Black women are currently three times more likely to die during pregnancy or immediately after. Jennifer Carroll Foy and Sen. Kaine could help reduce that.
ARLINGTON – After Jennifer Carroll Foy delivered her twin boys, something felt wrong. The former Virginia delegate and current candidate for governor recalled having pain worse than labor. She told doctors and nurses. However, rather than run tests, they put her on medication, dismissed her fears and said the pain was normal.
“I’ll never forget being home and dropping down to my knees in agonizing pain,” Jennifer said. “And then luckily I had my husband, Jeff Foy, who was with me. And he said, ‘This can’t be normal. This can’t be right.’”
Jeff picked up his wife, put her in the car and rushed her to the emergency room. Staff immediately admitted Jennifer, informing her that if she waited longer to seek emergency care, she would have died.
“If there was a little bit more investigation that was done, if my complaints were taken seriously, then I [wouldn’t have] been put in [that] predicament,” Jennifer said.
That’s an experience Black mothers across the Commonwealth and country can relate to. According to the Centers for Disease Control, white women who are pregnant or new mothers die at a rate of 12.7 per 100,000. For Black women, the maternal mortality rate climbs to 43.5 out of 100,000.
Why? In some cases, the CDC found Black women have less access to care. Even when there is treatment nearby, it’s not the best quality. And then there’s a bigger problem, one that dates back centuries. The women, much like Jennifer Carroll Foy’s experience, are simply not believed.
A Problem of Pain
A 2016 study from the University of Virginia offers a perspective on the issue. In an interview with Dogwood last October, study leader Kelly Hoffman said long-held false beliefs were to blame for the way some doctors treat Black women.
“Many previous studies have shown that Black Americans are undertreated for pain compared to white Americans, because physicians might assume Black patients might abuse the medications or because they might not recognize the pain of their Black patients,” Hoffman said. “Our findings show that beliefs about black-white differences in biology may contribute.”
That 2016 study gave 222 medical students a pair of hypothetical cases. The situation was the same in both, involving a ruptured kidney and a leg fracture. However, one patient was white and the other was Black. The students were asked to recommend treatment based on the patient’s level of pain.
While asking for these recommendations, the UVA team also used a different method to test the students. They presented a series of myths as fact, asking if the student believed in certain biological differences between white and Black people. The team asked things like if the medical student believed Black people aged at a slower rate or if they had thicker skin.
The study showed half of the students believed at least one myth. Those students also said as a result, they were more likely to base treatment off lower pain levels than what the Black patient described.
This echoes back to Jennifer Carroll Foy’s case. Instead of listening, the doctors wrote off her pain as normal and just prescribed medication.
‘This Needs to Begin’
Doctors in the healthcare field don’t deny there’s a problem with the nation’s Black maternal mortality rate. Some also agree there’s a need for reform. It came up May 6, during a hearing of the US House Committee on Oversight and Reform.
“Racism and implicit bias on the part of health care professionals contributes to racial and ethnic disparities in health outcomes,” said Dr. Tamika Auguste. “It is critical to change the culture of medicine by addressing racism and implicit bias across the health care system.”
Dr. Auguste is chair of the American College of Obstetricians and Gynecologists and testified during the hearing. She called for mothers to have access to Medicaid coverage for up to 12 months after giving birth. Also, for renewed training, to change the mindset some doctors have.
Jamila Taylor echoed her claims, but said more is needed. Taylor is the director of the group Health Care Reform and said a new law alone won’t reduce the Black maternal mortality rate. Structural racism, she said, is embedded in culture.
“It is a powerful social condition that has its roots in a centuries-long system of oppression and devaluing of Black people, and Black women, in particular,” Taylor said. “It not only persists today in our health care policies and practices—it has real, significant impacts on people’s health.”
In order to see change, she argued, you first have to alter the culture.
“We all have a role to play in dismantling structural racism,” Taylor concluded. “It is past time to implement policies and health care practices to ensure quality health care that is equitable and respectful of Black women.”
Solving The Problem
So if we identify the problem, what’s the solution? There’s work being done on both the state and federal level. On the federal side, Virginia Sen. Tim Kaine introduced the Mothers and Newborns Success Act on May 25.
Kaine’s bill would change several things. First, it would require the federal government to set up a program to better support new mothers during the postpartum period. Second, it would create a federal research network to come up with new ways to address the medical reasons mothers die during and after pregnancy. Third, it would set up several programs to raise awareness of maternal health warning signs, both for the public and medical professionals.
Fourth, it would improve the way data is collected about maternal health cases. That way we know what states need the most help and what areas in those states have the highest number of cases. Finally, it would work to improve access to prenatal care in rural communities.
Kaine also signed on as a co-sponsor for the “Black Maternal Health Momnibus” bill. On the House side, five of Virginia’s representatives did the same, including Elaine Luria, Jennifer Wexton, Donald McEachin, Gerald Connolly and Abigail Spanberger.
That bill is in many ways a carbon copy of Kaine’s, with some additions. One of those involves growing and diversifying the medical workforce. You bring in more Black doctors, nurses and in general people who will listen to what the patient’s saying.
You also fund community-based companies, groups already doing the work in many communities. As culture changes don’t happen immediately, we have to help people right now.
Don’t expect anything to happen immediately with either bill. Kaine’s bill hasn’t been placed yet. Meanwhile, the Momnibus bill was placed in a House subcommittee on April 23 and hasn’t been dealt with since.
Virginia Deals With Black Maternal Mortality
On the state side, Jennifer Carroll Foy made Black maternal mortality part of her campaign plan.
“Women shouldn’t have to have a ‘Jeff Foy’ in their lives in order to survive childbirth and postpartum,” Carroll Foy said. “What they do need is a governor who [doesn’t] just emphasize, but who understands this issue in a real way because it is my lived experience.”
Part of her plan is to allocate funding for doulas, paid for through Medicaid. Doulas serve a number of roles, providing emotional and physical support for women in the days before, during and after childbirth.
“Doulas are there to serve as advocates, to help women navigate the healthcare system and answer questions they have in relation to childbirth,” Carroll Foy said. “And so having those advocates, who will give culture-competent care to Black women and women of color overall, is important.”
She also wants more funding for the Virginia Maternal Mortality Review Team, with more diversity in Virginia’s medical schools.
“We need to ensure that our healthcare system looks like Virginia and that racial bias training is also happening in our clinics and hospitals,” Carroll Foy said. “But it’s also making sure that more women have access, or more people have access to health insurance, period. I believe that healthcare is a right and not a privilege.”
Amie Knowles reports for Dogwood. You can reach her at firstname.lastname@example.org