Black Maternal Health Week 2024
Statistics *and* stories matter in health communication
By official proclamation, President Joe Biden declared this past week (April 11-17) Black Maternal Health Week in the U.S. 2An advocacy group called Black Mommas Matter Alliance started Black Maternal Health Week in 2018. Their goal was to raise awareness around the horrifying differences in race-based maternal mortality. As President Biden noted in his official proclamation,
Women in America are dying at a higher rate from pregnancy-related causes than women in any other developed nation. Black women face even more risk and are three times more likely to die from pregnancy-related causes than white women.
Three. Times. More. Likely. To. Die. What a frightening statistic.
I also appreciate that the White House went straight to the root cause of the problem in its next sentence in the proclamation:
That is in no small part because of a long history of systemic racism and bias. Studies show that when Black women suffer from severe injuries or pregnancy complications or simply ask for assistance, they are often dismissed or ignored in the health care settings that are supposed to care for them. People of color — including expecting mothers — also bear the brunt of environmental injustices like air and water pollution, which worsen health outcomes. Too often, Black mothers lack access to safe and secure housing, affordable transportation, and affordable, healthy food.
The next sentences sums up the situation:
This is unjust and unacceptable.
From a health communication perspective, simple and straight to the point is powerful. It helps build trust with audiences and makes the potential threat more tangible than a bunch of unnecessary qualifiers and euphemisms for death and structural, long-standing biases.
I think this context is also a good illustration of the fact that statistics and stories can both be powerful. Statistics can sometimes be boring, but when they are surprising, they can get our attention and cause audiences to starting thinking more seriously about an issue.
There is also a long line of communication research showing how powerful narratives, or stories, can be. This is largely driven by how audiences are transported into the narrative world and identify with the story’s characters, leading to strong emotional connections to the story and its characters, as well as to less counter-arguing against the main point of the story.
For health narratives, a meta-analysis examining their effects across 25 different studies found that audio-video narratives can have a small effect on persuasion, while text-based health narratives did not convince people to change their behavior.
In the context of Black maternal health, the CDC has worked to showcase narratives of real women’s experiences with horrific pregnancy and birthing experiences through its “Hear Her” campaign. The aim of the campaign is to both educate Black women on symptoms of pregnancy complications as well as encourage them to advocate for themselves within the healthcare system.
Advocating for oneself while pregnant and often from a different background that one’s healthcare provider is not easy. It is a heavy burden and one that I personally. think should be refocused onto providers and healthcare systems. However, the campaign itself has many compelling narratives. One of which is of the most decorated track and field athlete in American history, Allyson Felix.
A bevy of medals was not enough to protect Felix from preeclampsia. Preeclampsia is often diagnosed when pregnant people have high blood pressure or high levels of protein in urine that indicate kidney damage (proteinuria). It affects at least 5% of all pregnancies, but Black women are 60% more likely to experience preeclampsia than are white women.
Felix’s preeclampsia was diagnosed when she was 32 weeks, followed by an emergency caesarean section. She and her daughter survived, but the experience was harrowing. She was not the first Black women celebrity to be in the news for a near deadly birthing experience. Serena Williams nearly died from a pulmonary embolism, or blood clot, when giving birth to her first daughter. She had to argue with medical staff to get a scan that saved her life, but then the blood thinners to break up the clot led to a dangerous hemorrhage from her c-section site.
These celebrity narratives can be powerful entry points for others to recognize the dangers that face Black birthing people, and hopefully become more engaged advocates for policy change. Since being dropped by NIKE while pregnant, Allyson Felix started her own shoe company and has become a tireless advocate for maternal health equity, even more so after one of her gold medal-winning relay teammates died from eclampsia (high blood pressure) while 8 months pregnant.
This issue has driven Felix in her business and her personal life. Felix’s shoe company, Saysh, developed a free returns policy for pregnant women whose shoe size changed (a very common occurrence during pregnancy). Felix also reframes the conversation around Black maternal health: She is a warrior, not a victim.
In a small study I conducted with my friend and mentor, Mary Beth Oliver, we found that directly quoting people affected by a social justice is results in more compassion from audiences (and less pity) than just paraphrasing their experience does. This tracks with Felix’s advocacy of giving voice to her experience and that of so many others.
Fittingly, during Black Maternal Health Week 2024, Allyson Felix, the warrior, gave birth to a son, Trey. This time, she had a Black woman doctor, a Black woman doula, and a very different birthing experience.
The end of Felix’s social media post announcing her son’s birth states the following: “My advocacy work around black maternal health will continue because every woman of color deserves to have the full experience of joy in birth, instead of the fear we are accustomed to.” Her voice is powerful in this moment, and hopefully one that people will continue to follow.
There are policy efforts to help alleviate some of those fears and give more women the (second) birth experience Allyson had. There is a Black “Momnibus” Bill under consideration in Congress, which would provide more funding for mental health, but it has yet to advance to a full up or down vote. You can contact your representatives and urge them to support it.
That’s all for this week. More next week!
P.S. Pancake pug watching the news closely this week.
