Building trust, community to end the Black maternal health crisis

June 10, 2024

Experts gather to discuss solutions to the critical health disparities faced by Black mothers and babies across the country

Key Takeaways:

Despite advances in medical science and gains since the pandemic, Black women in the United States are still twice as likely to die from pregnancy-related causes as white women, according to recent CDC statistics. In addition, the infant mortality rate for Black newborns is more than twice that of white babies. For Black women, these statistics are more than just numbers—they are a reminder of how deep-rooted health disparities can rend families and communities.

Finding solutions for the Black maternal health crisis requires collaboration between birthing people, health care providers, community leaders, and policymakers to understand and address the issues—many systemic—that contribute to these disparities, a group of advocates and health professionals said during a recent event hosted by the Johns Hopkins Center for Health Disparities Solutions.

A group of five women sit in a semicircle on stage
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Critical to addressing this effort is expanding access to a diverse maternity care workforce, the speakers said. It’s one of five core areas in The Centers for Medicare and Medicaid Services’ Maternity Care Action Plan, but supportive practices like midwifery are scarce in many communities of color, and the pipeline is narrow.

Kanika Harris, the Black maternal health and child health director at the Black Women’s Health Imperative, noted, “When I looked at HBCUs—the institutions where STEM and research and technology will help us to solve these issues—we don’t have schools of public health. We don’t have midwifery schools. We don’t have maternal health programs.”

Harris pointed to the need for programs like the Black Women’s Health Initiative’s NOURISH, which recently trained a group of HBCU students to become doulas so they can support the needs of birthing families.

Bringing more diverse health care providers into the delivery room could improve outcomes. Journalist Suzanne Malveaux noted that 30% of Black and Hispanic women in the U.S. who deliver in a hospital feel mistreated by the staff and practitioners, and Black women are 10 times more likely to report this treatment in a hospital when they are giving birth. Research has demonstrated diverse health teams improve health outcomes and leave patients feeling better about their care.

“When you have no connection to your doctor, that doctor has no connection to your community,” Harris said. “But birth is just not physiological. It’s all the things that are happening. Birth is community.”

To understand the efficacy of different efforts to improve maternal health, the Centers for Medicare and Medicaid Services (CMS) is monitoring learnings from maternal health pilot tests across the country.

CMS—which covers 40% of the births in this country through Medicaid, of which a disproportionate number involve Black women—is in a unique position to better understand how different policies work and drive change at a national level.

“What can we learn if we package them together, if we add a payment component?” said Dora Hughes, chief medical officer of the CMS Innovation Center. “If Medicaid is working together with the private sector, with state partners? We are really excited to think about what we will learn by doing big things at scale with a national focus.”