Are we listening? Obstetric anesthesiology and the national call for birth justice and accountability: a perspective from the United States

Abstract

Despite declining rates of pregnancy-related deaths worldwide, the United States (US) has seen an increase in maternal mortality. It is widely known that this increased risk of mortality impacts unevenly Black people, who are three-fold more likely to die from pregnancy-related causes than white people. This disparity in maternal mortality and morbidity is not unique to the US; countries like Brazil, the Netherlands, South Africa, and the United Kingdom (UK) report similar racial disparities in peripartum health outcomes. It is thought that many factors contribute to this tragic health inequity, including, but not limited to, structural racism, provider implicit bias, and lack of access to high quality, culturally humble reproductive health care. On July 25, 2020, activists for reproductive justice and birth justice published an open call in the New York Times entitled “How many Black, Brown, and Indigenous people have to die giving birth? National call for birth justice and accountability.” It is a powerful statement that uses an intersectional framework to understand reproductive inequities, while making demands for positive healthcare reforms and radically dreaming of a reality where the struggle for reproductive justice has been actualized. Using personal narrative, this paper reflects on the field of obstetric anesthesiology and how clinicians can make meaningful change to address and eventually help solve this health care inequity.