A number of factors cause moms to die in labor. Ohio reps hope a wide-reaching bill can help
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Ohio’s rate of 23.8 maternal deaths per 100,000 births is slightly higher than the national average, according to KFF. And it’s an issue disproportionately impacting Black women across the state. Black women in Ohio are more than twice as likely to die from pregnancy complications than white women, according to a 2020 report from the Ohio Department of Health.
Five Ohio representatives and one senator have signed onto a federal package of legislation that hopes to curb these pregnancy-related deaths, called the Black Maternal Health Momnibus Act. It’s a package of 13 bills that invests in everything from nutrition programs to maternal vaccination promotion to maternal mental health initiatives.
U.S. Rep. Emilia Sykes, D-Akron, co-introduced the bill last year. Speaking on the House floor last month, Sykes lamented Ohio’s high maternal mortality rates.
“Motherhood should be one of the greatest, most joyful times of their lives,” Sykes said. “But for far too many Black women in Ohio’s 13th Congressional district and across the country, this experience is often overshadowed by trauma, heartache and loss.”
Social determinants of health
Much of this legislation within the package aims to tackle social determinants of health, or the external factors that contribute to maternal mortality.
The Social Determinants for Moms Act would create a fund to address housing, transportation and nutrition needs. Another measure would expand the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) eligibility for new moms. Yet another would expand data collection and research around the causes of maternal mortality.
“We still see maternal mortality at such a high rate, many of them due to ineffective levels of care, toxic stress caused by racism,” Jazmin Long, president and CEO of Birthing Beautiful Communities, said. “There are so many factors that really lead into these poor birth outcomes and poor maternal fatalities that we see.”
Long’s nonprofit advocates for positive birth outcomes in northeast Ohio. She said many maternal deaths are avoidable . Among the pregnancy-related deaths occurring from 2012 to 2016 in Ohio, more than half were thought to be preventable, according to a report from the Ohio Department of Health.
Maternal care workforce in Ohio
Another part of the legislation will address the perinatal workforce, or maternal health care providers across the country. Across Ohio, Long said there’s a shortage of Black maternal health providers who can provide culturally congruent care.
“COVID really has decimated a lot of the workforce. And so some of the doctors and nurses who had consistently been in our hospitals retired or found other places to work because they got so burned out,” Long said.
In addition to OB-GYN doctors and nurses, Long said there needs to be an effort to train more Black midwives, doulas, lactation specialists.
Thirteen of Ohio’s 88 counties are considered maternity care deserts, according to the latest March of Dimes report and many of the state’s rural maternity wards have shuttered in the last decade.
A long road to passage
The Black Maternal Health Momnibus Act has been reintroduced for years, and has not garnered bipartisan support in the legislature. Although federal progress has been slow-moving, Long said there’s still work to be done on the state level to improve maternal mortality rates.
Ohio has recently invested in maternal and infant health. In March, Gov. Mike Dewine announced $5 million in funding for community organizations that support pregnant women. And the state recently approved Medicaid coverage for doulas.
But, Long said policies need to extend beyond health and address economic status in order to move the needle.
“We can look at things like universal basic income. We can look at things such as guaranteed income they're working on here in Cleveland, policies that would really … help to lift folks out of poverty,” Long said.
The Ohio Newsroom | Kendall Crawford
Fighting fibroids: U.S. Rep. Shontel Brown kicks off crusade with personal tale
WASHINGTON, D. C. - U.S. Rep. Shontel Brown says that developing uterine fibroids “was like having an uninvited guest take over your body, month after month, for years,” creating painful, unpredictable menstrual messes that took such a mental toll that she finally resorted to getting a hysterectomy.
The Warrensville Heights Democrat on Thursday brought her battle against the common medical condition to Congress, introducing legislation she’s dubbed the U-FIGHT Act: The Uterine Fibroid Intervention and Gynecological Health and Treatment Act.
It would authorize the Secretary of Health and Human Services to award grants to increase early detection of and intervention for uterine fibroids, education and awareness programs, and research. The grants would also address another uterine condition called Asherman’s syndrome, uterine scar tissue build-up following surgery, as well as disparities in pain control and management as it relates to uterine fibroids.
Medical experts estimates that 40% to 80% of women develop non-cancerous uterine tumors known as fibroids. Sometimes, they don’t cause difficulties. In other cases, the pain, and heavy, irregular bleeding they cause are disruptive. They’re most common in Black women, who tend to develop them at younger ages and be more likely to need medical treatment. Doctors don’t know their cause or why they’re more prevalent in Black women.
Brown said that Black women are three times more likely to be hospitalized for fibroids than white women, and three times more likely to need a hysterectomy. Despite the prevalence of fibroids, Brown says there’s no comprehensive federal program to address them. She said her bill would encourage early detection, treatment, education and research.
“A lot of women, a lot of Black women, when there is so much pain, they think that this is just part of being a woman, a normal part of your period,” Brown said at a Capitol Hill press conference. “Too many women delay medical care or are denied full treatment and care because they don’t know that the symptoms they’re suffering through aren’t normal.”
Brown’s legislation has 50 cosponsors in the House of Representatives, all Democrats. She says she’s working on bringing Republicans on board and getting similar legislation introduced in the U.S. Senate.
It is endorsed by organizations that include The White Dress Project, The Fibroid Foundation, Black Health Matters, Ohio Physicians for Reproductive Rights, American College of Obstetricians and Gynecologists, Birthing Beautiful Communities, The Center for Black Health & Equity, University Hospitals, Cleveland Clinic, and MetroHealth.
“Lack of research in the evaluation and treatment of fibroids and their much higher rates in black women reflects a significant disparity in our current health care system and we’re hopeful that this legislation will improve the health of women in Northeast Ohio and all across the country,” Elyse Mulligan, University Hospitals’ manager of public policy and community health engagement, said at the press conference.
Cleveland Clinic Chief of Staff Beri Ridgeway issued a statement that described providing education, research, and access to screening for uterine fibroids as “important to improving the quality of care for the millions of women affected by them.
“We look forward to working with Congresswoman Brown to advance legislation that would expand access to early screenings and detection methods for uterine fibrosis, a debilitating condition that impacts millions of women, especially women of color,” agreed a statement from MetroHealth President & CEO Airica Steed. “Together, we can create a healthier community for every woman.”
Brown acknowledged passing her bill might be an uphill battle. She noted that her long-ago congressional predecessor Stephanie Tubbs Jones, who represented the same congressional district from 1999 to 2008, first introduced a separate bill called the Uterine Fibroids Research and Education Act in 2001.
More than 20 years later, other members of Congress are still introducing the same bill to support National Institutes of Health research into uterine fibroids, in hopes it will eventually pass. These days, the bill is called the Stephanie Tubbs Jones Uterine Fibroid Research and Education Act.
“Let’s help women learn the facts,” said Brown. “Let’s expand access. Let’s study the problem. And let’s solve the problem.”
Cleveland.com | Sabrina Eaton