ST. LOUIS, Mo. -- Black women in Missouri are four times as likely to die during childbirth than white women, and during Black Maternal Health Week, reproductive-rights advocates want people to know many pregnancy-related deaths are preventable.

April Mickens Jolly, vice president of health equity and culture for Planned Parenthood of the St. Louis Region and Southwest Missouri, said reasons for the racial disparities range from lack of access to high-quality medical care in many communities of color, to implicit bias and racism within the medical system.

She argued Black women need to have the same access to social, economic and environmental resources necessary to build strong families.

"Factors that can make sure that Black women have the freedom to raise their children in safe and healthy places, both before, beyond birth and during the postpartum period," Mickens Jolly contended.

She noted in Missouri, four in five pregnancy-related deaths are preventable.

Public health experts urge health-care providers, as well as friends, family and partners, to listen to the concerns of pregnant people if they say something doesn't feel right, and find ways to adequately address those concerns.

Mickens Jolly emphasized expanding Medicaid, which Missouri voters approved last year, but lawmakers are resisting funding, could make a big difference.

She pointed to research which shows states that have fully implemented Medicaid expansion have also reduced rates of both infant and maternal mortality, and in some cases, begun to reduce racial disparities.

"Because of discriminatory and racist public policies, women of color and certainly Black women rely on publicly funded programs like Medicaid, more than white women do," Mickens Jolly stated.

In Congress, the Black Maternal Health Caucus has introduced what it calls a "Momnibus" package.

The bills range from investing in social determinants of maternal health such as housing, transportation and nutrition to growing and diversifying maternity-support systems. It also would improve data collection, support moms with substance-abuse issues or who are incarcerated, and invest in initiatives to reduce climate-change-related risks for pregnancy.

A federal judge has temporarily blocked an anti-abortion law in Idaho restricting people's ability to travel to other states for the procedure.

During the 2023 legislative session, state lawmakers passed a law restricting "abortion trafficking," which it describes as an adult bringing a child across state lines for an abortion with the intent to conceal it from the child's parents or guardians.

Kelly O'Neill, staff attorney for the nonprofit Legal Voice, said a U.S. district court judge agreed to their preliminary injunction request, blocking the law while the case is decided.

"The judge agreed that the law is unconstitutional and that it violates First Amendment freedoms, the right to interstate travel, and that it's unconstitutionally vague and that it's confusing," O'Neill outlined. "A person can't determine what conduct is legal and what might land you in prison for a minimum of two years."

Idaho has some of the most restrictive abortion laws in the country, with the procedure banned in nearly every instance. While abortions have decreased in the state, research shows they've increased in neighboring states where it is protected since Roe v. Wade was overturned, such as in Washington.

O'Neill noted Idaho is not the only state where lawmakers are attempting to restrict abortion.

"There's a huge wave of anti-abortion laws coming out of Idaho in particular and every state in the nation," O'Neill pointed out. "People are working and doing their part to try to push back against those and restore options of choices and freedom, and this is certainly a way that we're helping to do that."

The suit challenging the Idaho law was filed in July. The parties involved gave oral arguments in September.


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A Kansas state court judge has blocked several abortion-related restrictions, in a decision which is bound to have an effect in neighboring Missouri.

It is being considered a win for the Center for Reproductive Rights and Planned Parenthood on behalf of Kansas abortion providers. The ruling blocks laws requiring providers to give government-scripted information to patients, and to impose mandatory waiting periods, which delay care.

Alice Wang, staff attorney at the Center for Reproductive Rights, argued the restrictions violate the Kansas Constitution, including the rights to abortion and free speech.

"These restrictions are especially harmful now that Roe v. Wade was overturned, and Kansas clinics are overwhelmed with patients from neighboring states where abortion is banned," Wang pointed out. "Abortion is a human right, and Kansans deserve accurate, candid medical information."

Judge Krishnan Christopher Jayaram wrote the restrictions only serve to "stigmatize the procedure and instill fear in patients that are contemplating an abortion, such that they make an alternative choice, based upon disproven and unsupportable claims."

Emily Wales, president and CEO of Planned Parenthood Great Plains, said patients should not be denied care because they printed a form in the wrong color or format.

"We have been forced to turn away patients for reasons that are medically wrong and ethically unjustifiable," Wales pointed out. "Despite post-Dobbs, we'll do as we've always done, provide our patients with expert care informed by best medical practices. Our first question will be about care, and not font size."

There have been hearings on multiple abortion-related laws in Kansas this year, including a ban on the most common procedure used after 14 to 15 weeks of pregnancy, known as dilation and evacuation. Abortion has been illegal in Missouri since last June.


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Maternal mortality, or death from pregnancy-related issues, nearly doubled in the U.S. between 2018 and 2021 - and a person who is Black is three times more likely to die from these issues than one who is white. Nebraska ranked 17th
for maternal mortality, with a higher rate than the national average during those years.

Ashlei Spivey, executive director of the organization "I Be Black Girl," which works in Nebraska for reproductive justice, said data show some practitioners take Black patients' complaints of pain less seriously, with some erroneously believing Black people have a higher pain tolerance.

"How can we make sure medical practitioners - no matter if they're the OB or the phlebotomists - are getting cultural awareness training, that they're being in tune to the experiences of all the different types of patients that they're seeing, especially their Black patients,?" she said.

Awareness-raising events during this Black Maternal Health Month will culminate with a Reproductive Justice Summit on October 27th. Spivey said the speakers and breakout sessions will cover a number of issues that affect "reproductive well-being," including housing, transportation and wages. The keynote speaker will be renowned activist, author and professor Angela Davis. Registration closes after today.

Spivey said one of the steps they're taking is working with partner agencies to increase the number of doula-friendly
hospitals in the state.

"They're a trained companion that can help, and know that pregnant person more intimately," she explained. "And so they know this is this person's birth plan, how can we make sure that it's honored, and help that person have power and choice when working with their medical team - to address some of the things around not being heard."

Research shows doulas have a positive impact for both mothers and babies, and several states now include Medicaid coverage for doula care.

Spivey sees the "transactional" nature of U.S. healthcare - factors like insurance billing, what's covered and what isn't, and how many patients a practitioner is expected to see in a day - as contributing to the risks for patients.

"I think we need to remove that as transactional and really spend time with people, understanding what they're needing, and also making sure people feel empowered to hold doctors accountable. You know, people feel like they're the experts - they don't want to question," she continued.