What needs to be disrupted concerning birth equity, midwifery, and/or Medicaid in the United States? Some additional questions can help to inform the one above. What needs to be shifted in midwifery: payment models, retention, training, etc.? Can Medicaid also play a role, and how? What would need to be adjusted/disrupted in Medicaid? How can […]
As the United States continues to report relatively high maternal and infant mortality rates among comparable countries, the declining survival rates for African American mothers and their babies call for the attention of policymakers. African American women from all walks of life report the greater vulnerability to postpartum complications, significantly increasing their mortality rate. According to Taylor, Novoa, Hamm, and Phadke (2019), the death rate for African American infants is twice that of non-Hispanic white babies, while African American women continue to die from preventable pregnancy-related complications at three to four times the rate of non-Hispanic white women. Such statistics present racial disparities in maternal and infant mortality as a critical issue in the United States. Policies ought to be developed to restore the prevailing racial disparities in maternal and infant mortality to protect African American women and children from the various complications that increase their mortality rates. There is a need to expand Medicaid coverage and encourage indiscriminative practices among caregivers to encourage birth equity.
There is a need to extend Medicaid coverage among African American women to address the prevailing racial disparities in maternal and infant mortality. Many African American women are low-income earners who lose their Medicaid coverage two months after delivery (Gingrey 2020). Due to the high costs of healthcare services in the United States, such women lack enough finances to seek adequate care to address postpartum complications. As a result, the number of deaths among African American women and infants continues to escalate. According to Vilda et al. (2019), about an eighth of maternal deaths occur between 40 and 365 days after child delivery. Although Medicaid has provided financial support to many women during child delivery in the past, the coverage fails to accommodate postpartum complications that extend beyond 60 days. Extending Medicaid coverage to one year would constitute an important step toward addressing the prevailing racial disparities in maternal and infant mortality.
Moreover, while African Americans have been prone to racial discrimination and abuse in the United States society, healthcare policies need to be developed to encourage birth equity. While the public department of health pledges to provide conditions of optimal births for all people, focusing on addressing racial and social inequalities, black women experience multiple forms of racially-founded mistreatment in maternity care that adversely impacts quality and safety. A study conducted by Vedam et al. (2019) found that 27.2% of women of color and 18.7% of white women who have black partners experience mistreatment from caregivers. The forms of mistreatment vary from negligence to inappropriate administration of medicine. Such mistreatment exposes African American women to health complications that limit their ability to attend to their infants, which affects their health and raises the infant mortality rate. They also intensify postpartum stress among such women, which leads to a decrease in breast milk supply (Suarez 2020, 4). The government, therefore, needs to develop anti-oppressive standards for caregivers to minimize the rate of mistreatment among African American mothers and restore birth equity.
To hedge racial disparities in maternal and infant mortality in the country, the government needs to extend Medicaid coverage and develop anti-discriminative healthcare policies. Many black women lack enough finances to seek adequate care to address postpartum complications despite enjoying Medicaid coverage for 60 days. The coverage, therefore, needs to be extended to one year to ensure that the health and safety of African American women are protected. The government also needs to develop regulations that seek to discourage discriminatory practices in maternity centers.
Taylor, J., Novoa, C., Hamm, K. and Phadke, S., 2019. Eliminating racial disparities in maternal and infant mortality: a comprehensive policy blueprint. Center for American Progress, 1(1), pp.1-93. https://www.americanprogress.org/issues/women/reports/2019/05/02/469186/eliminating-racial-disparities-maternal-infant-mortality/
Gingrey, J.P., 2020. Maternal mortality: a US public health crisis. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2019.305552
Vilda, D., Wallace, M., Dyer, L., Harville, E. and Theall, K., 2019. Income inequality and racial disparities in pregnancy-related mortality in the US. SSM-population health, 9, p.100477. https://www.sciencedirect.com/science/article/pii/S2352827319301673
Vedam, S., Stoll, K., Taiwo, T.K., Rubashkin, N., Cheyney, M., Strauss, N., McLemore, M., Cadena, M., Nethery, E., Rushton, E. and Schummers, L., 2019. The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States. Reproductive Health, 16(1), pp.1-18. https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-019-0729-2
Suarez, A., 2020. Black midwifery in the United States: Past, present, and future. Sociology Compass, 14(11), pp.1-12. https://onlinelibrary.wiley.com/doi/abs/10.1111/soc4.12829
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Published On: 01-01-1970