How are DC Officials Combatting the Maternal Health Crisis? 

The Supreme Court implemented Roe v. Wade to protect a woman’s right to choose. Jan. 22 marked the 50th anniversary of the court’s decision. What once would have been an empowering day for many uterus-bearing people had become rather solemn considering the decision’s overturning in June 2022. 

This feeling was mirrored by the weather in Washington that day, as the skies were overcast and rain poured down onto the district’s streets. Amid the day’s gloominess, a ray of hope shone at Trinity Washington University as people gathered to view the 2022 documentary “Birthing Justice.”

Directed by Monique Matthews, the film explored the experiences and obstacles that Black women face during pregnancy, childbirth, and postpartum. It emphasized the importance of Black women having access to Black midwives and doulas and brought attention to the current state of maternal health across the United States.

The maternal mortality rate in the United States ranks the highest among other high-income countries, with rates being extremely high for Black women compared to other races– especially in Washington. Black birthing people make up about 90% of all pregnancy-related deaths across the district, even though they only account for 50% of total births according to the Maternal Mortality Review Committee.

Councilmember Christina Henderson was among the audience and spoke in a panel discussion to shed light on the maternal health crisis that is running rampant in the district. “One of the reasons I ran for office was because I thought it was appalling that we don’t have a hospital east of North Capitol Street that has labor and delivery services,” said Henderson.  
Those who live in Wards 7 and 8 must travel west of the Anacostia River to give birth, as there are no hospitals in the area that offer labor and delivery services. These two wards have the highest infant mortality rates across the nation’s capital:9.1 deaths per 1,000 lives births in Ward 7 and 9.3 in Ward 8.  Coupled with the lack of doula and midwifery services, many Black birthing people within the district don’t have direct access to transportation for prenatal appointments or labor and delivery services nearby.

To combat this, DC Health is funding the Healthy Start Program, which provides prenatal and doula services and support for parents and infants up to 18 months of age living in Wards 5, 7, and 8. In Feb. 2022, Mayor Muriel Bowser announced that Cedar Hill Medical Center will open in Ward 8 in 2024 and will give those located east of the Anacostia River access to obstetrics.

Although she’s excited for Cedar Hill, Henderson asks, “What do women do now? What do families do now?” 

D.C.’s Medicaid plan recently changed to cover doula services under the Doula Services State Plan (SPA). Per these revisions, all pregnant people would have access to 12 doula visits throughout their prenatal, childbirth, and postpartum journeys. 

Among low-income women (41% being Black), those supported by a doula were “four times less likely to give birth to a baby with a low birth weight [and] two times less likely to experience a birth complication involving themselves or their baby,” according to The Journal of Perinatal Education.

Both times Henderson gave birth, she had to pay for her doula services out of pocket. “I feel very strongly that we know what the research says. Having a doula in the room should not be something just for the privileged,” she said. 

In an October 2020 poll, 55 percent of Black Americans reported distrusting the healthcare system. Medical mistrust between the Black community and their physicians could be the effect of implicit bias within the healthcare system. 

Forty percent of first and second-year medical students believe that Black patients have a higher pain tolerance than their white counterparts, according to a 2016 study. “There’s still a lot of barriers and a lot of challenges when folks engage in care,” said Ebony Marcelle, Director of Midwifery at Community of Hope.“I think that makes people not want to go in and get care.” 

Community of Hope is a nonprofit that provides home visiting services, doula support, transportation to prenatal appointments, and more. Abayea Pelt, Community of Hope’s Senior Director of Maternal and Child Health, believes care providers must listen to their patients and build care plans with them. “We cannot do any of the work that we do if we don’t have a healthy professional relationship with them,” Pelt said. 

The organization strives to make sure any services provided focus on and cater to the patient’s needs. 

Before they dispersed, Henderson urged the crowd at Trinity Washington University to contact their representatives about the Black Maternal Health Momnibus Act of 2021, which would directly address the nation’s maternal health crisis. 

Components of the bill were passed to the House of Representatives with broad support. Even though there is still much work to be done, DC officials are working toward getting Black child bearers access to the care they deserve.