Reproductive revolution: Ending black maternal health inequities in 2020

The disparities in black women’s health are not new. Neither is the leading role that black women have played in the movement to dismantle poor health outcomes due to systemic issues of racism, sexism and classism. 

What is new, is the potential for black women and allies to collectively change the narrative and achieve equity in health outcomes, so that by 2025 and 2030 the statistics can more accurately reflect the lived experiences of black women. 

At the last Democratic presidential debate, Andrew Yang reiterated the fact that black women are “320% more likely to die from complications due to childbirth.” 

In 2019, the Centers for Disease Control reported black women in the U.S. are two to three times more likely than white women to die within a year of giving birth.

In Southern states, Louisiana and Georgia, maternal mortality is the greatest In Illinois in 2018, the black-white disparity is among the greatest, with black women six times more likely to die than white women, according to the Illinois Department of Public Health.

As a researcher on women’s health and wellness, I’ve spent the last year participating in grassroots workshops, doula training, and locally sponsored task forces on birth equity and breastfeeding initiatives to learn about what’s happening to improve black women’s maternal health.

Shaquan Dupart, a mother and doula, founded the Chicago Black Doula Alliance in 2019, organized to unite black women engaged in birth work. Over the past year, the Chicago Black Doula Alliance has hosted workshops and launched a podcast series. The workshops allowed women to share birth stories, describe their calling to work in the birth movement, and share information about the latest statistics on birth trends and practices. 

These meetings feel like sacred sister circles where deference is given to ancestors, women, mothers and babies. Mothers join the workshop with babies in tow and nurse their infants on demand. As stories are shared and statistics interrogated, participants in workshops like these, often do not recognize the black women represented by the grim maternal health statistics.

For example, lower reported rates of black women breastfeed are met with skepticism. These are tender issues, often calling into question the way statistics may misrepresent, distort, or tell an incomplete and ahistorical story of black women’s health and agency. 

In her book “Skimmed: Breastfeeding Race and Injustice,” Andrea Freeman examines the role of slavery in breastfeeding, and she identifies contemporary discriminatory practices by physicians, corporations, and government policies that exploit black women by pushing infant formula resulting in sabotaged breastfeeding efforts. 

According to the Office of Minority Health, black babies in the U.S. are two times more likely to die within the first year of life than white infants. The CDC reports black women are less likely to breastfeed than non-black women. Breastfeeding is recommended by the World Health Organization as the best nutrition for a baby’s first six months. 

Black women and their allies are organizing to put an end to the disparities in health. For example, black lawmakers in Illinois, Pennsylvania and California have proposed legislation to address bias in health care delivery and to extend Medicaid for postpartum care. 

Others work as birth workers. They are often described as having a calling to protect the birth space of black women. They work as healers, midwives, doulas, and researchers, 

Fueled by a passion for changing these statistics, many organize in sister circles and brainstorming sessions around the country, strategizing ways to improve black maternal health outcomes. 

Cindy McMillan, Walina Norris and Nikita Smart founded the doula organization, Sistas Caring 4 Sistas, in Asheville, North Carolina. In the past year, they have served over 90 pregnant women resulting in better maternal outcomes resulting in higher rates of prenatal care during the first trimester, a decline in low birth weight babies, and no maternal deaths among black mothers. 

Those involved in black birth work are aligned in their mission to achieve individual and collective healing from the traumas of colonial and present-day assaults on black women’s wombs. The workers are also responsible for honoring and integrating indigenous traditions in birth and postpartum care, and to reclaim autonomy, self-determination, and to promote the health and well-being of black women’s bodies. 

This is a call for a reproductive revolution.

The revolution has a legacy spearheaded by an army of various organizations founded by a collective of black women committed to the goals of reproductive justice. In 1997, SisterSong was founded and laid out tenets of the movement and coined the term reproductive justice. 

In 1983, Byllye Avery founded the Black Women’s Health Project in partnership with Spelman College. Today it’s known as the Black Women’s Health Imperative, a national organization dedicated to the health and wellness of black women and girls.

The work of these organizations, along with Black Women Birthing Justice, Black Mama Matters Alliance, and many others, have organized to collect black women’s stories about birth, healing, and health to inform policies to improve maternal health outcomes. 

As a black woman, mother of two sons and researcher, I collaborate with community-based organizations, center black women’s maternal health experiences, and use my unique position to build on the legacy and movement by bridging partnerships between the most privileged among us and the most silenced among us. It is work that demands sustained collective action to close the gap. 

To be sure, racism, sexism and classism will persist. Still, it will take building on the legacy of African American activism, organizing resources and philanthropy, and working with allies to avoid a stalled revolution.

As new year resolutions are set for 2020, organizing, coalition building and directing philanthropic resources to close the gaps in black women’s health in the U.S. is an essential strategy. 

It requires black philanthropy in partnership with corporations, private equity and venture capital firms. Black leadership in these venues, along with influencers in art, music and politics, must use their power to prioritize black women’s health to end inequalities in birth and postpartum care by 2030. 

This also includes tapping the legacy of black philanthropy via black sororities, fraternities and women’s clubs. The necessity is to invest in organizations dedicated to telling the story of black women’s maternal health and to those organizations that demonstrate evidence of improved black maternal health outcomes. 

Erasing the health inequities in black women’s experiences in pregnancy, childbirth and postpartum life must be a priority on the national and philanthropic agendas. Investment in black birth work is needed to make an impact.

Tracey Lewis-Elligan is an associate professor & chair of Sociology at DePaul University and a Public Voices Fellow through The OpEd Project.