Story at a glance
- The documentary, Birthing Justice, centers on the experiences of Black women and families as they navigate the joys and fears of being pregnant.
- The project, along with the work of Black women across the country, is the chance for people to listen to Black women and come together to create better outcomes for everyone, Matthews said.
- Black women have the worst maternal mortality rates in the entire country: they are three to four times more likely to die from pregnancy related causes than their white counterparts.
A new documentary is emphasizing how the maternal health crisis disproportionately affects Black women — and how Black women are pushing to end the disparities.
“The nationwide sorority of Black women and sisters coming together to make sure we end this crisis,” Monique Matthews, co-producer of the documentary, told The Hill.
The documentary, Birthing Justice, centers on the experiences of Black women and families as they navigate the joys and fears of being pregnant.
The film follows several women in their motherhood journeys as they advocate for themselves and their infants in a medical system that consistently downplays Black patients’ concerns.
The project, along with the work of Black women across the country, is the chance for people to listen to Black women and come together to create better outcomes for everyone, Matthews said.
“To be Black women-led does not mean Black women only,” Matthews explained. “We’re very clear that we want allies. We want people who are involved in the work but who will listen, go to the grassroots level and say what do you need?”
Black women have the worst maternal mortality rates in the entire country: they are three to four times more likely to die from pregnancy related causes than their white counterparts. Meanwhile Black infants are two times more likely to die within their first year than white infants. Between 2019 and 2020, the Black maternal death rate increased by 26 percent.
These statistics mean the U.S. ranks 33rd out of the 38 wealthiest nations when it comes to maternal health. If only Black women’s mortality rates are taken into account, the U.S. ranks 37th.
While the Black maternal health crisis is well documented, Matthews said it’s often not discussed in Black communities.
“It’s the friends, it’s the family members, it’s the sorority sisters, it’s the church members who sit in silence,” Matthews said. “Black women, we experience miscarriages, we experience stillborn births and we don’t tell anybody that we we’re pregnant until, like, the second or third trimester because we’re afraid of losing the child.”
Throughout the documentary, Black women shared the fears they had when they were pregnant. Many said they were scared they would die.
These fears aren’t uncommon, in part because of the maternal health crisis but also due to a general distrust of the medical system.
Implicit bias in the medical system has led to Black patients consistently having their complaints and symptoms dismissed and their pain left undertreated. Meanwhile, a history of intentional medical malpractice, such as the infamous Tuskegee syphilis experiment, remains heavy in the minds of many Black patients.
Patients have been looking to ameliorate these disparities by finding physicians of color more likely to offer better care than white doctors.
Ebony Marcelle is one of those providers. She is the director of midwifery at Community of Hope in Washington, D.C.
For Marcelle, midwifery is one of the solutions to tackling the maternal health crisis.
“We need more than just midwifery, but I feel like it’s an underutilized resource,” Marcelle said. “Midwifery is relationship-based care and when you are dealing with communities that are distrustful and dealing with higher levels of stress and PTSD, they’re the communities that need providers that are going to build those types of relationships with them.”
But sometimes finding culturally competent care is difficult. Community of Hope is one of the only hospitals to provide a birthing center and midwifery and doula services in Washington, D.C.
Maternity care deserts — or counties where there’s a lack of maternity care resources, no hospitals or birth centers offering obstetric care — are widespread throughout the country.
Nearly 7 million women and almost 500,000 births are affected by areas with little or no access to care, according to a 2022 report by March of Dimes. More than 2.2 million women of childbearing age live in maternity care deserts.
The lack of access to care also follows racial disparities. In 2020, according to the report, more than 16 percent of Black babies were born in areas with limited or no access to maternity care services.
The documentary also works to dismantle myths that Black women are somehow responsible for their own maternal deaths.
Kanika A. Harris, PhD and M.P.H., director of maternal and child health at The Black Women’s Health Imperative, lays out some of the myths that Black women are often confronted with about their health.
“The biggest misconception is there’s something that we are doing, there’s something inherently wrong with our body or makeup or genes, there’s something that we’re eating, there’s some ways that we are behaving, that somehow these bad habits have put us in a situation for poor maternal health outcomes,” Harris says in the documentary.
But the truth, Harris said, is that Black women are dying during pregnancy because of under-diagnosed conditions, their concerns are ignored and during the postpartum period they do not have easy access to physicians to help with postpartum complications.
The number one cause for Black maternal deaths are preeclampsia and eclampsia, which means 59 percent of Black maternal deaths are preventable.
“This is a society that has allowed this to happen,” Rep. Lauren Underwood (D-Ill.) said in the documentary. “We have allowed our moms to die for generations.”
Like many in the documentary, Underwood has been affected by the maternal health crisis.
“I lost a good friend of mine in January 2017, two weeks or three weeks after she delivered a beautiful baby girl. Her name was Dr. Shalon Irving,” Underwood told The Hill.
“She and I were friends from graduate school and at Johns Hopkins and Shalon’s death was just devastating. She has a dual doctorate in sociology and gerontology. We met in the masters of public health program. After we graduated, she went on to serve at the Centers for Disease Control and Prevention and the United States Public Health Service Commissioned Corps. And I remember the CDC director was at her funeral and in her remarks was just stunned like, how could this happen?” she said.
Since 2019, Underwood has co-chaired the Black Maternal Health Caucus with Rep. Alma Adams (D-N.C.) to pass legislation to protect maternal rights.
Dubbed “the Momnibus,” the package Underwood and Alma have introduced, along with Vice President Kamala Harris, is 12 bills that call for recognizing and fighting against the social determinants of health, funding for community-based organizations, diversifying the perinatal workforce and other key provisions.
At the time, the caucus had hoped the package would pass with President Biden’s Build Back Better plan but only one part of the package has been signed into law — the Protecting Moms Who Serve Act.
Still, Underwood remains confident the rest of the Momnibus legislation will pass, adding that films like Birthing Justice are an important component in the fight to end the maternal health crisis.
“There’s so many stories to tell,” Underwood said. “It’s not just about statistics, it’s not just a number. These are real families and communities. They’re excited about a new addition to the family, the hopes and dreams. To hear in Birthing Justice from the providers who are doing the work embedded in communities like Washington, D.C., where there are just such enormous disparities, to hear from families who have had severe complications and maternal deaths, I was pleased to be able to talk about the work that we’re doing in the Congress so that people know that there is a path forward.”
The Birthing Justice trailer can be watched at www.birthingjustice.com or those who wish to see the full film can organize a local screening through the website.