By Kiara Doyal,The Seattle Medium
As May marks Women’s Health Month, maternal health care in Washington is at a pivotal moment, especially for women of color. A recent report published by the Washington State Office of Financial Management (OFM) reveals an overall decline in the state’s birth rate, a rise in the costs of giving birth, and continued disparities in costs and access to maternal care depending on race and socioeconomic background. For many, the findings serve as a call to action to address disparities and improve care for every mother and child in the state.
The report highlights ongoing disparities in maternal health care access and outcomes, particularly based on race, age, education, and insurance coverage. One of the key findings from the report is a growing trend of women opting for home births or delivering in birth centers. Since 2019, the rate has increased from 3.5% to approximately 5%. Swee May Cripe, a senior research scientist at OFM, says that there are several factors that may be contributing to this increase.
“They may want to experience a sort of natural childbirth and desire a more personalized experience by avoiding unneeded medical interventions, or some may dislike the hospital atmosphere and desire to have better trust and interaction with their care provider,” said May Cripe. “It also could be because the centers and home environments provide a need to have a safer environment with more culturally relevant care, or sometimes it could be financial constraints or geographic barriers, where it’s difficult to have access to hospitals.”
In addition, Black women are less likely to receive early and adequate prenatal care compared to other groups.
“Black women also have higher costs of prenatal care visits and postpartum care. There is just a low attendance overall for Black women. However, not as low as Native, Hawaiian, and Pacific Islander women,” May Cripe said. “So, essentially, we have seen disparities for minoritized women, and it is just a measure of how wide the gap is for these women compared with either White, Asian, or Hispanic women.”
According to May Cripe, these findings highlight the urgent need to address systemic inequities that continue to shape maternal health care in Washington. The report says that while race is a social construct, it is racism, along with broader structural inequities, that drive persistent disparities in care. Over time, these gaps have remained persistent for Black women, who continue to face disproportionate challenges in accessing adequate maternal care, and the chronic stress caused by systemic racism not only affects their mental well-being but also impacts the outcome of pregnancy.
“We know that there are historical reasons behind this related to systemic inequities, and Black women experience institutional personal racism. Also, there are challenges in coordination between care from the clinical setting to community-based services,” said May Cripe. “And we also know that while women have access to health insurance coverage, having access to insurance does not always guarantee favorable outcomes, and Black women experience significant challenges in the area of national mortality and morbidity, and the disparities they face in access to quality care.”
“There is implicit bias in care, and there is a lot of mistrust. Those are totally valid because of the experiences that women are having,” she added.
While women’s health is important at every stage of life, the perinatal period is particularly concerning due to the current trends and disparities impacting women of color. May Cripe says that improving maternal care involves more than just providing insurance and support to women; it requires a deeper understanding of the systemic issues that cause these inequalities.
“For women, pregnancy health influences their capacity to take care of themselves, their families, and be important contributors to their communities. Everything speaks to the importance of the health of women,” said May Cripe. “So, thinking about how changing birth trends can influence health care, planning, policy, and resources, it is not just about providing insurance and support. It is about tackling the consistent disparities because we want to highlight and make aware the systemic inequities to ensure that women experience health equity regardless of their race and socioeconomic background.”
Recognizing the importance of equitable maternal health care, May Cripe stressed the need for both systemic improvements and community involvement in shaping effective policies to help promote women’s health.
“I think actually some actionable steps include how to improve prenatal labor, delivery, and postnatal care, and access to technology. This may involve both clinical care and the safety net, which is the network in the community to ensure that women have timely and adequate care, both prenatal and postpartum,” said May Cripe. “This would involve bringing community members to have a voice at the table of decision-making so that their experiences are heard and used to guide policy.”
“Having insurance coverage during pregnancy alone is not sufficient, but we want to make sure that there is an expansion of care throughout the continuum of a woman’s life,” she concluded.
