Black Moms Face a National Health Crisis

Black mothers continue to face a life-or-death crisis, especially during the COVID-19 pandemic.  Addressing how racism intersects with health care has never been more urgent. The health of women of color impacts the vitality of families, and indeed, whole communities. Research reported by the Center for American Progress finds that in 2018, 67.5 percent of Black mothers and 41.4 percent of Latina mothers were the primary or sole breadwinners for their families.  In lower-income households, the significance of women’s income to the health of the household is even greater.

In an earlier blog, we discussed the economic impact of the COVID-19 pandemic on women of color. Overall, women are over-represented in the sectors of the economy that are being crushed by social distancing policies. Women of color also are over-represented among the essential workers who are risking their health, and even their lives, to support those who are able to stay at home. 

The economic impacts of COVID-19 cannot be divorced from health disparities that preceded the pandemic. For example, in New York City alone, Black women are 12 times more likely to die from pregnancy-related complications than their white counterparts. Furthermore, Black infants in the US are more than twice as likely to die as white infants, a racial disparity that is wider than it was in 1850.

The United States is one of only 13 countries in the world where the rate of maternal mortality – the death of a woman related to pregnancy or childbirth up to a year after the end of pregnancy – is worse than it was 25 years ago, and it’s continuing to get worse. The COVID-19 pandemic has exacerbated this phenomenon, as expectant mothers have reportedly been forced to delay or miss regular check-ups or other care. People of color and people in rural areas, who are already medically underserved, are most affected by this. 

In Binghamton, The New York Times reported that due to social distancing measures in hospitals, pregnant people have had to give birth without their families or doulas. According to the same source, the disproportionate effect on mothers of color has not gone unnoticed by politicians. 

New York Senator Kirsten Gillibrand remarked:

“Our country has the highest maternal mortality rate in the industrialized world, and this has been compounded by the crisis caused by COVID-19. It’s painfully clear that we are not doing nearly enough to protect women of color and their babies, and we must do much more to end institutional racism in our healthcare system and ensure the resources are available to care for expecting and new mothers.”

However, over 60% of maternal deaths are preventable. The maternal mortality and morbidity crisis is largely driven by the disproportionate risk that Black women face during and after childbirth.  

According to the Centers for Disease Control and Prevention, Black mothers experience disproportionately high rates of hypertension and cardiovascular disease, two of the primary causes of maternal death. Higher incomes, more education, and even access to quality health care do not immunize Black women from the risk of maternal mortality. Serena Williams' pregnancy complications are a grim example of how racism intersects with access to health care that results in the present national crisis for Black mothers.

The stress of being a Black woman in the United States has significant negative impacts on maternal health, according to Arline Geronimus, a professor at the University of Michigan School of Public Health. She first coined the term “weathering” in 2007 to describe the ways in which toxic stress from repeated exposure to racial and gendered insults, attacks, and microaggressions trigger the premature deterioration of the bodies of Black women.  

Lab-based, literature-based, and anecdotal studies clearly reveal that shouldering these burdens in the context of chronic discrimination gets into the body in several ways. Geronimus and her colleagues found that Black women have high allostatic load scores, a measurement of stress-associated body chemicals and their cumulative effects on the body’s systems. Long-term exposure to stress from racism and discrimination can create racial battle fatigue leading to decay of the cardiovascular, metabolic, and immune systems which, in turn, increase susceptibility to conditions like hypertension and pre-eclampsia. These conditions directly lead to higher rates of infant and maternal death as well as the early onset of chronic illnesses like diabetes. Indeed, weathering can be measured at a chromosomal level.  

Universal Paid Family Leave is one small, but potentially mighty step to mediate and potentially reverse the deepening of this crisis. While the United States is one of the only industrialized countries in the world with a rising maternal mortality rate, it is also one of the only industrialized countries without Universal Paid Family Leave for all workers. The Family and Medical Leave Act provides unpaid leave to only 60% of the workforce, which is far from meeting the needs of low-wage workers.

Research shows that paid family leave can alleviate pregnancy-related conditions, including significantly lowering rates of maternal mortality, preterm births, low birth weight infants, congenital anomalies, and overall infant mortality​. Furthermore, research has shown that paid family leave disproportionately advantages women of color. 

In other words, Paid Family Leave can disrupt the race-based health disparities that are stealing the lives of Black women. Paid family leave can allow Black women to attend to our own health needs (as well as those of our loved ones) which can in turn improve our health outcomes.

A survey in March found that 80% of voters support providing all workers 14 days of paid sick leave and three months of paid medical leave.

The situation was already dire, but now the pandemic emphasizes its direness.

This current crisis must be addressed at all levels and must also include policy changes that can improve the health outcomes of Black women. We must call upon our government officials to explore and advocate for effective, evidence-based, and culturally-responsive policies and best practices for improving the health outcomes for Black women. Racial battle fatigue and Black maternal health must be treated as a national priority.

To contact your local representative about this issue of inequity and racism, visit here.