This is one in a series of articles about the pandemic and America’s First Female Recession. See more here. The views and opinions expressed in this article are those of the author and do not necessarily reflect the views or policy positions of NCRC.
COVID-19 has had an undeniably detrimental impact on both the health and economic landscape of the United States; however, one of the most troubling effects of the pandemic is its disproportionate impact on women of color. Making up nearly one-third of the front-line workforce, Black and Brown women have been vital contributors to their families and communities, suffering greater exposure to COVID-19 while simultaneously continuing to endure the burden of persistent racism, sexism and other forms of bias and discrimination.
Recent evidence suggests that the syndemic of COVID-19 and systemic racism has exacerbated racial maternal health disparities and has specifically worsened Black maternal health. In the first six months of the pandemic alone, Black women experienced a 2.3-year drop in life expectancy. Prior to the pandemic, Black mothers were 3-4 times more likely to die from pregnancy-related causes than White mothers. While data is not yet available, maternal health disparities are expected to worsen as a result of COVID-19.
Applying a Racial Equity Lens to Address Maternal Health Disparities
The devastating impact of COVID-19 on mothers of color calls for a holistic and multi-faceted policy approach that centers the intersectionality of women of color. In addition to facing long-standing maternal health disparities, this community has been burdened by trauma from having their health needs ignored as well as a history of unethical medical experimentation. These experiences with systemic racism will only exacerbate the deleterious impacts of COVID-19 on maternal health outcomes.
These contextual factors heighten the impact of “weathering,” further undermining the quality of life of mothers of color. In the past, policy responses have failed to account for this community’s unique socioeconomic and health care context. This has resulted in a “vicious cycle” of macro-level policies built on already rampant inequities that further perpetuate poor maternal health outcomes.
To avoid this “vicious cycle,” economic justice advocates and policymakers must take a new approach, applying an intersectional, racial equity lens as they develop and implement inclusive policy solutions.
What Can Economic Justice Advocates Ask From Congress? Support legislation to address racial disparities in maternal health outcomes
Earlier this year, Representative Lauren Underwood (D-IL) and Senator Cory Booker (D-NJ) introduced the Black Maternal Health Momnibus Act of 2021, a series of 12 separate pieces of legislation to address every dimension of the maternal health crisis in the U.S. The legislation includes policy solutions spanning health care access and coverage, data collection, workforce development and payment issues. We urge you to add your support to both the overarching Momnibus Act, as well as each of the 12 individual bills that are contained in it. Last fall, in our Response to the Senate Finance Committee’s Request For Information on Solutions to Improve Maternal Health, Families USA identified several policy recommendations we support to address health disparities among mothers and birthing people of color. Many of these recommendations are part of the Momnibus Act. Our three leading priorities are:
- Ensuring women have access to Medicaid throughout their pregnancy and for at least 12 months postpartum: Congress must permanently extend Medicaid coverage for all postpartum women for at least 12 months after giving birth with increased FMAP at 100% for the first five years, reduced to 90% thereafter (Relevant legislation: HR 4996; Families First Coronavirus Response Act)
- Expanding the culturally responsive workforce: Congress must expand Medicaid to ensure coverage for services provided by community-based doulas, perinatal community health workers, and other peer support service providers. (Relevant legislation: Title XIX of Social Security Act; S 1343; S 1600; HR 2602; HR 2751; HR 3344; HR 6142)
- Increasing access to community-based services and supports to help women thrive in their lived environment:
- Congress must promote and fund community-based, community-led perinatal care programs, particularly those led by Black and Indigenous women that have shown promising outcomes on reducing racial and ethnic disparities. (Relevant legislation: Black Maternal Health Momnibus Act of 2021)
- Congress must make home visiting a mandatory Medicaid benefit
- The disproportionate impact of COVID-19 coupled with the enduring stress of structural racism has presented mothers of color with a challenging landscape to navigate. The solution to the maternal health crisis in America lies in creating equitable conditions in which mothers of color can thrive. Now, more than ever, it is time for economic justice advocates to underscore the multiple impacts of COVID-19 and structural racism on women of color and hold policymakers accountable to take immediate action to achieve equity in maternal health care.
Raashmi Krishnasamy is the Health Equity Intern at Families USA. In this role, she assists in the development of strategic policy priorities and leveraging of partnerships to advance health equity and reduce health disparities in outcomes, health care access, and quality.
Lisa Shapiro is the Senior Advisor for Strategy and Children’s Policy at Families USA. Lisa oversees strategy, policy, partner relationships, and organizational issues.