Rep. Liz Miranda

New commission will probe maternal health

Legislation passed at the State House last week will create a commission to investigate racial disparities related to maternal health. The bill, created by Rep. Liz Miranda, Rep. Kay Khan and Sen. Rebecca Rausch, is meant to address the crisis of Black women dying in pregnancy and childbirth at higher rates than white women.

This special legislative commission will investigate the racial disparities related to maternal health. The issue came to the forefront recently when the National Center for Health Statistics released the first standardized maternal mortality data for all 50 states. The report showed that 658 women died of maternal causes in 2018 in the U.S., and the death rate for Black women was two-and-a-half times higher than for white women.

Dr. Ndidiamaka Amutah-Onukagha, a professor at Tufts University, worked with Miranda and several other women on the formation of the bill. Her research is focused on maternal health disparities.

“There is a disproportionate burden as it relates to maternal mortality and severe maternal morbidity, and that is also the case here in Massachusetts,” Amutah-Onukagha told the Banner.

“From the outside looking in, [Massachusetts] has great healthcare, tremendous hospitals, but we know that disparities still exist,” she said.

The commission will have 25 members, likely led by Black women who are midwives, doulas, nurses, researchers and community members who have survived a dangerous childbirth experience. If signed into law, two of the commission’s members will be appointed by the governor.

The purpose of the group, Amutah-Onukagha said, is to put together a set of recommendations that will change the way maternal health care is delivered in Massachusetts.

“Addressing severe maternal morbidity and maternal mortality

is a multifaceted problem,” she said. “You have to address it from multiple lenses, including acknowledging the role of structural and institutional racism in the way Black women are treated when we walk into clinical encounters.”

The bill passed in the House as a 23-member commission in July and included a member of the Massachusetts Maternal Mortality & Morbidity Review Committee. That committee’s latest review in 2017 found that the mortality rate for pregnant Black women in Massachusetts alone was almost two times higher than that of non-Hispanic white women.

Though recent legislation on a state and city level has been focused on racial justice through police reform, this bill is intended to pursue racial justice in other Massachusetts institutions.

“Maternal justice is racial justice,” Miranda said in a statement.

“This legislation allows us to approach the maternal mortality crisis as both a racial justice and public health issue by seeking to understand both the socioeconomic determinants of health while also tackling the issue of racism head-on.”

Some issues already at the forefront of maternal care are the use of doulas in the Black community, major complications like preeclampsia, and medical biases that endanger Black women. Amutah-Onukagha founded the MOTHER Lab at Tufts to continue research into these topics, and half of its members are Black women, many of them undergraduate students.

If the bill is signed into law, the new commission’s work would begin in March 2021 and likely review the research done at the lab.

Legislators also worked with Brandy Watts, community action network coordinator for the Boston Public Health Commission’s Healthy Start Initiative. In this role, Watts raises awareness for racial health inequities in maternal and child health. Miranda also credited maternal health advocates Timoria McQueen Saba and Nneka Hall, members of NARAL Pro-Choice Massachusetts, and the Massachusetts Medical Society.