Michigan bills seek to address racial disparities in maternal health care

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Tamika Johnson, a maternal health equity advocate for mothers of color, recalled Tuesday in the Michigan Senate Housing and Human Services Committee how an anesthesiologist made a mistake with her epidural as she was in labor with her son in 2022. That resulted in her lungs shutting down, being put on life support and having an emergency Cesarean section.

“Instead of it shutting me down from the waist down, it shut me down from the waist up. … I was telling her I’m struggling to breathe. I was having a hard time breathing … and she looked at me and she said if you couldn’t breathe, you wouldn’t be able to speak,” Johnson said. “I turned to my nurse and I asked her not to lean me down the bed. … I am begging my nurse not to lean down; then I lost the ability to breathe all together.”

Study shows sharp increases in maternal deaths over two decades

After “begging” for her life, Johnson said everything went dark. She could have died. Her son could have died. And afterward, Johnson became committed to ensuring no other mom gets silenced when trying to communicate needs with their doctors in maternal health care.

Especially when it comes to women of color, Johnson said patients’ pain and needs are disproportionately overlooked. The maternal mortality rate for Black women is more than twice as high as their white counterparts, according to the Centers for Disease Control and Prevention .

To combat inequities in health care for individuals giving birth, several senators are seeking to get a package of bills to the governor’s desk to set up requirements for monitoring discrepancies in health care and create avenues to report injustices from patients.

Michigan has taken action in the past to improve the lives of women before and after birth, but the state is in need of addressing maternal mortality for women of color, bill sponsor Sen. Erika Geiss (D-Taylor) said.

“We see significant disparities and outcomes for Black working people across socio-economic and educational levels,” said Geiss, who is Afro-Latina. “There are instances where Black women who are pregnant are not necessarily heard. That’s something that I think women, many women have experienced, but especially for Black women who are in the prenatal period or even during labor and delivery, who aren’t being heard by their health care professionals.”

The bills, SB 818 – 827 , would require the departments of Health and Human Services (DHHS) and Civil Rights (DCR) to collect data and examine maternal health care procedures and patient outcomes and report ways to combat existing issues in the health care system where there are discrepancies on the basis of race and ethnicity.

Emily Dove-Medows, an assistant professor at the University of Michigan’s School of Nursing who has been a certified nurse midwife for 13 years, said the bills, especially the reporting ones, will promote research to prevent preventable deaths.

“Patient-centered reporting requirements are another way of ensuring that those who experience racism and other forms of discrimination during obstetric care are heard. Racism is what the patient says it is and hospital systems must attend to those experiences,” Dove-Medows said.

Additionally, the bills would support areas to entry through scholarship or reimbursement for services for doulas and midwives.

State data from 2015 to 2019 reflects that Black women were nearly three times more likely to die from pregnancy-related causes. The data also showed that more than 60% of the state’s maternal deaths were preventable. Sen. Stephanie Chang, a Democrat who represents parts of Detroit, a majority-Black city, recalled being a person of color giving birth to her first child.

“I had my first baby when I first came into office, and one of the things that immediately struck me was, I have health insurance. I have a lot of education. I went to all my prenatal visits. … I was able to have all the information I needed to make the choices that I wanted to make and I had a great health team,” said Chang, who is Taiwanese American.

“But then being in this district, there were a lot of other people who did not have that same access to healthy food, do not have the same access to … information. … And may or may not have had access to the health team that they would have chosen. … And so I’m really excited about this package because I think it is long overdue to get this done.”

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