In the midst of an ongoing global pandemic that has claimed over 200,000 Americans, nationwide protests for the protection and preservation of Black lives, and a presidential election with so much at stake, March of Dimes is turning the country’s attention to an issue that should be at the center of social change and conversation in 2020: the Black maternal and infant health crisis.
With the re-launch of the #BlanketChange campaign, March of Dimes is inciting a movement that demands policymakers, political candidates, and elected officials take swift and meaningful action for the health and safety of US moms and babies. We spoke to March of Dimes President and CEO Stacey D. Stewart about true equity, access, and prevention for the future of maternal and infant healthcare in this country, and how #BlanketChange is leading the charge for a truly critical and life-saving call to action.
People are often shocked when I tell them that the US is one of the most dangerous developed nations for a woman to give birth, and that the statistics are even graver for parents and babies of color. Why, in 2020, is the US still failing to protect its birthing parents?
I do agree with you that it is shocking for a lot of people, and a lot of people would never expect one of the wealthiest countries in the world and a country where we spend more on healthcare than almost any other developed nation, to get the worst results for moms and babies compared to other highly developed countries. Our maternal mortality rates have been doubling over the past 25 years while every other highly industrialized country’s rates of maternal deaths have been declining. And we still have increasing rates of premature birth, which is the leading cause of infant death before the age of one year old and certainly it’s the leading cause of premature birth and death.
I think it’s really important to understand that we don’t do well for almost any woman and baby of color in this country and a lot of it has to do with the fact that we have very uneven access to health care in this country we have never provided universal health care in this country. And a lot of that is really based in history, where it was clear that the intent of the country was to deny health coverage to formerly enslaved people, and that has continued on as sort of a policy position in this country that not everyone would be provided or even to have the opportunity to access health coverage in this country and that has been the that has been our policy position, really up until the Affordable Care Act. But even with the Affordable Care Act, it still wasn’t complete universal coverage. So a big part of the answer to why are we still failing birthing parents is we’re failing a lot of Americans and unfortunately, a lot of who we’re failing the most cuts across both race and income. And then when you look at the fact that we’ve never provided adequate affordable health care to especially people of color, it really isn’t shocking that we have rates of premature birth among babies of color that are significantly higher than white babies, where Black women die at a rate of three to four times that of their white counterparts. It’s a combination of factors: the quality of care, availability of care, affordability of care. And then, even if care is available and even if you are a woman of means and even if you’re a woman of color with adequate education and income and access to health care, we still have a lot of racism that is embedded in the healthcare system and a lot of implicit bias among providers who, when they’re providing care to women of color, are failing those women. It seems to be based on some sort of disparate way of delivering care that’s disadvantaging many women of color. So there are a lot of different factors.
Most of what we think about in terms of health care isn’t what really happens in the doctor’s office, it’s in how we live. 80% of our wellness really comes in how we live – whether or not we have access to good income, whether or not we’re facing stress from society, from discrimination, from day to day living, access to affordable transportation, housing, all those things. And because many people of color often are facing pressures in those other systems, that is having an effect on our physical health as well and plays out in terms of our health and the health of our babies, too.
What are the main factors contributing to the Black maternal and infant health crisis in this country, and what is #BlanketChange doing to demand that those factors be addressed?
So really it is the main factors around affordability, health insurance coverage, and accessibility of care. And then it has to do with whether or not there is high quality care, irrespective of race or any other factors, and addressing some of the implicit bias that exists in the system. And then the last part of it is that a lot of the failure of protecting mothers is because a lot of our Black moms and babies live in areas that don’t support wellness and good health.
Blanket Change is really targeting three things: health equity, access, and prevention. So what Blanket Change really does is it asks everybody in the US to take a stand for maternal infant health. To demand that anybody who is going to receive our vote also takes a stand for maternal and infant health, and that they represent to us that they will go to Washington or go to the state capitol or whatever office they’re running for and demand the kinds of policies that will actually address those three things. Blanket Change is really an entire policy agenda. It’s intended to really address the maternal infant health crisis along those three areas of equity, access, and prevention.
March of Dimes’s 2020 report on maternity care deserts shows that there are 7 million women of childbearing age living in counties without sufficient access to maternity care. How can that be, and what does this statistic say about healthcare in the United States as a whole?
I think what it says at the end of the day is that we don’t really value the lives and the health of many people in this country, especially women, and especially women and babies of color. And I think it also means that we also don’t value the health and the lives of low income people. If we valued everyone individually, irrespective of income or race, then we would have universal health care, we’d have access to the care women need. The situation that we’re in right now really speaks to the fact that we have misplaced values in this country. Health ought to be something that everyone should have access to the ability to live the best life possible and contribute to the economy and to society at the highest level – but you can’t do that if you’re not healthy. If you don’t have your health, you have nothing right. So, I think what it means is that we’ve got to demand that the country look at the issue of health and health care as a priority for everyone. And if that means that people of color and low income people need to have a vehicle for their voices to be heard, then hopefully Blanket Change could be that vehicle so that everyone can know that our collective voices are even more powerful than our individual voices.
