Black women are 2.5 times more likely to die in childbirth than white women.

That’s according to a report released in January by the Centers for Disease Control and Prevention which also found that over 650 women died of a pregnancy-related cause in 2018. And some experts estimate that these numbers even fall short of the actual mortality rate, ProPublica reported.

The report comes at no surprise to some. When the Black Maternal Health Caucus was formed in April by Reps. Alma Adams (D-N.C.) and Lauren Underwood (D-Ill.), its 52 members committed to changing those numbers for the women most at risk: black women. Less than a year later, the caucus has nearly doubled in size.

In the coming weeks, it plans to introduce an omnibus package of bills to tackle the maternal health crisis, leaders say. Here’s more from caucus members and maternal health advocates on the front lines of the fight to prevent more black women from dying:

Rep. Alma Adams (D-N.C.)

A founding member of the caucus

On why she started the caucus: It is a public health crisis, but I don’t think people realize that. And when you look at the fact that moms in America are more likely to die in childbirth than moms in any other country that gets your attention. I’m a black mom and a grandmother, so that makes it personal for me.

My daughter was in crisis [when she was pregnant] and almost died. She’d go check in with the doctor, who’d say, oh, nothing to worry about, go home, take an Aspirin, that kind of thing. But women know their bodies. We have to get to the point where doctors are more sensitive to that and believe what they say.

On what better maternal health care for black women looks like to her: A significant reduction in the number of African American women losing their lives before, during and after childbirth. We have to close the disparity gap with these women and white women and that means that we’ve got to really seriously address the structural and systemic racism now.

On what’s next for 2020: We have to improve the care for women of color, but we also have to care for our pregnant veterans, incarcerated women, women in rural communities, just to name a few. We also have to identify barriers to mental health services. We have to increase the support to families before, during and after birth by adjusting some of the social determinants of health, like housing and transportation.

It’s important for us to listen to black women. Hopefully, some of the legislation we are proposing will provide opportunities for those who provide services to our moms to not only be better informed, but be more sensitive.

Rep. Lauren Underwood (D-Ill.)

A founding member of the caucus

On why she started the caucus: When I first came to Congress, I decided to set up some meetings with the more senior members. And during my meeting with Congresswoman [Alma] Adams we identified that we’re both interested in working on this maternal mortality issue.

My personal interest stems from my experience as a nurse, but also I had a friend that died three weeks after giving birth in early 2017. And so I knew that we had not seen the kind of national attention being paid to this particular disparity crisis. And so I wanted to work on that.

On garnering bipartisan support: I think it’s something that it is entirely within our grasp to solve right now. This is not an issue where we need more capacity or that there’s not the basic structures in place to be able to save lives. I mean, we have the ability to move forward.

On what improved maternal health looks like: Women should have a choice in their providers. They should be seen and heard by their providers. They can deliver in a setting of their choice and they can afford the care that they need. There should not be fear.

Rep. Deb Haaland (D-N.M.)

A member of the Black Maternal Health Caucus

On how her own experiences inspired her to join the caucus: I’m Native American, so I’m always able to go to the Indian Health Services for medical care, but sometimes it’s not always convenient. So, I relied on Planned Parenthood a lot [while pregnant] because it was affordable and accessible.

I had my daughter through a midwife and Medicaid paid for the midwife. [The Indian Health Service] had me apply for Medicaid. I think that women should have access to doctors, midwives, nutrition, prenatal care, no matter their income or background. I want to give a shout out to the [Special Supplemental Nutrition Program for Women, Infants and Children]. That is an amazing program that paid for essential things that women and babies really need.

When you're a single mom and you're a woman of color, your health care options are limited. Think about right now with President Trump trying to cut every single safety-net for women like me. I am wholeheartedly against cutting programs that help women get the health care they need. We’ll be introducing an [omnibus] bill coming in a few weeks that will present solutions to improve maternal health for women of color. And we’ll fight for those.

Rep. Lucy McBath (D- Ga.)

A member of the Black Maternal Health Caucus

On why she joined the caucus: Like many women in America, I struggled to get pregnant. After years of trying, my son Jordan was a miracle for me and my family. I’ve seen firsthand how important maternal care is to healthy outcomes. Some of the disparity is related to social factors, some of it is related to bias, however there is no reason that these problems cannot be fixed.

On what Congress can do to improve maternal health: One of those things is bias training for health care providers, which has been shown to have a significant impact on health outcomes for black women. Another is ensuring that all black women have coverage, not just during pregnancy, but before and after for at least a year. We have to be intentional in our solutions.

Angela Aina

Interim executive director of the Black Mamas Matter Alliance

On why having the caucus is important: We were in talks with Rep. Alma Adams on there needing to be a specific caucus on the issues around black maternal mortality in particular last year. That is something that has been ignored for so long. Having a specific caucus that is focused on black maternal health means we can really dig deeper into the systemic issues.

On what improved maternal health looks like: Centering holistic maternity care whereby the person is at the center. A woman may interact with multiple providers throughout her entire reproductive life span and how awesome would it be if all those people were working together?

The fact that we uplift holistic maternity care in it of itself is about heath and wellness of the individual person and their families and the larger communities. Black and brown communities are really centering the care of doulas and midwives. It’s very important for people to see that they do have other options.

Stacey D. Stewart

President and CEO of the March of Dimes

On the importance of centering black maternal health: I think for black women it’s a very unique challenge, one that’s rooted in the history of the country. You can be a highly educated black woman with healthy income and access to insurance and still potentially die on average at a higher rate than an uneducated white woman in this country. And so, when you peel back the layers of income and education, it’s clear the only big factor left is race.

On what better maternal health looks like: We need to go back to a time when pregnancy and childbirth was just viewed as a natural course of life. When midwives and doulas worked with health care providers to ensure that women felt secure and protected and felt like they had a support system to help them deliver in the safest and most successful way possible.

When women show up at any health care provider, they feel listened to, they feel respected, they feel heard, and they feel like their needs are being met.

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