February 5, 2023

Reproductive Justice

This month (and every month), we’re focusing on the reproductive justice movement, a movement and framework designed and led by Black women and femmes. Alongside activists and state legislators we’re working hard to address crucial health disparities affecting Black people living in Maine, and the current national trends are staggering. Due to systemic racism cancer rates among Black women are disproportionately high, and Black women are three times as likely to die from pregnancy complications than white women. While Maine was recently ranked slightly ahead of the (very low) national average based on quality of pre-birth care, a 2022 report commissioned by the Permanent Commission on Racial, Indigenous, and Maine Tribal Populations uncovered stark, widespread, and statewide barriers between Maine’s Black communities and critical prenatal care. 

Among the widest disparities reported are Maine’s maternal morbidity rates for deliveries which, while low overall, demonstrate statistically significant differences between Black birthing people and their white counterparts. Additionally, Maine’s infant mortality rates for Black birthing people were New England’s second-highest, with 6.8 of every 1000 deliveries resulting in infant deaths. The trends were linked partly to prenatal care, with expectant Black mothers experiencing more than 17% less access to adequate services. Timing of that care remains an issue as well. In 2019 Maine’s Pregnancy Risk Assessment Monitoring System (PRAMS) revealed that only 60% of expectant Black mothers reported receiving prenatal care as early as they wanted, compared to 90% of their white counterparts. According to a 2021 report by the Press Herald, Maine’s rates of disparities in adequate prenatal care were among the nation’s highest, rivaling Texas. 

What’s driving these disparities? The Permanent Commission on Racial, Indigenous, and Maine Tribal Populations reported a myriad of issues. Black populations continue to receive poor quality hospital care compared white counterparts, even when controlling for factors including income, insurance coverage, and education levels. Black and Indigenous women are also more likely to report being treated with disrespect by medical providers, a problem that’s compounded by the low numbers of minorities in the healthcare workforce. As a result, a level of distrust of the health care system persists, with many BIPOC (Black, Indigenous, and People of Color) people choosing to avoid facilities where they’ve experienced bias. Stress also proves a significant driver of disparity, with expectant Black mothers more likely to experience stress-related hormone responses that weaken the immunity or lead to preterm births. This increased stress has been linked to the compounded effects of structural racism. 

But even as these disparities persist, so do attempts to root them out. Recent efforts at the state level, including the passage of a bill in 2021 directing the Permanent Commission on Racial, Indigenous, and Maine Tribal Populations to study and propose solutions to disparities in prenatal care. That bill led to the report we cited here, giving a roadmap for reform to the Legislature. 

Here at Maine Family Planning, we’re committed to continuing our work in addressing the issues that create and sustain these disparities, both in medical care facilities and organizations like our own. Last year, we partnered with Cross Cultural Community Services for its Black History Month Community Wellness Fair, which provided events and resources for advocacy, teen health resources, paid family and medical leave, and developments in Maine’s relevant legislation. We’re on the planning committee again this year, and we just launched registration a few days ago! We encourage you to register and share this information with your networks.

This month is an opportunity for us to reflect on the work, celebrate the beauty of Black people and Black culture, and commit ourselves once more to the vision of reproductive justice for all.