Black Chicagoans address solutions to maternal mortality

At age 30, Jeanine Valrie-Logan was having a miscarriage.

The room was sterile, cold. Guarded only by a curtain to maintain a semblance of privacy and a thin hospital gown, she sat waiting for the procedure that would remove the remaining pregnancy tissue.

As she stood to sit atop the bed that would wheel her to the operating room, the physician asked her, “Do you want me to give you an IUD, so you don’t have any more unplanned pregnancies?”

The question stopped her in her tracks, and the fear and loneliness she’d been feeling suddenly replaced with profound anger.

“Who said this was an unwanted pregnancy?” she recalled thinking at the time. “I remember grabbing the nurse and being like, ‘Please do not let him put an IUD in.’”

Upon waking from the operation, she was told by a supervising nurse that throughout her sleep, she continuously repeated the phrase “Don’t let him take my uterus. Don’t let him take my uterus.”

The urgent pleas for control over one’s body have been echoed by Black women across Chicago and the country over the course of the nation’s history. Following the death this spring of U.S. Olympic champion sprinter Tori Bowie from complications related to childbirth, a national conversation has been sparked once again over America’s Black maternal mortality rate, the Black community’s mistrust of the medical field and the disproportionate effect on Black women.

In Chicago, where recent hospital closings have rendered entire swathes of the city “birth deserts,” the issue is laid plain: Black maternal health-care conditions remain dismal despite years of criticism, Black health-care officials say.

Tired of waiting on others to find answers, Black Chicagoans like Valrie-Logan are stepping up to create their own solutions to the lack of care. Nearly a decade after her miscarriage, Valrie-Logan, a midwife and mother of three, is on track to help open a South Shore birthing center dedicated to Black birthing people and their families by 2025.

The birth center is being designed, she said, to reflect the South Shore community in which it will be located.

“Our board is 100% Black,” she said, adding that she is focused on hiring individuals from the South Side to work at the birth center, “so that we have an understanding of what’s important to communities.”

Before 2019, Chicago had 19 hospitals with birthing units, with six located on the South Side. But after a series of closures, the North and West sides have six birthing hospitals remaining, while the South Side has been left with three.

[ Labor and delivery units are closing at Chicago-area hospitals. Here’s why. ]

“We don’t even have enough providers giving prenatal care,” said Dr. Jana Richards, an obstetrician-gynecologist and assistant professor at the University of Chicago. That means Black patients go “unheard,” she added.

“Even when they want to get prenatal care, it’s very hard to find,” she said. “Certainly on the South Side.”

Shay Dunn lives 30 minutes outside the city’s southwest borders in suburban Montgomery. She’s a Beyoncé fan, an avid iced coffee drinker and devoted mother of four.

Despite frequent social media updates from @dailywithshay on Instagram, her pregnancies weren’t always picture perfect. Throughout her third, she recalled experiencing discrimination and disregard from her health-care providers — culminating with a bad reaction to an epidural to which she says doctors didn’t sufficiently respond.

When the epidural unexpectedly wore off, she remembered telling her medical providers, “‘Hey, I’m feeling everything,’ and I know from past experiences that I’m not supposed to be feeling this right now,” she recalled to the Tribune.

“I felt like they weren’t too worried about what I was saying. It was more so like, ‘Let’s just get this baby here and get her down to recovery because we have someone after her to fill her spot,’” Dunn said. “I just felt like I was not being heard. And I just felt like, gosh, I was not supported during that time. And it was just not the birth experience that I wanted.”

She paused for a moment before exhaling, “It just felt like I was a number instead of a patient.”

Knowing that there’s a disparity in treatment for Black mothers in the U.S., Dunn decided to take care into her own hands when she became pregnant with her fourth child. She chose to give birth in the comfort of her own home aided by a midwife who shared her racial identity and a family connection.

Dunn’s initiative is familiar to other Black mothers and health-care advocates who are invested in expanding pregnancy education and birth options in the Black community, such as Chicago doula Lucretia Woods.

