(Source: MIRS.news, Published 04/10/2024) Sen. Erika Geiss (D-Taylor) is spearheading a nine-bill package to investigate and combat racial disparities related to pregnancy and maternal healthcare by establishing a team within Michigan's health department to review maternal deaths, among other proposals.
In 2021, the Centers for Disease Control and Prevention (CDC) reported 26.6 maternal deaths per 100,000 live births among white women in the United States. The rate for Black women was 69.9 per 100,000 live births, increasing from 55.3 in 2020 and 44 in 2019.
Meanwhile, the Michigan Department of Health and Human Services (DHHS) reported 77 deaths from 2015 to 2019 identified as pregnancy-related, with the most common causes being "hypertensive disorders of pregnancy, hemorrhage and infection/sepsis."
Black women were 2.8 times more likely to die from pregnancy-related causes from 2015 to 2019 in Michigan. White Michigan women experienced a pregnancy-related mortality rate of 10.7 per 100,000 live births compared to Black women's rate of 29.8.
"Part of it is about data collection, and making sure that we are then taking that data so (we) can utilize it and ask: 'Are there collective bad actors? Or is this like a generic sort of thought-process that we need to change?'" Geiss asked. "Or are there people who are frankly engaging in systemic racism that we need to address? And we can't do that without accurate data."
The bills that Geiss is directly sponsoring in the package are SB 818 and SB 819 .
Under SB 818 , DHHS creates a team to review Michigan's maternal deaths while putting together best practices for sharing maternal death-related data. The team would also coordinate meetings with maternal mortality review teams across the United States, and take part in regional and national assessment activities.
Moreover, the DHHS would study how public payment systems cover pregnancy labor and delivery and malpractice in private perinatal insurance policies. Starting in 2026, and every three years afterward, DHHS would report to the Legislature's health policy committees on:
- The most preventable causes of maternal mortality that the DHHS recognizes as having the "greatest impact" on Michigan's pregnant and postpartum population.
- How to reduce pregnancy-related deaths, maternal mortality and "morbidity in prenatal, perinatal, and postnatal clinical settings," particularly through consultation with a perinatal care quality collaborative designated to serve Michigan.
Geiss' SB 819 deals with patient-reporting tools for incidents of "obstetric racism" and "obstetric violence." Cases can include incidents when a patient's race influences treatment or diagnostic decisions during perinatal care, and situations where a patient faces physical, sexual, emotional or verbal abuse by someone overseeing them while in labor and birthing a child.
As a Black mother herself, Geiss said she would love to see every “Black mama” in the state have the beautiful, maternal journey that she had. She said she hopes that with the legislation, elected officials can better understand the frequency in which discrimination is impacting pregnancy care, and learn more about individual stories and experiences.
“How do we prevent the next person from having a horrible experience?” Geiss asked.
Other bills in the package are:
- SB 820 by Sen. Mary Cavanagh (D-Redford Twp.), has hospitals give the state's Department of Licensing and Regulatory Affairs (LARA) proof of their policy supporting "patient protection" in place.
- SB 821 by Cavanagh, instructs Michigan's Department of Insurance and Financial Services (DIFS) to gather information on malpractice in insurers' perinatal care policies following a request made by DHHS.
- SB 822 by Sen. Sarah Anthony (D-Lansing), guarantees that pregnancy status does not influence a designated patient advocate's right to make "life-sustaining treatment decisions."
- SB 823 by Sen. Stephanie Chang (D-Detroit), expands the term “sex” in Michigan's Elliott-Larsen Civil Rights Act to include pregnancy or lactation status.
- SB 824 by Sen. Sylvia Santana (D-Detroit), sets up a "non-punitive plan of safe care" for infants and parents if the infant is presented as being impacted by alcohol or a controlled substance.
- SB 825 by Anthony, adds licensed midwives to Michigan's Essential Health Provider Repayment Program.
- SB 826 by Chang, creates a scholarship program for low-income residents working toward becoming a certified doula.
- SB 827 by Santana, mandates that private insurers reimburse licensed midwives for services.
“It will impact private insurers . . . they will probably grouse a little,” said Geiss, chair of the Michigan Legislative Black Caucus. “(We're) asking them to do something differently, to think differently, to change their approach.”
