‘Birthing while Black’ is a national crisis for the US. Here’s what Black lawmakers want to do about it

For Black women in Congress, maternal mortality hits close to home. The Black Maternal Health Caucus seeks change

When Alma Adams’s daughter complained of abdominal pain during a difficult pregnancy, her doctor overlooked her cries for help. The North Carolina congresswoman’s daughter had to undergo a last-minute caesarean section. She and her baby daughter, now 16, survived.

“It could have gone another way. I could have been a mother who was grieving her daughter and granddaughter,” Adams told the Guardian, following a week in which the White House highlighted the crisis of pregnancy-related deaths among Black women. According to the Centers for Disease Control and Prevention (CDC), Black women die at three times the rate of white women.

For Adams and other Black women in Congress, who formed the Black Maternal Health Caucus, the issue hits close to home. Last week, during Black Maternal Health Week, they talked about how their experiences and the work of advocates had propelled legislation, known as the Black Maternal Health Momnibus Act of 2021, to fight a healthcare crisis that disproportionately affects Black women regardless of income.

The US has the highest maternal mortality rate among industrialized countries. Since 2000, the maternal mortality rate has risen nearly 60%, making it worse now than it was decades earlier. More than half of these deaths are preventable.

Underwood smiles during hearing
Lauren Underwood, an Illinois Democrat, is also a registered nurse. Photograph: Joshua Roberts/Reuters

Health experts point to the fact that other industrialized countries have significantly different approaches to motherhood than the US, including paid maternity leave, access to comprehensive postpartum care and enough maternity care providers, especially midwives, to meet the needs of their populations. Policy advocates add that the crisis among Black women is a symptom of racism in the nation’s healthcare system – from who has access to care to attitudes toward Black people and their bodies.

“It doesn’t matter what your socioeconomic status is. It doesn’t matter how much insurance you have, or how much education you have,” Adams said, adding that her daughter, Jeanelle Lindsay, had a master’s degree and health insurance. “Those things don’t matter. This could happen to anyone. Look at women like Beyoncé and Serena Williams, who had these near misses because the doctors really didn’t pay the kind of attention that they should have.”

Black women in the House used the week of recognition to bring attention to several bills that are part of a sweeping Momnibus package to address the dangers of birthing while Black. Their efforts to elevate the longtime work of organizations such as the Black Mamas Matter Alliance showed the power of representation in putting issues affecting Black women on the congressional agenda, said Lauren Underwood, an Illinois congresswoman and registered nurse.

“It takes women in these spaces to call out problems, set an agenda, and bring together a coalition of legislators, advocates, and community members to work toward comprehensive, evidence-based solutions that will save moms’ lives,” Underwood said in an email.

In January 2019, after Underwood received her committee assignments, Adams met with her to see if she wanted to launch a caucus focused on Black maternal health. One of Underwood’s friends, an epidemiologist at the CDC, had died three weeks after she gave birth. “I was still grappling with her death when I came to Congress,” Underwood said.

Three months later, they launched the caucus with 53 founding members, including Ayanna Pressley, Lucy McBath and Barbara Lee. Today, it has 115 members from both parties.

After consulting with maternal health advocacy groups, Underwood and Adams introduced the Momnibus Act in March 2020, nine bills aimed at combating maternal health disparities through investment in community-based programs and other efforts to rectify social determinants of health – the conditions in which people live, work and grow up – that affect who lives and who dies in childbirth.

Their legislative pursuit was timely, coming before a pandemic that would bring racial health disparities to the public’s attention. Between 2019 and 2020, the mortality rate for Black and Latina women and birthing people rose during the first year of the pandemic.

Kamala Harris, the nation’s first Black and South Asian female vice-president, amplified the issue last week during a speech at the Century Foundation, a progressive thinktank based in Washington DC. Harris called for “building a future in which being Black and pregnant is a time filled with joy and hope rather than fear”.

As a US senator from California, Harris was lead sponsor for the Senate version of the Momnibus Act in 2020, which stalled in committee. Underwood and Adams, along with Senator Cory Booker of New Jersey, reintroduced the Momnibus bill in February 2021.

Most of the proposals in the package are included in the Build Back Better Act, a social spending bill that is stuck in gridlock.

pressley at podium
Ayanna Pressley: ‘The Black maternal mortality crisis continues to rob us of our loved ones and to destabilize families.’ Photograph: Elizabeth Frantz/Reuters

“Were it not for Black women in the Congressional Black Caucus, there would not be a Black Maternal Health Caucus,” said the Massachusetts representative Ayanna Pressley. “When we say that we are the voice of Congress, we mean that.”

Pressley lost her paternal grandmother, whom she never knew, when she died giving birth to Pressley’s uncle in the 1950s. “Decades later, the Black maternal mortality crisis continues to rob us of our loved ones and to destabilize families,” she said during the Century Foundation event.

