Updated May 17 at 12:30 PM
Senator Cory Booker and Representatives Lauren Underwood and Alma Adams have reintroduced the bicameral Black Maternal Health Momnibus Act.
The Momnibus is comprised of thirteens bills backed by the Black Maternal Health Caucus members. Bills within the act would combat rising maternal mortality rates directly through healthcare reform and indirectly through addressing social determinants of health. Data collected in 2021 showed that maternal mortality rates have reached a nearly 60 year high.
“Maternal mortality and morbidity rates in the United States are unacceptable, and far higher than in other wealthy countries. The Black Maternal Health Momnibus Act of 2023 addresses this urgent crisis that affects thousands of American parents every year,” Congresswoman Adams, co-founder and co-chair of the Black Maternal Health Caucus, said in a press release.
“As many as 80% of maternal deaths are preventable with proper care and treatment. The Momnibus makes over $1 billion in historic investments in the health and care of moms. It is nothing short of a game-changer for Black mothers as well as every parent bringing a child into the world. Now more than ever, it is critical we pass the Momnibus and make sure no child grows up without a parent. As a Black mother and grandmother, take it from me: Black mamas can't wait!”
Congress passed sections of the bill's 2021 iteration, including the Protecting Moms who Serve Act which unlocked funds to support veteran mothers.
If Congress were to pass the act, further funding for improving maternal healthcare for veterans and incarcerated mothers would be unlocked, programs to improve data collection on the crisis would be launched and education programs on maternal vaccinations would expand.
Other parts of the bill would convene a task force to address the maternal health crisis. Said task force would direct the investment of funds into programs tackling social determinants of health.
Environmental factors leading to poor maternal health outcomes would be addressed through extending eligibility for the special Supplemental Nutrition Program for Women, Infants and Children (WIC) to the postpartum and breastfeeding periods and triggering investment in digital tools to improve maternal health in underserved areas.
The bill is cosponsored by 27 senators including Senators Elizabeth Warren, Raphael Warnock and Bernie Sanders.
While maternal health has been a hot topic for some time, the wildfire taking the lives of the nation’s mothers is still burning and disproportionately killing Black women.
While maternal mortality rates globally and in the U.S. increased for all women during the COVID-19 pandemic, the New York Times found that wealth did not protect Black mothers and infants from the effects of systemic racism. Infants born to wealthy Black mothers in the U.S. were more likely to die in their first year of life than infants born to the poorest white mothers.
During Fortune’s recent Brainstorm Health event, experts and advocates working to address the dangerous inequality Black mothers face spoke about what institutions can do to address the growing threat. The event came soon after National Black Maternal Health Week and began with a statement from the president proclaiming that “healthcare should be a right and not a privilege.”
“Black Maternal Health Week is a reminder that so many families experience pain, neglect and loss during what should be one of the most joyous times of their lives,” President Joe Biden said in a proclamation from the White House. “It is an urgent call for action. Black women in America are three times more likely to die from pregnancy-related complications than white women. This is on top of the fact that women in America are dying at a higher rate from pregnancy-related causes than in any other developed nation.”
Irogue Igbinosa, M.D., brought her expertise as a women’s reproductive health scholar and instructor at Stanford School of Medicine to the panel to help prevent the 80% of maternal deaths that are preventable. She reasoned that an important place to start when looking at the future of maternal health is clinical trials, only 2% of which are applicable to pregnant women.
The Centers for Disease Control and Prevention states that little is known about the effects of taking most medicines during pregnancy because pregnant people are often not included in studies that test the safety of new medications.
When it comes to applying the factor of race to healthcare decisions, Igbinosa said that oftentimes race is spoken of as a risk factor, creating the possibility for victim blaming. Instead, race should be seen as a proxy for racism, a way to interpret how the patient’s environment affects their health. She also implored institutions, including medical schools, to create more outreach programs with community-based partners.
“The theme for Black maternal health week was restoring Black autonomy and joy, and I think that is such an essential statement,” Igbinosa said. “People are trying to enjoy this time in their life, and they don't want to be mirrored by statistics and fear death when they're actually looking forward.”
Maven Clinic is one of many health tech companies working to improve maternal care. FemTech as a whole has seen exponential growth with little sign that the rise will be dampened by cooling markets. A slew of startups are finding ways to use remote patient monitoring to predict pre-eclampsia, the number one cause of maternal death. Others have looked to use virtual care to avoid postpartum infection.
Maven calls itself the largest virtual clinic for family health and reported having 15 million lives under management as of November of last year. The platform includes “enhanced support” for high-risk members and claims to decrease NICU admissions by 28% and C-Section rates by 20%.
“An app isn't going to fix healthcare. It's not going to fix structural racism,” said Maven chief medical officer Neel Shah, M.D. But, he said, digital tools can allow for digital monitoring, addressing a crisis before it happens and recreating trust between Black families and their doctors.
“The existential issue for the healthcare system right now is trustworthiness, and it's not the job of the people that we're serving to be more trusting of us, it's our job to be trustworthy,” Shah said. “To do that you have to be competent, have better outcomes, you have to affirm people by listening to them and reliably show up for people when they expect you to and when they need you to. That's what you can do digitally, you can show up for people.”
A continued drumbeat of those concerned about health tech fervor is that technology will only digitize inequalities that currently exist in an analog space. Loretta Ross, associate professor at Smith College teaching courses on white supremacy and human rights, spoke on the panel about how technology can solve maternal mortality health problems but only if done with care and caution.
Ross warned the medical experts in attendance to be critical of which patients receive breakthrough technologies and digital tools. The existence of tools is not enough, she said, the protection of rights like those to have or not have a child is not enough. Having a child under the conditions women want to have children, surviving the birth and raising a child in a safe and healthy environment are just as important.
“Too many times people are describing maternal mortality as either a genetic issue or a behavioral issue, but not as a sociopolitical issue,” Ross said. “Poor white women in Appalachia have the same relative maternal mortality statistics as upper-income Black women in New York City. We have to be able to look at these outside influences that aren't about race or behavior, but about the conditions that we're creating as a society that we're failing to address because we can't have the wrong solution to the problem. That's why the rates have been going up because we keep applying the wrong solutions.”
If passed, the Black Maternal Health Momnibus Act would usher in a suite of bills addressing maternal mortality including the establishment and funding of a Maternal Mortality Prevention Grant Program and an implicit bias training program for healthcare professionals. The Momnibus bills would also outline the rights of perinatal care patients.
Charles Johnson testified to Congress on the act and spoke on the panel regarding the state of Black maternal health and the death of his wife Kira Johnson. Kira died from a hemorrhage following the birth of their second son at Cedar-Sinai Medical Center in Los Angeles. Charles told the story of how his wife hemorrhaged for 10 hours before receiving emergency care.
“Governmental intervention legislation is a big part of this, but this is a complex set of challenges that needs a complex approach and a comprehensive set of solutions,” Charles said. “Every single provision in this legislative package will impact all families. It's just unfortunate that Black women and minorities are being the most impacted.”