Black women in the United States are three to four times as likely to die due to pregnancy-related causes as compared with white women. Black infants in the United States are over three times more likely to die due to complications related to low birth weight as compared to white infants. These disparities are not due to race; they are due to racism, as eloquently stated by Dr. Monica McLemore, Professor of Nursing at the University of California, San Francisco School of Nursing. Dr. McLemore argues that we need to stop blaming black women for poor health, but instead tackle the underlying causes that are rooted in racism. This racism is not just a few people with racist views, but it is systemic, a part of the structure of our society. The Aspen Institute describes systemic, structural racism as “A system in which public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing ways to perpetuate racial group inequity. It identifies dimensions of our history and culture that have allowed privileges associated with ‘whiteness’ and disadvantages associated with ‘color’ to endure and adapt over time.”
As a women’s health nurse practitioner, I have seen the direct effects of racism on the health of black mothers and babies. Whether this is due to implicit bias or to explicit discrimination, systemic racism creates an inequitable and dangerous situation. As a nurse, I was recently invited to join a zoom call with Rep. Lauren UnderwoodLauren UnderwoodLobbying world Each state's population center, visualized Maternal and child health legislation must be prioritized now MORE, a first-term congresswoman from Illinois. Underwood is an African-American nurse and is the youngest African-American woman to serve in the House of Representatives. She, along with Sen. Kamala HarrisKamala HarrisHarris invokes MLK in voting rights push, urges Senate to 'do its job' Voting rights is a constitutional right: Failure is not an option Left laughs off floated changes to 2024 ticket MORE (D-Calif.) and Rep. Alma AdamsAlma Shealey AdamsAdams: Maternal health is in 'a crisis within a crisis' The Hill's Morning Report - Presented by Facebook - Biden talks up bright side beneath omicron's cloud Overnight Health Care — Presented by March of Dimes — Supreme Court weighs abortion restrictions MORE (D-N.C.), have introduced the Black Maternal Health Momnibus Act of 2020 (S. 3424), to improve maternal health outcomes by ending preventable maternal mortality and morbidity associated with these alarming health disparities that are due to systemic, structural racism. This legislation is a combination of nine separate bills that are sponsored by various members of the bipartisan Black Maternal Health Caucus. Taken together, the Momnibus Act proposes: 1) investing to improve social determinants of health such as housing, transportation, nutrition; 2) funding community-based organizations focused on improving health outcomes for black women; 3) supporting Veterans’ Affairs health care for pregnant and postpartum Black women; 4) increasing the diversity within the health care professions; 5) funding research to learn about the underlying, root causes of disparate maternal and neonatal mortality and morbidity among Black women and their infants; 6) funding for maternal mental health and substance abuse issues; 7) improving maternal health care for incarcerated women; 8) increasing use of telehealth to improve access to care in under-resourced areas; 9) creating funding models that provide incentives to provide needed high quality health care to women throughout pregnancy, birth and postpartum.
The Black Maternal Health Momnibus Act of 2020 deserves strong support across the nation. It is a badly needed step, in fighting the racism that has infected our society since 1619. As a society, we need to right the wrongs that began with slavery and that persist today as seen in the devastating disparities in health and health care as well as the unjust killing of unarmed black men and women.
As a white woman, I cannot know the visceral pain of systemic racism that is one’s everday life experience, but I do see the horrific effects of it and I know that I need to listen to my Black friends and colleagues. I need to learn from them, and I need to work side-by-side with them in the anti-racism fight. As a nurse I have a responsibility and commitment to social justice because I know that social determinants of health are key to health. Systemic, structural racism is one predominant factor in social determinants of health. As a nurse it is imperative that I am also an anti-racist activist. One step in this work is to support the Black Maternal Health Momnibus Act of 2020.
Ellen Olshansky, PhD, RN, FAAN, is retired professor emerita at the Sue & Bill Gross School of Nursing at University of California, Irvine.