What explains the disparities in outcomes between Black and white mothers boils down to what Pressley called “policy violence”. It’s not just the discrimination that Black women and birthing people experience, but also the lack of access to quality healthcare and medical coverage.

“These are the result of centuries of laws in a systematic, systematically racist health care system that too often discounts our pay, ignores our voices, disregards our lives,” Pressley said. “Birthing while Black should not be a death sentence.”

In November 2021, Joe Biden signed into law one of the bills in the Momnibus package that invests $15m in maternity care for veterans. But other legislative efforts remain stalled in Congress. Eight bills that were part of the original Momnibus package are part of the Build Back Better Act, according to a tracker by The Century Foundation. They include awarding grants to community organizations to help pregnant people find affordable housing, documenting transportation barriers for pregnant and postpartum people, expanding food stamp eligibility and permanently expanding Medicaid coverage for mothers in every state for a year after childbirth.

And on Friday, Booker and seven other lawmakers introduced Mamas First Act, which would expand Medicaid to cover services from doulas and midwives.

“We’ve made historic progress, from the enactment of the first bill in my Black Maternal Health Momnibus Act to the recent cabinet meeting Vice-President Harris led, the first-ever White House cabinet meeting convened to address maternal health disparities as a national priority,” Underwood said.

Adams pointed to another piece of the legislation that feels very close to home: the Kira Johnson Act, named after a 39-year-old Black mother who, after complaining of abdominal pain, died in 2016 from a hemorrhage following a routine caesarean section. The bill would direct the health and human services department to send grants to community groups focused on improving the maternal health outcomes for Black, Latino and other marginalized communities and for training to reduce racial bias and discrimination among healthcare providers.

The connection between Johnson’s and her daughter’s situations resonated with Adams. The pain they experienced was dismissed – a familiar form of racial bias that the Momnibus package attempts to address.

“Either you have a mother, you are a mother, or you know women who are moms,” Adams said. “When we raise the tide for Black women, who are among the most marginalized and the most vulnerable, we ultimately raise the tide for all women.”


Edwin Rios

The GuardianTramp

Related Content

Article image
'Our community is bleeding': Asian American lawmakers say violence has reached 'crisis point'
House legislators hold hearing as Biden and Harris plan meetings with Atlanta leaders

Lauren Gambino in Washington

19, Mar, 2021 @1:50 AM

Article image
Democrats secure 218 seats in midterms to win control of House – as it happened
Democrats take back House and Republicans hold on to Senate as Trump lauds ‘tremendous success’

Sam Levin in San Francisco, Tom McCarthy,Amanda Holpuch and Erin Durkin in New York

07, Nov, 2018 @11:29 AM

Article image
'We are living the issues': record number of women of color run for Congress
Women like Candace Valenzuela and Marquita Bradshaw aim to make Congress look more like the people it serves

Adam Gabbatt in New York

02, Oct, 2020 @6:15 AM

Article image
Minority lawmakers vow to push back against Trump: 'We're not a racist nation'
The most diverse Congress yet faces uphill battle to resist possible proposals against Muslims and Latinos, while representing ‘the most vulnerable among us’

Sabrina Siddiqui in Washington

22, Dec, 2016 @12:00 PM

Article image
‘Feels like the good old days’: Joe Biden welcomes Barack Obama back to White House – as it happened
Former president returns to mark 12 years of Affordable Care Act, his signature legislative achievement – follow the day’s politics news

Vivian Ho

05, Apr, 2022 @9:11 PM

Article image
Biden and Harris release first public schedule as they begin transition – as it happened
President-elect and vice president-elect moving forward with process even as Trump refuses to concede and spreads misinformation

Martin Belam (now), Tom McCarthy, Sam Levin,Tom Lutz, Oliver Holmes and Martin Belam (earlier)

09, Nov, 2020 @9:42 AM

Article image
Proud Boys leader and three others convicted of seditious conspiracy for January 6 attack – as it happened
Enrique Tarrio’s conviction follows seven-day jury deliberation

Maya Yang

04, May, 2023 @8:00 PM

Article image
Biden addresses Americans after victory – as it happened
Democrat surpasses 270 electoral votes needed to win White House with Pennsylvania win – follow all the latest news and reaction live

Martin Belam (now), Tom McCarthy, Maanvi Singh, Oliver Holmes and Joan E Greve (earlier)

08, Nov, 2020 @10:04 AM

Article image
House votes to fund government amid shutdown threats by Senate Republicans – as it happened
House leaders settle on stopgap measure to extend funding until mid-February – follow all the latest news

Maanvi Singh (now) and Lauren Aratani (earlier)

03, Dec, 2021 @1:04 AM

Article image
US treasury pushes back as budget office warns Biden’s bill will swell deficit - as it happened
Nancy Pelosi is confident that Americans will soon have ‘historic cause for celebration’ – follow all the latest news

Maanvi Singh (now), Vivian Ho and Joanna Walters (earlier)

19, Nov, 2021 @12:54 AM