We Must Protect BIPOC Mothers During Covid-19
The 1,707 deaths from COVID reported on November 18th, in America is equivalent to one American dying per minute. As the numbers grow, the staggering 257,000 COVID-19 deaths tell an irrefutable story. America is struggling in this unparalleled health crisis. We are the richest country in the world, yet our most marginalized communities are suffering, our mothers and children of color are dying. Skyrocketing cases are a call to action. Our leaders must address the effect on maternal health in Black, Brown, and Indigenous communities and the long term ramifications.
As a Black, first-generation American raised by a single mother, I know, ignoring the inequitable effect of COVID on communities of color will lead to severe and long-lasting consequences. COVID-19 and healthcare neglect are decimating Black, Brown, and Indigenous communities, mothers, and children. Despite the life-threatening risks that these women face in the postpartum period during this pandemic, Medicaid currently only covers women for two months after their baby's birth. Given that Medicaid pays for nearly half of all births in the United States, Congress and the Biden Administration have a responsibility to do better. Medicaid coverage for mothers must be expanded to one year postpartum.
Race and ethnicity are known risk markers for other underlying conditions that impact health — including socioeconomic status, access to health care, and increased exposure to infection due to heavy representation of people of color in essential and critical infrastructure jobs. This leads to high COVID19 infection rates in Black, Brown, and Indigenous communities. Center for Disease Control statistics show that Black people have 2.1 times the COVID death rate compared to whites; 4.7 times the hospitalization rate; and 2.6 times the infection rates. Latinos have 2.8 times the COVID infection rates and 4.6 times higher hospitalization rates than Whites.
Inequity and implicit bias woven into healthcare systems lead to diminished access to the best care for communities of color. Ultimately, health disparities result in far worse health and birth outcomes for people of color than their white counterparts. Community health workers, doulas, and breastfeeding counselors are a lifeline for vulnerable populations. They provide culturally and ethnically reflective information and support, yet are not adequately compensated.
To improve outcomes for mothers, babies, and communities of color, Medicaid coverage for mothers must be extended to a year postpartum, and Medicaid coverage is provided more broadly for community health workers, doulas, and breastfeeding counselors.
The National Institute of Health notes that in the best of times, racial disparities are stark in pregnancy-related mortality. Notably, African American and American Indian/Alaska Native women are 3.2 and 2.3 times more likely to die from pregnancy-related causes than are white women. Severe maternal morbidity is also higher among Latina women compared to white women at 2.9 percent versus 1.5 percent.
HealthConnect One workers in vulnerable communities are witnessing the ravages of the pandemic firsthand. But ultimate outcomes are not yet clear. National research on the effects of Covid-19 on birthing outcomes of communities of color does not exist.
Birth justice is a fundamental need, as it is part of the start of life. Poor birth outcomes often have a snowball effect. Too often, illnesses emerge, infants fail to thrive, developmental delays surface. Sadly, maternal mortality outcomes are equally dire. Again, the data tells a compelling story about the variability of risk of death by race or ethnicity. Black women experienced 42.4 deaths per 100,000 live births, compared to 13.0 deaths for white non-Hispanic women during 2011–2016.
The good news is, there is legislation before Congress: The Helping Medicaid Offer Maternity Services (MOMS) Act (H.R. 4996) was introduced by Congresswoman Lauren Underwood (IL-14), together with a bipartisan group of members of Congress committed to improving the United States' alarmingly high maternal mortality rates. The bipartisan Helping MOMS Act would allow states to expand Medicaid coverage for new moms through the entire postpartum period.
Our communities are experiencing a crisis within a crisis as generations of systemic racism have made us more vulnerable to the pandemic’s effects. The heightened racial tension playing out in the nation provides a constant reminder of the ever-present interpersonal racism, bias, and divisiveness. Amidst this crisis, we showed up. Our votes shifted the course of the election; the large Black communities in Atlanta, Philadelphia, and Detroit and the Indigenous and Latinx communities in Arizona made a significant impact on the result. Our lives matter, our voices matter, our votes matter, and our participation in government matters.
As COVID rages on, long-standing inequities of birth experiences in communities of color put everyone at risk: women, children, and families. The lack of practitioners of color, lack of cultural sensitivity, lack of bilingual practitioners, and access to the best care, affect the outcomes of care for people of color. The incoming Biden Administration and new Congress are facing formidable problems and tough decisions ahead. The decision to help mothers facing life and death challenges as they give birth during this pandemic should be crystal clear.