Michigan projects aim to dismantle racism behind maternal and child deaths
Racism is killing mothers and babies in Michigan – and initiatives statewide are tackling this root cause and saving lives.
Black and Native Michigan mothers are nearly three times more likely to die of infant deaths than white mothers. Black Michigan mothers are more than twice as likely as white women to die from pregnancy-related causes. The sheer stress of everyday life in a racist society increases the likelihood of preterm birth, the leading cause of infant mortality. And these disparities persist despite the socioeconomic status or educational level of the mother.
âObviously, there are usually medical causes at play. But when you dig in and actually listen, there’s systemic racism at the heart of these disparities,â says Amy Zaagman, executive director of the Michigan Council for Maternal and Child Health. (MCMCH). âThe conditions that have been created over generations in communities contribute to stress levels. The environment and the circumstances in which things get complicated create scenarios where the response is not what it would be for someone. one that was white. It’s ingrained and long-standing, but it’s something that we as a society should and could change. “
While social determinants of health such as income, level of education, and access to healthy food, transportation and housing affect a woman’s health during pregnancy and the health of infants during pregnancy. first year, recent studies have concluded that racism is the underlying cause.
“Systemic racism is such a huge and ugly beast that we don’t like to tackle our health systems,” says Kyna King, family health programs manager at the Berrien County Health Department. âUntil we address systemic racism with action plans, we don’t address this right. How can we provide the necessary support to families as we also try to dismantle some of these systems?
Roadmaps to Birth Equity
Zaagman heads the Birth Equity Education Project (BEEP) at MCMCH. To date, BEEP has released five policy recommendations covering doulas, rethinking perinatal care, mental health, diversifying the health workforce, and payment reform. Recommendations on breastfeeding and substance use are underway.
âIt’s really about empowering and empowering all of the people who have a stake in helping women have healthy pregnancies and helping infants thrive,â Zaagman said.
Dr Jennifer Torres.
Taking a hands-on approach, the Michigan Public Health Institute (MPHI) Achieving Birth Equity Through Systems Transformation (ABEST) project focuses on root causes, including the role of racism, and addresses relationships and power within systems. ABEST seeks to build the capacity of state and local leaders to lead systems change and change mindsets to reduce these disparities for mothers and babies of color.
âHaving these experiences of systemic racism, of interpersonal racism throughout life, which causes wear and tear on a woman’s body,â says Dr Jennifer Torres, director of the MPHI Office of Women’s Health and Birth Equity. “This wear then has an impact on the health of the woman, her pregnancy and her baby.”
ABEST is currently working with the Michigan Intertribal Council (ITCM) Asabike Coalition and the Berrien County Raising Up Healthy Babies (RUHB) Task Force. RUHB’s goals include strategizing, campaigning, and changing health systems practices to affirm that Black, Indigenous and Colored Individuals and Families (BIPOCs) deliver as leaders in their lives. own care.
âWe call these birth equity roadmaps,â King says. âI think what’s really exciting is that they’re really focused on building the power and voice of the community, and really uplifting the people who give birth to BIPOC as leaders in their own. care.”
As an important first step, King took the time to listen. Conversations with community partners revealed the resources that partners were already making available to pregnant women and infants. Conversations with community members helped to better understand what was really important to families.
âIt is very important for our families to have a voice in their own care, and we are helping them create that voice,â King said. âThere’s a lot of great work going on. A lot of times the work takes place in silos. We wanted to make sure that we had collective power with this work, so that it wasn’t just something that came out of the department of County of Berrien, but we also have the support of our community partners to help support this work and also to move it forward. â
Zaagman agrees that hearing the pregnancy and birth stories of women of color is key to reducing these disparities.
âWe’re doing a better job of getting real feedback from people who have had loss and poor birth outcomes,â she says. “There are 100 women who will have severe morbidity for every woman who dies. There is a lot to learn from deaths and worse outcomes, but there is also a lot to learn from outcomes that impact mom’s health or the health of the baby for the rest of their life or a significant part of it.
Often overlooked: Indigenous mothers and infants
The ITCM Asabike Coalition is developing a toolkit for tribal leaders, health care providers and families who will create system changes around equity at birth; design policies and procedures that integrate Indigenous cultural practices and belief systems; and support access and equitable options that center the whole person and family, including culture and tradition, in the perinatal experience.
Nationally, Indigenous women are about three times more likely to die from pregnancy-related causes than white women. Due to the small population size, data on Indigenous mothers and babies has yet to be reliably collected in Michigan – and mothers or babies are often reported as white while they are. actually indigenous. Their number of deaths is therefore probably even higher.
“This is one of the things that we have worked on with the state and the United States government, especially those who work in the area of ââmaternal and child health and who are responsible for publishing these statistics,” he said. said Michelle Leask of the ITCM Honoring Our Children project. director. âA lot of times they don’t even follow Native American rates. You’ll see Black and White and maybe Latino.â
ITCM’s work on fairness at birth is to build better relationships with local health systems where members of Michigan’s 12 federally recognized tribes receive care. By encouraging these systems to provide culturally competent, bias-free care, Indigenous patients will not only receive better care, but will also feel empowered to use the natural supports that their tribal communities have traditionally offered.
âThe plan created by ITCM really revolves around a birth experience for everyone who puts tradition and culture at the center,â Torres said. âThey’re really looking at how we can make changes within the health systems where when Indigenous people give birth there is respect by centering their cultural practices around birth and really thinking about how Indigenous ways of giving birth. knowledge can be integrated into the Western world. ways that are often dominant in medicine.
Leask shares examples like giving the newborn a cedar bath, allowing the mother to bring her baby’s placenta home for a burial ceremony, and allowing skin-to-skin contact between the baby and the parents as soon as possible. possible after birth.
âSkin-to-skin contact has always been an important part of our culture,â says Leask. âNow science is definitely catching up and saying, ‘Yes, that’s an important and valid thing for bonding. But there are still health systems, especially if the mother has a cesarean or has other complications, where it doesn’t and always could. “
Because extended families play a more active role in the birth of a new baby, Leask would like hospitals to recognize the value of these “aunts”, grandmothers and others providing emotional support to women in labor.
âIn our communities, traditionally when a baby is born it’s a gift for the whole community. And everyone is excited about a new baby and everyone comes together,â Leask said. “We are doing a lot to try to elevate antenatal and postnatal care, to elevate the role of birth attendants and those who support families and young children – home visiting programs, Early Head Start. We make sure that our communities Native Americans have the resources to get our families involved in these kinds of programs and education. â
“It’s about building that community power and that community engagement,” Torres said. “This is to ensure that it is not only organizations and agencies that are leading the work, but that they are doing it in partnership with and led by community members – the individuals, families, who know these disparities. “
A freelance writer and writer Estelle Slootmaker is happiest writing about social justice, wellness and the arts. She is the development news editor for Fast growing medium and L’Arbre Amigos chairs, Wyoming City Tree Commission. His greatest achievement is his five incredible adult children. You can contact Estelle at [emailÂ protected] Where www.constellations.biz.
Photos courtesy of the subjects.