With only a quick scroll through Woods’ TikTok @creee28, viewers can find information about patients’ rights during delivery, organizations that offer free birth doula services for low-income mothers and warning signs of an emergency pregnancy — all with the latest trending audios in the background.

Outside of the small screen, Woods cares for Black mothers in the delivery room, showing up as a listener and an ally.

“Just having someone in the room that looks like you, it gives you this feeling of calmness, of peace. You feel safe, like, ‘There’s another me in the room and I know she’s gonna take care of me.’ It may not seem like a big deal, but it’s a big deal,” she said.

“If you are Black woman and thinking about going into birth work, do it, finish it, no matter what, just go through with it, because there’s a woman out there who’s gonna need you one day.”

Eva Marie Lewis is an advocate for these women. As founder of the Free Roots Operation, she’s launched an effort to combat poverty-induced gun violence by investing in Black women and their families, particularly single Black mothers.

“I’m not in the birth space at all. But the death rate that Black women have, after giving birth or during childbirth, I believe, is directly tied to the systemic negligence that Black women experience,” she said.

Lewis works each day to fill this care debt through wellness programs that help Black mothers cultivate self-investment. Her work leads Chicagoland’s Black mothers through everything from taking them out to Broadway plays, to providing them with free therapy to hosting self-love-centered workshops.

“Despite our contribution, despite the care that we show to others, despite our roles and communities, we are not receiving the care that we need anywhere,” Lewis said. “And thus, we are receiving a lack of care everywhere.”

There is no sole determining factor to explain why Black maternity patients die at higher rates than white patients, said Dr. Robin Jones, an obstetrician-gynecologist based at Rush University Medical Center with over 33 years of experience and the former chair of the Illinois Maternal Mortality Review Committee.

“Health care doesn’t sit in silos,” Jones said.

“When we review maternal deaths, you cannot just look at the medical circumstances of their deaths. Instead, we realize it’s larger than that. We’re looking at the communities in which they live.”

A lack of access to pharmacies, for example, makes it difficult for patients to get prescriptions, while food deserts mean healthy, fresh food is often out of reach.

“We’re looking at things like transportation, access to care, access to child care,” Jones said. “We’re looking at things like education, economic factors, all of which bear into: Why did this woman die?”

Recent policy adjustments have signaled potential increased attention given to these long-standing structural inequalities. For instance, in 2021, Illinois became the first state in the country to expand Medicaid benefits from 60 days to 12 months postpartum.

Regardless of these signs of progress, Jones notes that the question of Black maternal mortality isn’t solely an issue of class. It cannot be boiled down to a debate on transportation, location or Medicaid versus private insurance. This, at its core, is a question of race, Jones said.

“An African American woman like myself, with a (doctor of medicine) degree, is more likely to (have a) pregnancy-related medical death than her white counterparts with a high school education,” Jones said.

“Access is not a problem for me. Transportation is not a problem for me. I have an M.D. degree,” she added. “So we know that it’s more than the ‘social determinants of health’ that are playing a role.”

No amount of success inherently exempts a Black woman from racially biased treatment, said Jones, and her point plays out in national headlines.

Approximately one year after tennis star Serena Williams opened up about her “life or death” labor experience, Bowie — formerly the fastest woman in the world — was found dead at 32, eight months’ pregnant. Weighing 96 pounds, she died at home, alone and unaided by medical care.

[ Beyoncé, Serena Williams open up about potentially fatal childbirths, a problem especially for black mothers ]

When Bowie crossed the finish line in 2017 with her legendary lean to win the 100 meters at the world championships in London, Chicago’s maternal health experts said she carried a nation with her that bears bleak statistics: one in which she was three times more likely to die in childbirth simply due to the color of her skin; a nation in which generations of Black women faced nonconsensual and unanesthetized pain and suffering to create the medical technology of today; a nation in which, despite the world-class achievements she attained, there were not enough protections to save her life, and that of her child.

