Health groups are calling for a suspension of the state's plan on maternal mortality, saying it is a burden on patients

Dozens of maternal health organizations and advocates are urging California’s surgeon general to suspend the rollout of a plan aimed at reducing maternal mortalitysaying the recently announced initiative will not effectively tackle the crisis and “risks exacerbating existing inequalities”.

In a letter to The Times, representatives from organizations including the California Black Women’s Health Project, Black Women for Wellness and the California Nurse-Midwives Assn. criticized the plan for “unnecessarily burdening individuals” and failing to “explicitly identify and address racism as a root cause of maternal health inequality.”

The Blueprint for Maternal Health in California which was unveiled in September, includes strategies to try to reduce maternal mortality. Among them: Prompting Californians of childbearing age to fill out a new questionnaire to assess their risk of pregnancy complications, even before they become pregnant.

In their October 21 letter to State Surgeon General Dr. Diana Ramos, the advocacy groups said the Maternal Health Blueprint recognized racial disparities in maternal mortality rates but did not “ground those disparities in the evidence showing that systemic racism was the driving factor.” .”

Asked for comment on the letter, the state surgeon general’s office issued a statement saying it was “committed to working with partners across the state … to improve maternal health outcomes, reduce maternal mortality and save the lives of California mothers and pregnant women. people.”

Black women have faced a maternal mortality rate three times that of white women in California, show state data. The Centers for Disease Control and Prevention has done just that many factors blamedincluding health care disparities and underlying chronic conditions, as well as structural racism and implicit bias.

Studies have shown that disparities exist even for affluent black women, prompting maternal health researchers to increasingly focus on racial inequities in health care. prejudice And discrimination experienced by patients, and the physical consequences thereof chronic stress of enduring racism over time.

In an interview in September, Ramos said California’s previous efforts to prevent maternal deaths had focused on “health care,” allowing it to achieve “the lowest maternal mortality rate in the country.”

As it stands now, California has one much lower rate of deaths from pregnancy, childbirth, and their aftermath than in other parts of the U.S., although maternal mortality has soared in recent years due to the COVID-19 pandemic. The state is held up as an example to itself system for assessing maternal mortality.

“If we keep doing the same thing — just focusing on the care team — we will get the same results,” Ramos said in September, explaining why the newly announced plan emphasized patients knowing their risk level. “That’s why we bring in the patient.”

The Maternal Health Blueprint sets a goal of having at least 50% of “individuals of reproductive age” across the state complete a questionnaire about their risk of pregnancy complications by December 2026.

In the letter objecting to the plan, the coalition of groups said that the call for people to complete such a questionnaire “gives the impression of personal guilt and/or that individual behavior is to blame, thus making the user burdened and the role of the system in creating problems is discredited. this crisis.”

The groups said they knew of no research supporting ‘personal risk assessment’ as a way to improve outcomes for people giving birth. The blueprint also does not clearly describe next steps or what will happen to the data, their letter argued.

Dana Sherrod, co-founder and executive director of the California Coalition for Black Birth Justice, said that “omitting mention of systemic racism puts the blame back on patients.” The only time the term “systemic racism” appears in the blueprint is in reference to someone else’s findings state report.

Sherrod said that even when other factors are taken into account, “black women still have worse outcomes.” For example, one analysis of maternal mortality in California found that black mothers with the highest incomes had worse pregnancy-related mortality than white mothers with the lowest incomes.

A lot previous study found that black women did not have significantly higher rates of preeclampsia, postpartum hemorrhage, and other serious complications than white women, but that black women with such complications were two to three times more likely to die from them than white women with such conditions.

Even if “they are a healthy weight, educated and married — the things that should be protective — even if they do all these things, we still see poor outcomes,” Sherrod said.

The California plan also calls for the use of medical facilities an existing screening instrument to measure the risk levels of pregnant patients. Ramos told The Times that such screening could help determine where patients go for delivery, and ensure those at higher risk go to the facilities best equipped to support them.

However, the coalition warned that this could “further marginalize high-risk populations and divert resources away from struggling facilities, while at the same time overburdening higher-level facilities.” California is already facing ‘critical maternity care shortages’ the labor and delivery wards are closedthey pointed out.

“It’s already very difficult for many people to navigate the health care system and understand where to go to get the best care,” Sherrod said, “and this potentially makes that even more complicated.”

Coalition leaders are seeking a meeting with Ramos and with first partner Jennifer Siebel Newsom, wife of Gov. Gavin Newsom, who joined Ramos announcing the plan in September.

Ramos’ office said in its statement Monday that since the launch of their initiative, “Dr. Diana Ramos has met with several partners in maternal health and will continue to meet with others, including coalition members, to identify opportunities to collaborate. .”

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This story originally appeared in Los Angeles Times.