Black women are facing a maternal health crisis. Supporters want to make this an election issue in the US.

Francisca Shaw said she knew something was seriously wrong when she had to undergo an emergency C-section to deliver her third child, a daughter, at Seattle University of Washington Medical Center in 2015.

“I remember telling my doctor when I got cut, ‘I can’t breathe,’” Shaw recalled. “She said, ‘Oh yeah, you can.’”

Shaw’s uterus ruptured during the C-section, causing heavy bleeding. She required a hysterectomy and went into cardiac arrest, according to medical records reviewed by Reuters. Records show that she spent three weeks in the hospital after birth.

The University of Washington Medical Center did not comment on Shaw’s case, citing federal privacy laws, but said it was “committed to ensuring high quality and equity” in all its patient care.

Advocates are trying to use the November 5 election as a moment to raise awareness about the reproductive health disparities that impact Black women, including higher rates of pregnancy and birth complications and deaths, as well as higher rates of certain types of cancer.

Democratic candidate Kamala Harris has made abortion rights a central part of her campaign — and in her campaign appearances has blamed Republican Donald Trump for the deaths of two young black mothers in Georgia, a state with abortion restrictions.

With polls identifying inflation and the economy as top priorities for black women, Reuters spoke to 10 activist groups who said they aim to mobilize women of color around issues of systemic health inequality. The effort is part of a 30-year-old movement for “reproductive justice.”

Such concerns go beyond abortion rights, an issue that has galvanized women since the U.S. Supreme Court struck down the constitutional right to abortion in 2022.

Shaw, now 43, works as a certified doula, a non-medical professional who helps women during childbirth in Atlanta, Georgia. She said in an interview that focusing on reproductive health is crucial to winning her vote.

“Black maternal health and reproductive health should be a conversation I hear from every candidate so I can be on board with voting for them,” she said.

PREGNANCY COMPLICATIONS

Black women make up 13% of the United States’ female population, but were responsible for 41.5% of abortions, opens a new tab in 2021.

Black women in the US also face higher risks of having children. They are three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention.

Georgia – where black people make up 31% of the population – has the eighth highest maternal mortality rate in the US. Nearly 16% of women in the state have to travel more than 30 minutes to give birth in a hospital, according to a 2023 report opens a new tab by March of Dimes, a nonprofit organization dedicated to reducing maternal and infant mortality prevent. Nationally, less than 10% of women have to travel that far.

A line chart comparing maternal mortality rates between all women and black women in the United States between 2018 and 2022

A line chart comparing maternal mortality rates between all women and black women in the United States between 2018 and 2022

The CDC opens a new tab and health experts attribute these gaps to chronic conditions such as cardiovascular disease and hypertension, as well as structural racism, implicit biases from health care providers, and a lack of access to quality health care.

Leah Wright Rigueur, a professor of history at Johns Hopkins University, said abortion restrictions have made it even more difficult for black women to access emergency care for failed pregnancies or complications from medical abortions.

“The reproductive health landscape for Black women has become much more dangerous over the past two and a half years,” she said.

Since March, In Our Own Voice, a national coalition of eight reproductive justice organizations, said it has spent $2 million on digital ads, billboards and mailers addressing abortion access and reproductive health for voters in 12 states, including where elections are battlegrounds. Ballot measures on abortion were also discussed; Several states will vote on abortion access on November 5.

Regina Davis Moss, head of the coalition, said the groups have made more than 1 million voter contacts, targeting young voters, the LGBTQ community and low-propensity voters.

She did not provide figures on the total number of new voter registrations.

Since her ascension to the top of the ticket in July, Harris has given more attention to abortion than Joe Biden. She has called on Congress to enact a national law codifying access to abortion, and end a procedural rule that requires a supermajority in the Senate to pass legislation.

“The previous candidate wasn’t as outspoken,” Davis Moss said.

The Harris campaign highlighted black maternal mortality during a “Reproductive Freedom” bus tour in September and during a roundtable discussion in Michigan with Harris’ sister Maya.

On Saturday, U.S. Rep. Nikema Williams joined the Harris campaign and the Georgia Democratic Party in Atlanta along with healthcare providers and public figures for an event to discuss Black maternal health and abortion bans.

When asked, the Harris campaign did not point to specific policies on Black maternal health.

But during her time in the Senate, Harris was one of the original sponsors of the Momnibus Act of 2020, a package of thirteen measures aimed at expanding access to prenatal and postpartum care for mothers. She also supported funding research into uterine fibroids, which are more common among black women.

And the Biden administration allocated $470 million last year to improve maternal health, expand access to healthy food and adequate housing, and fund student loan and grant plans to increase the diversity of certified nurse midwives and nurses .

“I would be very curious if anyone could name another vice president who has made Black maternal health a priority,” said Keisha Lance Bottoms, a former mayor of Atlanta and a senior adviser to the Harris campaign.

During his campaign, Trump took credit for appointing Supreme Court justices who voted to overturn abortion rights. Trump expressed support for a ballot measure in his home state of Florida to overturn a six-week abortion ban and enshrine abortion rights in the state constitution, only to later reverse course.

Janiyah Thomas, a spokesperson for Trump’s campaign, said in a statement that the former president “has always made the health and safety of Black mothers a priority.”

She noted that Trump signed a law in 2018 that authorized $60 million over five years to create review boards of medical professionals and government health officials to investigate the causes of maternal deaths, especially among women of color.

HARRIS MANAGES RISKS

However, some experts believe Harris faces a challenge in combining two different constituencies: pro-abortion rights and pro-maternal mortality.

Dr. Nadia Brown, director of the women and gender studies program at Georgetown University, said white women and black women have historically had different approaches to abortion rights and reproductive health care.

“You’re not going to get black women saying I’m voting because I want to try to enshrine abortion rights, but you’re going to get black women talking about, I’m voting because I understand that there are a lot of attacks on bodily autonomy. and I want being able to protect that and view health care as a human right – as a dignity.”

And dr. Joyce Drayton, a board member of the Georgia Black Republican Council, said many Republican black women — while opposed to abortion — would welcome stronger comments from Harris on improving outcomes for black mothers.

“We have absolutely no problem working across the aisle to improve perinatal health care in rural Georgia,” Drayton said.

In the electoral battleground state of Georgia, which banned abortion after six weeks in July 2022, the issue of black maternal mortality has coincided with the right to abortion.

The Georgia Supreme Court reaffirmed the ban this month after it was overturned by a lower court.

Last month, ProPublica reported, a new tab was opened on the deaths of two Black mothers, Amber Thurman and Candi Miller, who were denied medical treatment after experiencing complications related to medication abortions.

Harris spoke about the deaths at a campaign rally in Atlanta days later, saying Thurman would still be alive today if she hadn’t waited 20 hours in the hospital for post-abortion care.

Since the spring, Naomi Desta-Bell and her colleagues at the Feminist Women’s Health Center, a clinic in suburban Atlanta that offers contraception, abortion, gender-affirming care and other services, have spent their weekends working on arts, music and LGBTQ voter registration -festivals. They also work with churches.

Desta-Bell said she has experienced growing interest among voters in the state of Black maternal health and reproductive justice. “There’s a lot of passion here.”