The California Department of Justice has shed light on a critical issue plaguing maternity care facilities in the state: the lack of training on recognizing implicit biases among labor, delivery, and birthing care staff. This revelation comes as studies have shown that implicit biases significantly contribute to the alarmingly high rates of maternal mortality, particularly affecting Black women.
State Attorney General Rob Bonta emphasizes that the United States leads the developed world in maternal mortality rates, and this issue disproportionately impacts communities of color.
“In California, Black women make up 5% of pregnant patients but account for 21% of total pregnancy-related deaths,” Bonta reveals. “The rate of maternal death for Black women is three to four times higher than for white women.”
This problem is not limited to patients alone; even healthcare professionals may unknowingly harbor these negative attitudes and beliefs, further underscoring the need for training and awareness.
Implicit Bias and Maternal Mortality
Implicit bias can have devastating consequences, affecting interactions between patients and providers, treatment decisions, adherence to treatments, and actual health outcomes. During a press conference, Bonta shared a personal experience illustrating how implicit bias impacted the care of his wife, Assemblymember Mia Bonta, who felt her pain was dismissed, and she was unfairly accused of seeking drugs.
Implicit bias perpetuates racial disparities in healthcare, and its effects extend beyond pregnancy and childbirth. It influences provider treatment decisions and impacts patients’ adherence to treatment, which can lead to unequal health outcomes.
The California Dignity in Pregnancy and Childbirth Act (Senate Bill 464)
To address this pressing issue, California enacted the California Dignity in Pregnancy and Childbirth Act (Senate Bill 464) in 2019. This legislation mandated training on implicit bias for health providers treating women before or after pregnancy. The training aimed to raise awareness about and mitigate implicit biases that may affect patient care.
Despite the law’s introduction, the California Department of Justice’s findings indicate that many healthcare facilities had not completed or even begun training their staff on implicit bias by August 2021. The training was crucial for enhancing the quality of care and reducing maternal mortality rates, particularly among communities of color.
Progress and Challenges Ahead
By July 2022, 81.4% of applicable personnel at healthcare facilities had complied with the training requirements. However, lawmakers and healthcare professionals emphasize the need for more rigorous enforcement, data collection, and accountability to ensure that training programs are regularly reviewed and evidence-based. The fight against implicit bias in healthcare continues, with the hope of achieving equitable maternal care for all birthing mothers.
Global Health Equity Week
The release of the California Department of Justice’s report coincides with Global Health Equity Week, a time when communities worldwide unite to address health disparities. During this week, people are urged to write letters to their governors and state Medicaid directors to advocate for the elimination of maternal health disparities. Additionally, a webinar during the Global Health Equity Summit explored the impact of cultural, racial, and linguistic factors on maternal care experiences and outcomes, highlighting the urgency of the issue.
Addressing the Disparities
Efforts to tackle maternal health disparities are multifaceted and require a collaborative approach. Expectant mothers are encouraged to connect with organizations like Black Women for Wellness, the California Black Women’s Health Project, and Planned Parenthood, which has a Black health initiative.
Combining legislative action, funding, training, oversight, and data collection is essential to achieving equity in maternal care. Implicit bias in healthcare is a challenge that demands sustained attention and action to ensure that all mothers receive the care they deserve.