'Birthing Justice' highlights the Black American maternal health crisis

For Black pregnant people in the United States, the road to a healthy parent and baby can be rocky at best and deadly at worst. 

A new documentary titled “Birthing Justice” pulls back the curtain to reveal some of the most horrifying data around Black maternal health in the U.S. It gives Black pregnant people a platform to tell their pregnancy and delivery stories and chronicles the history of an American health care system born out of a bias that remains in many hospitals and medical schools across the nation today. 

Black pregnant Americans are three times more likely to die from pregnancy-related complications than white pregnant Americans, the Centers for Disease Control and Prevention reports. And according to the Department of Health and Human Services Office of Minority Health, Black infants are nearly four times as likely as white infants to die during birth. 

“I had no idea how much this problem was hiding in plain sight,” the co-writer and director of the film, Monique Matthews, told the American Independent Foundation. “Prior to coming on board, I had a cousin that I reconnected with and I asked him about his little sister, who was my younger cousin. And he told me that she passed away and she was like, 28, and I was like, ‘How did she pass away in the hospital?’ And he was like, ‘She gave birth. And then, you know, I was excited and I called back and I got a call that my sister passed away.’ And I was devastated.”

Matthews said many of the women she spoke with at screenings of the film told her their heartbreaking pregnancy and delivery stories. 

“Inevitably, someone pulls me aside, ‘Hey, you know, that happened to me. I didn’t realize.’ Because some women don’t know that they’re actually a part of the statistics. So we wanted to make this accessible. We wanted to demystify the process while affirming life and affirming womanhood and affirming reproductive rights and a woman’s choice and the right to life for everyone,” Matthews said.

The feature-length film highlights the health care inequities in cities such as Washington, D.C., where the Black maternal mortality rate is 69.9 deaths per 100,000 live births, according to a 2019-2020 report released by the Maternal Mortality Review Committee, established within the office of the city’s chief medical examiner in 2018. 

The documentary additionally highlights the accomplishments of the Martin Luther King Jr. Community Hospital, located in South Los Angeles, an area where the population is 15% Black and nearly 30% of residents live below the poverty line. 

After years of undergoing numerous investigations of substandard care, in 2007 the old Martin Luther King Jr. Community Hospital, called “Killer King” because of its dismal record of care for patients, was closed, and a new hospital was opened in 2015, in a partnership between Los Angeles County and the University of California Los Angeles.

In 2019, the hospital began consulting in a statewide initiative called the Birth Equity Collaborative along with other hospital leaders in order to begin to improve birth outcomes for Black pregnant people. 

According to the Collaborative’s website: 

The Birth Equity Collaborative adopted the World Health Organization definition of respectful maternity care as a guiding princip[le], which refers to care organized for and provided to all women and birthing people in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth, regardless of their race, ethnicity, nationality, gender, religion, sexuality, age, disability, HIV status, immigration status, housing status, income, or insurance status and type. 

Today, California has the lowest rate of maternal mortality in the nation. 

The film, which screened in Houston, Texas, on May 2, was hosted there by the Texas Organizing Project, just as the Texas House of Representatives passed a bill to extend Medicaid to new mothers for a year after childbirth. H.B. 12 has been referred to the Senate Health & Human Services; Republican Gov. Greg Abbott reportedly supports the bill. 

Texas has one of highest percentages of uninsured people in the country, and it’s one of just 11 states that has still not expanded Medicaid coverage past the first 60 days after a mother gives birth. 

Dr. Doshie Piper, the board president of the Texas Organizing Project, told the American Independent Foundation that she hopes the film will “educate the public on the prevalence of poor Black maternal health outcomes [and] … encourage our voter base to call their representatives to get more involved, because we’re involved. And so we want to expand our network. And we also want to educate individuals on how important it is to have representation that believe in the families in our communities’ health care as a priority.”

The film also focuses on H.R. 959, the Black Maternal Health Momnibus Act of 2021, a slate of 12 bills that addressed maternal health issues, focusing on Black pregnant people and social supports such as Medicaid extension, improvements in health care for incarcerated mothers, and support for moms struggling with mental health conditions and substance use disorders. 

“Let’s push the whole Momnibus Act through on all 12 bills,” Dr. Kanika Harris, director of maternal and child health with Black Women’s Health Imperative, says in the film. [1.27.20] “Let’s get that rolling and see how we transform maternal health in this country.” 

Ebony Marcelle, the director of midwifery at Community of Hope, located in Washington, D.C., says in the film: “All of the bills are focused around trying to change outcomes; it’s really, really exclusively focused on Black maternal health, and they’re so needed, right? Because we’ll commonly hear, Oh, it’s three to four times more likely, but really in some areas it can be eight times more likely. In certain areas of the Bronx it’s 14 times more likely.” 

Matthews argues that Black childbearing people need to begin holding hospitals accountable for maternal deaths. 

“We hold insurance companies accountable. If these hospitals have a high [maternal death] rate, they get a lower mark. If I’m a Lyft rider, and the driver has complained about me, no one’s gonna pick me up. And if that’s happening at Lyft, why is that not happening in our health care and our hospital systems?” she said.

“Birthing Justice” is streaming on PBS for the next six months. 

Matthews says she hopes audiences will take away from the film that “Black joy is a tool that we enjoy specifically, because joy is something that you adopt.”

She adds: 

You know, when you just look at whatever is happening in America, like I said, if it’s a thunderstorm in the real world, in Black America it’s a tsunami or it’s a hurricane, right? So with that, it’s like anger can only take you so far, and righteous anger is important. As Dr. Joia Crear-Perry [president of the National Birth Equity Collaborative] says, however, to move past that, you see everyone in the film finding joy in their work, because we want to promote life. … So Black joy is really important, as a tool, not just for the film, but for us to take as we move forward.

Published with permission of The American Independent Foundation.