The Slatest

Congress Faces the Gut-Wrenching Facts of the Black Maternal Mortality Crisis

Rep. Cori Bush and others testify about the dangers of childbearing in America.

A woman holds her baby tightly.
Andrae Ricketts/Unsplash

“I didn’t think that there could even be a possibility that there could be a complication,” Missouri Rep. Cori Bush told the House Oversight Committee Thursday. Bush was testifying to her colleagues about the premature birth of her own son, Zion, as part of a hearing focusing on America’s ongoing Black maternal mortality crisis, as Congress considers the Black Maternal Health Momnibus Act of 2020.

Bush and other speakers offered gut-wrenching testimonies about the realities of Black experience with pregnancy and childbirth. Black people who give birth in the U.S. are three times as likely to experience maternal death during or after delivery as their white peers, who themselves die at a higher rate than in any other comparably wealthy nation. There’s no definitive reason for this atrocious outcome, but systemic racism, poor healthcare access, apathetic clinicians, and weathering all play a role in why the phenomenon transcends class and educational lines.

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In a 2019 study on how birthing people are treated by clinicians, 22.5 percent of Black patients reported experiencing some type of mistreatment. Black babies are also at risk since they are more likely to be born premature and more likely to die when treated by white doctors. And when Black women have access to Black doulas, they are more likely to survive birth and the period afterward.

The Momnibus Act is a broad collection of nine separate bills aimed at improving Black maternal health outcomes. One bill is centered on addressing the social determinants of Black maternal health—like housing, nutrition, and transportation—by creating a task force to come up with solutions. A second bill focuses on funding community organizations, while a third seeks to recruit perinatal workers who reflect a variety of backgrounds. This includes support for Black doulas and lactation consultants.

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Such data was given a specific, personal dimension in Thursday’s testimony. Below are some of the stories, edited for length and clarity, from Bush, actor Tatyana Ali, and Charles Johnson, the husband of Kira Johnson and founder of 4Kira4Moms.

Rep. Cori Bush

I sit here before you as a mother, a single mother of two. Zion, my eldest child was born at 23 weeks gestation versus what is considered a normal pregnancy of 40 weeks. When I was early in my pregnancy with him, I didn’t think that there could even be a possibility that there could be a complication.

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I became sick during my pregnancy. I had hyperemesis gravidarum, which was severe nausea and vomiting. I was constantly throwing up for the first four months of my pregnancy. Around five months, I went to see my doctor for a routine prenatal visit. As I was sitting in the doctor’s office, I noticed a picture on the wall that said, “If you feel like something is wrong, something is wrong. Tell your doctor.” I felt like something was wrong. So that’s what I did, I told my doctor that I was having severe pains. And she said, “Oh no, you’re fine. You’re fine. Go home. And I’ll see you next time.”

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I went home and, one week later, I went into preterm labor. At 23 weeks, my son was born at one pound, three ounces. His ears were still in his head. His eyes were still fused shut. His fingers were smaller than rice and his skin was translucent. A Black baby with translucent skin. You could see his lungs. He could fit within the palm of my hand.

We were told he had a zero percent chance of life. The chief of neonatal surgery happened to be in the hospital that morning and saw my case on the surgical board. And she decided to try to resuscitate him. It worked. For the first month of his life, Zion was on a ventilator fighting to live. For four months, he was in the neonatal care unit. The doctor who delivered my son apologized. She said, “You were right. And I didn’t listen to you. Give me another chance.”

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Two months later, I was pregnant again. So I went back to her. At 16 weeks, I went for an ultrasound at the clinic and saw a different doctor who was working that day. I found out again, I was in preterm labor. The doctor told me that the baby was going to abort. I said, “No, you have to do something.” But he was adamant.

“Just go home. Let it abort. You can get pregnant again because that’s what you people do.”

My sister Kelly was with me. We didn’t know what to do after the doctor left. We saw chairs sitting in the hallway. My sister picked up the chair and she threw it down the hallway. Nurses came running from everywhere to see what was wrong. A nurse called my doctor and she put me on the stretcher. The next morning, my doctor came in and placed a cerclage on my uterus. And I was able to carry my baby, my daughter, my angel, who is now 20 years old.

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My son who was saved is now 21 years old.

This is what desperation looks like—that chair flying down a hallway. This is what being your own advocate looks like. Every day, Black women are subjected to harsh and racist treatment during pregnancy and childbirth. Every day, Black women die because the system denies our humanity. It denied us patient care.

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Tatyana Ali 

I had a very healthy pregnancy and, when it came time, I was laboring and dilating normally. When my husband and I got to the hospital, it was like we were on a clock. I kept very close track of the hours. I remember [the clinicians] trying to get me to take an epidural though it wasn’t in my birth plan, interrupting me again and again, in the midst of my labor pains and making it seem imperative until finally we relented. I wanted to get onto my hands and knees to push because I could still feel my legs. But every time I tried five of the 10 people in the room, all screaming at me, at the top of their lungs, would push me back down. They’d pin me down by my feet.

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I could feel my baby’s wet hair here because he’d been crowned for hours. One doctor climbed up onto the side of the bed, pushed his forearm into my belly, squeezed downward. I could still feel the pain days later. And when my husband and I yelled no to the forceps, they used suction—a plunger. I screamed stop because they were aggressively popping it off of his head again and again. Without warning, one doctor pushed my baby all the way back inside me. I screamed in pain. My body started shaking uncontrollably, then I lost consciousness. When I woke up, I heard my baby cry.

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“That’s our baby,” I told my husband, “Don’t let them hurt him. Go, go and get him.” Then I went unconscious again.

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I remember the warmth that washed over me when I finally got to hold him. I remember two nurses, in particular, in the maternity ward who were kind and gentle with me. He spent four days in the NICU. The head pediatric urologist explained to us that it would take time for our baby to urinate on his own because of the traumatic nature of his birth. Our prayers were answered when he did and we could leave.

