Mass. AG awards $1.5 million in grants to address maternal health inequities

Massachusetts Attorney General Andrea Campbell awarded $1.5 million in grants to 11 organizations to address a “maternal health crisis.”

The announcement was made at Whittier Street Health Center — one of the recipients — in Roxbury with members of the other ten recipients.

“We each have a role to play in addressing the maternal health crisis in Massachusetts where, for example, Black birthing people experience the highest rates of labor and delivery complications compared to other races and ethnicities," said Campbell. “I’m proud that my office is leveraging its grant making tool to do exactly that.”

Beyond addressing birthing, the grants are going to organizations to address prenatal, perinatal care, increase access to doulas and breastfeeding support.

Inequality and childbirth

According to a recent Department of Public Health report cited by Campbell, severe maternal morbidity nearly doubled in Massachusetts from 2011 to 2020.

“We've used this as a call to action for many across the commonwealth to really increase monitoring and support for birthing people and to really focus our attention on those who are at greatest risk,” said Department of Public Health commissioner Dr. Robbie Goldstein to GBH News.

Of people facing complications with birth, Black, non-Hispanic birthing people are consistently experiencing the highest rates of complication, said the report.

One of those individuals was Kimberly Owens.

“Each time she went to the hospital to deliver her children, providers, physicians who met whomever was responsible for her care did not listen to her when she said that her baby is going to be coming sooner than the due date,” her sister Donnette McManus told GBH News.

The due date mentioned by Owens' physician was August 5, 2019.

Her baby was born on July 24, and Owens died soon after at a Massachusetts hospital, at the age of 39. “August 5, 2019 was the date that she was buried,” said McManus.

She is raising her three nieces and was part of the Special Commission on Racial Inequities in Maternal Health.

“I realized that she [Owens] is among the many African American mothers who died due to negligence, bad healthcare, and a lack of understanding,” said McManus in the report. “What questions should mothers ask? Why don’t healthcare providers listen? Who is ultimately responsible? What could have been done to prevent our loss and other families’ losses?”

Where the money goes

Recommendations issued by the commission's report ranged from expanding cultural competency training of providers; improving accountability for providers when a mother dies or is harmed; expanding reimbursement parity for certified nurse midwives to getting additional data from state agencies and the medical examiner’s office to examine inequities.

Mother’s Milk Bank Northeast serves over 100 hospitals in the region by providing pasteurized donor milk to premature babies, and is receiving $128,000 in grant money. Donor milk isn’t covered by MassHealth insurance in most circumstances.

“We'll be using the funds to subsidize donor milk so that it's equitably available to less-resourced families across the state,” said Deborah Youngblood, executive director. She said they’ll also promote “culturally competent education — so that people understand the benefits and the uses for donor milk.”

Cambridge Health Alliance Foundation will use their funds to rebuild its doula program, which suffered from provider burnout and loss of staff. They’ll hire multilingual doulas and train them to assist their 200 annual patients.

“I think we have to think about providers that understand the culture and the language of where our patients are coming from and engaging in care and building trust for those patients,” said Dr. Tara Singh, Cambridge Health Alliance's chief of obstetrics and gynecology.

At Whittier Street Health Center, a $150,000 grant will be used for prenatal and postpartum care, mental health services and hiring culturally competent staff.

“What the data is showing that part of what is causing the maternal mortality is, you know, things such as structural racism, implicit bias and lack of access to culturally competent care,” said President Frederica Williams.

Another solution to bolster the community birth infrastructure. That, State Senator Jo Comerford said, was addressed in this year’s budget with the inclusion of $250,000 to Seven Sisters Midwifery and Community Birth Center, Massachusetts’ last freestanding birth center in Northampton.

“They want to set up a doula program that is quite diverse, that would pull doulas and train them for accreditation. So the Senate pushed that through,” she said.

Another budget item includes $1 million to create more birth centers. There’s another $350,000 for a Maternal Mortality and Morbidity Review Committee to study maternal deaths and pregnancy complications, and make recommendations to change those outcomes.

Goldstein says his office is starting to see improvements in maternal health outcomes, but solutions can come from the smallest things.

“If we do better monitoring of blood pressure, we will see better maternal health outcomes from that. That’s a pretty easy program to implement in healthcare systems,” he said.

Other grant recipients include Berkshire Medical Center, Cape Cod Children’s Place and Greater Lawerence Family Health Center.