U.S. Rep. Cori Bush served as a witness in her own congressional committee hearing on Thursday examining the Black maternal health crisis in America, providing emotional testimony about how she nearly lost the lives of her two children.
The 44-year-old congresswoman from St. Louis recalled sitting in her doctor’s office when she was five months pregnant and seeing a sign on the wall that read: “If you feel like something is wrong, something is wrong. Tell your doctor.”
Bush told her doctor about her severe abdominal pain, but her doctor dismissed it, saying, “Oh no, you’re fine. You’re fine. Go home, and I’ll see you next time.”
A week later, at just 23 weeks gestation, Bush went into labor. Her son, Zion, was born weighing just over a pound.
“His ears were still in his head. His eyes were still fused shut. His fingers were smaller than rice, and his skin was translucent.… We were told he had a zero percent chance of life,” Bush said.
Zion was on a ventilator for a month and in intensive care for four.
Bush’s doctor acknowledged not listening to her and asked for another chance. Two months later, Bush was pregnant again and decided to stick with the same doctor.
At 16 weeks, Bush went into preterm labor again. Another doctor told her she was going to lose the baby.
“I said, ‘No, you have to do something,’” Bush said. “But he was adamant, and he said, ‘Just go home. Let it abort. You can get pregnant again because that’s what you people do.’”
Bush’s sister was with her. They didn’t know what to do. So her sister picked up a chair and threw it down the hallway. Nurses came running.
A nurse put her on a stretcher and called Bush’s doctor, who placed a cervical cerclage on the opening to her uterus. Her daughter, Angel, is now 20. Zion is 21.
“This is what desperation looks like. That chair flying down a hallway,” Bush told the committee. “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.”
The hearing, held at the U.S. Capitol in Washington, D.C., was called by the House Committee on Oversight Reform to examine how racism in health care affects the disparities in Black maternal mortality, which has likely been worsened by the COVID-19 pandemic.
The maternal mortality rate in the U.S. ranks 55th in the world and is the worst among similarly developed nations. The risk falls more on America’s Black residents.
Black women giving birth in the U.S. are nearly three times more likely to experience pregnancy-related death than their white counterparts, data shows. They experience higher rates of pregnancy complications, infant loss and miscarriage.
“The CDC (Centers for Disease Control and Prevention) also estimates that 60% of these deaths are preventable,” said Rep. Carolyn Maloney, D-New York, chair of the committee. “America is failing Black people, and it does not have to be this way.”
In Missouri, disparities are more stark. According to the state’s latest annual report from 2017, Black women are four times more likely to die than white women. Sixty women died from pregnancy-related complications that year, and 80% were found to be preventable.
‘Listen to us’
Before the hearing, Bush participated in a press conference where she revealed how she’s told her birth stories countless times, but no one believed her.
“Listen to us, believe us,” she said, “because for so long, nobody has.”
The nearly four-hour hearing included testimony from about a dozen medical experts, researchers and those who experienced trauma or loss first-hand.
Many, including committee member Rep. Ayanna Pressley, D-Massachusetts, called the hearing historic. “It is not every day that a congressional hearing centers Black women and the experiences of Black people.”
Advocates described how research shows medical students believe that Black people don’t feel pain the same way white people do, how implicit bias and negative stereotypes lead to inequitable care. A patient’s socio-economic status doesn’t matter.
“Black women with college degrees are twice as likely to experience maternal mortality than white women without a high school diploma,” said Dr. Veronica Gillespie-Bell, medical director of the Louisiana Perinatal Quality Collaborative. “We’ve got the power to change that.”
Congressional leaders also spoke about federal policies and proposed legislation — such as the Black Maternal Health Momnibus Act of 2021 — that could improve health outcomes.
The Momnibus Act would take several actions such as: address social determinants of health such as housing, transportation; invest in community organizations moving the needle on health outcomes, grow and diversify the health care workforce caring for moms and babies; improve medical data collection; expand telehealth to treat mental health issues; and promote maternal vaccinations.
Because one-third of pregnancy-related deaths occur up to one year after giving birth, committee member Rep. Robin Kelly, D-Illinois, urged states to expand Medicaid coverage to women up to one year after giving birth. Half of all births in the U.S. are covered by Medicaid, yet coverage ends 60 days after giving birth.
Last month, Illinois became the first state in the U.S. to extend Medicaid coverage to 12 months postpartum.
In Missouri, where approximately 24,000 women lose their Medicaid coverage two months after giving birth, the Legislature extended coverage up to 12 months for those with a substance use disorder diagnosis and is waiting federal approval to include those receiving treatment for postpartum depression or other mental condition, according to Generate Health St. Louis.
‘A harsh truth’
No matter what great policies are in place, however, they will not work unless racism is addressed, testified Charles Johnson. His wife Kira died five years ago, 12 hours after giving birth to their second son at Cedars-Sinai Medical Center in Los Angeles.
His wife had a healthy pregnancy and went in for a scheduled C-section. After the delivery, doctors found blood in her urine and ordered a CT scan immediately — per protocol to prevent hemorrhaging, a leading cause of maternal deaths.
Nothing was done for hours, however. Johnson said he repeatedly begged staff to help his wife as he watched her shiver and lose blood.
He was told, “Sir, your wife just isn’t a priority right now.”
When she finally was taken in to surgery, her abdomen was filled with three and a half liters of blood.
“I’m going to share with this committee a harsh truth. That truth is, for all the wonderful work you are doing, you cannot legislate compassion … and it was lack of compassion lack of humanity that failed my wife and is failing Black mothers time and time and again,” Johnson said. “It was not my wife’s race that was a risk factor. She did everything right. It was racism that was the risk factor, and we must do better.”