By Megan Sayles
On day one of its Annual Legislative Conference (ALC), the Congressional Black Caucus Foundation (CBCF) took on Black maternal health, Black infertility, family building and reproductive justice.
Experts from across the country weighed in on challenges, opportunities and policies regarding reproductive health for Black women, who disproportionately experience maternal mortality, infertility and miscarriages.
According to the Centers for Disease Control and Prevention (CDC), Black women are three times more likely to die from a pregnancy-related cause than white women. The public health agency also reports that they are more likely to encounter infertility compared to their white counterparts.
âAcross the board, Black women and Black birthing people have worse maternal health outcomes than our white counterparts,â said Nicole M. Cooper, executive vice president and chief strategy and innovation officer at United Way Worldwide. âFrom preterm births, to lack of access, to equitable care, to insufficient prenatal care and poor postpartum recovery supports and services, the U.S. health system is failing Black women and their families during a time that should be full of joy and hope.â
Examining infertility and maternal mortality in the Black community
Dr. Lasha Clarke is the assistant director of research and translation at Morehouse School of Medicineâs Center for Maternal Health Equity. Since 2021, the center has been conducting a Fertility Equity Study.
Clarke shared that the study has concluded that Black women face infertility twice as much as white women. They are also half as likely to seek fertility care. Clarke stressed the importance of destigmatizing infertility.
âInfertility is a medical condition â not a social condition,â said Clarke. âItâs not something that we need to feel a sense of shame or blame around.â
The center also found that in certain segments of the country, Black women are five times more likely to die during childbirth. Even when controlling for socioeconomic factors, they are more likely to experience maternal mortality than their counterparts. Clarke said this is also reflected in infertility.
âIn our study and even in the broader literature, Black women who are of high socioeconomic resources are reporting the same thing,â said Clarke. âThey are experiencing infertility, but there are barriers to seeking care that are not strictly the finances of it.â
These barriers include racial biases and discrimination from providers and limited access to education about maternal health and fertility.
The role of doulas and midwives
Considering the poor state of Black maternal health in the U.S., many women turn to non-traditional care providers, like birthing centers, doulas and midwives.
Baltimore County Delegate Jennifer White Holland (D-10) pointed out that Maryland does not have any free-standing birthing centers.
âThat limits the options that birthing people have in finding other alternatives to receive their care,â said Holland.
She noted that the state has made progress on supporting doulas. In 2022, Maryland started the Medicaid Doula Services Program, which provides reimbursement to these professionals. But the compensation is not yet enough.
âUnfortunately, the reimbursement rates are so low that there isnât really an incentive for doulas to participate, which makes it very cost-prohibitive for many birthing people to access doula services,â said Holland.
Leah Jones, director of maternal health and birth equity initiatives for SisterSong, said her organization is aiming to mitigate certification issues for community midwives in Georgia.
âTheyâre literally people who can teach physicians how to do their work. Theyâre reflecting our communities, our issues and our stories. However, they have licensing issues in Georgia,â said Jones. âWe have been on a continuous fight to make sure their legitimization gets pushed through legislation and that communities can reach into midwives, doulas and birth workers who look like them, talk like them and live in their neighborhoods.â
Black men as allies in the fight for reproductive rights
Historically, a dangerous and unfounded stereotype has been propagated about Black fathers being absent parents. Data from the CDC refutes this generalization. It found that Black fathers were more likely to feed and eat meals with their children; bathe and dress them; and take them to activities, compared to other racial groups.
âThe best piece of advice that I ever received as an expectant father was that everything she feels, the baby feels,â said Charles Johnson IV, founder of 4 Kira 4 Moms. âItâs your job fundamentally to make sure that she feels safe, protected and happy at all times, as much as humanly possible.â
He started his organization after his wife, Kira Johnson, died during a routine C-section in 2016. Johnson said itâs critical for Black men to be informed about the spectrum of labor options and how to advocate for their partners even before they become pregnant.
Sheehan Fisher is an associate professor of psychiatry and behavioral sciences at Northwestern University. He also serves as associate dean of diversity, equity and inclusion for the institution. Fisher acknowledged that for a lot of Black women, pregnancy can be an isolating experience. This is only compounded by their heightened risk factors for poor maternal health outcomes. Fisher said he believes Black men should eliminate the isolation their partners may feel while on their maternity journey.
âShe needs a partner who can be an advocate throughout the whole experience,â said Fisher. âFathers are not clinicians or doctors, but they can be trained to know what to look out for.â
Charles Daniels Jr., CEO of Fatherâs Uplift, explained that Black men must first address their mental health in order to be good partners through pregnancy.
âWe need to go to therapy,â said Daniels. âWe need to get the necessary help to be able to be present.â