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Birth and reproductive justice is a human right. So why aren’t more and more providers honoring this? Why must mothers keep dying?

Especially in Onondaga County, with the maternal mortality rate over 85% higher than the national average, attention to birth justice should be heightened. The 2020 NYS Vital Statistics reported that the maternal mortality rate for the county increased from 12.9 per 100,000 live births to 32.2 between 2015 – 2018, with diminishing performance in 2023. As I tried to dig deeper for additional context as to what is driving the increase of maternal deaths in our county, the answers were nowhere to be found.

I read through Onondaga County’s 2019 Health Department Annual Report to search for more answers: the term maternal mortality was only mentioned once. I read through Onondaga County’s 2022 – 2024 Community Health Assessment and Improvement Plan , looking for anything that addresses the outrageously high increase in maternal deaths, but found nothing. So again I ask, why aren’t more people sounding the alarm around this issue?

If you were to Google main causes of maternal deaths in New York state, you’ll find that since 2012, the top five causes of pregnancy-related deaths were embolism, 52%; hemorrhage, 20%; cardiomyopathy, 44.4%; hypetensive disorders, 3.9%; and infection, 2.6%.

The majority of pregnancy-related deaths occur during the final week of pregnancy, yet many postpartum mothers aren’t scheduled to be seen by their provider until six weeks after birth.

Readily accessible statistics that give a more honest look into the maternal deaths in NYS and in our county aren’t available to us. These are statistics stemming from medical neglect, medical coercion, profit-centered hospital policies, racist attitudes and unilateral decision making.

In my quest to achieve birth and reproductive justice, it is these forgotten stories I remember.

This absence of transparency calls to mind how many pre-med and medical students I’ve encountered over the years have no idea what the origins of modern day gynecological practices are in the United States.

It is far more convenient for medical schools to leave out that Dr. Marion Sims, known as the “Father of Modern Gynecology,” used enslaved Black women as test subjects to advance surgical techniques. The lack of awareness regarding how Black women’s bodies were simply collateral damage, from slavery to present day, informs the type of care we receive. The foundation of gynecology is rooted in the disregard of Black women’s bodily autonomy, which remains prevalent in our present society.

As a birthworker, I have witnessed a fair share of birthing experiences that were exacerbated by such racist methods and medical interventions. I’ve had countless clients tell me the reason they wanted me to be their doula is because they didn’t want to die while giving birth.

There is a popular false notion that doulas are the answer to maternal mortality. Often, I have to push back against this belief, because we cannot be the sole solution. Oftentimes we, as Black women, even experience the same maternal morbidity and mortality as our clients.

Healthcare providers who refuse to change their style of practice, who refuse to see birthing people as capable of making informed decisions are contributing to the rise of maternal mortality and morbidity. Providers cannot expect Black mothers to simply trust their years of experience and education when so many of our sisters, cousins, best friends, aunties and mothers relay such horror stories around giving birth.

This is why I write and fight for those marginalized:

• My client who sat in an emergency room waiting room for forty minutes bleeding through her lavender dress from a placental abruption, which resulted in her having to have an emergency c-section and delivery at twenty five weeks gestation. Earlier that day, she called her doctor’s office with complaints of labor pain, but was told to drink water and put up her feet.
• My countless clients who have been coerced into labor inductions despite making it clear to their providers that they wanted to go into labor spontaneously.
• My client whose obstetrician stood in the doorway of her hospital room, blocking her from going for a walk to naturally encourage her baby to descend into her birth canal. She was told by the same doctor that if she didn’t have the baby within a certain amount of time he was going to “go in there and get him.”
• My client who had a Child Protective Services case wrongfully opened up against her because she decided to give birth in the safety of her home with those who she trusted.
• My client was told she couldn’t labor in water because there weren’t any waterproof mobile fetal heart monitors on the labor and delivery floor, only for the missing equipment to miraculously appear after my client avidly advocated for herself and her needs.
• Nurses who begin administering intravenous Pitocin without asking for the patient’s consent or even informing her of what is being placed in her body.

Birthing people are being forced to labor in bed and without the opportunity to use gravity and movement to progress labor.

I cringe every time I hear a healthcare provider say “at least mom has a healthy baby” directly after their patient has gone through a very traumatic experience in childbirth. We should want more than healthy babies after birth. We should want birthing people to still feel whole, not feel like a vessel who has been shown no regard for their mental health or well-being. We need to raise the bar on what is acceptable maternity care. It is not fair that birthing people, especially Black people, have to go into labor on defense because they are chronically aware of what they are up against: a racist, ableist, xenophobic and profit-driven health care system.

If you’ve read this far, maybe you’re wondering, “What can I do to join the fight against maternal mortality in our local community?” Know that there are multi-faceted solutions.

First off, we need systems of accountability. Why are providers allowed to continue physically, mentally and emotionally scarring mothers with impunity? Parents should be able to go home, bond and snuggle with their babies without flashbacks to the trauma inflicted upon them during childbirth.

Secondly, legislation needs to be implemented that focuses on preventative solutions.

You must recognize that the experiences of birthing people are heavily impacted by the medical industrial complex that places a huge emphasis on maximizing profit over saving lives. You must understand who within our community has the power to make long-lasting changes for the betterment of maternal health outcomes.

Here at Syracuse, you can start by urging the Mayor’s Office and Syracuse Common Council to implement and fund a city-wide initiative to advance community-based doula care through Sankofa Reproductive Health and Healing Center, which would allow us to continue the life saving work we’ve been doing for the past decade. Doulas are not health care providers, but for some reason, city officials continue to push the narrative that they cannot fund community-based solutions for maternal health when they have funded public health-related issues such as gun violence and COVID-19 education and prevention efforts.

Moreover, you can join birth workers in contacting our NYS legislators to support the Certified Professional Midwifery Bill. Although certified professional midwives are highly skilled and capable of supporting healthy, low-risk pregnancies in the home setting, they have yet to receive a pathway to licensure in the state of New York. Expanding access to community-based, midwifery-led care is a necessity to address our current maternal mortality crisis.

Arlo Stone | Design Editor

Lastly, expanding our education in reproductive care is essential.

Health care providers and legislators need to reflect on how racism and white supremacy has affected us all, especially in healthcare. We need an unrelenting commitment to unlearning negative stereotypes and validating myths, and to relearn the truths about racial medical history that are often omitted. We need health care providers dedicated to reproductive justice. We need obstetricians who understand that in labor and childbirth, medical interventions are not always necessary.

If you are in a position of power at Syracuse University, SUNY Upstate Medical University, Crouse Hospital, St. Joseph’s Hospital Health Center, Upstate Community or any of the other healthcare and educational institutions in Onondaga County, I urge you to use your sphere of influence and leverage your position of power to make birth justice a reality in Central New York.

Institutions can leverage their power by ensuring Black-led reproductive justice organizations such as Sankofa Reproductive Health and Healing Center and Doula 4 a Queen have a no-strings attached space to offer care to families at most risk for dying or being harmed in childbirth.

Local hospitals and healthcare facilities need to make anti-racist medical care a priority, which would include more effort than a few guest presentations from community-based organizations. Anti-racist frameworks need to be embedded in the curriculum.

What are you willing to do to save the lives of your neighbors and fellow community members?

SeQuoia Kemp is a Nurse , Certified community-based Doula and founder of Doula 4 a Queen and co-founder of Sankofa Reproductive Health and Healing Center.

Published on February 8, 2023 at 11:52 pm