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The Guardian
17-04-2025
- Health
- The Guardian
Black maternal health is about more than survival – it's about thriving
Maternal deaths have recently dropped in the US – that is, unless you're Black. Black women continue to face the highest rates of maternal mortality in our country. To be Black, pregnant and hopeful in the US is to hold on to life with a fierce and unyielding grip against devastating odds. Black women are navigating pregnancies in a healthcare system that too often ignores our pain, dismisses our concerns, fails to value our lives and underserves us throughout the entire journey to motherhood. As we mark Black maternal health week, the path to becoming a mom remains fraught with pain points for Black women. For too many Black women, the journey to motherhood may start with dismissive doctors and racially motivated mistreatment: a soon-to-be mother's voice is silenced in the very spaces meant to protect her health. The experience of giving birth is compounded by systemic inequities that compromise her safety and dignity. Stillbirth and miscarriage rates remain disproportionately high due to inadequate prenatal support, while unequal pain treatment leaves Black mothers suffering in silence – ignored or under-treated. A heightened tendency for unnecessary C-sections reflects deep-rooted biases in medical decision-making, exacerbated by implicit racial bias. When the baby is born, the postpartum period is often marked by systemic gaps in care that leave Black women vulnerable to physical, emotional and financial strain. Limited access to postpartum mental health support means many struggle with anxiety and depression without adequate professional guidance, worsening the already heightened maternal mortality rates among Black women. The absence of comprehensive postpartum resources leaves Black mothers navigating recovery, newborn care and maternal health largely on their own, reinforcing a cycle of isolation and inequity. It takes a village to raise a child – and to protect an expecting mother. So while we've heard many grim stories through our research at the health advocacy organization United States of Care, we've also heard stories of communities banding together to meet the needs of Black women and mothers. Across the country, community-based maternal health organizations are building capacity and cultural responsiveness in maternal healthcare that offers what I like to call 'bright spots'. These bright spots are not just exceptions, but blueprints for the rest of the country. An expecting mother may turn to culturally aligned healthcare providers who offer specialized care, fostering a deep sense of trust, support and security for both her and her baby. Doulas can improve her experience by providing personalized care that is tailored to her and guides her through the pregnancy journey. Additionally, telehealth like the Maven Clinic and Pomelo Care can promote racially concordant care, provide access to interdisciplinary care teams, and bridge access to care gaps. And tech innovations the Irth app, a 'Yelp-like' app that offers provider reviews from Black and brown women, can empower her to make informed decisions about her care. When the baby arrives, she may reach out to organizations focused on addressing maternal mental health, like the Houston-based Shades of Blue Project, which offers structured journaling support groups for Black women and aims to decrease the stigma related to seeking mental health treatment. She may seek a doula or lactation consultant that supports her with her breastfeeding challenges or access local programs like Breastfeeding Awareness and Empowerment Café, a Philadelphia-based community lactation and perinatal mental health support program that is replicable, scalable, peer-driven and low-barrier intervention that has the potential to improve outcomes. In countless neighborhoods across the US, community organizations on and offline are creating lifelines for Black women where our healthcare system falls short. These local efforts provide a national model of cultural responsiveness, holistic care and trust building that we hope to see innovators, policymakers and leaders across the country adopt. As we recognize these local initiatives, it's important to consider what sustains them: strong community ties, committed leadership and diverse funding streams. Maternal health solutions must happen both at the bedside and in the halls of power: more policymakers, philanthropists and healthcare institutions must step forward to invest in these models, scaling them while preserving their community-driven success. Black maternal health is about more than survival; it's about thriving. It's about empowering Black mothers to experience joy in their pregnancies, to be supported from preconception all the way through postpartum, and to raise their families in a world that values their lives. Let these bright spots serve as both inspiration and a guide. It's time for Black women to be listened to, cared for and treated with the dignity we've always deserved. We can build a future where the health and wellbeing of Black mothers is no longer an anomaly but a standard. Venice Haynes is a social and behavioral scientist with more than 17 years of public health experience. She is the senior director of research and community engagement for United States of Care
Yahoo
06-03-2025
- Health
- Yahoo
