Rising from the Fire

Fire. Our relationship with it is basic and one of survival. It can be harnessed for use and it can rage out of control.  It can destroy and it can burn clean to begin the process of renewal.

The year of 2020 has brought fire on many levels from a global pandemic to a nation that has reached its institutional racism boiling point inflamed by too many examples of injustice.  As chaos ripples across the United States, it is evident that the time for change is ripe.

From the genocide of Indigenous Americans as European colonists claimed the Americas to the economy that was built on the backs of enslaved Africans, the culture of hierarchy and oppression was built into the foundation of our country.  Both populations continue to suffer from this culture.

We know that black mothers die at a rate of 40.8/100,000 which is 3.2 times that of their white counterparts, and we know that black infants die at a rate of 10.97/100,000 which is 2.5 times that of white infants.  For Indigenous mothers the rate of maternal mortality is 29.7/100,000 and for their infants the rate of mortality is 1.6 times that of white infants.  A CDC study, based on analysis of national data on pregnancy related mortality from 2007-2016 found that:

• Overall, pregnancy related mortality increased on 15 to 17 deaths per 100,000 births
• Non-Hispanic black and non-Hispanic American indigenous people experienced higher pregnancy related mortality than all other racial/ethnic populations
• For women over the age of 30, pregnancy related mortality for black and indigenous people was 4-5 times higher than for white women
• The pregnancy related mortality for black women with at least a college degree was 5.2 times that of their white counterparts.
• Cardiomyopathy, thrombotic pulmonary embolism and hypertensive disorders of pregnancy contributed more to pregnancy related death among black women than white women
• Hemorrhage and hypertensive disorders of pregnancy contributed more to pregnancy related deaths among indigenous women than white women.

Regardless of the intention of any policy or program, the impact of the many system breakdowns for people of color is continued genocide.

We can choose to be an accomplice or an ally and there are many resource lists available for those who want to do their part.  Here are 8 ways (https://www.self.com/story/how-to-reduce-black-maternal-mortality) we can work as a community and a nation to reduce black maternal mortality:

1. Collect more data
2. Address black maternal mental health care
3. Counter implicit bias among health care providers
4. Uplift the voices of affected communities and families
5. Extend Medicaid coverage up to one year postpartum in every state
6. Expand 4^th Trimester care
7. Normalize trauma-informed care
8. Recognize that stopping maternal death is just one part of the goal

The Chaos theory is an interdisciplinary theory that understands that within the apparent randomness of complex systems, there are underlying patterns, interconnectedness, constant feedback loops, repetition, and self-organization.  The butterfly effect is an underlying principle of chaos best stated as:  when you change the initial condition, you change the outcome exponentially.

As we see the chaos enveloping our communities, what initial condition can we change within ourselves, within our profession, within our communities that will lead us to the justice we need as our outcome?  The time for change is ripe.