Advocates, experts tout proposals to reduce Black maternal deaths in North Carolina

Posted on April 30, 2023 on https://ncnewsline.com/briefs/proposals-to-reduce-black-maternal-deaths-in-north-carolina/

By: Lynn Bonner

Charity Watkins said her pregnancy-related heart failure went undiagnosed. Photo: Lynn Bonner

Charity Watkins spoke of the day seven years ago when she was in the hospital with pregnancy-related heart failure, fearing she wouldn’t survive to see her infant daughter grow up. 

Watkins, a social work assistant professor at NC Central University and a maternal health researcher at Duke, recalled how her symptoms of fatigue, shortness of breath, nausea and radiating pain down her left arm were dismissed for weeks after her daughter was born. 

“It wasn’t the flu, as I was told by my OB at four weeks postpartum,” she said Wednesday. “It wasn’t postpartum depression, as I was told by my OB at six weeks during my postpartum check-up. It was a medical emergency.”

Watkins, chair of the nonprofit Equity Before Birth, spoke at a news conference in support of a bill that offers a multi-pronged approach to addressing inequities in maternal health care. 

The maternal mortality rate in the state doubled from 2019 to 2021, and increased faster than the national rate, NC Newsline has reported. Nationally, Black women are 2.6  times more likely to die from pregnancy-related causes than are white women, according to the CDC. 

Watkins said she was left with “the emotional scar of how my life would have been different if I had a different birth story. 

“What if my providers reviewed my records, noted my apparent family history of cardiovascular disease and had me evaluated early on in my pregnancy?  What if my OB referred to that same family history when I reported health concerns during those two separate visits?”

What if she had a doula?

“What if I was white, would my complaints of heart attack symptoms been taken seriously and resulted in immediate care?”

Senate Bill 467 and its companion House Bill 552 would require the state to develop an implicit bias training program for health care professionals who provide maternal care, would appropriate $500,000 to train a diverse workforce of lactation consultants, and establish a Maternal Mortality Prevention grant program.

Bills aimed at improving Black maternal health have been filed in previous sessions, but have not made it out of legislative committees. In those years, North Carolina’s maternal mortality rate has gotten worse. 

“I believe in filing the legislation because it’s the right thing to do,” said Sen. Natalie Murdock, a Durham Democrat and the Senate bill’s primary sponsor. There’s time to add funding for Black maternal health programs to the state budget legislators are writing, she said. 

Dr. Sarahn Wheeler, an OB/GYN at Duke said she was encouraged to see implicit bias training in the bill, because doctors are hungry for information on how to prevent inequities and bad outcomes. 

“They are horrified at the stories they hear and are horrified at being part of a system that is creating inequitable outcomes over and over and over again,” said Wheeler, who is vice-chair of diversity, equity and inclusion in Duke’s OB/GYN department, and vice-chair of the Diversity and Inclusion Committee for the Society of Maternal-Fetal Medicine. 

“My colleagues are hungry for skills and for knowledge in order to be able to provide more equitable care,” she said, and implicit bias training is an important start. 

She also supported a bill that would have five community nonprofits that support Black maternal health, including Equity Before Birth and MAAME in the Triangle, share $1.25 million. 

Community groups are crucial to addressing the complex problem, Wheeler said. “There’s a need for an all-hands-on-deck approach.”

Although supporters held signs proclaiming “Black Maternal Health is Nonpartisan” on Wednesday, no Republicans had signed on to sponsor the Senate bill or its House companion. 

Separate House and Senate bills that have bipartisan support would increase the Medicaid reimbursement rate for health care providers who offer obstetric care and authorize the state Medicaid program to fund doula services. 

The provisions were not included in the proposed budget that passed the House. In an interview Wednesday, Sen. Jim Burgin, a Harnett County Republican, said he was going to try to put the provisions into the Senate budget proposal. “We have to make an impact,” he said.