By W. T. Whitney, Jr.
Oct. 15, 2016
The lives of some women in the United States don’t matter. Too many expectant and new mothers, and particularly black mothers, are dying. Few are aware of a catastrophe hidden in part because flawed data collection has led to unreliable statistics. Their inadequacy led the Centers for Disease Control (CDC) to confess in 2014 that, “Maternal mortality data are not included in this year’s report.”
The professional journal “Obstetrics & Gynecology” recently disclosed the faulty record keeping in an article. That publication offered new, alarming data which the public learned about through brief coverage by the national media, for example, the New York Times.
The story is this: the CDC documented the U. S. MMR rising from 7.2 in 1987, to 14.5 in 2000, and to 17.8 in 2011. “MMR” refers to the number of women per 100,000 live births who die during their pregnancy or within 42 days (or within the following year, according to another version), and who die from causes related to childbirth. The study appearing in “Obstetrics & Gynecology” revealed the MMR for 2014 to be 23.8. The MMR for Texas moved from 17.7 deaths in 2000 to 35.8 maternal deaths in 2014.
Back in 2010, 48 countries had lower, more favorable MMRs than that of the United States; 31 countries demonstrated MMRs of 10 or less. According to “Obstetrics & Gynecology,” 157 of 183 countries reduced their maternal deaths between 2000 and 2013. There’s been a 45 percent worldwide drop since 1990.
Yet the United States registered a 138 percent increase in MMRs between 1990 and 2014 – from 10 to 23.8. In 2015, that country ranked 61st in the world in overall maternal health.
The news gets worse. Black mothers face a fourfold greater risk of death than white mothers – whose own risk far exceeds international norms. The CDC reported that 11.8 white women died in 2012 per 100,000 live births. The MMR for black mothers was 41.1. By matching these percentages with the number of births, one discovers that 1625 black mothers and 466.5 white mothers died that year.“
In Georgia, in 2010, 2011 and 2012, the rate of maternal mortality for white women was 14 per 100,000 live births … For African American women, it was 49 per 100,000.” Another study found similar results “even when controlling for age, socioeconomic status and education.” A government report recalled that,“The risk of maternal mortality remained 3 to 4 times higher among black women than white women during the past 6 decades.” Crucially, “46 percent of maternal deaths among African-American women [were] preventable compared with 33 percent of such deaths among white women.”
What causes danger for black women? Blame often falls on the victim and her circumstances. She is obese, for example; or lives with violence; uses drugs; has mental health problems; or suffers from some other illness. But, tellingly, medical evaluations of African – Americans are often incomplete or incompetent. Poor people, black people included, suffer more illnesses than higher – income people do – including heart disease, which is a leading cause of black mothers dying. Significantly, “bias, prejudice and stereotyping by health care providers contribute to delivering lower-quality care.”
Black women without easy access to health care often delay their prenatal care, or go without. Either way, their lives are at risk. States refusing to extend Medicaid coverage, as provided for under the Affordable Care Act, is one leading cause of reduced access today. The closing down of women’s health-care facilities is another, for example, Planned Parenthood offices recently in Texas.
From the foregoing, it’s clear that racism contributes to the U. S. epidemic of maternal deaths. But discrimination based on social class plays a role also.In 2010, Amnesty International issued a report that condemned U. S. governmental policies regarding maternal health. Titled “Deadly Delivery, the Maternal Health Care Crisis in the USA,” it insisted that, “Discrimination is costing lives… [W]omen face barriers to care, especially women of color, those living in poverty, Native American and immigrant women.” An Amnesty International spokesperson denounced both a “haphazard approach to maternal care [that is] scandalous and disgraceful,” and a lack of “political will.”
The report demonstrated that women die because they are black, or because they are poor, or both; “Women of color are at least twice as likely as white women to be living in poverty.” It listed class – mediated barriers to adequate health care during pregnancy and afterwards. They are: language barriers, shortages of health-care resources and specialists in rural areas and inner cities, educational disparities, and lack of insurance coverage leading to little or no health care. Food shortages would be another.
Racial discrimination and class discrimination overlap. The World Health Organization concurs with Amnesty International’s conclusion that, “Higher poverty rates increased the risk of maternal mortality for both white and black women.” Indeed, white women giving birth in the United States are much more likely to die than counterparts in dozens of other countries.
In the United States not a few academicians and officials belittle the fact of social-class distinctions; they may use race as a proxy for class. Class dynamics do operate in the current maternal-health catastrophe. But, just as surely, racial oppression grinds away to deadly effect.
The American Public Health Association was clear in 2011: “Preventable maternal mortality isassociated with the violation of a variety of human rights, including the mother’s right to life, the right to freedom from discrimination.” The statement quoted Mahmoud Fathalla, a former president of the International Federation of Obstetricians and Gynecologists: “Women are not dying because of untreatable diseases. They are dying because societies have yet to make the decision that their lives are worth saving.” He was saying, in effect, that women’s lives don’t matter.How can that be?
Political prisoner and former Black Panther Mumia Abu-Jamal explained on September 9: “The truth is White Americans have sculpted and supported an edifice of utter separation –for centuries. And today, we still dwell in two very different worlds and head-spaces: one of privilege and another of privation.”Abu – Jamal’s remarks, “as we witness the decay of capitalism [and] its utter dog-eat-dog ruthlessness,” were about playwright Jean Genet and his “theater of the absurd.”
Perhaps, however, the deaths of mothers derive from logic as much as from absurdity. The accumulation of relevant health statistics was an afterthought for record keepers and policy-making higher – ups within the U. S. government’s public health bureaucracy. Because that capitalist government couldn’t accomplish such a fundamental task, its zeal for all people’s health logically becomes, for the rest of us, mere wishful thinking.