'A continual cycle': Losing a baby late in pregnancy is more common in the South, new report shows
Losing a baby late in pregnancy is more common in the South than in other regions of the United States, according to a new report given exclusively to NBC News. The difference is dramatic: Compared with other parts of the country, the odds of having a high rate of late-stage pregnancy loss are nearly three times greater in Southern states. The lack of Medicaid expansion in the South, along with the region's large rural population and relatively low levels of adequate prenatal care, contributes to the high rates of fetal loss in the second half of pregnancy, according to the report by United States of Care, a nonpartisan health care advocacy organization. 'We are losing lives,' said Venice Haynes, lead author of the report. 'At what point are we going to stand up and say enough is enough?' The new analysis found that the mean fetal mortality rate for 16 Southern states in 2023 was 6.05 fetal deaths at 20 weeks' gestation or more per 1,000 live births and fetal deaths, compared with a mean fetal mortality rate of 5.25 for all other states. The analysis is based on provisional data from the Centers of Disease Control and Prevention. Fetal deaths after 24 weeks' gestation have been declining steadily since 1990, according to a CDC report last year. States in the South — including Mississippi, Georgia and Arkansas — had the highest rates. The new report found that the South also has higher rates of postpartum depression and fewer perinatal health workers compared to other regions in the United States. The new data is 'a very significant finding,' said Dr. Amanda Williams, interim chief medical officer of the March of Dimes, which has found that the South also has the highest rates of preterm births in the country. Williams said she isn't optimistic about the outlook for mothers and babies in the South. Congress is considering drastic cuts to Medicaid. Nationally Medicaid covers 41% of births, with especially high rates in many Southern states. In addition, nearly every Southern state has a strict abortion ban, and research suggests such laws are prompting obstetricians to leave and discouraging young doctors from working there. 'We anticipate it will get worse,' Williams said. 'This is an area of the country that needs more investment, more support, more providers, not less.' There are many causes of late stage pregnancy loss — or stillbirths — including infection or a fetus' genetic condition. Often the cause is never known. One reason for the high stillbirth rate in the South is that Black women experience fetal loss at more than twice the rate of other groups. Black women have higher rates of underlying diseases such as hypertension and diabetes, which can put a pregnancy at risk. More than half of the Black population lives in the South, according to a recent Pew Research report. Black women also have high rates of stress, which can affect a pregnancy. Kim Smith, a Black woman who lives in South Carolina, developed a severe type of preeclampsia called HELLP syndrome, and when she was five months pregnant she lost her daughter, Lauren Kelly. Some studies have shown a possible link between stress and preeclampsia, a condition in which a pregnant woman develops dangerously high blood pressure. Smith, 42, was raised in Greenville, North Carolina, by a single mother. 'My mother's a minister, my aunts are ministers, my uncles are bishops. We grew up in a very loving and faithful family,' she said. But Smith's family was poor and lived in a neighborhood with frequent shootings and high rates of drug abuse. Racial tensions were high: She remembers as a child hearing people making racist comments, and the Ku Klux Klan sometimes marched near her neighborhood. 'I recall as a child hearing gunshots and hearing police sirens and ambulance sirens on a regular basis,' she said. Smith married and moved to Irmo, South Carolina. When she became pregnant with her daughter in 2011, she was an administrator at federally qualified health care centers in underprivileged neighborhoods with poor health outcomes. It was difficult work as she observed the impact of poverty and racism on the community. 'That level of stress is not unique to me. It was just kind of the culture,' she said. While she worked hard and relied on her faith and her family's love, she said, it wasn't always easy. 'When you experience life, what do you do? You make the best of it, and you push through. And we give ourselves a badge for that. But at the end of the day, our bodies remember the stress,' she said. 'Your body remembers what you experience.' After she lost her baby, Smith changed jobs and took other steps to reduce stress in her life. She went on to have three sons — all healthy pregnancies — and is now a health tech entrepreneur. In many ways, the South is a perfect storm for bad outcomes for pregnant women, according to an analysis done for NBC News by the Perinatal Data Center at the March of Dimes. Compared with other parts of the country, the South has the highest percentage of uninsured women ages 19-54 and the highest percentage of women that age living in maternity care deserts, where access to maternity care is limited or absent, according to the March of Dimes. The region also has the highest percentage of births in which the mothers received inadequate prenatal care. Even though the South stands out, the entire United States suffers from high rates of pregnancy and postpartum complications, said Natalie Davis, CEO of United States of Care. The maternal mortality rate in the United States is higher than in other developed countries — more than four times the rates in the United Kingdom, Australia or Germany, according to the Commonwealth Fund. The group has also found that the United States has a low supply of midwives and OB-GYNs compared with most other developed countries — 16 per 1,000 live births compared with, for example, 35 in the Netherlands and 43 in France per 1,000 live births. 