SPEAKIN’ OUT NEWS
MONTGOMERY, Ala. – Black women in Alabama face an alarmingly high risk of dying from pregnancy-related complications, according to a new report calling for sweeping changes in how the state provides maternal care.
The ACLU of Alabama’s Moms Matter report describes Alabama as the nation’s most dangerous state for pregnancy and childbirth. The report cites an overall maternal mortality rate of 65 deaths per 100,000 births – rising to 100 deaths per 100,000 births among Black Alabamians.
Released Aug. 3, the report grew from more than a year of community conversations and a six-city listening tour involving 145 women. Sessions were held in Selma, Montgomery, Tuscaloosa, Birmingham, Mobile and Anniston.
The women described long trips for obstetric care, financial and transportation barriers, inadequate mental-health support and medical professionals who sometimes dismissed their pain or disregarded their wishes.
“Alabama must rethink how we approach maternal health, but that work shouldn’t begin in committee rooms in Montgomery,” ACLU of Alabama Executive Director JaTaune Bosby Gilchrist said. “It should begin in the living rooms and community centers where families have been navigating this reality every day.”
Geography compounds the crisis. The report says 34 percent of Alabama’s counties are maternity-care deserts. Pregnant Alabamians travel an average of more than 17 miles – or approximately 23 minutes – to reach the nearest birthing hospital. March of Dimes separately reports that 34.3 percent of Alabama counties are maternity-care deserts and 27.9 percent of women lack a birthing hospital within 30 minutes.
A mother from Alabaster said the hospital three minutes from her home had closed its obstetrics unit, leaving her 30 minutes from the hospital where she could receive care. Other participants reported difficulty finding transportation for prenatal appointments and urgent complications.
A Tuscaloosa mother said she had experienced discrimination in medical settings throughout her life, including withheld information, dismissive treatment and difficulty receiving needed assistance.
Official state findings also document a severe racial divide. The Alabama Department of Public Health reported that during 2020-2021, the pregnancy-related mortality rate was 77 deaths per 100,000 live births among non-Hispanic Black women, compared with 28.2 among non-Hispanic white women. State reviewers determined that 78 percent of pregnancy-related deaths during that period were preventable.
The ACLU is urging lawmakers to expand insurance coverage for doulas and community health workers, strengthen postpartum-depression screening, improve access to midwives and freestanding birth centers, and protect access to contraception.
Hospitals are also being asked to improve communication, provide implicit-bias training and allow doulas to support patients without being counted as regular visitors.
The report’s message is unmistakable: A Black mother’s ability to survive pregnancy and childbirth should never depend on her race, ZIP code, income or whether someone believes her when she says something is wrong.