Black Infant and Maternal Health

Anderson: Pregnancy is often described as one of the most joyous times in a woman´s life. However, about 700 women in the United States die each year as a result of pregnancy or delivery complications. Hello, and welcome to "Comcast Newsmakers." I´m Tetiana Anderson. Data from the Centers for Disease Control and Prevention show that, "Considerable racial disparities in pregnancy-related mortality exist." Dr. Joia Crear-Perry, the Founder and President of the National Birth Equity Collaborative is here to discuss the problem and the need for a solution. Dr. Crear-Perry, thank you for joining us.

Crear-Perry: Thank you so much for having me.

Anderson: So, I understand that for you, this issue is a personal one. Explain your story.

Crear-Perry: Yeah. So, when I was in medical school, I was pregnant, and I had a baby really early. And at the time, they were teaching us -- and it´s not that long ago, I know -- in the ´90s, though, that the risk factor was because of my race, because I was Black. So, I spent a lot of time really thinking why we say that and where that comes from. So, when we found out that Black women were dying in child birth at four times the rate of White women, we really needed to take a look at what were the causes for that and make sure we weren´t problemitizing Black women and showing there are structures and systems that cause this difference. There´s nothing innately wrong based upon our skin color.

Anderson: So, your organization says that the higher rates of Black women and babies dying surrounding childbirth is not one of socioeconomic status.

Crear-Perry: Exactly.

Anderson: Why do you say that?

Crear-Perry: We have data to support it. We have proof that shows no matter our income, no matter our education, no matter our weight -- those are all the things -- even our prenatal care, despite those things, we still have worse outcomes than the equivalent White woman. So, a Black woman, like me, who has an M.D., or a Black woman with a PhD has a higher risk of dying in childbirth, according to data from New York City and other places, than a White woman with no high-school education. So, since we know there´s no genetic difference, there´s no magical gene for Blackness. Melanin is just hyper -- more in other people than others. Then we know that there must be something going on in this country that is causing that to happen.

Anderson: And we´ve heard high- profile stories of Black women talking about this.

Crear-Perry: We have.

Anderson: Beyoncé, Serena Williams have had their own experiences with this, as well.

Crear-Perry: For sure. And we also want to point out the reason that the United States has the worst outcomes for maternal health in the industrialized world are not just because of Black women, right? We also have high rates and problems for healthcare in general because we don´t value women as much in this country. So, we don´t have things like paid leave. We don´t have access to resources for childcare. And those are the things that help support you not being stressed when you have a baby. But when you add on racism to that, you find things like even a woman like Serena or Beyoncé going to the hospital and not being listened to, not being heard.

Anderson: Which is what happened in the case of Serena Williams.

Crear-Perry: It did. It did. She had to advocate for herself. So, you really want to challenge the system and say, "Women should not have to advocate to live." You should value them and see them and listen to them and believe that they have truths about their body. If they say something´s wrong, you should investigate and not ignore them for that.

Anderson: Your organization also talks about the social determinants for health...

Crear-Perry: Yes, exactly.

Anderson: ...for Black moms and babies. What does that mean, and what are those?

Crear-Perry: We were so excited back about 20 years ago when we started talking about social determinants. Before then, we really talked about health as something innate to an individual, right? Health was based upon what you ate or if you had different genetic makeups. But now we recognize that your health is also determined by things like where you live, access to healthy fruits and vegetables in your community, being able to exercise. And so, those social structures around you -- having economic equity. That´s important. Having the ability to be paid for the work at the same pay. Those things are social determinants of health. So, not just your choices, but all the structures and systems around you that cause you to have poor health outcomes.

Anderson: And are some of the complications that are related to this hospital-based? And are there other birthing alternatives that may lead to a different outcomes? I don´t know -- midwives, doulas?

Crear-Perry: For sure. Yeah.

Anderson: Talk to us about that.

Crear-Perry: The countries that have better outcomes than us have a much bigger system when it comes to midwifery. I can say as an O.B./GYN we are doing a disservice to our country that we don´t have more access to midwives and doula support, which are women who support you during pregnancy and are advocates with you while you´re pregnant. So, it´s important for us to think about why wouldn´t we have a more robust midwifery system in this country. The princess in London just had her baby at home. What´s wrong with home births, right? It´s important for us. The reason that people fear it is that we don´t even make room for it. We´re not allowing for different -- We´re not allowing for people to have options. And so, that creates a system that harms and says, "No, we´re gonna punish you for having a home birth," versus if we could legalize things, we could make rules to make it safe. Because pregnancy should be normal and physiologic and an easy thing. It´s not a medical complication until it becomes one. Then you need the fancy O.B. to come in and fix things. But it shouldn´t start off at the highest level of care for something that´s really been natural and been done for hundreds of years, thousands of years.

Anderson: Dr. Joia Crear-Perry, thank you so much.

Crear-Perry: Thank you for having me.

Anderson: And thank you for joining us, as well. For more great conversations with leaders in your own community and across the nation, visit comcastnewsmakers.com. I´m Tetiana Anderson.