Commonwealth Magazine


When Nneka Hall was pregnant with her third child, she had a symptom of preeclampsia, a serious pregnancy complication, but her doctor never caught it. Hall felt her daughter was hiccuping and worried that something was wrong, but the doctor told her she had a recurrence of depression because of her separation from her husband.

“My child was telling me something was wrong. I was repeating it and was not heard,” Hall said.

Her daughter was stillborn.

Unfortunately, Hall’s experience of feeling like her doctor wasn’t listening to her isn’t unusual for black women during pregnancy and childbirth. Hall said she spoke to black doctors who physically moved from one emergency room to another where their colleagues work to offer treatment for postpartum preeclampsia because their patients were not taken. seriously.

And black women’s outcomes during pregnancy and childbirth are far worse than their white counterparts. In Massachusetts, a black woman is nearly twice as likely to die from a pregnancy-related cause as a white woman. Black women are 70% more likely than white women to have serious health consequences related to pregnancy and childbirth.

The legislated Select Commission on Racial Inequalities in Maternal Health recently released a 74-page report exploring why these disparities exist and what can be done about them. Two commission members, state Rep. Liz Miranda, a Democrat from Roxbury, and Hall, the founder of Quietly United in Loss Together Corporation, spoke this week Codcast on the report.

The report concludes that there is no single cause for inequalities in maternal health. There are factors related to the health system, families, communities, racism and poverty.

For example, the use of a doula – a trained person who can support a woman during childbirth in a non-medical way – can improve birth outcomes. But doulas cost between $800 and $2,000 and are not covered by insurance.

Yet Miranda said resources alone cannot explain inequities, although money and insurance are a factor in access to care. She noted that her Cape Verdean sister gave birth to a 21-week-old baby who did not survive after a doctor downplayed her symptoms. But black tennis star Serena Williams had her own near-death experience with childbirth and had to personally insist on tests after hospital staff seemed uninterested.

“Birth is the only space where it doesn’t matter what level of education you have, where you live, what your socio-economic status is. Black women still die two to three times more than white women across the country and even here in Massachusetts,Miranda said. “There’s a lot of structural and systemic racism, ageism, and gender issues between black and white women,” Miranda said. “The other things that make it difficult to give birth as a black person giving birth are the bad weather of black people. We are stressed. Highest income inequality. We live in historically segregated communities.

Miranda said many women — especially women like the non-English speaking immigrants she represents — don’t know what resources are available to them. “There is a lack of cultural competency, there is a lack of diverse prenatal workforce with the language ability to help our diverse communities in Roxbury, Dorchester, Mattapan, Hyde Park,” she said. .

Hall said there are volunteer doula programs in hospitals, midwives who accept payment plans and state home visiting programs, but people don’t know about them. “I’ve given birth four times in the Commonwealth,” Hall said. “The first time I heard about the home visiting program that is available through the Mass. Department of Health for anyone was when I was working as a contractor for the Department of Health. Massachusetts Public Health..”

The Committee on Health Care Financing recently sent for consideration, or rejected through legislation, two bills that would have established a licensed and regulated system of professional midwives while requiring midwives to be covered by insurance and that they pay the same amount as other medical care providers for the same services. Today, Massachusetts is one of the few states that does not recognize national midwifery certification, making it harder for women to seek midwifery care.

Meet the author

Journalist, Commonwealth

About Shira Schoenberg

Shira Schoenberg is a reporter for CommonWealth magazine. Shira previously worked for over seven years at Springfield Republican/MassLive.com where she covered state politics and elections, covering topics as diverse as the launch of the legal marijuana industry, issues with the state’s foster care system and the elections for US senators. Elizabeth Warren and Governor Charlie Baker. Shira won the Massachusetts Bar Association’s Excellence in Legal Journalism Award in 2018 and several articles have won awards from the New England Newspaper and Press Association. Shira covered New Hampshire’s 2012 presidential primary for The Boston Globe. Prior to that, she worked for the Concord (NH) Monitor, where she wrote about state government, city hall, and Barack Obama’s 2008 primary campaign in New Hampshire. Shira holds a master’s degree from Columbia University’s Graduate School of Journalism.

About Shira Schoenberg

Shira Schoenberg is a reporter for CommonWealth magazine. Shira previously worked for over seven years at Springfield Republican/MassLive.com where she covered state politics and elections, covering topics as diverse as the launch of the legal marijuana industry, issues with the state’s foster care system and the elections for US senators. Elizabeth Warren and Governor Charlie Baker. Shira won the Massachusetts Bar Association’s Excellence in Legal Journalism Award in 2018 and several articles have won awards from the New England Newspaper and Press Association. Shira covered New Hampshire’s 2012 presidential primary for The Boston Globe. Prior to that, she worked for the Concord (NH) Monitor, where she wrote about state government, city hall, and Barack Obama’s 2008 primary campaign in New Hampshire. Shira holds a master’s degree from Columbia University’s Graduate School of Journalism.

Miranda, who is running for the state Senate, said the lack of progress on various bills related to maternal health indicates the need to increase the representation of women and people of color in the legislature. . She hopes that this session or the next, there will be an appetite to pass an omnibus “birthing justice” bill. “It’s not a situation that we can choose or choose what intervention we’re going to do now,” Miranda said. “Speaking as a black woman, saying black women die twice as fast as white women, but Massachusetts is better, doesn’t do me justice..”

“I for one don’t give up on black women, indigenous women and women of color because I know that if we work to improve their birth outcomes, we improve outcomes for everyone,” said Miranda. “And that’s the most important thing. We can get to zero. We can save mothers, we can save partners, and we can save babies in Massachusetts if we focus and center and let black and brown women lead in this space.

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