The Washington PostDemocracy Dies in Darkness

Opinion Finally addressing maternal and infant mortality rates in Virginia

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December 27, 2019 at 4:35 p.m. EST
Virginia Gov. Ralph Northam (D). (Steve Helber/Associated Press)

Malinda Langford is senior vice president of programs, Ondrea McIntyre-Hall is director of health access and nutrition services, and Nanci Pedulla is director of the Healthy Families program at Northern Virginia Family Service.

Long after a pregnancy ends, the experience leaves a lasting memory on a woman and can have a profound effect on her in the transition to motherhood and beyond. Until September, after nearly a decade, Aaliyah Samuel had never shared her firstborn child’s birth story publicly. But on that fall afternoon, Samuel, who is African American and a fellow at the Center on the Developing Child at Harvard University, sat in an Annandale conference room with other moms, health-care providers, community leaders and officials from the Virginia governor’s office to talk about how her son Caleb came into the world and died two days later. Reluctantly, she stepped into the spotlight to convince Richmond policymakers that racial disparities in maternal health are very real and must be addressed.

Samuel’s participation in the fall “listening session” paid off. This month, Gov. Ralph Northam (D) announced that his proposed 2020 budget includes $22 million to combat maternal and infant mortality and reduce the disparity in Virginia’s maternal mortality rate.

The United States is one of only 13 countries in the world in which the rate of maternal mortality continues to be worse than it was 30 years ago. Since 2016, according to the Centers for Disease Control and Prevention, black women in Virginia died as a result of childbirth at three times the rate of white women, with at least two-thirds of these deaths being preventable. Many of these black women lack access to stable health care and face institutional biases and racism that create barriers to receiving appropriate care. Moreover, these increased rates of death — and oftentimes grave pregnancy-related disabilities — occur regardless of the socioeconomic status, education or Zip code of black women. In turn, racial biases affect the health and well-being of their children, sometimes with the most devastating of consequences.

Samuel’s nightmare began when she went into labor at 24 weeks and her husband was out of the country. She vividly remembers the responding emergency medical technicians joking about her and her plight while she cried out in pain. Worse, they listed her as a single mother on Medicaid. She was neither. Based on their targeted assumptions, the EMTs drove her to a hospital with no maternity services, delaying her and her baby the critical care needed. “They didn’t see me for who I was, but rather for who they thought I was,” Samuel said.

Northam is addressing biases head-on by investing in proven strategies. For instance, he has proposed $12.8 million to make home-visiting services eligible for Medicaid reimbursement. Northern Virginia Family Service’s years of experience have proved that home visits from culturally humble, specialty-trained professionals are one of the most effective ways to improve pregnancy outcomes, promote positive parenting practices, improve child health and development, promote school readiness, prevent child abuse and lead to higher high school graduation rates and, ultimately, to a stronger, well-integrated workforce.

But this is just the beginning.

“As a commonwealth, we can and must do better,” Northam said in making the budget announcement. For Samuel and all the black women and their families who have and continue to experience the inequities that racism perpetuates within the health-care system, the time for action is now. Our strategy must be to look deep within systems to upend those structures, practices and behaviors, striving for equitable pregnancy and birth experiences and outcomes for all women.

Read more:

The Post’s View: D.C.’s maternal mortality rate is at crisis proportions

Tyra Wilkes: Black mamas matter

Leana S. Wen: The one health-care word I wish Democrats would say during debates

Laura Jenkins: Working to reduce infant mortality in Maryland