Senate Bill 464 Confronts Black Maternity’s Outrageous Mortality Rate

A key Senate panel today approved a plan confronting the higher rate of California Black women dying during childbirth at a much higher rate than women of other racial and ethnic groups.

As approved by the Senate Health Committee, the Dignity in Pregnancy and Childbirth Act, by Sen. Holly J. Mitchell, seeks to reduce pregnancy-related preventable deaths and associated health disparities by addressing implicit bias among perinatal health providers.

Senate Bill 464 would establish a training program to help medical professionals identify and correct unconscious or conscious biases and misinformation. The program will also address personal, interpersonal, institutional, structural and cultural barriers to health care access.

The bill confronts a profound injustice, unknown to many Californians, that has baffled health professionals until recently. In California, the rate of maternal mortality has decreased 55 percent since 2006. For women of color, however, and particularly Black women, the maternal mortality rate remains three to four times higher than white women. Although Black women make up only 5 percent of the birth cohort in California, they comprise 21 percent of pregnancy-related deaths.

Studies have concluded that disparity is not explained by socioeconomic status, access to prenatal care, education level and general physical health.

Middle- to high-income Black mothers have worse birthing outcomes than white women in abject poverty. Black women who are non-smokers have worse birthing outcomes than white women who smoke a cigarette every day.

Evidence now points to implicit bias as one of the causes for the wide disparities seen between Black women’s maternal mortality numbers and those of other ethnic groups.

According to the California Birth Equity collaborative, an initiative at Stanford University’s California Maternal Quality of Care Collaborative, increasing evidence points to racism, within and across multiple levels, and not race, as a key cause of these disparities.

A 2016 study by University of Virginia researchers found that white medical students believed biological myths about racial differences in patients, including that Black patients have less sensitive nerve endings, are able to tolerate more pain, and have thicker skin than their white counterparts.

SB 464 is supported by a broad coalition from throughout the state, including women’s rights groups, community activists, academics, reproductive rights organizations, and advocates for children and women of color.

“California has a responsibility to ensure that all its residents can have safe and dignified pregnancy and childbirth,” Mitchell said. “By preparing perinatal medical providers to better care for mothers in some of the most vulnerable moments in their lives, this bill will preserve lives so that childbirth becomes a joyful moment for all mothers, and not a life-threatening event for Black mothers.”

California has plenty of reasons to celebrate the recent downward trend in maternal deaths. The Dignity in Pregnancy and Childbirth Act takes the state one step closer to being able to fully celebrate that trend by making it inclusive, and ensuring that all women benefit from improvements in our health care system.

SB 464 will next be reviewed by the Senate Appropriations Committee. A hearing date has not yet been set.

Ray Soteros

The Actors' Gang

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