As the COVID-19 pandemic rages on, what motivated you to launch the #BlanketChange campaign “2.0” in this particular moment?
Well, we actually launched Phase One of it two years ago before the midterm elections. We saw the opportunity, as people were going to the polls for the midterm, to get really activated and focused on the idea that one of the key issues that ought to be an issue that everyone looks at, relative to the qualifications of any candidate, is whether or not they care about these issues of mom and baby health. We did a big launch on the National Mall, and we happened to do it around the same time that a big piece of legislation was pending in Congress – the Preventing Maternal Deaths Act. We launched Blanket Change in October and the Preventing Maternal Deaths Act was passed in November. I’m not saying that because of Blanket Change, that all happened, but we’d certainly like to think that it had a big part to play in putting that legislation over the line of success.
And so the idea here is the same thing. One of the best opportunities we have to engage people around policy change is when they’re actually going to pick their policy makers, and so the idea of Blanket Change “2.0” was because, you’re right, this is a very important election. And if we’re going to emphasize the issue of health care at any time in our history, doing it during a pandemic is probably one of the best times for us to really re-examine where this country is on health access, health care, maintaining good health – and we ought to be looking at it for those who are most vulnerable. Pregnant women are some of the most vulnerable individuals in the midst of this pandemic. We know pregnant women have more vulnerable immune systems. putting them at greater risk of severe illness as a result of coronavirus. We know that women of color are three to five times more likely to contract coronavirus and are more likely to become severely ill. We’re now clear of the disproportionate impact the coronavirus is having on communities of color, so this is something that we’ve got to really create an urgent response to, and now’s the time.
We’re in the midst of a very important (and divisive) election in this country, with much at stake in all three branches of government. What role does the outcome of this election have on America’s maternal and infant health crisis?
This election is probably one of the most consequential elections that we’ve ever had, with respect to health care for all Americans, especially for the most vulnerable. We have a challenge to the Affordable Care Act that’s pending with the Supreme Court. We have a candidate running for reelection who has run on a platform of repealing Obamacare but has never put forth replacements, and that’s going to roll back some of the gains that we were able to make under the Affordable Care Act. The Affordable Care Act not only did more to make sure there was coverage available for many women, but it also put in certain essential health benefits, like making maternity care and essential health benefits so that every private plan would have to on a mandatory basis include maternity care as a part of private insurance. That was something we didn’t have before the Affordable Care Act, so that actually made it more possible for women to get access to care. To the extent that we have many of these maternity care deserts in rural areas and some in urban areas, we need an administration at the highest level, we need a Congress that’s going to be willing to look at different models for providing health care for women and for women of color. We’re not suggesting we should have hospitals in every single county in the country, but if we’re not going to have a hospital that delivers that kind of care, then we certainly need to be looking at the models of telehealth and doulas and midwives, who provide really high quality care – and sometimes, they’re doing that in hard to reach places for women that need that help the most. We need leaders who are going to be willing to look at new, innovative approaches that are sustainable, that we can pay for and that we’re willing to pay for, to make sure that women don’t have to go without the care they need, irrespective of their race, ethnicity, income level or where they live.
For people who want to get involved in the fight for birth equity but don’t know where to start, what are some actionable “first steps” that they can take today?
We ask everyone to go to BlanketChange.org or go to MarchofDimes.org and you can sign up. It’s really easy, I did it yesterday myself. I tweeted at my member of Congress to step up for this bill that actually did pass the house yesterday, so it actually works! And we’re going to keep that kind of campaign up with different messaging over time. So as we get more and more successes, we can certainly be tweeting at members of Congress [and other elected officials]. And the good thing is that it’s not just targeted to Republicans or Democrats – we want everybody to be on board with what’s best for moms and babies. And then, March of Dimes maintains a really active advocacy agenda, not just now, but long term. So, if you sign up now, we’d love to keep people engaged and keep people active and advocating for these issues and this cause. It’s really important.
To end on a hopeful note, what is your wish for the future of maternal and infant health care in the United States?
I do maintain a lot of optimism that women’s voices are becoming louder, more powerful. Whether it’s the Women’s March, or how many women now are serving in Congress and in elected office in general, it’s clear that women are taking the appropriate place in helping us shape policy and shape our national priorities. I have two daughters. I know that they’re powerful and they’ll grow up to really understand their voice in the world and that they’ll be joined with lots of other young women around the country, and hopefully around the world. Our policies have been set up to not serve our needs, and with our leadership and our voices, we can certainly make a difference. I know that, we’ve seen that in other respects, and we’re seeing it right now even in terms of some of the progress we’re beginning to make around maternal and infant health. It’s going to require more, more, more: more effort, more engagement, more people involved, more people who care. But I think we’ve got some momentum, so I’m excited and optimistic around the future.
Thank you for helping us demand #BlanketChange and don’t forget to register for the virtual Town Hall here. It will feature exciting discussions with Olympian Allyson Felix, Rep. Alma Adams, March of Dimes leadership and more