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RFLC Research Spotlight: Black Maternal Health Research

In the first two months of this year, the Black Maternal Health Momnibus Act was introduced in Congress, the Massachusetts legislature passed an Act to Reduce Racial Disparities in Maternal Health, and Kentucky legislators introduced a package of 21 bills under the Kentucky Mother and Infant Health Project, recognizing that maternal health disparities are a racial justice issue.

Because the maternal mortality crisis in the United States operates at the individual and systemic levels, policy responses must cover a range of strategies. 

The Maternal Health State Policy Agenda from the Center for Reproductive Rights describes the key role that data plays in achieving the following policy priorities:

  • Ensuring quality maternal mortality data collection and appropriate resource allocation for the prevention of maternal health harms (policy example: community participatory maternal mortality and morbidity review)
  • Expanding and ensuring access to maternity care and preventive health services (policy example: health insurance and coverage)
  • Advancing health equity by addressing racism within and beyond the health care system (policy example: implicit bias training)

For a comprehensive resource on the Black maternal health crisis, including a research overview, download the Black Mamas Matter Alliance toolkit.


Black researchers, researchers of color, and reproductive justice organizations lead the way in conducting research to understand the disparities in sexual, reproductive, and maternal health care in Black communities and communities of color:

Preterm Birth Initiative

      • Published in the Maternal and Child Health Journal in January 2021, this article “detail(s) the results of the first study to develop a conceptual framework of structural racism from the perspectives of Black women across the reproductive lifespan in the field of maternal and child health.”
      • Participants defined nine unique domains of experience with structural racism. Negative societal views of Black women and people, inadequate housing, inadequate medical care, discrimination in law enforcement, hidden health and community resources, discrimination in employment, and discrimination in education were identified across the reproductive lifespan and two domains were uniquely associated with pregnancy and post-partum experiences: deficits in infrastructure to provide safe and healthy environments, and the policing of Black families in private and public spaces.
      • One of the authors of the paper, Dr. Monica McLemore RN, PhD, FAAN, summarizes the importance of this research: “For too long, research has been focused on individual level factors that contribute to health disparities that are not helpful when attempting to address a complex issue like racism. It is essential that future research center the voices of people who experience the condition as they have unique perspectives on the harm, but also the solutions to mitigate these harms.”

 

Chambers BD, Arega HA, Arabia SE, Taylor B, Barron RG, Gates B, Scruggs-Leach L, Scott KA, McLemore MR. Black Women’s Perspectives on Structural Racism across the Reproductive Lifespan: A Conceptual Framework for Measurement Development. Matern Child Health J. 2021 Jan 4.

 

National Birth Equity Collaborative (NBEC)

        • Led by founder and president Dr. Joia Adele Crear-Perry, MD, FACOG, NBEC works toward a vision of all Black mothers and babies thriving through training, policy advocacy, research, and community-centered collaboration. NBEC’s 2020 Birth Equity Agenda highlights the role of governments and policy in meeting this goal.
        • One of NBEC’s research initiatives, the Birth Equity Index, assessed a set of 50+ social and structural determinant indicators in 100 metropolitan areas across the United States with the highest Black infant mortality rates to examine their collective impact on infant mortality rates and illustrate the racial inequity within the rates.

     

    Wallace ME, Green C, Richardson L, Theall K, Crear-Perry J. “Look at the Whole Me”: A Mixed-Methods Examination of Black Infant Mortality in the US through Women’s Lived Experiences and Community Context. Int J Environ Res Public Health. 2017 Jul 5;14(7):727

     

    Black Mamas Matter Alliance Research Working Group

            • The Black Mamas Matter Alliance (BMMA) is a national network of Black women-led organizations and multi-disciplinary professionals who work to ensure that all Black Mamas (inclusive of all birthing persons of African descent) have the rights, respect, and resources to thrive before, during, and after pregnancy.
            • Many policy approaches to addressing Black maternal health disparities necessarily involve research and data collection. This paper provides an historical overview of research on Black maternal health and provides new framing that centers the subjects of the research moving forward “given the transparent assumption that researchers do not possess any solution to Black maternal health that Black women do not already know…”
            • The authors mark the relevance of this research vision to policymaking, saying: “In addition to re-envisioning research, we can introduce bold and most innovative approaches to improving health across the reproductive life course, building on existing health data contextualized by the Black Futures Lab and the Black Census, to develop a comprehensive reproductive justice agenda. Such an agenda could include paid family leave; universal basic income; a cessation of the criminalization of pregnancy and pregnant people; comprehensive health coverage; the provision of doulas and midwives to communities ill-served by the current healthcare system; and, finally, envisioning the patients and communities we work with as ideal participants in the current and future healthcare workforce.”

         

        Black Women Scholars and the Research Working Group of the Black Mamas Matter Alliance Black maternal health research re-envisioned: Best practices for the conduct of research with, for, and by black mamas. Harvard Law and Policy Review. 2020 Nov;14:393-415.

 

For additional resources, messaging guidance, or to be connected with a research expert on reproductive health topics, please reach out to [email protected].