So, there are signs of hope, both in community activism and in policy.īlack women are nearly three times as likely to die of pregnancy complications than white women in the United States. For example, the Black Maternal Health Caucus has sponsored a federal bill called the Black Maternal Health Momnibus Act-still pending-that includes 13 different pieces of legislation devoted to things like the social determinants that underlie poor outcomes in maternal health, innovative payment models, care for those with mental health conditions and substance use disorder, and extending care across the postpartum period, when a lot of the preventable deaths are occurring. We also have more men and women of color in key policymaking positions. The most important of these is the amazing growth and support of Black-led, community-based organizations at the forefront of activism for higher investment in maternal health. I have, though, seen some really wonderful things that make me hopeful. The increased attention began around 2017, and political change is slow, as we well know. McCloskey: Increased attention is always a good thing, but it takes time to turn that attention into action and more money-and of course, the political will has to be there. Has this attention brought about any positive change? BU Today: The US high maternal mortality rates-especially among Black women-have received significant media attention in recent years. And the effects are carried across generations. In essence, the research tells us that racism has enduring biological effects, and they are magnified during pregnancy, which itself is a stress test for things like metabolic and cardiac health. The continual experience of racism-both deeply rooted, historic, structural racism and the interpersonal racism that is still so prevalent within healthcare and in our society-is toxic, even deadly. Researchers have begun to dig into the causes of stress among Black and indigenous women that exceed those of white women. McCloskey: For some time, researchers have been realizing that these disparities don’t go away when you control for factors like people’s income, people’s social standing, or employment, and so there’s something deeper at play. What does research tell us about why these disparities exist? BU Today: You have long been interested in ending racial disparities in the health of women and their babies. The other thing that struck me is that there seem to have been multiple factors that led to such a tragic ending-factors that could have been intervened upon. I dug into details a little bit and learned that, in fact, her death happened while she was alone. My initial reaction was to want to read about what happened-with a sinking feeling that her death was going to be another example of the lack of listening to Black women during and after childbirth. Q &A with Lois McCloskey BU Today: What was your reaction when you heard the news that Tori Bowie had died from pregnancy complications?
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