When we found out we were pregnant again we had to find another way. The first time we met our midwife, I felt like I had met her before. She’s a brilliant Black woman with a beautiful smile. Her laugh reminds me of my very own cousin, Valerie. I remember her spending hours with us visiting our home, helping my eldest as he was just learning to walk up the stairs on his own. I remember her asking for permission every time she touched my belly and never using a speculum or getting an intra-vaginal check, like my OBGYN did at every appointment. We decided to have a home birth and she gave us choices. She was a reservoir of information, never too busy to take a call or answer a text.

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Last minute, my youngest changed his position and went lateral. I had to have another C-section, but we had planned so thoroughly that we knew exactly which hospital would respect our team. When I broke down weeping after the anesthesiologist said I would feel nothing from the chest down again, my midwife prayed and held my feet. She knew my story and prepared me for the time when the trauma of my birth might return. She also knows that I believe in prayer. She knew me that well. She suggested that I walk into the OR instead of being put on a gurney in order to feel a sense of agency and autonomy that had been taken from me previously.

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I got to hold my youngest right after she entered the world. She latched right away. During postpartum visits with our midwife, she provided lactation support. She checked in on my baby’s growth, my physical wellness, my nutrition, my mental and emotional wellbeing, and how we were adjusting as a family. Both my babies were born via be a C-section, but the experiences could not have been more diametrically opposed. My eldest and I were not safe. My youngest and I, cared for by a Black midwife, were.

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The birth of my oldest was my first experience of a kind of institutionalized racism and paternalism that can kill. Throughout my advocacy efforts, I’ve heard firsthand stories of people in pain being dismissed, threatened, and called drug seeking. I’ve heard stories of the sheriff’s department coming to homes in the middle of the night because families refuse to take elective tests. I’ve heard stories of child services being called moments after babies are born because the parents seem unfit. The similarities amongst Black families and the treatment and similar outcomes for indigenous families and queer families and disabled families and incarcerated working people are stunning and they all have similar root causes.

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All pregnant and birthing people deserve to be treated with loving, patient-centered care.

Charles Johnson

I was fortunate enough to meet a woman who absolutely changed my life. And so when we talk about my wife Kira, we’re talking about sunshine personified. We’re talking about a woman who raised cars, who ran marathons, who spoke five languages fluently, and really challenged me to be a better man in every single aspect of my life. I’ve always wanted to be a father. And so I was ecstatic when we found that we were welcoming our son Charles V in September 2014. Kira and I always talked about how cool it would be to have back-to-back boys who would grow up being rambunctious best friends.

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We were absolutely over the moon when we found out we were welcoming our second son, Langston, in April 2016.

The painful irony is that, as a father and as a husband, you want the best for your family. You want the best for your wife. So we made the decision to give birth at Cedars Sinai Medical Center in Los Angeles because it was our understanding that this hospital had what was supposed to be a sterling reputation, particularly in the area of obstetrics and delivery.

On April 12th, 2016, we walked into [the hospital] on what we expected to be the happiest day of our lives and walked straight into a nightmare. It’s important to understand that throughout Kira’s entire pregnancy, she was not only in good health, she was in exceptional health. All signs pointed to both her and Langston being extremely healthy. So at our doctor’s recommendation, we went in for a routine scheduled C-section. Langston was born perfectly healthy—10 fingers, 10 toes, and we were overwhelmed with joy welcoming this tremendous gift into our lives.

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Shortly after birth, we were taken back to recovery, which is standard in a cesarean delivery. Kira was resting. I was watching her rest and Langston was in the incubator. And I was just soaking in the pride of being a father for the second time. Our family was finally complete.

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Then things began to take a turn for the worst. As I’m sitting there watching Kira rest, the catheter coming from her bedside began to turn pink with blood. This is around four o’clock in the afternoon. I brought it to the attention of the doctors and staff and they examined Kira physically. They took her vitals. They drew blood and they did an ultrasound. And very early on, they could see that her abdomen is beginning to fill with fluid. They ordered a CT scan. It was supposed to be performed … immediately.

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Five o’clock came. No CT scan. Six o’clock came, seven o’clock came. No scan. By seven o’clock, my wife is shivering uncontrollably because she’s losing so much blood. Eight o’clock comes. No scans. I’m begging and pleading, “Please do something! Help her!” At around nine o’clock, I pulled a nurse aside and I asked her to, “Please help me. My wife isn’t doing well. She’s weak. She’s in pain. She’s losing color. Please help me.”

And she responded to me, “Sir, your wife just isn’t a priority right now.”

Your wife isn’t a priority.

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Ten o’clock came. 11 o’clock came. And it wasn’t until after 12:30 AM that they finally made the decision to take Kira back for surgery. When they opened her up, there were three and a half liters of blood in my wife’s abdomen from where she’d been allowed to bleed and suffer needlessly for 10 hours.

Cries for help fell on deaf ears.

As I said when I was here in 2018, in support of the Preventing Maternal Deaths Act—and I’m  gonna say it again—you’re gonna hear from brilliant people, many of whom I look up to tremendously. And they’re gonna tell you about the statistics. But there’s no statistic that can quantify what it’s like to tell an 18 month old that his mommy’s never coming home. There’s no point in your data collection that can begin to measure the impact of what it is like to try to explain to a son who will never know his mother just how amazing she is.

I’m going to share with this committee a harsh truth: For all the wonderful work that you’re doing. You cannot legislate compassion. It was lack of compassion and lack of humanity that failed my wife and is failing Black mothers time and time again.

It was not my wife’s race that was a risk factor. She did everything right. It was racism. That was the risk factor. We must do better.

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