WASHINGTON — For Jennie Jacoby, JD, healthcare bias is a two-generation problem in her family.
“My story started with my mother, who is a Black woman,” Jacoby said in a phone interview, adding that her father is white and Jewish. “When my mom was pregnant with me 32 years ago, she had access to really great care, but unfortunately due to some implicit bias and medical racism, she had preeclampsia and the doctors completely missed it — they assumed she was just an overweight black woman, which is really a dangerous assumption to make; that, on top of doctors being distracted by the fact that my parents were in an interracial marriage, really caused harm to her pregnancy. She almost lost her life and I was born at 3 lbs. 12 oz.”
“Then fast forward to me — I was pregnant 2 years ago with my daughter, and I am an Ivy League-educated attorney and a maternal health advocate … and the same thing happened to me,” she said. “I had my mom’s exact experience … The doctors still relied upon assumptions they really should not have been relying on. I almost lost my life as well, and I had to have a C-section that quite honestly could have been avoided if they had caught my condition sooner.”
As a result of her family’s experiences, she’s telling her story “to Congress, to the administration, to really ground people to the reality that the problem is actually getting worse, and if it could happen to me, it could happen to any Black or brown person in this country. We really need to do something so my daughter doesn’t go through this as well.”
Jacoby, who is federal policy counsel at the Center for Reproductive Rights, helped a group of House and Senate members — led by Reps. Lauren Underwood (D-Ill.) and Alma Adams (D-N.C.), and Sen. Cory Booker (D-N.J.) — put together the “Momnibus,” a package of 12 bills aimed at improving maternal health and healthcare for Black women and other women of color. The bills include measures to:
- Make critical investments in social determinants of health that influence maternal health outcomes, including housing, transportation, and nutrition
- Grow and diversify the perinatal workforce to ensure that every mom in the U.S. receives culturally congruent maternity care and support
- Improve data collection processes and quality measures to better understand the causes of the maternal health crisis in the U.S.
- Support moms with maternal mental health conditions and substance use disorders
- Promote innovative payment models to incentivize high-quality maternity care and continuity of insurance coverage from pregnancy through labor and delivery and up to 1 year postpartum
- Invest in federal programs to address the unique risks for and effects of COVID-19 during and after pregnancy
- Promote maternal vaccinations to protect the health and safety of moms and babies
“As maternal mortality rates continue to drop around the world, they are rising in the U.S., leaving behind devastated families and children who will grow up never knowing their moms,” Underwood said in a press release announcing the Momnibus, which she and her co-sponsors introduced on February 8. “This crisis demands urgent attention and serious action to save the lives of Black mothers and all women of color and birthing people across the country.”
Underwood and Adams also are co-founders of the House’s 115-member Black Maternal Health Caucus, which is dedicated to “elevating the Black maternal health crisis within Congress and advancing policy solutions to improve maternal health outcomes and end disparities.”
The Association of Black Cardiologists endorsed the package of bills, noting in a statement that “the maternal mortality rate is significantly higher among Black women, who are three to four times more likely than white women to die from pregnancy-related complications. Other birthing people of color, including Hispanic, Native American, and AAPI [Asian American/Pacific Islander] women, also suffer from disproportionate rates of adverse maternal health outcomes.” In addition, “Peripartum cardiomyopathy contributes to 23% of maternal deaths; embolic events, hemorrhage, and hypertension are also major contributors. The majority of these deaths are preventable.”
This is not the first go-round in Congress for this type of maternal health legislation. In 2020, the House passed H.R. 4995 and H.R. 4996, which each contained elements of the Momnibus, but neither bill went anywhere in the Senate. The American College of Obstetricians and Gynecologists called the two bills “two critically important bills that will improve maternal health outcomes.”
So far, the Momnibus has 95 co-sponsors — all Democrats, although there are a few Republicans in the Black Maternal Health Caucus and a few Republican co-sponsors of individual bills included in the legislation, especially H.R. 958 — informally known as the Protecting Moms Who Served Act — which addresses maternity services for veteran mothers of color, Jacoby said.
Jacoby declined to say what she thought the chances of passage for the Momnibus were, but added that with the House, Senate, and White House all under Democratic control, “The potential for proactive maternal health policy is unparalleled right now … I think we’re going to see some proactive policy come out over the next few years.” Of course, it’s always possible that some bills in the Momnibus package could be broken off and passed individually even if the entire package doesn’t pass, she said.