African American, American Indian and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention.
Gov. Ralph Northam (D) announced in December that his proposed budget will include approximately $22 million to combat this. The money will go toward expanding Medicaid coverage, increasing home visits and supporting Medicaid reimbursement for doula — a woman employed to provide support and guidance — services for new mothers, according to a press release provided by the Governor’s website.
According to a National Geographic article, the U.S. and Serbia are the only developed nations with rising maternal mortality rates since 1990. In June, Northam proposed the goal of eliminating racial disparity in Virginia’s maternal mortality rate by 2025, and as a part of this effort, Secretary of Health and Human Resources Daniel Carey organized a 10-stop “listening tour” across the state.
The press release said the feedback from mothers, medical professionals and community advocates from the tour was used to plan what services the money would support. Deputy Secretary of Health and Human Resources Gena Berger said a lot of the information gathered from the tour matched with over 15 years of data collected by Virginia’s maternal mortality review team. She emphasized the importance of Northam’s claim to eliminate racial disparity in the state’s maternal mortality rate as a driving force for those who wish to see it through.
“I think that it was necessary to set a very bold goal to get the attention of the medical community,” Berger said. “I think we’ve been successful in pulling people together to offer a number of ideas and approaches to the problem, and so we are really putting together a strategic plan that outlines where we want to head in the next five years in order to accomplish that goal.”
JMU associate professor and director of undergraduate studies in writing, rhetoric and technical communication Cathryn Molloy said she’s happy that money will be devoted to this cause at the government level. With a research area in the rhetoric of health and medicine, she said she feels strongly about the issue of racial- and gender-based disparities in healthcare.
“It’s ambitious,” Molloy said. “We’re in a really frightening and alarming time where we’re seeing women of color dying from pregnancy-related complications in childbirth and postpartum much more frequently than white women. I do think that dedicating some money to figuring out this problem is a worthwhile thing.”
The FAMIS MOMS program, a Virginia health insurance program for uninsured pregnant women, currently provides Medicaid coverage for women during pregnancy and 60 days postpartum, according to its website. The press release explains that Northam’s budget will extend this coverage up to one year postpartum.
Molloy’s interest in the topic began when two colleagues — a man and a woman — described to her the same set of symptoms, but their treatments were different. The man’s doctor had several diagnostic tests done on him, but the woman’s doctor prescribed her with Prozac immediately without looking into any other causes for symptoms. Now, a few years later, she has published a research project focusing on people who have been misdiagnosed with symptoms in their heads but really had diagnosable medical diseases.
JMU associate professor of anthropology Rebecca Howes-Mischel has also published research on the topic of maternal mortality, however, hers focuses on the indigenous women in Oaxaca, a region in southern Mexico. She called attention to Northam’s inclusion of reimbursing doula services, which she said she sees as a valuable resource for new mothers.
“I was really glad to see the increased push toward considering doula care,” Howes-Mischel said. “I would hope that that actually materializes because having an advocate for you is one of those policy initiatives that does seem to lead to better outcomes.”
Molloy explained that because racial disparity is such a complicated problem, it’s hard to determine how to fix it. She highlighted the role that implicit bias — attitudes or stereotypes that affect our decisions in an unconscious manner — can play in these disparities. Similarly, associate director of JMU’s Center for Civic Engagement Carah Whaley said she thinks that even though Northam’s proposal is a good first step, it doesn’t address the broader systemic forms of racism that people of color face.
“I don’t want to undersell the importance of direct access,” Whaley said. “We know that this is fulfilling a need, but I think that we also need to think about addressing the underlying causes more directly, which is essentially making people more aware of their biases.”
Berger said implicit bias training was not included in the budget proposal because this initiative has already begun. She explained that Northam told health officials to work on increasing implicit bias training for health professionals in June and that they don’t need a budget requirement to carry this out.
The press release said that the budget also includes funding to increase access to affordable and reliable contraceptives, which has been shown to lower rates of preterm and low birth weight births. Berger added that the budget includes Medicaid expansion for addiction recovery treatment services due to data that shows severe mental illness and substance use disorders are major causes of pregnancy-associated death.
Whaley works to develop programming around issues that are of concern to students, including racial inequality in society. In addition to Molloy, she said that she thinks addressing racial disparity in healthcare at the level of medical training could be beneficial in mitigating the issue.
“It’s such a thorny, complex problem,” Molloy said. “It probably needs to be tackled from a lot of different angles, so it’ll be really interesting to see how it plays out once that two-year budget gets set.”
Contact Kamryn Koch at email@example.com. For more coverage of JMU and Harrisonburg news, follow the news desk on Twitter @BreezeNewsJMU.