New Black mothers in Illinois are dying at alarming rates
Even before certified nurse midwife Lakieta Edwards launched her own practice earlier this year, calls poured in during the pandemic from local pregnant women searching for support from a Black medical professional.
While some women are comforted knowing they’ll have family or friends in the delivery room to advocate for them, early pandemic visitor restrictions meant many would be giving birth alone.
They’re thinking, “I’m not going to have my people there with me, I might die,” said Edwards, who in January launched Chicago Nurse Midwife—which provides well-woman exams, prenatal and postpartum care, and home birth services—”out of necessity because literally women were crying out for this.” All but two of Edwards’ current patients are women of color who live on the South Side.
Black women in Illinois are nearly three times as likely as white women to die of a pregnancy-related condition, according to a new report from the Illinois Department of Public Health, which analyzed 129 deaths that occurred in 2016 and 2017. During that period, 83% of deaths among women who were pregnant or within one year of pregnancy were “potentially preventable.”
While Black women were more likely to die from pregnancy-related medical conditions, including chronic disease, white women were more likely to die from pregnancy-related mental health conditions, such as suicide or drug overdose, the report says.
The disparity has narrowed since the state released its 2018 report, which found that Black women were more than six times as likely as white women to die from a pregnancy-related condition. However, “it is not due to conditions improving for Black women, but is instead due to worsening conditions for white women,” IDPH Director Dr. Ngozi Ezike said during a press briefing Thursday. “Any amount of disparity between the groups is unacceptable.”
A lack of access to medical care is a primary driver of poor outcomes among pregnant women of color, according to industry experts.
Mounting expenses and dwindling inpatient volumes have led several hospitals serving Black and Brown communities to shutter or cut service lines in recent years. St. Bernard Hospital and Holy Cross Hospital last year moved to discontinue labor & delivery services. And Jackson Park Hospital & Medical Center closed its 17-bed obstetrics unit in 2019.
“Sometimes for smaller institutions it’s a struggle to maintain a service such as this,” said Dr. Dakisha Lewis, medical director and chair of obstetrics and gynecology at Advocate Trinity Hospital in Calumet Heights. “It’s not a service that necessarily brings in top dollar, but it’s an emergency service needed in the community.”
There are 92 obstetrician-gynecologists per 100,000 residents on the South Side, compared with 229 obstetrician-gynecologists per 100,000 on the North Side, according to the Health Care Council of Chicago’s February report on the future of safety-net hospitals.
While some health systems have opened clinics on the South Side, women often are directed to facilities in other areas—the Illinois Medical District on the Near West Side, for example—when it comes time to give birth or address certain concerns, Edwards said, noting that many women find it difficult to connect with providers if they’re seeing a different person every time they go to the doctor’s office.
Advocate Aurora Health, which runs Advocate Trinity Hospital, is working with federally-qualified health centers to create “a pipeline between the patients they see in the office and giving those patients a hospital home,” Lewis said. The 26-hospital system also is looking to develop agreements with area hospitals that have closed their labor and delivery units to ensure patients have a place to go for care, she said.
It’s not uncommon for women of color show up to the emergency department saying, “This is my fourth baby. I tried to see a provider once and had trouble getting an appointment,” Lewis said. Going without prenatal care “leads to higher-risk delivery and increased risk for perinatal morbidity—and sometimes even increased risk for mortality.”
Mercy Hospital & Medical Center’s impending sale to a Michigan biomedical technology firm will preserve access to comprehensive maternity services in Bronzeville. Elected officials and community members rallied against Mercy’s initial plan to close, with many saying that losing access to maternal health services in the area would be detrimental for residents.
Meanwhile, the state has been working for years to better understand pregnancy-related complications and deaths—particularly among women of color, who have higher rates of poor health outcomes.
Earlier this month, Illinois became the first state to extend Medicaid benefits for new moms to 12 months postpartum from just 60 days to improve health outcomes. The state also moved to cover doula services for those one Medicaid. And a bill introduced earlier this year by state Rep. Robyn Gabel, (D-Evanston), aims to increase the number of birthing centers in Illinois, with a focus on certain areas—including Chicago’s South Side—to address “disparate perinatal and child health outcomes.”
Among Chicago women who experienced a pregnancy-associated death, 71 percent were covered by Medicaid (the government-run health insurance program for low-income people) and 19 percent had private insurance, according to a 2019 report from the Chicago Department of Public Health.