With Black women seven times more likely to die from pregnancy-related complications than white women in New Jersey, a law signed by Gov. Phil Murphy soon will require doctors and nurses to undergo training to root out any unconscious bias that may affect the treatment they provide.
Studies published in medical journals and media reports have documented the presence of implicit racial bias in maternal medicine, which has resulted in Black women not getting the attention for pain and other symptoms before a catastrophic problem arises. Professional tennis star Serena Williams drew attention to the problem when she described how she nearly died after giving birth to her daughter. Williams said she needed to insist her doctors perform a CT scan after she had difficulty breathing. The scan detected blood clots in her lungs.
The law Murphy signed Monday requires every hospital that delivers babies and provides perinatal care to create a bias training program, approved by the state Department of Health. The curriculum would include “information about communicating more effectively across racial, ethnic, religious, and gender identities” and a discussion on racial, ethnic other disparities within the field of perinatal care, and how it “may contribute to pregnancy-related deaths and maternal and infant health outcomes,” according to the law.
Doctors, nurses, nurse practitioners and midwives will be required to complete the training in order to receive or renew their license, according to the legislation. Hospitals which don’t comply would face fines, and medical professionals who do not complete the implicit training could jeopardize their license, according to the law, which takes effect in six months.
“Government officials and healthcare professionals alike have been making a concerted effort to improve maternal health outcomes in our state,” said Assemblywoman Shanique Speight, D-Essex, who sponsored the bill with Sen. Teresa Ruiz, D-Essex. “But this endeavor ultimately cannot succeed unless every mother receives the same standards of treatment. That means we have to address the underlying biases that are serving as a barrier to quality healthcare for far too many women of color in New Jersey.”
An article published in October in The Lancet, a prominent U.K.-based medical journal, studied the Black maternal mortality problem and said “expanding implicit bias training and education in clinical settings is critical to promote awareness of how bias affects care and puts Black women’s lives at risk.”
“In many ways, racism is embedded in medical education and practice, and racialized constructions of pain tolerance, for example, affect how, when, and whether pain is treated in Black patients—with direct implications in maternal care,” according to the Lancet article. “Far too often, these perceptions influence how soon Black women receive needed care; dispelling them and educating providers on how they affect care is crucial.”
Other studies have found pregnant Black women have had difficulty communicating with or being taken seriously by doctors when they have expressed worries about their health, making them less likely to raise their concerns again.
New Jersey’s overall maternal death rate — 47 women out of every 100,000 live births — is dramatically higher than the national average of 20 women dying during or soon after childbirth, according to Nurture NJ, an initiative led by First Lady Tammy Murphy.
The First Lady’s office recently released a plan based on numerous meetings with mothers, hospital officials medical professionals and state officials that aims to reduce the state’s maternal mortality rate by 50 percent in five years. The infant mortality rate is nearly as grim for black newborns, who are three times more likely to die than white babies before they reach their first birthday.
“The plan is designed to make transformational change in a system that has historically failed mothers and babies of color,” said the governor’s spokeswoman Alexandra Altman.
Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio.
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