By Maddy Esses
Separately, women and Black Americans both face discrimination within healthcare, but Black women endure a unique intersectional experience, including a lack of maternal care, which deserves correspondingly tailored solutions. The California Momnibus Act was put in place in 2021 to combat this inequality [1]. This law helps pregnant women and new mothers receive essential care. It extends Medi-Cal coverage to provide a full year of postpartum care and includes services offered by doulas, professionals specialized in supporting pregnant women and new mothers [1]. The policy works to address the important issues that women face with respect to health care due to their race and gender.
The California Momnibus Act is a crucial step forward in helping achieve equality for black women in health care as they suffer from a unique intersection of race and gender inequality. Focusing on gender inequality, there is a lack of research with respect to women’s health care that negatively impacts the quality of care they receive. Seventy-five percent of all medical studies have been conducted on men, which is problematic as Women and men’s bodies are clearly different and should be studied individually [2]. Furthermore, “several studies have reported associations between Black patients’ experiences of perceived bias and discrimination with worse pain outcomes” [3]. There is a failure by physicians to address these biases, which only perpetuate the discrimination and inequalities within health care [3]. As a result, Black patients can be less likely to receive appropriate dosages of medication, which perpetuates discrimination in healthcare. Due to the two separate racial and gender biases, black women in particular experience a unique form of discrimination. Scholar and writer Kimberly Crenshaw asserts that merely adding Black women to the existing feminist or anti-racial analytical structure does not provide an understanding of their burdens nor a solution; therefore, Black women deserve their own study and analysis [4]. When a Black woman encounters discrimination, it can be challenging to pinpoint its exact source, as it may stem from various forms or directions.
In order to help issues of biases, The California Momnibus Act works to improve maternal health, particularly among racial and ethnic minority groups. It additionally creates a fund to support the workforce of midwives and improves data collection in the Fetal and Infant Mortality Review process. It also helps to address the structural racism and socio-economic factors significantly contributing to the unequal health outcomes observed among people of color during childbirth [5]. This act focuses on including “Medi-Cal coverage for doulas, extending Medi-Cal eligibility for postpartum people, providing easier access to CalWORKs for pregnant people and establishing a guaranteed income pilot program that prioritizes pregnant Californians with low-incomes” [5]. This ensures that new parents have continuous access to healthcare during the critical postpartum period, reducing risks of complications such as postpartum depression, infections, or chronic conditions [5]. Furthermore, it works to “grow and diversify the perinatal workforce to ensure that every mom in America receives maternal health care and support from people they trust” [6]. By diversifying the workforce and adding these clauses within the act, the health care system is closer to finding equality. With help from this act California has the lowest mortality rate of all of the states in America [7].
This policy has been a great step in equality for black women in healthcare, yet there are still some potential shortcomings and challenges. In order to be efficient, adequate funding and resources are required and without funding these proarms such as mental health support can be limited [8]. Additionally, though this policy gives more people access to doulas, there is a “dysfunctional arrangement” in California as they help the same people with multiple births before they are paid for the first one [8]. This is unfair to the healthcare workers as they are not being compensated for the work they are contributing. Additionally, the policy is being stalled nationally; it is a part of a package of twelve bills made by the Black Maternal Health Caucus and some of the other bills are paused due to budgetary restrictions: “One proposed bill earmarks $175 million to improve housing, nutrition and environmental conditions” [9]. It is great that the act is making successful efforts in California, but for it to make an even greater impact, it should be in action nationwide. The maternal mortality rates in the US are significantly higher than in European countries, showing the need for process and more acts such as the California Momnibus Act [10]. There needs to be more fundraising for the act and others similar to it to ensure everyone is receiving the care they deserve and the health care workers are also being paid sufficiently. This stalling of the package as a whole is a setback in the process of rights for Black women within healthcare.
Works Cited
1] Capital & Main. 2021. “Can California’s Momnibus Act Create a Better Future for Black Moms and Babies?” Capital & Main, October 4, 2021. https://capitalandmain.com/can-californias-momnibus-act-create-a-better-future-for-black-moms-and-babies.
[2] Mother Jones. 2016. “Men, Women, and Health: Inquiring Minds Want to Know.” Mother Jones, July 19, 2016. https://www.motherjones.com/environment/2016/07/men-women-health-inquiring-minds.
[3] JAMA Network. 2024. “Implicit Bias and the Role of Race in Pain Management: Implications for Improving Patient Care.” JAMA Network Open. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2793179.
[4] Crenshaw, Kimberlé W. 1989. “Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics.” University of Chicago Legal Forum 1989 (1): 139–167.
[5] Governor’s Office of California. 2021. “Governor Newsom Signs Momnibus Act to Tackle Racial Disparities in Maternal and Infant Health.” California State Government, October 4, 2021. https://www.gov.ca.gov/2021/10/04/governor-newsom-signs-momnibus-act-to-tackle-racial-disparities-in-maternal-and-infant-health.
[6] Black Maternal Health Caucus. n.d. “Momnibus.” U.S. House of Representatives. https://blackmaternalhealthcaucus-underwood.house.gov/Momnibus.
[7] Los Angeles Times. 2024. “California Sets Goal of Reducing Maternal Mortality by Half.” Los Angeles Times, September 17, 2024. https://www.latimes.com/california/story/2024-09-17/california-sets-goal-of-reducing-maternal-mortality-by-half.
[8] CalMatters. 2024. “Midwife Medi-Cal: The Next Frontier in Maternal Health Care.” CalMatters, February 12, 2024. https://calmatters.org/health/2024/02/midwife-medi-cal.
[9] CODEPINK. n.d. “U.S. Feminism Needs a Wake-Up Call.” https://www.codepink.org/us_feminism_needs_a_wake_up_call.
[10] CBS News. 2023. “Women in Louisiana Fight to Get Maternal Health Care: 60 Minutes Transcript.” CBS News, April 30, 2023. https://www.cbsnews.com/amp/news/women-in-louisiana-fight-to-get-maternal-health-care-60-minutes-transcript-2023-04-30.
Photo Credit: Joe Floorl (via Flikr), Racism is a public health crisis, https://flic.kr/p/2j8FAFZ
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