Around the world, the United States is admired and followed as the globe’s leading superpower. However, the continuously high rates of maternal mortality in the United States greatly distinguishes it from its international counterparts.
The Center for Disease Control and Prevention (CDC) defines maternal mortality as “the death of a woman during pregnancy, at delivery, or soon after birth.” In the United States, about 700 women die each year as a result of pregnancy or delivery complications. While most of the complications that arise during pregnancy are preventable or treatable, the United States struggles to decrease its maternal mortality rates as women’s lives, especially women of color, are consistently put at risk.
Throughout the country there are people, and more importantly policymakers, who believe healthcare is a privilege rather than a right. The right to healthcare is not explicitly mentioned anywhere in the United States Constitution, making policy decisions around how to access it a source of tension between political parties and lawmakers. Furthermore, access to maternal healthcare tends to suffer as a result of this political tension. The difficulty in improving maternal healthcare is further compounded by the fact that reproductive health is a subset of healthcare that predominately impacts women, making it a less funded and researched area of healthcare.
Looking to legislative history to examine the steps taken forward to help improve these disheartening facts, the Affordable Care Act (ACA) stands out as a beacon of hope. The ACA expanded Medicaid to reduce the amount of uninsured women who are of a reproductive age and new mothers in the year after delivery. The ACA also forced insurers not to charge women higher health premiums than men, which used to be a common practice as women were expected to have more healthcare costs during their childbearing years. Additionally, reimbursement for midwives was increased to the amount physicians receive for performing the same service- an incredibly important addition for expanding access to personnel who can safely perform births. Though legislation such as this exists to improve maternal mortality rates in the U.S., devastating statistics around this issue continue to occupy the country and disproportionately impact women of color.
According to the CDC, black women are three times more likely to die from a pregnancy-related cause than their white counterparts. This is largely due to social determinants of health that historically and continuously place women of color at a disadvantage when receiving healthcare through structures of systemic racism and implicit bias. In Washington D.C., 95% of pregnancy-related deaths occurred among black women between 2013-2017. In 2017, United Medical Center’s Obstetrics unit in Washington D.C. closed due to lack of revenue and malpractice, leaving nowhere to give birth for women living in Wards 7 and 8 which are primarily occupied by black residents. Women living in these Wards are forced to travel to Maryland or cross the Anacostia River to safely deliver their babies. This reality is sadly not unique to the nation’s capital as high maternal mortality rates continue to plague the U.S. even with legislative victories like the ACA.
Unfortunately, the hope once raised by the passage of the ACA now appears to be overshadowed by the impending United States Supreme Court decision set to overturn Roe v. Wade this summer with Dobbs v. Jackson Women’s Health Organization. This upcoming decision is bound to disproportionately impact women of color as they will be forced to carry unwanted pregnancies to term and then give birth in a system that is already causing them irreparable harm. This upcoming decision has the power not only to increase the U.S.’s maternal mortality rate, but also change the course of how women’s rights and specifically their place in the healthcare system is respected in this country. Furthermore, how do we move forward in a society where after almost fifty years of progress from Roe v. Wade, our fate rests in the hands of a court who fails to recognize how a decision regarding women’s access to abortion will inevitably have a devastating impact on women of color accessing maternal healthcare?