Black maternal health disparities in the United States are tied to a system that has historically devalued and exploited Black women. Centers for Disease Control and Prevention data show Black women have a maternal mortality rate three to four times higher than their white counterparts. Throughout this blog post, we use the terms “woman” and “women,” but we recognize not all people who give birth and face the maternal health crisis identify as women.
In 2017, the Black Mamas Matter Alliance declared April 11–17 Black Maternal Health Week to bring more attention to the Black maternal health crisis and the Black women across the country working to address it. Black Maternal Health Week seeks to deepen the national conversation on Black maternal health in the US by centering the voices of Black women and implementing the reproductive justice framework in public policy, advocacy, and community organizing.
This year, the theme of Black Maternal Health Week is “Claiming our Power, Resilience and Liberation.” It spotlights Black women’s voices and amplifies Black-led organizations’ research surrounding Black maternal health. Without Black women, the picture is incomplete, and the solutions are inadequate.
Evidence-based versus evidence-informed research
Evidence-based research integrates clinicians’ experience and judgement with clinical research, such as diagnostic tests. It uses a rigorous scientific approach well suited for numerical data and clinical trials.
On the other hand, evidence-informed research often includes community-based solutions created by and for communities. Evidence-informed studies have elicited positive outcomes and can create positive engagement, build trust, and better target the needs of specific groups and the social determinants of health. The value of evidence-informed research is its person-centered approach that both incorporates individual experiences and disaggregates outcomes.
Person-centered research can strengthen Black maternal health legislation
Our new brief, created in collaboration with the National Birth Equity Collaborative, offers a set of policy recommendations to advance Black maternal health equity. The recommendations are informed and grounded by interviews with Black providers, Black researchers, and Black-led organizations.
One primary theme emerged from the interviews: addressing the role of structural racism and white supremacy in creating and perpetuating the Black maternal health crisis is essential. For legislation to truly be comprehensive, it must incorporate a racial equity lens. This means policymakers must start by examining the historical and social contexts of previous policies and make tangible commitments to addressing inequities. This could include increasing funding to support research to explore the social determinants of health that perpetuate the Black maternal health crisis.
“[In research], you control for access to care, you still see the same likelihood for adverse outcomes, so, what’s the bigger picture? It’s the history that is internalized and somaticized and that plays out in the outcomes that we’re continuing to see. If I could boil it down to one thing, it’s structural racism. And that bleeds through everything from housing, to access, to educational opportunity.”
—Researcher, MedStar Health
After research, the next step is establishing evidence-based policy priorities and acting on them. This could include increased access to health insurance, insurance coverage for skilled birth workers, or the creation of better systems for collecting data on Black maternal health outcomes.
Most importantly, gathering community perspectives must be the initial step toward developing policy, not an afterthought. Black women must be part of a process that empowers them at every step. Evidence-based research has value, but it should be paired with person-centered, evidence-informed research to present a more complete picture.
In 2020, Representatives Alma Adams and Lauren Underwood, founders of the Black Maternal Health Caucus, reintroduced a package of 12 bills known as the Black Maternal Health Momnibus Act of 2021. The Momnibus includes more inclusive, higher standards for data collection, increased funding to community-based organizations, an emphasis on the effects of the social determinants of health, and comprehensive COVID-19 data collection.
When it comes to solving the Black maternal health crisis, Black women are not research subjects; we are the experts.
The Urban Institute has the evidence to show what it will take to create a society where everyone has a fair shot at achieving their vision of success.