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US Race Relations and Black Maternal Health

The United States’ poor race relations have captured world news headlines. While the global community watches in shock, the self-professed nation of “freedom” struggles to come to terms with its racist past and present. Legislators and law professionals are central to the topic of reform. If the US is ever to overcome its vast history of oppression and prejudice, the law must recognize its history of racial biases whilst simultaneously protecting the people most at risk. Reform is needed across criminal justice, education, financial institutions, and, as is the focus of this article, healthcare.

Black women in the US have faced a constant struggle when dealing with the healthcare system. In fact, they are more likely to be uninsured, to live in communities with poor hospitals, and to face discrimination when visiting doctors or clinics. Statistics show that black women are 22 percent more likely to die of heart disease, 71 percent more likely to die of cervical cancer, and 243 percent more likely to die from pregnancy or childbirth-related causes than white women.

While money and social advantages may improve their everyday lives, it does not reduce the risks experienced when receiving prenatal and postpartum healthcare services. Many pregnant black women of good financial status, successful careers, and high social standing have died because their doctors did not take them seriously when they reported health problems. As stated by National Public Radio Special Correspondent Renee Montagne:

“Black expectant and new mothers frequently said that doctors and nurses didn’t take their pain seriously – a phenomenon borne out by numerous studies that show pain is often undertreated in black patients for conditions from appendicitis to cancer”.

These implicit biases and prejudices of healthcare workers are killing black mothers and reducing the trust that minority communities have in the healthcare system.

The Black Maternal Health Momnibus Act of 2020 is the most comprehensive piece of legislation to date which addresses the social determinants that affect maternal health outcomes. US Representative Lauren Underwood introduced the legislation on 9 March 2020 with the support of Congresswoman Alma Adams and US Senator and Vice Presidential Candidate, Kamala Harris. While the bill has yet to pass the House or the Senate, it will provide an essential legal foundation for updated standards of practice in maternal health services, hospital accountability, and investments into maternal health research.

The goal of the Black Maternal Health Momnibus Act, as stated in the bill itself, is “to end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes.” The legislation is comprised of nine individuals bills that cover a wide range of maternal health concerns including:

  • investments into social determinants for mothers (transportation, housing, and nutrition)

  • protecting women veterans and their maternity care

  • improved data collection to better understand the US maternal health crisis

  • justice for incarcerated mothers

  • improved technology to save mothers

The Kira Johnson Act is one of the nine bills that make up the Momnibus Act. The namesake of the bill, Kira Johnson, died in 2016 after a scheduled C-section at Cedars-Sinai Medical Center in Los Angeles. Her doctor was negligent as he allowed Kira to bleed internally for nearly ten hours while both Kira and her husband watched her catheter fill with blood.

This was not the doctor’s first offence yet even after Kira’s death he was allowed to practice medicine (albeit at a different hospital rather than Cedars-Sinai Medical Center). In 2018, Kira’s husband, Charles Johnson IV, provided testimony to Congress in support of the Preventing Maternal Deaths Act. However, while the bill provided important authorisations for mortality review committees and research at the Centre for Disease Control and Prevention, it did not directly confront the underlying social determinants that lead to increased mortality rates for black and minority mothers.

The Kira Johnson Act will fill the gaps unaddressed by the “Preventing Maternal Deaths Act.” This bill specifically “awards grants to improve outcomes and reduce bias, racism, and discrimination in maternal care settings.” According to Jamila Taylor of The Century Foundation, the “historic” Kira Johnson and Black Maternal Health Momnibus Acts help “fill many of the policy gaps that currently exist”. This is a huge step in reforming maternal healthcare and addressing racial biases. For too long the United States has ignored the plight of black mothers. Even though this legislation can never compensate the black mothers who have unjustly died, it is a step in the right direction.

These new maternal health bills will go far in protecting black and minority mothers of all social standings, and hopefully will increase the trust between mothers and maternal healthcare services. Consequently, these new pieces of legislation can act almost like a model of how the US should tackle racial justice in other areas of life. Investing in communities, research, and guidelines for accountability could help reduce the impacts of racial biases in the justice system, police departments, education, and more. Ultimately, greater attention to investing in mothers will provide key advancements in combating prejudice and improving the United States’ race relations.


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