'Our message to every governor is that no state's doing well at this,' she said. 'Every state needs to focus on this.' There are high-tech and low-tech approaches to addressing pregnancy complications like stillbirth. Researchers are developing artificial intelligence tools to predict which pregnant women are likely to go into premature labor. Programs such as Kid One in Alabama and Green Cars for Kids in Florida provide rides for expectant mothers to get to their prenatal appointments. 'They're missing their appointments because bus connections are too long or there isn't even a bus that goes to their neighborhood,' said Dr. Catherine Tom, president of Green Cars for Kids. Providing the rides so the women can get care 'is so simple — it's not rocket science.' Another program, Nurse-Family Partnership, connects low-income first-time mothers-to-be in 40 states with nurses. Sharon Sprinkle, the director of the program in several Southern states, said her teams have prevented many 'near misses' by educating their clients about signs of early labor, preeclampsia and other pregnancy complications. Too often, pregnant women report back that their concerns were 'minimized or totally dismissed, when, in fact, if they were listened to, the outcome would have been better,' she said. Nurses in the program teach clients to 'unleash their power and be comfortable having conversations with physicians to say: 'This is what's going on. I need you to listen. And if you won't listen, find somebody else in your office who will listen.'' Sprinkle, a registered nurse who has worked in infant and maternity care in the South for decades, said she isn't surprised by the new findings about stillbirths. Neither is Dr. Cornelia Graves, a maternal-fetal medicine specialist and professor at the University of Tennessee Health Science Center. Graves said poor pregnancy outcomes in the South will continue because of high rates of underlying diseases such as diabetes, obesity and heart disease. 'We know that women who are unhealthy give birth to unhealthy babies who then become unhealthy children who then become unhealthy mothers,' she said. 'It is a continual cycle.' This article was originally published on
NBC News
06-03-2025
- Health
- NBC News
Late pregnancy loss more common in the South
Losing a baby late in pregnancy is more common in the South than in other regions of the United States, according to a new report given exclusively to NBC News. The difference is dramatic: Compared with other parts of the country, the odds of having a high rate of late-stage pregnancy loss are nearly three times greater in Southern states. The lack of Medicaid expansion in the South, along with the region's large rural population and relatively low levels of adequate prenatal care, contributes to the high rates of fetal loss in the second half of pregnancy, according to the report by United States of Care, a nonpartisan health care advocacy organization. 'We are losing lives,' said Venice Haynes, lead author of the report. 'At what point are we going to stand up and say enough is enough?' The new analysis found that the mean fetal mortality rate for 16 Southern states in 2023 was 6.05 fetal deaths at 20 weeks' gestation or more per 1,000 live births and fetal deaths, compared with a mean fetal mortality rate of 5.25 for all other states. The analysis is based on provisional data from the Centers of Disease Control and Prevention. Fetal deaths after 24 weeks' gestation have been declining steadily since 1990, according to a CDC report last year. S tates in t he South — including Mississippi, Georgia and Arkansas — had the highest rates. The new report found that the South also has higher rates of postpartum depression and fewer perinatal health workers compared to other regions in the United States. The new data is 'a very significant finding,' said Dr. Amanda Williams, interim chief medical officer of the March of Dimes, which has found that the South also has the highest rates of preterm births in the country. Williams said she isn't optimistic about the outlook for mothers and babies in the South. Congress is considering drastic cuts to Medicaid. Nationally Medicaid covers 41% of births, with especially high rates in many Southern states. In addition, nearly every Southern state has a strict abortion ban, and research suggests such laws are prompting obstetricians to leave and discouraging young doctors from working there. 'We anticipate it will get worse,' Williams said. 'This is an area of the country that needs more investment, more support, more providers, not less.' 