Publicizing the risks facing pregnant people — especially Black women

It’s fitting that USC celebrated the naming of Allyson Felix Field on Monday, just as Black Maternal Health Week (April 11-17) was about to begin. That’s because Felix — elite athlete, Olympian and entrepreneur — is also a fierce advocate for pregnant people.

“I went through a really difficult time when I decided to start a family. I had been sponsored by Nike for almost a decade and I wasn’t fully supported through my pregnancy — and a lot of other women aren’t as well,” she said Monday in a USC Facebook video. “Our contracts are performance-based; if you have a baby, there’s nothing in place to protect you.”

Felix kept in top shape during her pregnancy by running and swimming. But at 32 weeks, she underwent an emergency cesarean section because of severe preeclampsia­ that threatened her life and her baby’s. She shared her story in a widely circulated New York Times op-ed, resulting in policy changes at Nike to support its pregnant athletes.

She’s also become one of the faces of the U.S. Centers for Disease Control and Prevention’s Hear Her campaign to prevent pregnancy-related deaths. The campaign centers on taking the concerns of pregnant women seriously, encouraging health care professionals to listen closely to their patients and be aware of unconscious biases that could shape responses to a potentially fatal problem.

“Medical racism is a significant concern during pregnancy. Many Black mothers report that their symptoms are overlooked or minimized by doctors and nurses, and they may be understandably reluctant to interact with prenatal care providers as a result,” said Darby Saxbe, a professor of psychology at the USC Dornsife College of Letters, Arts and Sciences. “The evidence suggests that pregnancy progresses best when mothers get high-quality social support from their medical care team as well as from their family and community networks.”

Access to basic maternal care major concern for Black women in America

Black women in America are three times more likely to die from pregnancy-related complications than white women, according to federal statistics. 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. New laws that criminalize abortion care are exacerbating the problem by restricting treatment for miscarriages, ectopic pregnancies and other complications.

“A lack of access to basic women’s health care jeopardizes the health of many pregnant people, particularly people of color. Women of color are two to three times more likely to experience maternal mortality than other groups, which is likely linked to the documented barriers to health care they already face, including lack of access to care, low socioeconomic status, provider bias,” said Nicole Mitchell, an OB-GYN with Keck Medicine of USC.

“Providing women’s health care to these patients, many of whom live in rural communities or states with little to no access to this type of care,” Mitchell continued, “is imperative to reduce the risk of pregnancy complications and maternal mortality, and to protect their personal agency to decide what is best for their health and well-being.”

Emily Smith-Greenaway, an associate professor of sociology and spatial sciences at USC Dornsife, analyzes the influence of mortality conditions on family systems, the impact of child loss on family dynamics and the consequences of community mortality conditions for women’s fertility.

Black Maternal Health Week: Focus provides snapshot of global situation

She said this week’s focus on the state of Black women’s health in the U.S. offers a snapshot of what we see on the global stage.

“Due to structural inequalities, colonial legacies and the pernicious effects of racism, Black women worldwide disproportionately experience poorer reproductive health outcomes — leading them to be more likely to experience maternal morbidity and mortality. And these reproductive inequalities have intergenerational effects,” Smith-Greenaway said. “Black children — from the time of birth — experience higher rates of morbidity and mortality.

“And although we typically think of these inequalities from an individual risk perspective — emphasizing how disparate health outcomes disproportionately burden Black mothers and their children — in my research I seek to emphasize that health disparities not only are reflections of the social and economic inequalities that define our globe but may also have a hand in perpetuating them.”