black maternal health – Doula School Canada

2024 Medicaid & CHIP Beneficiaries at a Glance: Maternal Health

[vc_row][vc_column][vc_column_text title=”2024 Medicaid & CHIP Beneficiaries at a Glance: Maternal Health” css=”.vc_custom_1718910346497{margin-bottom: 0px !important;}”]In the United States, publicly-funded healthcare is provided through Medicaid and CHIP (Children’s Health Insurance Program). These are joint programs of state and federal governments that provide health insurance to low-income people, children, people with disabilities, and pregnant people. These eligibility parameters mean that there are individuals who are eligible for coverage during their pregnancies and the postpartum period who are not eligible at other times. Medicaid finances 41% of births in the United States. Federal law requires states to provide coverage up to 60 days postpartum. A bill in 2021 gave states the option of participating in an extended coverage program offering coverage up to one year postpartum.

In May 2024, Centres for Medicaid and Medicare Services (CMS) released an infographic summarizing beneficiaries’ maternal health data. CMS collects demographic data on age, race and ethnicity, and geography. They collect outcome data on maternal mortality and severe maternal morbidity (SMM), underlying causes of maternal mortality, dental care access, postpartum contraceptive utilization, spacing between pregnancies, chronic conditions, timeliness of prenatal and postpartum care, smoking, behavioral health and substance use, neonatal abstinence syndrome, postpartum depression (PPD), preterm birth, and low-risk cesarean delivery. Additionally, they collect health system data on healthcare service provider distribution, state quality improvement activities, and state participation in an opt-in extended postpartum coverage program.

Key Take Aways

The data highlight key areas of disparity for Medicaid beneficiaries and provide an important road map for healthcare policymakers and system designers regarding where care could be enhanced. For example, the data show that Black birthers experience mortality 2.6 times more often than their white counterparts. This finding corroborates other research and supports advocacy efforts for publicly funded doula care as an intervention to reduce Black maternal mortality rates. Another useful observation is that birthers under the age of 19 experience higher than average rates of PPD (22% compared to an average of 17%). This suggests that in addition to universal PPD screening, additional attention should be paid to this group during the postpartum period.

This 9-page resource provides invaluable information to support US birthworker advocacy on expanded access to birth and postpartum doula care, freedom of provider choice and birth location, and mental healthcare. For birthworkers in Canada and other jurisdictions, it is an illuminating example of what can be learned from comprehensive demographic and outcome data collection practices.

Keira Grant (she/her) Inclusion and Engagement Lead – Racialized Communities

Keira brings a wealth of experience to the Online Community Moderator role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community building initiatives.[/vc_column_text][/vc_column][/vc_row]

Why Black Futures Begin with Birth

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Why Black Futures Begin with Birth

Written by Keira Grant – DTC EDI Lead for Racialized Communities

February is widely known as Black History Month. This term has rubbed me the wrong way since I was a kid, but it took me a while to put my finger on why. The reference to “history” is full of loaded assumptions that are highly convenient to colorblind multiculturalism. It suggests that racism toward Black people is something that happened a long time ago, maybe in a faraway place. Then slavery ended and then there was Black excellence.

Of course, there have always been excellent Black people, but that’s not really how the story goes. The beliefs that made slavery possible for centuries are part of the fabric of society. Even when we are excellent by eurocentric, capitalistic standards, it could still go the way it went for Tyre Nichols.

The violence that brutally ended the life of Tyre and so many others like him flows through all social institutions, not just policing. In countries such as the United States and the United Kingdom where race-based health data is collected, these data show that Black birthers are anywhere from 3 to 4 times more likely to die in childbirth than their white counterparts. Our babies are also at a significantly increased risk of death. This holds true, independent of education and socioeconomic status. The birth stories of celebrities like Beyoncé Knowles, Serena Williams, and Tatiana Ali, (whose story we’ll be discussing at March’s Equity Watch Party), bring these statistics to life.

At this time, many players in the Canadian healthcare system are calling for the collection of disaggregated race-based data. In the US, the collection of these data, and the resultant evidence of disparities has led to increased funding for programs that improve Black maternal health, including a proliferation of programs for accessing a Black doula. It has also supported requirements that health professionals receive training in implicit bias.

It’s been widely reported in the news that Tyre Nichols called out for his mom during the brutal attack that ended his life. Every Black person who dies as a result of structural violence is someone’s baby. When systemic disrespect and harm toward Black birthers and babies is normalized, rationalized, and justified it is the start of a pattern that impacts Black people across the lifespan. Emerging research is actually demonstrating that racial stress accelerates the aging process of Black women.

Creating a circle of love and support around Black birthers and their babies that is honest about what we are up against, and that celebrates our lives and well-being can have a profound impact on how someone’s life starts. It can affect how their life continues by showing them and their families that it is possible to create spaces where Black people are affirmed and nourished.

We talk about equity, diversity, and inclusion in this work all the time. During February, we have additional opportunities for our members to learn and engage in dialog about anti-Black racism and racial health equity in perinatal care. We are using the language Black Futures Month, “a visionary, forward-looking spin on celebrations of Blackness in February”.

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