'Your body remembers' There are many causes of late stage pregnancy loss — or stillbirths — including infection or a fetus' genetic condition. Often the cause is never known. One reason for the high stillbirth rate in the South is that Black women experience fetal loss at more than twice the rate of other groups. Black women have higher rates of underlying diseases such as hypertension and diabetes, which can put a pregnancy at risk. More than half of the Black population lives in the South, according to a recent Pew Research report. Black women also have high rates of stress, which can affect a pregnancy. Kim Smith, a Black woman who lives in South Carolina, developed a severe type of preeclampsia called HELLP syndrome, and when she was five months pregnant she lost her daughter, Lauren Kelly. Some studies have shown a possible link between stress and preeclampsia, a condition in which a pregnant woman develops dangerously high blood pressure. Smith, 42, was raised in Greenville, North Carolina, by a single mother. 'My mother's a minister, my aunts are ministers, my uncles are bishops. We grew up in a very loving and faithful family,' she said. But Smith's family was poor and lived in a neighborhood with frequent shootings and high rates of drug abuse. Racial tensions were high: She remembers as a child hearing people making racist comments, and the Ku Klux Klan sometimes marched near her neighborhood. 'I recall as a child hearing gunshots and hearing police sirens and ambulance sirens on a regular basis,' she said. Smith married and moved to Irmo, South Carolina. When she became pregnant with her daughter in 2011, she was an administrator at federally qualified health care centers in underprivileged neighborhoods with poor health outcomes. It was difficult work as she observed the impact of poverty and racism on the community. 'That level of stress is not unique to me. It was just kind of the culture,' she said. While she worked hard and relied on her faith and her family's love, she said, it wasn't always easy. 'When you experience life, what do you do? You make the best of it, and you push through. And we give ourselves a badge for that. But at the end of the day, our bodies remember the stress,' she said. 'Your body remembers what you experience.' After she lost her baby, Smith changed jobs and took other steps to reduce stress in her life. She went on to have three sons — all healthy pregnancies — and is now a health tech entrepreneur. 'No state's doing well' In many ways, the South is a perfect storm for bad outcomes for pregnant women, according to an analysis done for NBC News by the Perinatal Data Center at the March of Dimes. Compared with other parts of the country, the South has the highest percentage of uninsured women ages 19-54 and the highest percentage of women that age living in maternity care deserts, where access to maternity care is limited or absent, according to the March of Dimes. The region also has the highest percentage of births in which the mothers received inadequate prenatal care. Even though the South stands out, the entire United States suffers from high rates of pregnancy and postpartum complications, said Natalie Davis, CEO of United States of Care. The maternal mortality rate in the United States is higher than in other developed countries — more than four times the rates in the United Kingdom, Australia or Germany, according to the Commonwealth Fund. The group has also found that the United States has a low supply of midwives and OB-GYNs compared with most other developed countries — 16 per 1,000 live births compared with, for example, 35 in the Netherlands and 43 in France per 1,000 live births. ' Our message to every governor is that no state's doing well at this,' she said. 'Every state needs to focus on this.' Stopping a 'continual cycle' in the South There are high-tech and low-tech approaches to addressing pregnancy complications like stillbirth. Researchers are developing artificial intelligence tools to predict which pregnant women are likely to go into premature labor. Programs such as Kid One in Alabama and Green Cars for Kids in Florida provide rides for expectant mothers to get to their prenatal appointments. 'They're missing their appointments because bus connections are too long or there isn't even a bus that goes to their neighborhood,' said Dr. Catherine Tom, president of Green Cars for Kids. Providing the rides so the women can get care 'is so simple — it's not rocket science.' Another program, Nurse-Family Partnership, connects low-income first-time mothers-to-be in 40 states with nurses. Sharon Sprinkle, the director of the program in several Southern states, said her teams have prevented many 'near misses' by educating their clients about signs of early labor, preeclampsia and other pregnancy complications. Too often, pregnant women report back that their concerns were 'minimized or totally dismissed, when, in fact, if they were listened to, the outcome would have been better,' she said. Nurses in the program teach clients to 'unleash their power and be comfortable having conversations with physicians to say: 'This is what's going on. I need you to listen. And if you won't listen, find somebody else in your office who will listen.'' Sprinkle, a registered nurse who has worked in infant and maternity care in the South for decades, said she isn't surprised by the new findings about stillbirths. Neither is Dr. Cornelia Graves, a maternal-fetal medicine specialist and professor at the University of Tennessee Health Science Center. Graves said poor pregnancy outcomes in the South will continue because of high rates of underlying diseases such as diabetes, obesity and heart disease. 'We know that women who are unhealthy give birth to unhealthy babies who then become unhealthy children who then become unhealthy mothers,' she said. 'It is a continual cycle.'
