Dozens of maternal health organizations and advocates are urging California’s surgeon general to halt the rollout of a plan aimed at reducing maternal mortalitysaying the recently announced initiative will not effectively address the crisis and “risk exacerbating existing inequities”.

In a letter provided to The Times, representatives of organizations including the California Black Women’s Health Project, Black Women for Wellness and the California Nurse-Midwives Assn. criticized the plan for “placing an undue burden on individuals” and failing to “explicitly name and address racism as a root cause of inequities in maternal health”.

The California Maternal Health Plan unveiled in September sets out strategies to try to reduce maternal deaths. Among them: having Californians of childbearing age fill out a new questionnaire to assess their risk of pregnancy complications, even before they get pregnant.

Read more: California Surgeon General Sets Goal to Reduce Maternal Mortality by 50%

In their Oct. 21 letter to state Surgeon General Dr. Diana Ramos, the advocacy groups said the maternal health plan acknowledged racial inequities in maternal mortality rates but did not “ground these disparities in evidence that shows systemic racism as determining factor. .”

Asked for comment on the letter, the state surgeon general’s office issued a statement saying it is “committed to working with partners across the state … to improve maternal health outcomes, reduce maternal mortality and save the lives of California mothers and pregnant women. people.”

black women suffered a maternal mortality rate more than three times that of white women in California, show state data. The Centers for Disease Control and Prevention has got many factors wrongincluding health care disparities and underlying chronic conditions, as well as structural racism and implicit bias.

Studies have shown that disparities exist even for black women who are wealthy, prompting maternal health researchers to increasingly focus on racial inequities in health care, bias and discrimination experienced by patients and the physical effects of chronic stress to endure racism over time.

In an interview in September, Ramos said California had focused primarily on the “healthcare framework” in its previous efforts to prevent maternal deaths, helping it achieve the “lowest maternal mortality rate in the country.” .

As things stand, California had a much lower rate of deaths related to pregnancy, childbirth and its consequences than elsewhere in the US, although maternal mortality has increased in recent years amid the COVID-19 pandemic. The state was presented as a model for him maternal death review system.

“If we keep doing the same thing — focusing only on the healthcare team — we’re going to get the same results,” Ramos said in September, explaining why the newly announced plan emphasized patients knowing their level of risk. – That’s why we bring the patient.

Read more: Dozens of patients file lawsuit against former OB-GYN and Cedars-Sinai, alleging wrongdoing

The maternal health plan sets a goal of having at least 50 percent of “persons of reproductive age” in the state complete a pregnancy complication risk questionnaire by December 2026.

In its letter of objection to the plan, the coalition of groups said that asking people to fill out such a survey “gives the impression of personal blame and/or that individual behavior is to blame, burdening the user and discrediting the system’s role in creating. this crisis”.

The groups said they were not aware of any research supporting “personal risk assessment” as a way to improve outcomes for people giving birth. The plan also doesn’t make clear the next steps or what will happen to the data, their letter claims.

Dana Sherrod, co-founder and executive director of the California Coalition for Black Birth Justice, said that “by omitting to address systemic racism, it puts the blame back on the patients.” The only time the phrase “systemic racism” appears in the plan is in reference to someone else’s findings state report.

Sherrod said that even after taking other factors into account, “women of color still fare worse.” For example, a single analysis of maternal deaths in California found that black mothers with the highest incomes had poorer rates of pregnancy-related mortality than white mothers with the lowest incomes.

A lot previous study found that black women did not have significantly higher rates of preeclampsia, postpartum hemorrhage, and other major complications than white women, yet black women who had such complications were two to three times more likely to die from than white women with such conditions.

Even if “they’re a healthy weight, they’re educated, they’re married — the things that should be protective — even when they do all of those things, we still see poor outcomes,” Sherrod said.

Read more: Several patients are suing Cedars-Sinai over alleged OB-GYN misconduct

The California plan also requires the use of medical facilities an existing screening tool to assess the risk levels of pregnant patients. Ramos told The Times that such screening could help guide where patients go to deliver, ensuring that those at higher risk go to the facilities best equipped to support them.

The coalition warned, however, that this could “further marginalize high-risk populations and divert resources from distressed facilities, while overburdening higher-level facilities.” California already faces “critical gaps in maternity care.” labor and delivery wards closedthey pointed out.

“It’s already very difficult for many people to navigate the health care system and understand where to go to get the best care,” Sherrod said, “and this can make it even more complicated.”

Coalition leaders are seeking a meeting with Ramos and first mate Jennifer Siebel Newsom, the wife of Gov. Gavin Newsom, who joined Ramos in announcing the plan in September.

Ramos’ office said in its statement Monday that since the launch of their initiative, “Dr. Diana Ramos has met with several partners in the maternal health space and will continue to meet with others, including coalition members, to find opportunities to work together. .”

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This story originally appeared in Los Angeles Times.