California Forum

Pregnancy can be life-threatening for black women. SB 464 can change the equation

Black History Month has come and gone. It is a month that reminds us of the resilience, fortitude and strength black Americans have exhibited to stay alive and thrive in this country.

Black women in particular have borne the brunt of adverse experiences created by the nation’s racist foundations. While significant strides have been made, black women continue to suffer needlessly and disproportionately from the seeds of white supremacy that many of us continuously work to uproot.

The issue of black maternal mortality hit news cycles hard last year, prompted by tennis superstar Serena Williams’ revelation that her childbirth experience brought her near to death. Shortly after she gave birth, Williams knew – from decades of intimate knowledge about her body – that blood clots were forming. Yet she could barely get medical staff to pay attention. After demanding a CT scan and blood thinner, and after initially being ignored, she was eventually treated for life-threatening blood clots. This saved her life.

Another high profile black woman, TV Judge Glenda Hatchett, lost her daughter-in-law, Kira Johnson, hours after Kira gave birth to her second child at Cedars-Sinai Medical Center in Los Angeles. Kira and her husband, Charles, waited seven hours before a doctor ordered an internal exam. It took even longer for Kira to be taken to surgery to stop her bleeding. That was time Kira didn’t have to spare.

Those high-profile stories elevated the issue of black maternal mortality. Soon, story after story reported what black women have been saying for years – that no matter the level of education, career, or financial success achieved, being a black woman in America is hazardous. Why? Because even in 2019, the pain, knowledge and experiences of black women are not taken seriously. This is deadly.


The California Dignity in Pregnancy and Childbirth Act, Senate Bill 464, authored with Assemblymember Shirley Weber (D-San Diego) — co-sponsored by Western Center on Law & Poverty, ACT for Women and Girls, Black Women for Wellness, and NARAL Pro-Choice California — was introduced in the State Legislature to address this issue.

The bill would require all perinatal healthcare providers to undergo implicit bias training to curb the impact of bias on maternal health. The bill would also make California’s data collection of pregnancy-related deaths more robust. For example, it would require that data be sorted by county, facility, and racial and ethnic identity.

The national picture for maternal mortality in the United States is bleak. Ours is the only developed nation in the world where the maternal mortality rate is rising. In fact, the maternal mortality rate in the U.S. has doubled in the past two decades, and black women are three to four times more likely than white women to die in childbirth. Many of those deaths are considered preventable.

California is the only state to buck that trend. Since 2006, the overall maternal mortality rate in California has been cut in half, due in large part to the creation of the California Department of Public Health’s California Pregnancy-Associated Mortality Review (CA-PAMR) project, which tracks pregnancy-related deaths and makes recommendations for improvement of maternal care.

Holly Mitchell

Courtney McKinney
Courtney McKinney

Unfortunately, black women have not benefited from California’s progress in the matter. Black maternal deaths in California are still three to four times higher than the state average, which means that California remains, like the rest of the U.S., among the deadliest places for a black woman to have a baby in the industrialized world.

A 2018 report released by the CA-PAMR Board found that black women made up only five percent of the population that gave birth in California, but 21 percent of pregnancy-related deaths. The report also showed that 41 percent of California pregnancy-related deaths were likely preventable.

The idea of implementing implicit bias training to prevent negative outcomes related to race is not new. The business sector has already started to train employees on implicit bias – Starbucks is one of the higher profile examples. There is also a growing movement among medical schools toward implicit bias training, but much of it is voluntary.

SB 464 seeks to approach the issue with the same urgency the problem presents, which means implicit bias training would be required, not optional. This is not because the bill’s sponsors and authors assume the worst about medical providers, but because bias permeates the minds of everyone in a society – including medical professionals. By giving doctors, nurses and frontline providers the tools to identify their own assumptions and misconceptions, we can help improve outcomes for black mothers.

In 2019, there’s no reason black women in California should die from childbirth at rates that mirror developing nations. Ours is the 5th largest economy in the world. We’ve made a commitment to providing health care for our most vulnerable residents.

Since black women are among the most vulnerable when it comes to giving birth in our state, we must focus our attention and resources toward making sure they are properly cared for before, during and after they give birth.

Senator Holly J. Mitchell, a co-author of SB 464, is a state Senator representing California’s 30th District in Los Angeles. Courtney McKinney is the Associate Director of Communications for Western Center on Law & Poverty.