Addressing Disparities in the U.S. for Maternal Health and Rights

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By: Kathleen McDonald, Independent Consultant; Natalie Ramm, Communications Coordinator, Maternal Health Task Force, Women and Health Initiative

As we approach the International Day of Maternal Health and Rights, we are reminded of the Manifesto for Maternal Health, item 6 of which states:

A much greater emphasis must be put on reaching the unseen women who are socially excluded because of culture, geography, education, disabilities, and other driving forces of invisibility. If we are serious about redressing gender and access inequities, we have to ask fundamental and difficult questions about the nature of our societies and the value, or sometimes lack of value, we ascribe to individuals, especially women, in those societies.

These disparities are especially apparent in the United States. While much global attention has focused on the 99% of maternal deaths that occur in low- and middle-income countries, the U.S. is one of the few countries where the maternal mortality ratio (MMR) has actually risen over the past decade.

More troubling are the inconsistencies between ethnic and socioeconomic populations. According to Amnesty International, an African-American woman is nearly four times as likely to die as a white woman during birth, a disparity that has persisted for the last 20 years. Similar disparities exist between Caucasian women and Native American, Asian American and Hispanic populations. In addition, women who access life-saving maternal health services can face discrimination from health care providers based on their ethnic and social background.

In Mississippi and Georgia, many women of color have sought the help of a doula to advocate for them during delivery after experiencing discrimination and stereotyping during a previous childbirth, but were denied. Reproductive injustice contains many personal accounts of poor quality service and discrimination like this one:

My fifth daughter, was born with deformities. . . . When they saw her [they made assumptions]. . . . Of course, I’m Black, I’m young, it’s my fifth child, I’m under 25. The assumption by the hospital staff was I must have done drugs. The reason I know that is because as soon I woke up and got out of recovery, they questioned me about drug use five times. Then they came and did two blood draws . . . It made no sense for them to do it, and then they refused to let me have my baby for five hours. Finally, because they probably thought she was a fetal alcohol syndrome baby, and they thought I had done drugs, finally, they let me have my child. But [before this] they questioned my mom about whether or not I had done drugs; they questioned my boyfriend about whether or not I had done drugs.

The US health system is failing women of color and their families, and violating their basic human right to access high quality health care. To learn more about this area, please check out the resources listed below.