Black women have the highest maternal mortality rate in the United States — 69.9 per 100,000 live births for 2021, almost three times the rate for white women, according to the Centers for Disease Control and Prevention.

“Every time a Black birthing person is lost through pregnancy or postpartum… every single one is like a punch to the stomach,” Valrie-Logan said, reflecting on Bowie’s passing. “And then it just makes me think about how that’s just what we see on the news. There’s so many more that we don’t know their names.”

Some attribute the issue in part to the Black community’s deeply seated mistrust in the medical field, coming from decades of mistreatment and unethical experimentation in America.

Long before Williams and Bowie, there was Anarcha, Lucy and Betsey. In the 1840s, the three enslaved teenagers, between 17 and 19, were forced to endure inhumane medical procedures, often without anesthesia, for the sake of advancing science under the study of physician J. Marion Sims. His experimentation led to treatment for the childbirth complication of vesicovaginal fistulas — and what Sims described as “agony” for his test subjects.

In modern times, research shows medical professionals continue to exhibit implicit bias against Black patients, believing them to experience less pain and spending less time with them.

“History repeats itself, just in different ways,” said Woods, the Chicago doula.

During her own pregnancy, Bowie “didn’t trust the hospitals. She wanted to make sure that the baby was gonna be OK, with her being in control,” Kimberly Holland, Bowie’s agent, told CBS News following the Olympic athlete’s death.

With this history, providers and patients alike grapple with one central question: How can trust be rebuilt?

“Let’s start with the number of Black and brown individuals who are actually admitted to medical schools,” Jones said. She advocates for ensuring that “when you look around that boardroom table, it is representative of the United States or at least the community in which they serve. This is how trust is built.”

At UChicago Medicine in Hyde Park, where Richards works, 73% of the approximately 600,000 patients in the hospital’s service area are Black.

“I think it’s mistrust both ways,” Richards said. “When you don’t have a relationship with the doctor, the doctor doesn’t get to know you and it’s hard for the doctor to trust you. But it’s also hard for you to trust the doctor.”

For Valrie-Logan, shivering in her hospital room over a decade ago, heavy with fear, the trust came from another source: her nurse.

“I know she was a woman of color, because of the way we looked at each other,” Valrie-Logan said. Following the doctor’s inappropriate question, Valrie-Logan remembered the glances that she and her nurse exchanged. “It was not necessary to have any words.”

A midwife herself, Valrie-Logan does everything she can to ensure her patients feel they can trust her in the same way, she said.

“When I go with people into surgeries,” Valrie-Logan said, “I walk with them, instead of ahead of them.” As she was taken into surgery, she remembered the doctor walking in front of her. The nurse, however, walked alongside her.

Throughout the procedure, she called out in Spanish, a language she presumed the doctor could not understand — but the nurse could.

After the surgery ended, the nurse stayed with her for hours. She took her hand, talked her through the operation and reminded Valrie-Logan of the safety that having an ally could provide.

Moments like these, built on a sense of connection and trust with one’s medical provider, are what Valrie-Logan hopes to provide to the city’s South Side.

“I think it takes a completely new system,” she said on the rebuilding of trust. “And that’s literally what we’re trying to build at the birth center.”

At the birth center, clients will be provided with a team of experts to assist throughout the pregnancy, complete with a lactation counselor, a doula and a nurse-educator. Along with pregnancy care, the birth center will also provide reproductive health care, STD testing and family planning resources.

Fundraising efforts are underway for the anticipated 2025 opening: https://www.chicagosouthsidebirthcenter.org/

Valrie-Logan said she imagines a medical center in which Black women are believed. She hopes to cultivate a space where Black women’s health is not looked at through the lens of a “particular body part” but rather that of a complete human being.

“That’s another vision I have for the birth center,” she said. “Yes, we’re gonna braid your hair, we’re gonna give you food, we’re gonna sit in this garden and we’re gonna make sure you feel that you feel loved.”