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In RI, there has been a steady increase in births attended by midwives, with a rise from 12.1% to 19.6% from 2015 to 2021. This highlights the growing demand for midwifery services during childbirth. The American Congress of Obstetricians and Gynecologists (ACOG) projects a shortage of 22,000 OB/GYN physicians by 2050 and a 6% increase in demand for pregnancy and birth, gynecological care, cancer screening, and preventative services. *
In RI, there has been a steady increase in births attended by midwives, with a rise from 12.1% to 19.6% from 2015 to 2021. This highlights the growing demand for midwifery services during childbirth. The American Congress of Obstetricians and Gynecologists (ACOG) projects a shortage of 22,000 OB/GYN physicians by 2050 and a 6% increase in demand for pregnancy and birth, gynecological care, cancer screening, and preventative services. *
What We Know!
Source: RI Kids Count Brief
In 2020, the Rhode Island severe maternal morbidity rate was 88 per 10,000 delivery hospitalizations down
from 122 per 10,000 in 2019. Black (155 per 10,000) and Hispanic (106 per 10,000) women all had higher
rates of severe maternal morbidity than white women (86 per 10,000) between 2016-2020
In 2021, the percentage of low-risk cesarean births in Rhode Island (30%) was higher than it was in 2017
(28%) and continues to be above the Healthy People 2030 national objective of 24%. Nationally, Black
birthing people have higher rates (31%) of low-risk cesarean births than white birthing people (25%). Between
2017-2021 in Rhode Island, Native American, non-Hispanic white, and Hispanic women had the highest rates
of low-risk cesarean births.
The Black infant mortality rate is the highest of any racial or ethnic group even after controlling for risk factors such as socioeconomic status and educational attainment. Structural racism as well as exposure to discrimination and racialized stress in the workplace and community negatively impact birth outcomes for Black women and their babies. In Rhode Island between 2016 and 2020, the Black infant mortality rate was 9.8 deaths per 1,000 live births, which is more than three times the white infant mortality rate of 2.7 deaths per 1,000 live births.
We Need Immediate Change
RI Kids Count Racial and Ethnic Disparities in Maternal, Infant, and Young Children’s Health in Rhode Island states,
Root Causes of Disparities: Quality of Care/Implicit Biases in the Medical System
Pervasive racial bias and unequal treatment of Black women and birthing people in the health care system often result in inadequate treatment for pain and lead to significant unintended outcomes and disparities. This, coupled with stress from racism and racial discrimination, contribute to the unacceptable health outcomes among Black women and their infants. Medical racism and interpersonal discrimination historically has impacted Black health and continues to impact Black birthing people today.
According to data from the Centers for Disease Control, 80% of maternal deaths are preventable, signaling that there are deaths that could have been due to poor timeliness, quality of care, or inaccuracies in listening to patients’ needs.
SISTA Fire’s Community-led Participatory Action Research and Birth Justice Demands
SISTA Fire’s Community Participatory Action Research engaged 300 womxn in one-on-one interviews, street outreach, conversations with birth workers, community listening sessions, and online forums on the state of Black women and Women of Color in Rhode Island. This research specifically focused on Women and Infants Hospital, which delivered a majority (82%) of all births in the state between 2017 and 2021.
Key findings from this research included:
• Patients are not being communicated to about their condition in their own language. Medical providers often discuss patients and offer recommendations in front of them in a language they do not fully understand.
• Patients are not being asked about their trauma histories by providers so they can be provided care that is trauma informed.
• Patients reported that their severity of pain was not acknowledged or adequately treated. There were many reports of Black and Brown womxn saying they did not feel believed.
• Many patients felt that the hospital does not see postpartum care on a continuum that exists outside of the hospital setting.
Krause, Susan A., Susan A. DeJoy, and Heather Z. Sankey. "Innovations in midwifery education: the academic
medical center model." Journal of Midwifery & Women's Health 64.5 (2019): 649-656.
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