From the DCMaternalHealth.com website. Via screenshot
On Wednesday, September 12, Mayor Muriel Bowser kicked off the inaugural Maternal and Infant Health Summit. Together with a powerful roster of panelists that included mayors from cities around the country as well as doctors, specialists, agency directors and prominent female thought leaders, Mayor Bowser spent a day talking about an issue that is both a citywide crisis and a cause dear to her heart as she becomes a mother to baby Miranda.
The District’s maternal mortality rate as of 2018 hovers around 36.1 deaths per 100,000 live births (down from 40.1 in 2016), which is close to double the countrywide rate of 20.8, according to the United Health Foundation. The fact that the nation’s capital could have such a sustained crisis and such alarming numbers seems especially unacceptable, which is why this summit is timely. The Mayor seemed confident and in her element leading the mayors’ panel– the first session of the day– and acknowledging that this crisis, much like Flint, Michigan’s water crisis or Rochester, New York’s lead crisis, are problems that can be fixed by learning lessons from the past, connecting with people who have gone through these tough spots, and using technology and follow-up in order to increase the well-being of a population.
We look forward to seeing what kinds of concrete results come off this summit. One of the goals stated on the lavish program was for attendees to have the “opportunity to connect with each other and engage with thought leaders between sessions and at the health fair following the event.” This is promising and we look forward to seeing how the Mayor’s office will follow up with these interactions. I did a little connecting and engaging myself, and talked to Judy Berman, deputy director at DC Appleseed, a non-profit dedicated to finding solutions that improve the quality of life for DC residents; and to Laura Brown, executive director of First Shift Justice Project, an organization devoted to fighting for low-income parents’ and pregnant women’s rights.
When I asked Judy what she thought could make a difference in terms of maternal and infant mortality, she said, “A really robust home visiting program. It can bridge the pre- and postnatal periods and has proven outcomes. DC puts minimal local resources there and hasn’t effectively addressed the uptake issues. Also, expanded doula options. I don’t believe any of the Medicaid providers pay for doulas—again, proven outcomes. And I want to see her commit to full funding of Birth to Three for All. It’s big money over the next decade but it’s truly groundbreaking stuff.”
Laura felt that the summit “expressed a value on maternal health, which is important, and it was very well-attended, which is also important.” However, she had issues with the approach. “The focus was too much on experts and not enough on the lived experience of women in this community. The two stories [from the panel on D.C. moms] were essentially success stories, but if all the services we offer here in DC are so great, why are so many women and kids dying?”
She continued: “There are many issues that touch on [infant and maternal mortality], but you can’t tackle them all at once. To establish priorities… they need to collect stories from women in Wards 7 and 8, which are the wards most impacted, especially the morbidities; the families of the moms who died, as well as moms who had infants who died… After priorities are established, the experts and professionals can find other groups who have addressed these issues and adopt best practices and solutions tailored to DC.”
Judy echoed those sentiments: “This has been a problem for a long time, but newly publicized. Serena Williams’s situation also helped [raise public awareness of the problem] because it could no longer be relegated to the poverty issue pile.” (Serena Williamshad life-threatening blood clots after giving birth and her postpartum care was substandard despite her strong self-advocacy). She went on to add, “Clearly, there are a lot of advocates and others, including the moms themselves, who care about these issues and they need to be heard. If there is no follow-up after the summit, the whole thing will have been pointless.”
At a press conference after the Mayors’ panel, I asked Mayor Bowser about improving the quality and access to fresh food as a more holistic part of care –an important issue that Laura thought would be among the easier ones to solve for at-risk populations. Mayor Bowser replied, “…We’ve spent the past three years investing in Joyful Markets that are now present in every elementary school in wards 7 and 8, where children and their families can… shop on one day at school so that they have more healthy choices. … While we [in the D.C. government] don’t build supermarkets, we can make environments right for retailers to make different decisions and we’ve been very focused on a number of development projects that the city will help support in one way or the other, so they will have a better opportunity to attract a retailer or a grocery store.”
Joyful Food Markets are no-cost markets: a great solution run by local non-profit Martha’s Table. Unfortunately, the markets are only available at each school site once a month, which is not often enough to ensure a continued supply of fresh produce and food for a family. Thank you to Greg, the kitchen manager at Martha’s Table, for referring me to the schedule for Joyful Markets, which you can find here. While the work that Martha’s Table does is extremely valuable to the communities it serves, maternal health is best achieved by the combination of a healthy diet and quality medical care.
A Greater Greater Washington article from 2017 featured a “grocery walk”– a type of protest to highlight the lack of available food in the District. The article also chronicled the ill effects on residents’ diets and health resulting from a lack of better food options. From the article: “People who live in Ward 8 are five times more likely to die from diabetes than residents who live in Ward 3. These same neighborhoods also have the lowest income levels and the highest percentage of black residents in the city.” The author, who works at a program called DC Greens, which in addition to food advocacy and education, takes a similar approach at supplementing residents’ diets, states in her article: “Our program is a step in the right direction, but it doesn’t fill the gap left by the dearth of grocery stores, which offer a wider array of foods and are open longer and more often than farmers’ markets. We need the city to share our commitment to helping our neighbors access fresh food.”
Solving larger problems begins with solving smaller problems. If you visit DCMaternalHealth.com, you can find more resources and information on the topics discussed, as well as finding resources on different areas related to the topic of infant and maternal well-being.