For example, hospitals in Black neighborhoods are more likely to close than those in White neighborhoods, making it difficult to find the care needed to stay healthy. Additionally, the quality of care that Black people receive is greatly affected by how they are treated by providers. Research has shown that many health care providers still hold false beliefs, such as beliefs of biological differences between Black and White patients, which influences how they treat them differently. This has potentially deadly consequences for Black patients whose experiences of pain or concern may be dismissed due simply because of the color of their skin.
While national attention has focused on the onset of the COVID-19 pandemic, limited focus has been placed on how this impacts pregnant and postpartum women’s health and experiences, and specifically Black women. Given the presence of multiple social and structural barriers and the higher rates of maternal mortality Black women already face, there are several concerns regarding how COVID-19 will impact Black maternal health:
- Patients not seeking care for prenatal or postpartum concerns due to fear of exposure
- Mothers and infants released from the hospital earlier than usual
- Limitations to the number of support persons mothers can have in the delivery room
- Providers cancelling or limiting appointments
- Increase in maternal mental health concerns with growing pandemic anxiety and isolation
- General misinformation surrounding the pandemic
Black women often experience implicit bias in many forms throughout the perinatal period. Their feelings of pain and discomfort may be dismissed by providers, leading to severe life-threatening consequences. In our current health system, which is overburdened with COVID-19 cases, this may be heightened. Additionally, to slow the spread of the virus, many hospitals and other clinical settings across the country are only allowing one support person in the delivery or patient room and some are not allowing visitors at all. Having loved ones or a doula present at birth improves the birthing experience by ensuring that women are supported and even advocated for in a way that Black women need.
In an effort to address these concerns, a number of Georgia-based stakeholders came together to develop a toolkit titled, Navigating Covid-19: Resources for Pregnant and Postpartum Families. Stakeholders wanted to make sure that families felt supported and informed to make decisions around the pregnancy and postpartum period that make them feel empowered. This resource is meant to provide guidance for families on how to plan for pregnancy, labor, and the postpartum period during the COVID-19 (coronavirus) pandemic.
Key Information and Resources
- Women with COVID-19 can breastfeed if they wear a mask (if available), wash hands thoroughly before, and clean the surfaces they touch.
- Regardless of visitor limits, a woman and her support person(s) should be treated with dignity and respect throughout the labor and delivery process.
- If a woman has pregnancy Medicaid coverage, this means coverage can continue beyond 60 days postpartum as long the public health emergency continues.
Due to the current public health emergency, navigating our health system may be difficult at this time. Resources within this toolkit include how to prepare for delivery, postpartum and infant health information, and how to apply for public benefits.
Advancing equity in maternal health and health outcomes requires multifaceted approaches that address systemic barriers. Doing so we will create a society where we will have healthier mothers, healthier children and ultimately healthier families. While some may not consider maternal mortality a priority at this time, given the current global pandemic, focusing on Black maternal health is necessary maybe now more than ever. The issues that face Black mothers have not disappeared and may be exacerbated by the coronavirus (COVID-19) pandemic, creating an even higher mortality rate.
Natalie D. Hernandez, PhD, MPH, is an assistant professor and interim director, Center for Maternal Health Equity at Morehouse School of Medicine. Amber Mack, MSW, is a research and policy analyst at Healthy Mothers Healthy Babies Coalition of Georgia.