-Saxon” women were not having as many children as Catholic immigrants and people of color.

Dr. Horatio R. Storer, a leader of the medical campaign against abortion, asked who would settle the nation as it spread westward. Would the frontier “be filled by our own children or by those of aliens?” he asked. “This is a question that our own women must answer; upon their loins depends the future destiny of the nation.”

This is why white people today must understand the history of “white male” colonizing on behalf of themselves, using black and other non-white lives that were deemed less than, and for their use. No, it wasn’t us, but if you’ve ever considered that it was your ancestors, and if you understand epigenetics you can see how critical it is to see how your white life is privileged. “Epigenetics is the study of how your behaviors and environment can cause changes that affect the way your genes work.”

Keep that as a lens for reading the following sections. The question before us now is how to we stop the practices of drugs, intervention, and separation of the majority of humans during their birth from the mother. ACOG and it’s members need to lead the change within their ranks to create a health-based, mother-baby protecting practice. The routine, ritualized deeply ingrained practice of separating mother and baby repeatedly from induction to surgery to cord cutting to nursery is barbaric.

Be honest. It’s just you here, in your epigenetics. When you read that - pay black women $5,000 a month (not even a living wage in DC) for one year to be primary caregiver of their babies, what was your first thought? First feeling? I am betting that despite your sincere concern for Black Lives Matters you had some systemic programming pop in. What thoughts and feelings did you have about paying black women for a full year to care for their babies - as attachment science tells us is the minimal for all humans? Don’t ignore or resist your feelings. Work it. It’s the systemic racism alive in you that is killing women.

My art work here is the stories of five professional black women that I transcribed into visual art. I have cut away the “white parts” and put the work - the transcription of the stories of black women - on to reflective mirror-like material. As the viewer looks at the beautiful, mesmerizing design, I want the viewer to see themselves (literally in the mirror behind) in the black women’s stories of past and present - and future. My show/series is called See-Feel-Do. I want the viewer to see themself, FEEL it, in them, and then be compelled to DO something.

What we do? It’s been prominent in the news for at least twelve years that black women die more often. I used that statistic in my film that released in 2013. And, it’s getting worse, not better.

When you look at the problem of black women dying 3-6 times more often than white women in birth, where do feel this? When, how, where, what do you see in your reflection in the systemic racism that creates the physical, mental, and emotional toll on black women? For 400 years. Where do you feel this in your body? Are you willing to feel it? Do you see your role, your self, in the issue? What can you do once you see and feel this? Are you ready to understand it, stop it? To stop commodifying black women and their babies for white culture.

"The Black maternal health crisis as we know it today devolved from a system that once deemed Black women the most valuable of all commodities. In 1619, the United States of America was as nascent as its capitalist system, the foundations of which were built on the backs of Africans brought to the Americas as chattel (1–3). After this new nation won its independence, slavery and the growth of capitalism continued hand in hand. Banks, insurance companies, higher education institutions, manufacturing, and health care institutions formed a constellation of enterprises that were created because of and relied on the enslavement of Black people. This began a sustained effort of constructing systems, structures, and policies that inured toward white supremacy and further subjugated Black people.

Such surveillance ensured that enslaved Black women continued to reproduce: Between 1807 and 1860, the number of enslaved Black people in the U.S. increased from just over 1 million to over 3.9 million (3). Also see Figure 1.”

That is shocking. Let that sink in. Again, FEEL it in YOUR body, can you? Your body is where you hold and feel empathy and compassion. Can you feel the brutality of that statistic? Enslaved black women increased the population of enslaved people from one million to FOUR million in just over fifty years. When you get the magnitude of that, it should make you feel sick, you might feel like weeping, falling to your knees wondering “how could I possibly compare my white European ancestor’s ability to pull themselves up by their bootstraps in America. Free to do so.”

These are the people - white men and their own oppressed women - who created everything, every system, including the medical and obstetric systems.

How do you feel now about the possibility of financially supporting single black mothers the equivalent of a living wage for the first year postpartum?

The Black Mamas Matter Alliance is a national network of Black women-led and Black-led, birth and reproductive justice organizations and multi-disciplinary professionals, working across the full-spectrum of maternal and reproductive health.

Dr. Joia Crear-Perry is founder and president of the National Birth Equity Collaborative, an NCRP nonprofit member. She is a Board Member of Black Mamas Matter Alliance.

Dr. Joia Crear-Perry was also on this panel, ”From Birth Control to Death: Facing Black Women’s Maternal Mortality”, that was moderated by Professor Kimberle’ Crenshaw in Washington DC in 2018. The panel of five women examined intersectionality and the many factors impacting poor maternal health and survival outcomes for pregnant black women.

This conversation culminated the April, 2018 #herdreamdeferred Series: A Week on the Status of Black Women, organized by the African American Policy Forum (AAPF) in Washington DC. Featured speakers: Laurie Bertrum Roberts, Dr Joia Crear-Perry, Jennie Joseph, Kira Shepherd, Aarin Michele Williams.

The portraits also hold the joy, the hope, the bliss, and the dreams of these women and on behalf of all birthing women.

The first one was during a discussion of the issues and the sharing of their work. This was a theme through each sharing was the impact of the Catholic Church hospital system on black women. All women, but disproportionately to black women.

When the panelists again each shared their ideas for HOPE and CHANGE, focused on the capital region of Washington DC, I did the second one. I didn’t even notice until later how the middle image is the shape of DC.

My immediate intention with my art work about black mothers and babies is to inform residents of Washington DC for the Black Maternal Health Conference and Training Institute in September 2022. My overall intention is support the black women to lead a collaborative effort to address the systemic issues IN THE MEDICAL SYSTEM and my hope - a birth trauma and attachment educator - is less medicalized and more midwifery birth in Washington DC.

^^ That’s me! I look sad because this is so sad.

Below the two soul portraits. I share my process of working with these portraits by going to the locations - Catholic Church and the US State Capitol - that are in power over women’s bodies and babies’ births.

In July 2019, I began to work with these two Soul Portraits - see my art residency page.

I seek to incorporate my mother-baby-father attachment healing process with the art, and I seek to use it to support black men to engage in the process of addressing the systems that created and maintain the systemic abuse that is known to be the cause of the high mortality rate of black women and babies.

Men rising up to address the the local hospital, state, and federal laws that allow the medical system to misuse drugs and technology at birth is the goal of my docuseries, The Other Side of the Glass.

In July and August 2019 I had an art residency and focused on my pieces related to black women’s mortality rate, the Catholic Church, and Fentanyl in epidural.

Resources:

National Geographic: American women are still dying at alarming rates while giving birth

Connecticut Health Team. U.S. Maternal Mortality Rate Is Disgraceful; Worse For Women Of Color

Health Affairs: The United States Maternal Mortality Rate Will Continue To Increase Without Access To Data. “Over the past two decades, the US maternal mortality rate has doubled, making the US the only developed nation in the world with an increasing maternal mortality rate.”