Racial Inequities in Maternal Health Commission hosts first listening session

June 30, 2021 | Dennis Hackett
dhackett@thereminder.com

The Massachusetts Legislature’s Joint Committee on Public Health’s Racial Inequities in Maternal Health Commission meets for a Microsoft Teams meeting.
Screen capture by Dennis Hackett

WESTERN MASS. – In the first of four listening sessions, the Massachusetts Legislature’s Joint Committee on Public Health’s Racial Inequities in Maternal Health Commission, co-chaired by Sen. Jo Comerford and Rep. Marjorie Decker, received testimony from residents of Western Massachusetts about both their personal and professional experience with racial inequities in maternal care.

To start the listening session, Dr. Hafsatou Diop, one of the commissioners and the director of the Division of Maternal and Child Health Research and Analysis with the Massachusetts Department of Public Health, gave a presentation detailing the inequities in maternal care based on race.

One area Diop explained there is a racial inequity is that Black women are far more likely to be at risk to pregnancy complications under the umbrella of Severe Maternal Morbidity (SMM).

“Because pregnancy related deaths are so rare, we have been looking at other complications that were similar enough where women could have died but did not. These conditions are called Severe Maternal Morbidity. Severe Maternal Morbidity is 50 to 100 times more common than maternal death and we also see sharp inequalities with Black women having a 70 percent greater risk for SMM,” she said.

Some of the complications due to SMM include hemorrhage, stroke and other significant issues that can have a lasting impact.

“There are a lot of women who have suffered SMM and leave with the trauma of having almost died along with other mental health issues as a result of that,” Diop said.

Based on data going back to 1998 for women that did not receive blood transfusions, Diop said it seems as if medical progress has not affected complications due to SMM in Black women.

“The first one is that SMM rates are going up for all the race and ethnicity groups. The second message is the SMM rates for Black women is higher than any other race group. The third message is that as of 1998 the SMM rate for Black women was still higher than any other racial group in 2009. It almost seems like the medical progress has not affected black women,” she said.

When discussing postpartum depression symptoms, Diop said Asian and Black women suffer higher rates of symptoms compared to white women.

“Women of color, both Asian non-Hispanic and Black non-Hispanic, have statistically significantly higher rates of postpartum depression symptoms compared to white women,” she said.

When looking at the number of women reporting postpartum depression symptoms between 2007 and 2019, Diop said the numbers were too high across the board.

“Even white women are not doing well if 10 percent are reporting mental health symptoms after birth, that is not good, and that number is too high. Nobody is doing well here, there are differences by race, but no one is doing well here,” she said.

Commissioner Nneka Hall, who founded the Quietly United in Loss Together Corporation, said the data from Diop was traumatic to listen to.

“It was triggering, it was traumatic and it speaks to the reason why this commission is 99 percent Black. For me, doing this work for the past 10 years as of July, it still hits me that just because I am a Black woman I almost died, just because I am a Black woman my daughter did die,” she said.

Rochelly Maldonado, who has worked as midwife in Western Massachusetts over the last five years, said there needs to be more access to midwifery education for diverse students.

“Greater access to midwifery education would increase the care provider preparedness to address racial inequalities in maternal health. Care by midwives has been linked to improved outcomes for vulnerable populations and the lowering of pregnancy related complications,” she said.

While the United States spends more money than any other high resource country on maternal care, Maldonado said that is not reflected in the midwives in the country.

“The U.S. spends more on maternal care than any other high resource country, with that being said, the U.S. has fewer midwives per maternal population than any other high resource country,” she said.

The Racial Inequities in Maternal Care Commission will host three more listening sessions to gather more input from across the state.

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