WASHINGTON — A House hearing on reducing maternal morbidity and mortality among Black mothers started off harmoniously, as would be expected, but later devolved into disagreement over root causes of the problem.
“Our nation is facing a maternal health crisis,” said Rep. Carolyn Maloney (D-N.Y.), chairwoman of the House Committee on Oversight and Reform, at the beginning of Thursday’s hearing, which was entitled, Birthing While Black: Examining America’s Black Maternal Health Crisis. “Across the globe, our maternal mortality rate ranks the absolute worst among similar developed nations and 55th overall.”
Deaths Unequally Distributed
“The danger of giving birth in the U.S. is not equally distributed,” Maloney continued. “The CDC estimates that Black women are more than three times as likely to die during or after childbirth as white women. Black Americans experience higher rates of life-threatening complications at every stage of childbirth, from pregnancy to postpartum. It doesn’t have to be that way; CDC estimates 60% of these deaths are preventable.”
To understand the problem, “we have to take the blinders off our history and acknowledge that our healthcare system, including reproductive healthcare, was built on a legacy of systemic racism and mistreatment of Black people, and that legacy continues today,” she added.
Rep. James Comer (R-Ky.), the committee’s ranking member, agreed. “Maternal mortality for Black women is 2.5 times the rate for white women and three times the rate for Hispanic women,” he said. “We all agree that is unacceptable. The United States is one of the most advanced healthcare systems in the world, and we can and should have lower mortality rates. There are a range of factors contributing to this process, from lack of access to proper care to maternal mental health crises, which take the lives of so many mothers.”
One of the witnesses at the hearing was Charles Johnson of Los Angeles, who told the story of what happened when his wife, Kira, gave birth to their son Langston at Cedars-Sinai Hospital in April 2016. Langston was born healthy and everything was going well until around 4 p.m., when Johnson noticed that his wife’s catheter was turning pink and filling with blood. The medical staff examined Kira and ordered an immediate CT scan, but nothing happened for several hours.
“Around 9:00 I pulled a nurse aside and I asked her, ‘Please help me. My wife isn’t doing well. She’s weak, she’s in pain. She’s losing color, please help me.’ And she responded to me, ‘Sir, your wife just isn’t a priority right now.'” At 12:30 a.m., they took her back for surgery, “and there were 3 and a half liters of blood in the abdomen from where she had been allowed to bleed and suffer needlessly — for 10 hours,” he said. Kira eventually died from her complications.
Rep. Bob Gibbs (R-Ohio) asked Johnson whether anyone at the hospital had been held legally accountable in Kira’s death. “Unfortunately, there has been zero accountability in my wife’s case,” Johnson responded. He said the fact that California has legal damage caps that limit the value of a human life to $250,000 means that “doctors who are perpetual bad actors are not held accountable … The doctor found grossly negligent for her death by the California Medical Board is still practicing medicine,” despite being found negligent in the deaths of Kira and six other women.
Poverty an Issue?
Gibbs said the legal issue “should be addressed” and that bad doctors “should be held accountable and removed from their positions.” He noted that although there had been a lot of discussion about racism in the healthcare system, “in the medical community, we have lots of Black nurses and doctors,” and that there are also lots of Black people in urban police departments that have issues with police brutality, “so there are some things that are hard to reconcile.”
He said inner-city Black poverty was a large part of the problem. “And one of the reasons they are trapped in poverty is because our education system has totally failed our Black community. And they don’t have the choice to get out to a better opportunity … And in a lot of families, the father is not there. So there’s a lot of other issues that go into this too, I believe.”
Rep. Kweisi Mfume (D-Md.) took issue with Gibbs’s remarks. “We must be very, very careful when we say quality of education and lack of opportunity contribute to these high death rates,” Mfume said. “As has been said over and over again, this affects affluent Americans; it has nothing to do with status in life and everything to do with your race.”
He pointed out that Johnson and another Black witness at the hearing, who experienced discrimination and poor treatment during her pregnancy, “represent affluent, well-educated taxpaying citizens … and underwent things we don’t want to happen to anybody.”
Joia Adele Crear-Perry, MD, founder and president of the National Birth Equity Collaborative, agreed, noting in response to a different committee member that, according to the CDC, “Black people were still five times more likely to die in childbirth, despite having an advanced degree,” so it’s not fair to “blame them and say, ‘Go to school and your outcome will be better’ because we go to school and we still die.”
Biases are also evident early in medical training, said Veronica Gillispie, MD, medical director of the Louisiana Perinatal Quality Collaborative. “Starting back to Marion Sims, who was known as the father of modern gynecology, who performed his procedures on slave women without anesthesia, even though anesthesia was available at the time,” she said. “What got perpetuated and what got published in the textbooks is that Black individuals don’t feel pain in the same way.”
In addition, “in a study that was done at a medical school where they interviewed over 200 white residents and white medical students, they believed that Black individuals have thicker skin and that our nerve endings are not the same so that we don’t feel pain in the same way,” Gillispie said. “They also found in the study that the higher their disbelief was about individuals in their pain tolerance, the more likely they were to not prescribe appropriate pain medications. And so what has been perpetuated through history has to be corrected.”
Other Issues Raised
Rep. Andrew Clyde (R-Ga.) wanted to discuss something entirely different. “The irony is not lost on me that while my [Democratic] colleagues sit here today to talk about protecting the life of mothers, we cannot forget that mothers are indeed the bearers of life, and so we must protect the sanctity of life in its entirety,” he said. Clyde also complained that House Democrats have not supported Republicans’ efforts “to ensure taxpayer dollars do not fund abortion providers such as Planned Parenthood … It sickens me that the government continues to funnel tax monies to Planned Parenthood.”
Clyde, who represents a rural area of Georgia, also objected to the subject of the hearing, adding, “I do not believe my constituents should be left out of today’s conversation just because they don’t fit into the racial lens of today’s hearing.”
“In fact, Georgia is in the top 10 of the highest maternal mortality rates in the country, with 48.8 deaths per 100,000. In 2019, the Georgia House of Representatives formed a study committee on maternal mortality and reviewed 3 years of maternal death rates in the state. They found that 60% of deaths were preventable” and that rural women had higher maternal death rates than urban women, he added.
Clyde’s comments did not sit well with Rep. Alexandria Ocasio-Cortez (D-N.Y.). “I don’t want to hear a single person on this committee or outside this committee, talk about valuing life when they continue to uphold the death penalty, when they continue to support policies that disproportionately incarcerate and lead to the deaths of black men and people throughout this country, and uphold an absolutely unjust medical system that exists for profit, that allows people to die because they can’t afford to live,” she said.
“And if we want to talk about Planned Parenthood, let’s talk about how many lives Planned Parenthood has saved,” she continued. “And how many babies have been born because of the prenatal care provided by Planned Parenthood. And if you’ve never met a Planned Parenthood baby, I’m happy to let you know that I am one, and that my mother received and relied on prenatal care from Planned Parenthood when she was pregnant with me.”
Source: MedicalNewsToday.com
