MY BODY, MY VOICE: Pregnancy is often a death sentence in Georgia

MAJORITY REPORTER: Barbara Ann Luttrell.

According to Amnesty International, we are in the midst of a “maternal health care crisis in the USA,” and the worst state of all is Georgia — worse than many much poorer countries. The numbers are even more dire for black women, who are three to four times more likely to die in pregnancy than their white counterparts — a racial disparity that exists regardless of socioeconomic or education level.

If you have ever been to the state Capitol, you’ve probably seen the big signs, declaring Georgia the “number one state for business.” What the banners fail to mention is that we are also the number-one state for women dying from pregnancy and childbirth.

It’s so bad that in 2018, the Yale Global Health Justice Partnership (GHJP) released a policy report titled, “When the State Fails,” which asserts that “the state of Georgia is failing in its obligations to women by making decisions that perpetuate a maternal mortality crisis disproportionally impacting Black women.” Which translates to: Georgia lawmakers — this is on you. But the report doesn’t just place blame. It also lists the four primary structural causes of Georgia’s maternal mortality rate and some feasible solutions, including improved access to maternal care, particularly in rural communities; increased access to insurance, such as expanding Medicaid; increased funding for maternal health in Georgia; and accountability around data analysis and use.

So, when Georgia’s Maternal Mortality House Study Committee held its inaugural meeting this September, I was looking forward to hearing about some concrete solutions for this public health crisis. When I arrived at the meeting, it was clear I wasn’t alone in my anticipation — the room was packed with eager onlookers. It didn’t take long for that feeling of hope to fade, and the familiar feeling of utter disgust and disappointment to creep in.

After a round of  introductions, Committee Chair Representative Sharon Cooper, a nurse by training, kicked off the meeting by saying that more men need to become OB-GYNs because “women (OB-GYNs) quit delivering babies too early.” The room, full of mostly women — many of them OB-GYNs, muttered in surprise and confusion. She went on, “Not that (women) don’t do a great job...” 

That pretty much set the tone for the rest of the proceedings.

We then heard from a series of experts about the current state of maternal health in Georgia, known causes of the crisis, and potential solutions. Unfortunately, that information didn’t seem to fit the agenda of Representative Cooper. The meeting quickly devolved into an attempt to manipulate the data so that Georgia’s maternal mortality numbers would look better instead of figuring out how to reduce pregnancy-related deaths in the state. Representative Cooper actually asked a testifying physician if there was anything we could do to “make Georgia’s numbers not look so bad.” Around the room, jaws dropped in unison. Some committee members went so far as to ask how we could be sure that a hypothetical pregnant woman who dies in a car accident isn’t accidentally counted in Georgia’s maternal mortality numbers. I haven’t done a deep dive into the available data, but I can assure you, Georgia isn’t the top state for maternal mortality because a bunch of pregnant women are driving recklessly. Not one person asked how we could actually predict and prevent maternal deaths. When one expert reiterated the fact that black women are dying at exponentially greater rates than their white counterparts, Representative Cooper said that seemed “reasonable” given increased rates of diabetes and high blood pressure in black women. The audience grumbled in disbelief. There are many words I might use to describe the fact that black women are needlessly dying across our state, but “reasonable” is not one of them. The only “reasonable” thing I heard that day was from Representative Carolyn Hugley, who tried to put the expert testimony in perspective for her colleagues. “In any event, regardless of the best or most favorable number for Georgia or the worst for Georgia, for women of color it’s still a crisis, is that right?” she said. The audience echoed her frustration. When we left the meeting, it felt like we were no closer to a solution than we were when we walked in.

Georgia has thrown some money at the problem though. In fiscal year 2019, Georgia allocated a measly $2 million of the state’s overall $4.8-billion health budget to maternal mortality. Meanwhile, half of Georgia’s counties still have no OB-GYN; unregulated, fake women’s health clinics posing as “crisis pregnancy centers” — of which there are nearly 100 scattered across the state — receive state funding; Georgia still hasn’t expanded Medicaid; and regressive Georgia lawmakers focused the bulk of their time and energy in 2019 to pass an abortion ban that outlaws the procedure before most people even know they’re pregnant, thereby forcing Georgians to carry pregnancies to term that could very well be their death sentence.

The most baffling part of this whole embarrassing statistic, is that most of these deaths are totally preventable. Just this year, the Georgia-based Centers for Disease Control and Prevention (CDC) released a new report which found that nationally, three out of five pregnancy-related deaths could be prevented. In Georgia, the number of preventable deaths is more than half. CDC determined that each pregnancy-related death was associated with several failures of the system, including a lack of access to appropriate and high-quality care, missed or delayed diagnoses, and lack of knowledge among patients and providers around warning signs — all things that could be addressed through policy change.

By now, you might have made the rational assumption that Georgia’s maternal mortality crisis is a consequence of the state lagging behind our ever-evolving science and technology, but you’d be wrong. In fact, pregnancy-related deaths steadily INCREASED in Georgia from 1987 to 2014, despite major advances in modern medicine. The problem here isn’t a mystery. As Dr. Melissa Kottke, one of the expert witnesses at the committee meeting, put it, when it comes to solving these problems, “we don’t have to guess about the things that work.” So why isn’t Georgia doing those things? Because Georgia’s maternal mortality crisis is the result of structural inequality, decades of racist policies, and blatant apathy on the part of many of our lawmakers. But what those elected officials haven’t taken into account is that more than half of Georgians can get pregnant, and we will vote like our lives depend on it. -CL-

To see a map of the nearly 100 state-funded, fake women’s health centers across Georgia, visit https://crisispregnancycentermap.com

To read Yale Global Health Justice Partnership’s policy report on Georgia, titled “When the State Fails,” visit bit.ly/WhentheStateFails