What's behind BIPOC maternal mortality rate?
Sapphire Garcia-Lies and Melody McCray-Miller want to prevent BIPOC maternal mortality. They cite unneeded C-sections and racial bias as causes.
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Maternal health advocates Melody McCray-Miller and Sapphire Garcia-Lies are tired of seeing women of color die as a result of pregnancy. Black, Hispanic and indigenous women account for two of every three maternal deaths in Kansas. That’s far out of proportion to their numbers in the population. BIPOC women account for fewer than 1 in 4 Kansan women.
“It’s devastating to our communities. We should be screaming it from the mountaintops,” said McCray-Miller, a former Kansas state representative and Sedgwick County commissioner. She is also a member of The Wichita Beacon’s Community Advisory Board.
“A Black woman having a baby is like a Black man at a traffic stop with police,” she said.
Maternal mortality means dying within a year after pregnancy
McCray-Miller has teamed up with Garcia-Lies, founder of the Kansas Birth Justice Society, (formerly the Wichita Birth Justice Society), to issue a call to action on bringing down the rate of maternal deaths. Maternal mortality is defined as the death of a woman during pregnancy or within one year of the end of pregnancy.
Specifically, the two want the state to examine whether women of color are dying due to systemic racism that causes health care systems to treat them differently.
On Nov. 12, 2022, the pair hosted a documentary film screening and panel discussion to bring attention to the underlying issues, which they attribute to systemic racism and health inequity.
The documentary “Aftershock,” which can be seen on Hulu, tells the story of Black fathers left behind when two young Black women died due to childbirth complications. Both became activists calling attention to the national problem of maternal death disproportionately impacting women of color.
Low-income women and unnecessary C-sections
“To fix it, we have to name it,” McCray-Miller said. “And the name is systemic racism.”
The November event drew a few dozen women but just a few men – two of whom included Wichita Mayor Brandon Whipple, who read an official city proclamation in support of the call to action, and Gerald Finney, the widower of Rep. Gail Finney, for whom a scholarship in doula training is named. It is funded by the Kansas Birth Justice Society.
According to the film, and McCray-Miller and Garcia-Lies, two underlying problems contribute: Health care providers do not take complaints of pain expressed by women of color seriously, and hospitals encourage low-income women to have unnecessary cesarean sections. The C-section disparity is well-documented.
C-sections are major surgery and carry a higher risk of post-birth complications than vaginal births. But vaginal births often require hours of hospital time, while a C-section delivery can be done in less than an hour. C-sections also carry a higher reimbursement rate for the hospital.
Doulas reduce maternal death from unnecessary C-sections
Studies show that access to doula care can reduce the rate of unnecessary C-sections in women of color, which is why Garcia-Lies started a birth center. She’s formed a team of doulas — professional companions for mothers throughout pregnancy and birth — entirely comprising women of color. Doulas, however, are generally not covered by Medicaid or private health insurance, so systemic barriers remain to low-income women.
The numbers cited by McCray-Miller and Garcia-Lies are supported by the last report issued by the Kansas Mortality Review Committee, published two years ago, in December 2020. It reviews data from 2016-2019. During this period there were 57 deaths of Kansas women within a year of giving birth, but many of those died from unrelated causes such as car accidents, homicide, drug overdose and mental health problems.
A subset of these – 13 women – died from causes directly associated with pregnancy. Two out of three of these were women of color – a ratio far out of proportion of representation in the population. Non-Hispanic whites account for 75% of the population but just 39% of this subset of deaths.
Activists wants Kansas to study cause of BIPOC maternal mortality
The pair would like to see better health insurance coverage of doulas and action from the state to study the problem more closely, examining whether women of color are dying due to systemic racism that causes health care systems to treat them differently.
Specifically, they support legislation championed by Sen. Oletha Faust-Goudeau of Wichita. SB 42 would require the state to examine more thoroughly the social determinants of health associated with these maternal deaths, and would develop metrics and support continuity of care for all women.
SB 42 was introduced in the last legislative session and received a hearing on Jan. 20, 2022, where representatives of several organizations provided testimony in support. These included: Kansas Action for Children, Kansas Catholic Conference, Health Forward Foundation, Wichita Birth Justice Society, Kansas Birth Equity Network, Kansas African American Affairs Commission, Nurture KC and the Kansas Breastfeeding Coalition.
The Kansas Department of Health and Environment provided neutral testimony, calling their current methods for gathering and assessing maternal mortality data “adequate.” The bill died in the Senate Committee on Public Health and Welfare without ever coming to a vote.
McCray-Miller said she expects the bill to be reintroduced in the coming legislative session.
For more information about maternal health and women of color, and options available for healthy outcomes, visit ksbirthjusticesociety.org.