Bill aims to reduce Black maternal deaths, which are prevalent in the Central Valley
Gov. Gavin Newsom signed a bill Monday aimed at reducing maternal mortality rates following decades of disproportionate deaths among Black and Indigenous women.
The bill will gather information to provide better care and improve access to maternal and mental health services. Nicknamed the California Momnibus Act, Senate Bill 65 will establish a maternal mortality board to improve research and data collection pertaining to racial and socioeconomic factors that contribute to deaths among moms and infants.
The board will also be responsible for providing recommendations to close racial disparity gaps, examining the impact of climate change on pregnancy outcomes and gathering information on perinatal outcomes in lesbian, gay, trans, gender nonconforming and intersex communities. Further, SB65 will expand midwifery workforce via training, offer doula care for Medi-Cal enrollees and provide low-income people with cash assistance through their pregnancies and first few years of their babies’ lives.
Jennifer Newsom, first lady of California, began the live streamed presentation of the bill signing by sharing her belief that Black moms receive an unacceptable lower level of care, harsh language from some healthcare professionals and even some forced cesarean sections.
“These deaths and racial gaps in mortality rates didn’t happen in a vacuum,” she said. “They are the legacy, as we all know, of systemic racism and inequality.”
Maternal mortality rates hadn’t been properly addressed, producing worsening outcomes among some women and widening the racial disparity gap, Gov. Newsom admitted. He believes however, the bill will allow for a higher level of accountability.
“I’m just glad we’re here doing more justice to women and girls in advancing the cause of social and racial justice,” he said.
The signing highlights yearlong efforts to improve maternal health, said Democratic state Sen. Susan Talamantes Eggman, who represents San Joaquin County and portions of Stanislaus and Sacramento counties. Once a mental healthcare provider, she believes it’s important to invest in a mother’s mental healthcare postpartum.
“We know healthy moms make healthy babies and healthy families,” she said.
Through the Momnibus Act, Medi-Cal will be expanded to provide mental health services to mothers up to a year after giving birth. A pregnant person deemed low-income will also qualify for additional assistance through the CalWORKS program.
The bill is part of a national effort to reduce maternal mortality as rates have increased since the start of surveillance reporting in the U.S. in 1987, making America the country with the highest rates among developing nations, according to the American Journal of Managed Care (AJMC).
A maternal death is a death occurring while pregnant, or within one year from the end of the pregnancy, as defined by the state’s pregnancy mortality surveillance system (CA-PMSS). Common causes of pregnancy-related deaths are infection or sepsis (12.7%), cardiomyopathy (11.5%), other cardiovascular conditions (15.5%), hemorrhage (10.7%), thrombotic pulmonary or other embolism (9.6%) and more, according to the Centers for Disease Control and Prevention (CDC).
High mortality rates concentrated in Central Valley
Although California’s maternal mortality rate has remained low and stable compared to the national number, Black, Hispanic and Asian/Pacific Islander women are more likely to die of pregnancy-associated or related causes than compared to their white counterparts, CA-PMSS reports. In fact, the pregnancy mortality ratio for Black women was 56.2 deaths per 100,000 live births, four to six times higher than ratios for Hispanic (11.0), Asian/Pacific Islander (13.3) and white (9.4) women.
The surveillance report also shows that the highest pregnancy-related deaths in the state are concentrated in the San Joaquin Valley, excluding Stockton, amounting to 17.8 deaths per 100,000 live births. Reasoning for that fact may stem from socioeconomic disparities that play a key role in health risks and outcomes, said Chelsey Donohoo, epidemiologist for Stanislaus County Health Services Agency, in an email to The Bee.
Healthcare, education, economic stability, workplace conditions, neighborhood environment, racism and discrimination can all influence health outcomes. But in Stanislaus County, those social disparities are more prevalent among the Black community, leaving many without the ability to afford their basic needs.
Black residents (19.4%) are the largest group in the county to live in poverty, despite being only 3.5% of the population, the U.S. Census shows. Black women (78.2 years) also have a lower life expectancy compared to white women (81.1 years), reports the American Journal of Public Health.
“As a staple of public health, prevention works starts with addressing the social determinants,” said Donohoo.
This story was originally published October 5, 2021 at 6:00 AM with the headline "Bill aims to reduce Black maternal deaths, which are prevalent in the Central Valley."
