CA maternal mortality rate disproportionately impacts Black women; some turn to midwives for care

LOS ANGELES (KABC) -- In "Our America: Hidden Stories," local journalists shine a light on some of the issues covered in the new Hulu docuseries "The 1619 Project," which examines the country's history through the consequences of slavery.

Among the topics covered in the docuseries by Pulitzer prize-winning journalist Nikole Hannah-Jones are race and healthcare.

For example, locally and nationally, the maternal mortality rate disproportionately impacts Black women.

Eyewitness News learned how mothers, midwives, and community leaders are taking a different approach to birth and working toward solutions in California. In the U.S., the vast majority of births are in the care of OBGYNs.

For many, the shift to midwifery care outside of hospitals is influenced by the reality that Black individuals experience worse maternal health outcomes than their counterparts.

Between 2018-2021, the national maternal mortality rate steadily rose from 17.4 to 32.9 per 100,000 births.

"It scared me, the rate of maternal and infant mortality," said Roxanne Kalie-Rowe, who is preparing for her second home birth.

"What was really alarming was how high the caesarean rate is, especially for mothers who didn't experience high-risk pregnancies," added Kalie-Rowe.

Although racial or ethnic disparities in pregnancy-related deaths narrowed in California between 2017-2019, the ratio for Black individuals was still three to four times higher than all other groups.

"To think that because I am a Black woman, and by virtue of that fact alone, my birth experience proves detrimental either to the baby I'm delivering or to my very life," said Los Angeles County Supervisor Holly Mitchell.

Mitchell was a women's health advocate before holding elected office.

As a California state senator, Mitchell authored a bill signed into law that requires all perinatal healthcare providers to undergo implicit bias training.

"The data that we were exposed to, in terms of attitudes about Black women, by medical students; this notion that ... our skin is more difficult to penetrate, this notion that we have a higher tolerance for pain," said Mitchell.

Mitchell also authored a county motion passed this year that aims to increase access to doulas, a new Medi-Cal benefit.

"We wanted to take full advantage of this new Medi-Cal benefit and make sure that doulas are supported and brought into the system, so they could work collaboratively as quickly as possible with our Medi-Cal managed care network here in L.A. County," she said.

"I think a pillar of midwifery care is individualized care," said Allegra Hill, a midwife and lactation consultant who began as a doula.

Hill and Kimberly Durdin -- also a midwife and lactation consultant -- co-founded the Kindred Space LA birthing center in South Los Angeles, where they support individuals with low-risk pregnancies.

The Medical Board of California licenses midwives, while doulas are non-clinical healthcare workers who can provide support before, during, and after pregnancy.

Research shows that access to doulas and midwives can help improve health outcomes.

"We come from a long line of midwives, Black midwives, people taking care of their community, people actually giving a damn on if somebody has what they need to be healthy," said Hill.

Mitchell is named after her paternal great grandmother, Holly Blanks, who was a midwife in small town in Mississippi.

"There was a point in time where there was a real honor associated with the profession," said Mitchell. "As healthcare became more professionalized, it narrowed kind of the focus of who was perceived as an 'accepted' professional," Mitchell added.

Natalie Gouché gave birth to her first child in a hospital, her second in the car on the way to the hospital, her third at home in the care of Kindred Space LA and plans to do so again.

"You feel more at ease. You're more comfortable," said Gouché. "You are well taken care of and listened to which I think is something that a lot of women don't feel when they're in a hospital setting. They feel dismissed. I know that I did, and I have several friends that have experienced that as well," Gouché added.

"A lot of the time we just need to be reminded of what our power is and, and how normal birth can look," said Kalie-Rowe.

There are plans in place for each client who may want or need to seek hospital care during or after delivery. Increasing access to midwifery care to those who choose this path comes with challenges.

Midwives like Hill report hurdles preventing them from getting paid by private or public insurance.

"We submitted our application to become Medi-Cal providers two years ago, and it has not been approved yet," Hill said.

In the meantime, Hill said one organization has helped keep their center afloat by paying for some clients' midwifery care. They continue exploring ways to fundraise.

"Start doing the research. Start asking questions," said Kalie-Rowe. "You deserve to have the birth of your dreams. You deserve to have a life-changing experience-- you deserve it."