In the United States, Black women are 3-5 times more likely to die in childbirth than white women.¹ Adverse maternal health outcomes among Black birthing people are not solely attributed to social determinants like poverty and educational attainment or access to healthcare.² Structural racism, including the effects of historical reproductive oppression and the devaluing of Black bodies, persists today in more subtle health care policies and practices.² The implications of racism and historical oppression in healthcare combined with the de-prioritization of Black birthing people by medical professionals are contributing factors to this shocking disparity. More knowledge and awareness of this issue within the medical and public health fields is a critical step to reducing Black maternal mortality. There is a role for every federal, national, and local health organization in advancing Black birthing outcomes to counteract America’s historical mistreatment of Black bodies.

This week (April 11–17) marks the fourth annual Black Maternal Health Week. Black Maternal Health Week is a time for building awareness, activism, and deepening the conversation about Black maternal health in the United States. Founders of the national Black Maternal Health Week, the Black Mamas Matter Alliance (BMMA), is a national network of organizations and leaders from the maternal health, human rights, and reproductive justice fields who believe that every woman deserves access to quality and holistic healthcare. This year’s theme is “Black Mamas Matter: Claiming our Power, Resilience, and Liberation,” will amplify community-driven policy, research, and care solutions and enhance community organizing on Black maternal health.

On April 13, President Biden signed the first-ever proclamation marking Black Maternal Health Week. It calls for all Americans to recognize the maternal health crisis and the importance of reducing our unacceptably high rates of Black maternal mortality and morbidity.

“Improving maternal health outcomes—particularly among Black women—is priority for the Biden administration and for the Department…Expanding access to health insurance coverage, preventative care and investing in rural maternity care is one step forward. With the American Rescue Plan, President Biden gave states tools to combat the racial disparities in pregnancy-related deaths by providing an easier pathway for states to ensure mothers access to the care they need after birth. Continuous healthcare coverage reduces health care costs and improves outcomes.”

– Xavier Becerra, United States Secretary of Health and Human Services

Advancing Black maternal health requires the prioritization of Black birthing people across all medical and public health agencies. Thus, it is important that local health departments (LHDs) utilize their unique roles as chief health strategists within their communities to uplift the needs of Black birthing people. According to NACCHO’s 2019 National Profile of Local Health Departments, the majority of LHDs provide services to support the health of birthing people, including Women, Infants, and Children (WIC) services (68%), early and periodic screening diagnosis and treatment (38%), prenatal care (30%), and well child clinics (30%). Due to LHDs’ frequent interaction with preconception, prenatal, and postpartum patients, and their strong relationships with community partners, they are well situated to address inequities in Black birthing outcomes through the following strategies:

WIC Service Provision, Home Visits, and Family Planning

• Utilize appointments to assess and document the experiences of Black people in their prenatal and postpartum journey, identify gaps, and foster areas of improvement
• Link community members to needed maternal health services and assure the provision of adequate, culturally responsive healthcare when otherwise unavailable
• Provide community members with educational materials and resources on healthy birthing, specific to Black people to increase self-advocacy and overall knowledge
  

LHD Stakeholder Partnerships

• Expand maternal mortality review boards to monitor, track and investigate instances of severe maternal morbidity to account for near instances of death and to develop recommendations to prevent future deaths
• Collaborate to create and disseminate materials on Black maternal health (e.g., birthing while Black infographics)
• Work to provide more birthing resources for Black moms (e.g., access to birthing classes)
• Facilitate culturally responsive training, training in racial bias, and training in providing quality care to Black people, Indigenous people, and people of color
• Work with community partners to bring awareness to Black maternal health disparities and provide tailored resources for Black birthing people

LHDs with Clinical Services Provision

• Identify a birthing advocate who liaises between the LHD and medical providers to support the needs of the birthing person and the provider and to ensure that patient needs are met
• Require culturally responsive training for healthcare professionals
• Identify diverse OBGYNs, doulas, and nonclinical professionals to serve as additional resources for Black moms

Tacoma-Pierce County Health Department in Washington State and LA County Health Department in California are prioritizing the reduction of the Black maternal mortality gap by utilizing Black Maternal Health week to encourage awareness, activism, and community building. Both health departments have utilized social media campaigns, outreach efforts and collaborated with their community partners to promote the importance of Black Maternal Health Week and have created online and community events to uplift Black Maternal Health Week and to spread awareness to their communities and partners.

To learn more about Black Maternal Health Week or to download campaign materials and resources, visit the Black Maternal Health Week website.

References

1. Melillo, G. (2020, June 13). Racial disparities persist in maternal morbidity, mortality, and infant health. Retrieved
   April 14, 2021, from https://www.ajmc.com/view/raci...
2. Taylor, J. K. (2020). Structural Racism and Maternal Health Among Black Women. The Journal of Law, Medicine &
   Ethics, 48(3), 506–517. https://doi.org/10.1177/1073110520958875