How California can address disparities in maternal health

Guest Commentary written by

Dana Sherrod

Dana Sherrod is co-founder and director of the California Coalition for Black Birth Justice and an expert in advancing health and racial equity at hospitals and government agencies.

In 2018, I gave birth to my second daughter. What was meant to be a beautiful, joyful experience quickly shifted to a dire situation that required an emergency cesarean section under general anesthesia.

This meant I was unconscious during my birth, and my husband was not allowed in the operating room to witness the birth of our child.

Ten days after delivery, I began vomiting and ran a fever. I had developed an infection from the surgery, which required a second, three-day stay in the hospital, and time away from my breastfed newborn and then-4-year-old.

Unfortunately, my traumatic experience and being dismissed during labor and delivery remains common in the U.S. – particularly among Black women. The maternal death rate continued to climb in 2021, according to the Centers for Disease Control and Prevention, and continues to disproportionately impact Black women.

As a Black mother with firsthand experience, I simmer with righteous anger. Despite the data, the storytelling and the deaths, we continue to fail mothers, especially Black mothers. In Los Angeles alone, within the first 90 days of this year, our community has been shaken by two Black maternal deaths, April Valentine and Bridgette Cromer.

We are grieved, angered, frustrated and confused.

In times of despair and faced with constant, repeated injustices, Black women have always picked up the pieces and bridged the gaps in the aftermath of community trauma. Today, we continue to shoulder the immense added responsibility of advocating for healing and deep, systemic change.

But, if we truly intend to disrupt and ultimately reverse inequities in Black maternal health, we need what PolicyLink CEO Michael McAfee calls “transformative solidarity.”

That is to say, we need sustained investments in Black-led organizations, new ways of working together, and equity-centered actions from our policymakers, philanthropists and health care systems.

In 2020, in response to the murder of George Floyd and other unarmed Black Americans, community foundations donated $125 million to causes supporting Black communities, up from $78 million in 2019. However, that money was mostly short-term funding, and only accounted for 2% of the total investments from community foundations, according to the National Committee for Responsive Philanthropy.

Those of us on the frontlines of the Black maternal and infant health crisis feel the effects of the funding disparity as we often lead community-based organizations and nonprofits that are woefully underfunded and stretched beyond their capacity.

Standing in true solidarity means deeper investments in Black-led organizations, grassroots movements and birth workers who have a demonstrated commitment and connection to this work. Long-term, multi-year investments will help us move the needle by providing sustained resources.

Standing in true, transformative solidarity also means holding health care systems accountable for the quality of care delivered. In one study, Black women reported higher-than-average experiences of mistreatment, such as being shouted at and scolded, and having requests for help ignored or refused. There remains an egregious gap in required accountability measures within hospitals and health care systems to identify and address racism and biases.

California leads the nation in its commitment to birth equity, especially for Black women. In 2021, Gov. Gavin Newsom signed the California Momnibus Act, which created a fund to strengthen the midwifery workforce, extend Medi-Cal coverage up to 12 months postpartum, and established a guaranteed income pilot program that prioritizes pregnant Californians with low incomes. Yet despite the state’s budgetary and legislative victories, these policies must be coupled with mechanisms for transparency and accountability.

The day I gave birth, I was confronted by our nation’s shameful legacy of grossly mistreating Black women receiving medical care. For Black families to thrive, California needs Black voices at the forefront, securing long-term anti-racist investments, and developing solutions that incorporate both measurability and accountability.