Black D.C. residents comprised 90% of the pregnancy-related deaths in the city, a study finds

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The city I grew up in was once referred to as “Chocolate City.” That has changed. Today, Washington, D.C., is less than 50% Black, so, when I read a recent study finding that Black birthing people in D.C. make up 90% of birth-related deaths, I was understandably shocked.

But, the real shocker was that of the 90%, no white residents in my hometown reported pregnancy-related deaths, yet this group made up 30% of the births.

If you know D.C., you won’t be surprised to learn that Wards 7 and 8, east of Anacostia River, are where the remainder of the city’s “chocolate”—aka, Black and lower-income—residents live. These neighborhoods comprised 70% of the pregnancy-associated deaths.

While Wards 2 and 3, neighborhoods home to such tony spots in the city as Georgetown, Chevy Chase, and Dupont Circle, are mostly where white, wealthy residents live. The study found no pregnancy-associated deaths in these areas.

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The study conducted by the Maternal Mortality Review Committee (MMRC) looked at deaths associated with pregnancy in D.C. between 2014 and 2018. During this period, 36 D.C. residents died in pregnancy.

“Eleven were maternal deaths, 10 were pregnancy-related deaths occurring 43 days to one year following the termination of a pregnancy, and 15 were deaths occurring within one year of the termination of pregnancy due to accidental or incidental causes,” the report reads.

The report defines pregnancy-related death as “a death during or within one year of pregnancy, from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy,” and this includes “maternal deaths within 42 days and pregnancy-related deaths 43 days to one year following the termination of a pregnancy.”

Dr. Christina Marea, a cofounder of MMRC, told DCist, “The disparities and the statistics are very real and very concerning, and they are very much along racial lines—racial lines that are underlined by these social and structural causes. … There’s nothing about Black birthing people that makes them more likely to die, it’s the environments to which they’re exposed in our social, environmental, and health systems.”

According to DCist, the committee reviewed D.C.’s maternal and pregnancy-related deaths and how the issue aligned with the health issues that disproportionately impact the city’s Black residents—illnesses such as heart disease and hypertension—all related to systemic racism such as access to health care and quality education, environmental issues, housing, and bias, according to the Office of Disease Prevention and Health Promotion (ODPHP).

“Yes, there are increased rates of pre-existing and pregnancy-related cardiovascular diseases that contribute to mortality,” Marea told DCist. “But let’s go farther upstream than that, and say ‘why are young women at such high risk of developing heart disease or other cardiometabolic disorders at such a young age?’ Well, we look at these social and structural factors that increase the chronic stress that their bodies are under.”

Since the formation of the committee, several initiatives and a budget for 2022 were put into place.  

“When I introduced the Maternal Health Resources and Access Act, I knew it was the first step in a necessary expansion of insurance benefits and supports for expecting mothers enrolled in the District’s Medicaid and Alliance health plans,” D.C. Councilmember Christina Henderson said in June 2021.

“These investments include increased access to doula services and subsidized transportation to prenatal and postpartum appointments. When you combine these changes with other important measures the Committee funded today, like the Postpartum Coverage Act of 2019 and the Certified Midwife Credential Amendment Act of 2020, we begin to make real movement toward reducing the disparate maternal health outcomes across the District.”