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 Abstract

Excerpted From: Aly McKnight, The Human Rights Approach to Address Black Maternal Mortality: Why Policymakers Should Listen to Black Moms, 14 Northeastern University Law Review 679 (June 2022) (177 Footnotes) (Full Document)

 

AlyMcKnightThis Note argues that the United States (U.S.) government has a responsibility under international human rights standards to address the domestic crisis of Black maternal mortality. If the U.S. aims to meet its international obligations and build a robust policy framework to address maternal mortality as a human rights issue, it must center Black mothers' advocacy and expertise. Centering the expertise, storytelling, and experiences of impacted individuals through participation is a central tenet of human rights advocacy work, and in failing to center Black moms, the U.S. continues to ineffectively address Black maternal mortality. The current approach the U.S. uses to address Black maternal mortality fails to acknowledge the white supremacist ideologies upon which public perception of Black motherhood has been built, and, as a result, has perpetuated racist policies. This Note utilizes the Reproductive Justice movement's human rights framework, which has been advocated for by Black activists and scholars, to evaluate some of the recent U.S. policy initiatives.

Part I of this Note provides an overview of the crisis of maternal mortality in the U.S. This crisis demonstrates a dereliction of the country's international human rights obligations, and it evinces the moral failings of leaders who have neglected to address this crisis. In this Note, I specifically focus on the deaths of Black mothers, and the crisis of Black maternal mortality which demonstrates the failure by the U.S. to address racial discrimination in maternal health. This Note provides a brief historical overview of some U.S. government policies that have served to undermine the health of Black mothers, leading to discrimination, disproportionate negative health outcomes, and Black maternal deaths.

Part II defines the human rights framework for understanding maternal mortality by discussing the provisions of several international human rights treaties that protect maternal health. The human rights framework addresses the intersections of the right to life, the right to health, and the right to equality and nondiscrimination. The U.S. has legal obligations to prevent and reduce maternal death under these international treaties. In this section, I also contextualize the evolution of the global maternal health strategy through the United Nations' Millennium Development Goal (MDG) and Sustainable Development Goal (SDG) frameworks.

Part III introduces the Reproductive Justice movement, a movement founded and led by Black women that is rooted in international human rights principles. The Reproductive Justice movement has made strong efforts to address and attack the issue of maternal mortality and promote maternal health. This Note presents examples of several strategies implemented by Reproductive Justice advocates to forward the human rights framework in a maternal health context.

Part IV presents some recent examples of U.S. legislative initiatives to combat maternal mortality and improve maternal health. I argue that the U.S. policy plans to address maternal mortality would function more effectively by mirroring the human rights-centered approaches presented by Reproductive Justice activists and organizations.

[. . .]

The Black maternal health crisis in the U.S. is a representation of the human rights American policymakers are willing to ignore to preserve the false narratives that uphold white supremacy. If policymakers centered the effective, system-wide strategies proposed by Black mothers to improve Black maternal health, we would likely see change not only in the maternal mortality rate, but in health outcomes throughout the nation. Pregnant women and Black individuals were not proportionately represented in COVID-19 vaccine trials, but by centering the needs and perspectives of Black mothers in future vaccine development, we might see both populations adequately represented in future vaccine studies. We might see robust efforts to fund social welfare programs such as cash assistance, expanded Medicaid, and food assistance, rather than many of the non-evidence-based programs that the PRWORA currently grants states block grants to fund. We might see more salient efforts from more policymakers to provide affordable health insurance to everyone through an effort like Medicare for All. And we might see more resources invested in sexual education programs, substance misuse prevention programs, mental health services, and public education and training programs for our youth. These solutions combat Black maternal mortality, but they do so much more. Simply put, if U.S. policymakers are not focused on preventing our country's systems from disproportionately killing Black mothers, they are likely negating opportunities to transform the national health care system, opportunities to address racial injustice, and opportunities to provide stronger futures for our children. Addressing Black maternal death forces U.S. policymakers to holistically confront our human rights abuses and develop nuanced solutions that uplift not only Black moms, but individuals throughout our national systems.

A shining light in February 2021 was the introduction of the Black Maternal Health Momnibus Act of 2021 by the Congressional Black Maternal Health Caucus, led by Congresswomen Alma Adams and Lauren Underwood. This legislation includes twelve individual bills that have now been combined into one set of legislation to address Black maternal health priorities. These priorities range from the social determinants of health, to health insurance coverage, to further research on Black maternal death. The reach of the Momnibus Act includes meeting needs that have an impact on maternal health, including providing housing, transportation, and healthy food, as well as funding the community-based organizations that are already doing maternal health work. Additionally, the Momnibus Act calls for the diversification of the maternal health workforce so that mothers receive care that is culturally competent. It addresses meeting the needs of specific populations, including moms who are veterans, incarcerated moms, and moms with mental illness or substance use disorders. Comprehensive legislative packages like the Momnibus legislation are a direct result of the Reproductive Justice movement's persistent organizing and activism. Though groups like SisterSong, BMMA, and Center for Reproductive Rights have focused their human rights advocacy on international reporting mechanisms, the Momnibus bill is evidence that Reproductive Justice advocates have packaged the human rights framework as an effective policy strategy for reducing maternal mortality.

The work of the Reproductive Justice movement, BMMA, SisterSong, and allied organizations demonstrates that Black mothers organizing know how to prevent maternal death in the U.S. Through the Reproductive Justice movement tactics, grounded in human rights principles, they have provided the U.S. with a playbook to decrease maternal mortality and save Black lives. It is past time policymakers listened to them.


J.D. Northeastern University School of Law (2022), B.A., Public Policy Studies and Sociology, William Smith College (2015).


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