Tiffany Casby cradles her newborn son Zayne, shortly after birthing him at Embrace Midwifery & Birth Center in Richmond in 2017. (Photo by Cheyenne Varner).

By Tyran Green

Today in Virginia, Black mothers like me still struggle to survive having children.

Virginia’s maternal mortality rate for Black mothers is more than twice what it ought to be (compared with White mothers). That’s the statistic, but people need to know what it’s like to be a young, pregnant, Black person in a city like Portsmouth where I live. Then maybe they’ll understand better why there are these disparities.

I have five grown kids. When I got pregnant for the first time, I was very young. I didn’t have a good education, and I only got on Medicaid after I got pregnant. Young women like I was don’t get pre-natal care until they get to their second or third trimester. They don’t know how important it is. They haven’t been educated about it, and back then we didn’t have health insurance unless we were pregnant, anyway.

I didn’t understand that pre-natal vitamins are important to keep your teeth and your bones healthy. I also didn’t have any dental insurance. Years later, when my teeth were bad because of five pregnancies, I went to public health because I still didn’t have dental insurance, and they pulled out all my molars. They said they couldn’t do any repair work.

When I got pregnant again, I decided to educate myself, and I signed up for a Lamaze class. The only one I could find was in a wealthy neighborhood, and all the other mothers in the class were White. I learned a lot, and I advocated for myself with doctors, but they still treated me differently.

Doctors know that they won’t get paid as much when a patient has Medicaid. Some doctors don’t take it at all. Others do but they don’t give their Medicaid patients the same care that people get who have better insurance. Even though I knew a lot about pregnancy and childbirth when I had my younger kids, I still never felt I was treated with respect when I was in labor. All of my friends could tell you similar stories about being sent home when their labor was advanced, no one caring when they said they’re in pain, and so on. I wasn’t surprised by the story in 2019 about the doctor in Portsmouth who was performing hysterectomies on Black women without their consent.

I’m on the board of Virginia Organizing. We supported Del. Lachrese Aird’s declaration that racism is a public health crisis. The treatment of pregnant Black people is one of the reasons for that public health crisis. My experience is no different from what all the Black mothers I know have been through.

The American Rescue Plan includes better funding for Medicaid, and some of it goes to these disparities in Black maternal mortality.

Gov. Ralph Northam also released a plan to study and make a difference in the rate of mortality for Black mothers. “Our Administration remains fully committed to pursuing policies that ensure equitable access to health care for Black, Indigenous, and other women of color,” said Governor Northam. “This plan is the culmination of more than a year of work with diverse stakeholders and provides a roadmap with actionable recommendations for creating the systemic change necessary to achieve our goal of eliminating racial disparities in maternal and infant health outcomes in Virginia by 2025.”

Virginia’s Medicaid administration has applied for permission to extend post-partum Medicaid coverage from 60 days to a full year. So far, the change will only apply to a demonstration program. At Virginia Organizing, we want the extension to be made permanent.

These changes are a good start but not enough. As long as there are disparities in what doctors are paid for treating different people, there will be disparities in how low-income Black mothers are treated, and that means there will be disparities in who survives and who doesn’t.

Tyran Green is a leader in the Portsmouth Chapter of Virginia Organizing and a member of Virginia Organizing’s state governing board.