Pregnancy, childbirth, and recovery are experiences that are intense, transformative, and full of unpredictability. Most women will interact with the healthcare system more frequently than they ever have before, over the course of many months spent obsessing over the details, preparing for this major life moment, and doing everything possible to stay healthy and balanced until the big day. This was my experience (save a few details).
In light of the closure of United Medical Center in DC, I realize that I was incredibly lucky – I didn’t spend my pregnancy in fear of losing my doctor during pregnancy, or my life during childbirth. That’s not the case for thousands of mothers in Southeast DC.
No mother should have to risk her life giving birth, and no family should have to endure such a devastating loss. Yet, if DC were a state, it would have the highest maternal mortality rate in the nation. The exact number stands at around 40 deaths per 100,000 births, more than double the national average. And at the most conservative estimates, black women are more than twice as likely as white women to die in childbirth, an outright injustice. DC families have faced this tragedy for decades, and the city has quietly sidestepped it.
After years of unacceptable inaction, the DC Council recently passed a bill to establish a Maternal Mortality Review Committee–a group tasked with investigating the causes of maternal mortality in the city and making recommendations to fix them. We should always strive to be more informed about such a critical issue–but this is woefully insufficient for the pressing needs of DC mothers and families, which have existed for decades. We don’t need a committee to tell us things we already know, because there are very clear things we can act on right now in order to make DC a safer place to give birth. Expecting mothers can’t afford to wait for proposed solutions to be unearthed by our bureaucracy a few years from now.
First, we know we have to meet mothers where they are. There is a stark inequality in maternal health care resources in this city, and poor, black mothers are being disproportionately harmed. Two of the last remaining health centers in Wards 7 and 8 closed this year, leaving women in Southeast without a trustworthy, local space to receive much-needed care. There’s an easy answer to this problem–ensure highly qualified, accessible maternal care throughout the city, not just in its wealthiest neighborhoods.
We also know that prenatal care must be reliable, which is not currently the case. Independent from the clinic closures, a switch in Medicaid contracts automatically transferred pregnant women to a plan that MedStar does not accept. Without any notice, pregnant women were told they had to switch providers or forego affordable prenatal care altogether. This sudden change falls the hardest on women who don’t speak English, or whose work schedules don’t afford them the time to navigate a maze of a healthcare system. No woman should have to scramble to guarantee affordable care.
This could have been avoided. Community advocates and the Department of Health have called for full integration of services provided to expectant parents and families, but the DC Council did not act. There are community organizations, government agencies, private sector, and academic initiatives aiming to improve maternal health care in DC, but their efficacy will be limited so long as they operate separately. We should be coordinating care providers–ranging from nutritionists, nurse midwives, doulas, breastfeeding instructors, and obstetricians–into a network for expecting families. We can’t let major changes, like the latest insurance contracts or clinic locations, slip through the cracks. Every step of a pregnancy and early childhood should be supported without administrative gaps or confusion.
This holistic approach is absolutely critical to improving maternal health. Each stage of a pregnancy–and any complication experienced during it–are interconnected, and we need a healthcare system that reflects that. That’s why I was particularly disappointed when Charles Allen responded to pressure from lobbyists and amended the Maternal Mortality Review Committee bill to exclude investigations of maternal morbidity, medical emergencies that happen within a year of pregnancy. Maternal morbidity is both more common and less widely understood than maternal mortality. It can affect the bond between a mother and her baby, and creates huge financial costs for families. And if we don’t find out why women are being hospitalized after their pregnancies, it’ll be much harder to assess the factors contributing to maternal mortality.
I am the only candidate in this race with substantive experience working in healthcare, and I bring the knowledge and skills necessary to begin to tackle these critical issues. We need to consider the full picture of maternal health; we need to provide comprehensive, cohesive networks of services, and evaluate every aspect of this crisis to inform policy decisions. DC government must also recognize that these issues are concentrated among the city’s most vulnerable, and work proactively to earn their trust in a system that has failed them. Only then will we be able to assure the equitable and dependable maternal care that our city deserves.