When does it end?
Between 2008 and 2017, Ohio’s pregnancy-related maternal mortality rate rose from 17.0 deaths per 100,000 live births to 18.8 deaths per 100,000 live births. With this increase in the rate of pregnancy-related deaths in Ohio, Black women are the most affected. A 2019 report on pregnancy-associated deaths, found that between 2008 and 2016, Black women in Ohio experienced maternal mortality rates of nearly 30 deaths per 100,000 live births.
So again, when will Black people, Black women, dying at a disproportionate rate end? The constant fear of injustice, invalidation, and even death plagues the minds of many Black people in our communities, including myself. Although I have not encountered the experience of being a pregnant Black woman or a Black mother, I too fear that my concerns or questions related to my health won’t be heard or taken seriously; that my healthcare providers won’t recognize if I’m in pain or experiencing a medical crisis because of a racist stereotype that “Black women are too strong to feel pain.” I too fear for the lives of my future children, as they will be seen by many as a threat and deemed unworthy of life because of the color of their skin.
The Black maternal health crisis plagues our country and our communities in Ohio. Black mothers are two and a half times more likely to die from pregnancy-related complications than white mothers. These disparities in maternal health outcomes for Black women can be attributed not only to disparate access and quality of maternal health care services, but also to racial disparities in access to and quality of care, discrimination, and implicit bias in the health care system experienced before, during, and after pregnancy, as well as stress and trauma associated with structural and institutional racism.
“Understanding reproductive justice in Black communities means acknowledging and understanding our 400-plus year history of having our reproductive and birthing choices stripped away. To not understand this is to ignore the systemically racist and oppressive practices embedded in our healthcare system that reveal themselves in erroneous healthcare communication and deficient culturally relative services.” – Jessica M Roach, MPH / Dorian L. Wingard, MPA, Restoring Our Own Through Transformation (ROOTT)
Ohio House Bill 142 (Crawley, Brinkman), legislation with bi-partisian support in the Ohio Statehouse, has the potential to address the maternal mortality crisis. This bill would require Medicaid to cover doula services, an important tool for strong maternal and infant health outcomes that is currently out of reach for many as the cost of hiring a doula often ranges from $600 to $2,000. The legislation would also create a program under the Department of Rehabilitation and Correction that provides doula services to incarcerated individuals participating in any prison nursery program.
A study from the Ohio Department of Health found that between 2012 and 2016, 57% of pregnancy-related deaths could have been prevented in Ohio. By providing a professional advocate and support to birthing people in Ohio, House Bill 142 has the opportunity to save lives and promote more discussions and actionable measures to address inequities in our society, particularly facing Black women and women of color.
“According to the March of Dimes, studies suggest that increased access to doula care— especially in under resourced communities—can improve a whole range of health outcomes for mothers and babies, lower health care costs, reduce C-sections, decrease maternal anxiety and depression, and help improve communication between low income, racially/ethnically diverse pregnant women and their health care providers.” – Jaime Miracle, NARAL Pro-Choice Ohio
This is at least the second time that this bill has been introduced in the Ohio Statehouse in recent years, and the issue has gained traction in many other state legislatures. In the 133rd General Assembly (2019 – 2020), legislators from the Ohio House and the Senate began legislative efforts to advance bills (House Bill 611 and Senate Bill 328) that would provide doula services for those on Medicaid. However, our state lawmakers failed stalled progress these bills and they, ultimately, did not become law. No matter our race, place, or income, this legislation matters. The reality is: children are going without mothers, and once again, families are being torn apart.
In early June of 2021, the current version of the bill (House Bill 142) received a second hearing with proponent testimony from advocates, healthcare providers, and experts. Although June’s hearing had many community members from across the state come to testify, we still need to ensure that more hearings are held for this bill and ultimately that our state representatives and senators vote YES to House Bill 142.
“HB 142 allows people who historically cannot afford doula services, especially Black women, to determine positive healthcare outcomes before, during, and after birth. This safe birthing bill acknowledges healthy birth outcomes for parents and children and goes beyond doctors, nurses, and other medical staff’s expertise.” – Jasmine Henderson, Ohio Women’s Alliance
Doulas are able to provide needed additional support, create a more supportive environment during delivery, and make the experience of pregnancy much less difficult for the mothers rightfully advocating for their own lives and the lives of their children. House Bill 142 will make these services more affordable and accessible for expectant partners.
This bill does not fix all forms of racism and maltreatment Black and Brown people face in our country, and more specifically, in Ohio, that contributes to maternal mortality and morbidity. But, it is one central solution. Our policymakers and advocates have also emphasized the need for this bill to recognize and address that, similar to other infrastructures and systems, injustices within our healthcare system do exist – and that concrete solutions, like House Bill 142, exist to uproot those injustices.
“We must ensure that all new mothers can thrive, and that begins with strong support for maternal health. Nationally, Medicaid covers more than half of births, playing a critical role in maternal care and health outcomes for babies. When mothers can access the crucial support and services they need throughout their pregnancy and delivery, it can help support stronger health outcomes for mom and baby. However, the state of Ohio fails to provide Medicaid coverage for doula services, putting them out of reach for many women who want and need to access them.” – Erin Ryan, Women’s Public Policy Network
This bill will make a difference – but it will take action from our lawmakers to make that possible. I urge you to call on your representative and members in the Families, Aging, and Human Services committee to increase support for this legislation because all Ohio women, birthing individuals, and families have the right to accessible and affordable resources for a safe pregnancy, birth, and postpartum care. This bill helps us continue to invest in expectant parents and their families, strengthen our communities, and promote a more equitable future for all Ohioans.
ABOUT THE AUTHOR: Stephanie Ogonuwe (she/her)
Stephanie serves as a Program and Policy Intern at the Ohio Women’s Public Policy Network. She is a third-year student from Hilliard, OH. At Ohio State, she serves as a Residential Advisor, Undergraduate Student Government Senator, and member of the Post-Mount Leadership Society Board. Stephanie enjoys music, photography, and traveling; she plans on pursuing a career in medicine and public policy.