On the campaign trail, 2020 presidential hopefuls, Sen. Kamala Harris and Sen. Elizabeth Warren, are highlighting the disproportionately high rates of pregnancy-related deaths among black women — an issue health care providers and lawmakers increasingly are flagging as a crisis.
Warren says she plans to strategically apply the lessons learned from reforms enabled by the Affordable Care Act and set one price for the care a mother needs.
"I support these efforts, and I have another idea: hold health systems accountable for protecting black moms," she wrote in an Essence Magazine op-ed Tuesday.
Harris introduced a resolution to designate April 11-17 as Black Maternal Health Week, in an effort to raise awareness of the issues pregnant black women face in this country.
According to a study conducted by the Centers of Disease Control and Prevention, "considerable racial disparities in pregnancy-related mortality exist." In the most recent data retrieved by the CDC, during 2011-2014, the pregnancy-related mortality ratios were 12.4 deaths per 100,000 live births for white women compared to the 40 deaths per 100,000 live births for black women.
Gaining public awareness
"This issue really started gaining public awareness over a year ago when Serena Williams shared her own challenges accessing postpartum care to address a health complication she experiences just days after giving birth to her daughter," Dr. Jamila Taylor, senior fellow and director of women’s health and rights for the Center of American Progress told ABC News. "Serena went to her health care provider and expressed pain and discomfort, and initially she was ignored."
Williams revealed in an interview with Vogue magazine in January 2018 that she underwent multiple operations after sustaining a pulmonary embolism the day after her emergency cesarean section.
Williams told ABC News that she "dealt with a lot of issues" with her health in the past, including "blood clots in my lungs" and "everywhere in my body."
"Even Serena Williams — a world-class tennis champion — was invisible in that moment. And this is a common theme throughout the stories we see of black women who have died from maternal complications," Taylor added.
The root of the cause?
Warren and Harris blame it on "racism" and disparities in how health care is offered. So do some researchers.
"The data shows that Black women are three to four times more likely than white women to die from pregnancy or childbirth-related causes," Warren wrote in her column. "This trend persists even after adjusting for income and education. One major reason? Racism."
At a CNN town hall, Harris detailed her own initiative to address black maternal mortality rates.
It is "a matter of racial bias in the health care delivery system," Harris said. "Those women are not taken as seriously when they show up at the clinic or the doctor’s office or the hospital."
"Racism drives racial disparities in maternal mortality," she told ABC News. "Black women’s pain and discomfort being ignored and the devaluation of black women in the health care system are just a few examples of how bias and racism manifest within the health care system."
A number of African Americans also lack access to quality health care, according to federal statistics.
According to the CDC, In 2017, 27.2% of Hispanic and 14.1% of non-Hispanic black people aged 18-64 were uninsured.
"Three out of four black women give birth at low-quality hospitals," Taylor said. "The postpartum period is a sensitive time for new moms and access to health care is extremely important."
According to a study published in 2016 by the National Institutes of Health, the U.S. has not released an official maternal mortality rate since 2007.
The Center of American Progress suggests the country improve its data collection by ensuring states "standardize and improve the quality of their birth and death certificate data and committees that help states identify and review cases of fetal and infant mortality."
The organization also recommends diverse stakeholders serve on maternal/fetal and infant mortality review committees.
Improving the quality of care, enhancing support for mothers before and after birth and providing access to critical maternal services could also help improve outcomes, the report noted.
Warren suggests looking at what she sees as the root cause.
If health systems are able to reduce the disparities found in maternal death rates for women of color and increase survival rates they will "earn a bonus," Warren told a gathering of women of color at the She the People forum in Houston. If not, "money will be taken away from them."
"I want to talk to the hospitals …I want to talk to them in a language they understand: money," Warren said. "I want to see the hospitals see it as their responsibility to address this problem head-on and make it a first priority. The best way to do that is to use money to make it happen."
Harris has introduced a Senate bill that she hopes will tackle the issue.
If passed, Harris' bill would fund $25 million dollars into training programs to help reduce bias in the medical profession. Another $125 million would go toward identifying moms with high-risk pregnancies and provide them with additional medical care. The bill would also direct the National Academy of Medicine to advise medical schools on how to incorporate bias recognition. Harris had previously tried passing a version of this bill during the previous Senate session in August.
"We must take action to address this issue, and we must do it with the sense of urgency it deserves," she said.