Black Maternal Health Week celebrates 10-year milestone

When the Black Mamas Matter Alliance launched Black Maternal Health Week a decade ago, it was a rallying cry against systemic oppression, reproductive injustices, and health inequities that continue to impact Black mothers and birthing people.

Ten years later, as the nation observes the 10th annual Black Maternal Health Week, under the theme “Rooted in Justice & Joy,” advocates, physicians, and birth workers across Houston say the movement has grown from a grassroots campaign into a national force, but the crisis that created it remains stubbornly alive.

In the United States, Black, non-Hispanic women experienced the highest rates of pregnancy-related deaths, being three times more likely to die from such causes compared to white, non-Hispanic women. This trend is also evident in Harris County, where from 2016 to 2020, Black women had the highest pregnancy-related death rate across all racial and ethnic groups, specifically 83.4 deaths per 100,000 live births.

Dr. Erica Giwa has delivered babies in Houston for 15 years. The Medical Director of OB-GYN at Legacy Community Health, the largest federally qualified health center in Texas, said she spent the first years of her career unaware of a Black maternal health crisis.

“I had been in practice five to seven years before I knew there was any issue,” Giwa said. “When I learned about it, I joined a work group to evaluate the first set of data, and the data was astounding.”

What the data revealed challenged the prevailing assumptions in medicine regarding the demographics of women who are dying at alarming rates. Initially, it was believed that these were low socioeconomic women lacking access to healthcare. However, further investigation shows that this is not the case; educated women with college degrees and good salaries are dying at a rate three times higher than their white and Hispanic counterparts.

“I think one of the successes of the last decade is that we’re more comfortable saying implicit bias is a factor, in casual conversation, in professional conversation,” Giwa said. “Everyone knows this is something we have to address.”

The extension of Medicaid postpartum coverage from six weeks to 12 months was a landmark policy win. But she pointed to two critical gaps that remain: The sustainability of community programs when grant funding runs out, and the urgent need for cardiology and obstetrics to work more closely together. 

“The number one cause of maternal death is cardiovascular disease,” Giwa said. “We are identifying high-risk patients in ways we never could before, but these two specialties need to come together more.”

Community advocates fight for mothers

Dr. Charlee King knows the system’s failures firsthand as a patient. The Houston-based certified lactation consultant and founder of Mommy’s Sweet Treats launched her business after her own hospital experience following childbirth left her without a single conversation about breastfeeding.

“I had tons of nurses come in and out of my room, but not one talked to me about breastfeeding and its benefits,” King said. “It made me feel like a horrible mother.”

That experience sent her back to school to earn lactation certification and ultimately led her to launch a company dedicated to filling the void. But beyond her business, King offered a pointed critique of where the movement still falls short.

“Houston still has the highest mortality rate of Black women dying during childbirth,” she said. “A lot of the assessments being used are not based on Black women; they’re based on a different demographic. I always say they use a ruler to measure Black women, where we need a yardstick.”

King also raised concerns about the commercialization of Black maternal health advocacy. “I’ve seen a whole bunch of businesses pop up. Are you doing this because you want to advocate for the community, or is this for profit?” she said. “If we can continue to lead with advocacy and the results, I’m all for it. But I don’t want us to lose the real goal.”

Representation of doulas and midwives

DeShaun Taylor has heard the word “free” come to mind when she thinks about Black Maternal Health Week and the way her profession is treated.

“Everything has started with midwives, flowed through midwives, and we are the cornerstone of Black maternal health,” said the licensed midwife and founder of Harmonious Birthing, who trains doulas and midwives across Houston and beyond. “But you look at the lineup for these panels, and there’s not one midwife included.”

Black midwives are significantly underrepresented in the healthcare industry in the United States, making up approximately 4.9% to 7.3% of the workforce. Despite the fact that culturally sensitive treatment is shown to improve results, more than 90% of midwives in the United States are white.

Taylor’s path into birth work was forged through trauma. Ten years ago, while serving in the Army, she experienced a catastrophic birth, denied informed consent, subjected to a procedure while begging providers to stop, and ultimately flatlined on the operating table.

“They still proceeded with the surgery before giving me another dose,” she said. “I ended up going into shock.”

After seeking help from the she sought help for significant memory loss that followed, Taylor eventually found her way to doula work, then pursued a four-year midwifery degree. Today, she has trained more than 100 doulas, is a registered preceptor with the North American Registry of Midwives, and has launched a midwifery academy to address a staggering gap. 

She attributed that shortage in part to the historical suppression of Black midwifery dating to the 18th and 19th centuries, when systemic barriers effectively pushed Black birth workers out of the profession. 

Access to resources such as doula services remains largely out-of-pocket in Texas, with Medicaid coverage limited and inconsistent. 

“The government needs to see us as providers so we can get credentialed. Streamline doulas into insurance policies the way they do for OB-GYNs and dentists. Let Black women know they have options,” Taylor said. “When someone becomes pregnant, no one at the doctor’s office is saying, ‘Did you know you can hire a doula? Have you thought about a midwife consultation?’ True justice starts there.”