April 11–April 17 is Black Maternal Health Week, a week dedicated to amplifying the stories of Black mothers and elevating effective policies and solutions to eliminate racism, bias, and inequities in maternal care. To celebrate Black Maternal Health Week, Ready, Set, Soar Ohio has invited members of the Ready, Set, Soar coalition to participate in a Black maternal health Q&A. Throughout the week, we will be sharing Q&A articles featuring different experts on a range of topics related to Black maternal health.
Q: What does access to health care look like for Black mothers in your community?
Ryan Adcock: Black moms are about 15% less likely to access prenatal care during the first trimester than their white counterparts. And, they are about twice as likely to miss prenatal care entirely. We need to be thinking about these gaps as systemic failures rather than the result of individual choices. Redesigning prenatal care to better fit the need of Black moms should be a priority. This could include expanding hours, adding additional locations and expanding options like group prenatal care that may appeal to new audiences. Interestingly, when COVID-19 shifted care to include expanded tele-health options, we actually saw an increase in Black moms accessing prenatal care. When the pandemic ends, it may be important to keep some of these new solutions in place.
Q: How do we – whether as advocates, community leaders, health care providers, or policymakers – elevate the voices of Black mothers when addressing maternal health?
Mike Moroski: Black mothers are included in all of the conversations, work, and advocacy of the Cradle Cincinnati Policy Committee. A great example of this is our advocacy at the Ohio Statehouse regarding Doulas. After a couple years of socializing this important issue in Columbus, the Ohio House produced a bill sponsored by Representative Erica Crawley and a resulting Senate version sponsored by Senator Stephanie Kunze. While they did not pass, there is a new version of the bill that will likely be contained in the next state budget. It is imperative that Black women be at the table when these conversations happen and that it is not just advocates or lobbyists speaking on their behalf.
Q: What are examples of community approaches to supporting Black mothers and addressing racial disparities in maternal health?
Dr. Meredith Shockley-Smith: We center Black women in everything we do at Cradle Cincinnati and our community arm Queens Village Cincinnati. Queens Village’s strategy is the heart of our community approach: Gather Black women in a safe and supportive space that centers and celebrates them; ask them what they need and want; and give them the power and tools to activate those solutions. That may mean mediations workshops, entrepreneurship workforce programs, creative writing sessions or gardening groups.
Fundamentally, Queens Village is a supportive community of powerful Black women who come together to relax, repower and take care of ourselves and each other. We center Black women’s voices on changing not just racial disparities in birth outcomes but also the conditions that drive inequity in maternal and infant health. We provide a safe space for Black mothers to support and be supported by their peers, to connect, to relieve stress, to process trauma and to build a better world together for ourselves and our children.
Q: From your perspective, where are we as a state when it comes to Black maternal health?
Dr. Meredith Shockley-Smith: Cradle Cincinnati is focused on Hamilton County and Cincinnati, and here in the southwest corner of the state, we are making steady improvements though we still have a way to go. In 2019, we saw the fewest Black infant deaths in Hamilton County history, due to the fall in number of Black extreme preterm births—babies born before the end of their mother’s second trimester. In 2014-2018, Hamilton County averaged 59 Black infant deaths per year. In 2019, there were 45 Black infant deaths. To us, this is the single most important statistic of all to assess where we are at and how far we have to go.
Q: What will it take to get where we need to be? What are things that policymakers, government agencies, and health care providers must do to address racial disparities in maternal health?
Dr. Meredith Shockley-Smith and Mike Moroski: The implicit bias that drives many of the inequities in Black Maternal Health is fundamentally connected to self-perpetuating systems in our society. Only massive disruption will change the paradigm and center Black women in a system that for centuries has sought to keep them quiet. A place to start, particularly in the medical field, is enacting mandatory implicit bias and anti-racism training for all pre-med students in state-funded colleges and universities.
Beyond that, we need to think big and bold. We need politicians, legislators and policymakers who are not afraid to speak up for change beyond a well-written resolution. We need co-conspirators in every sector who are ready and willing to go beyond allyship and commit to action steps to change the system. A white policymaker, for example, needs to do more than have a "Black Lives Matter" Facebook photo - they need to make decisions that ensure Black lives actually matter.
Ryan Adcock is the Executive Director and Co-Founder of Cradle Cincinnati. Mike Moroski is the Partnership and Policy Manager at Cradle Cincinnati. Dr. Meredith Shockley-Smith is the Director of Community Strategies at Cradle Cincinnati. Learn more about Cradle Cincinnati and Queens Village by visiting www.cradlecincinnati.org/.