In Georgia, The Most Dangerous State for Pregnant Women, Policy Change Could Save Lives

Black women in Georgia are three times more likely to die from pregnancy-related complications than white women nationally, according to data from the CDC. Georgia, which has the second-highest maternal mortality rate in the nation, is one of the most dangerous states to be pregnant in today. 

According to CDC data published through America’s Health Rankings, Georgia’s maternal death rate reached 66.3 deaths per 100,000 live births from 2013 to 2017, as opposed to the national maternal death rate of 29.6. This means pregnant Georgians were two times more likely to die during their pregnancy and up to one year postpartum than the average American. 

Maternal Mortality: Georgia, U.S.

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Maternal Mortality by Race

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 Why It’s Newsworthy: Georgia has the second-highest maternal mortality rate in the country, which disproportionately affects women of color and women who live in rural areas of the state.  

 

Pregnant people in Georgia face barriers in accessing quality care including lack of health insurance coverage, sparse locations of health care providers in rural areas, and systemic racial and gender-based disparities. These inequities fuel the state’s current maternal mortality crisis.

José Cordero, a Patel Distinguished Professor of Public Health at the University of Georgia, is an expert on maternal and child health. His concern for the state’s high maternal mortality rate is based on the lack of access to quality prenatal and postpartum health care. Cordero explained that maternal mortality is broken up into two categories: pregnancy-related and pregnancy-associated. 

As he explained, the causes of death for women who die within a few months of delivery are usually pregnancy-related. But, for those who die up to a year after giving birth, the cause tends to be from conditions that were exacerbated or made worse by the pregnancy. 

“It’s important because [cause of death] refers to the care of women and the lack of access to care,” said Cordero. 

A Yale Global Health Partnership study of maternal mortality and racial disparity in Georgia found similar barriers to quality care. The study shows the state’s decision not to expand Medicaid under the Affordable Care Act has left 240,000 residents in a coverage gap. This gap accounts for many Georgians who earn too much to qualify for Medicaid but too little for private insurance. 

2018 Uninsured Georgians

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Uninsured Women Georgia

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Even pregnant people who qualify for Medicaid are still likely to lose coverage 60 days after delivery, which is noteworthy considering that 79% of pregnancy-associated deaths occurred between 43 days and one year after pregnancy, according to the 2014 Maternal Mortality Report by the Georgia Department of Public Health.

Cordero said the acknowledgment of systemic racism in Georgia’s health care system is a start, but he insisted that Medicaid expansion for postpartum care is one of the most important policy actions legislators can take to save lives.

“The reality is that we should treat health, and access to health care, not as something that some people can and should have and others can’t. In every country, except the U.S., and I think it’s Russia, all other countries consider access to health a human right. We haven’t figured that out yet,” said Cordero.

Mokah Johnson, a progressive candidate for Georgia House District 117, feels strongly about the importance of legislation in reducing the state’s maternal mortality rate. Even as Johnson runs for office, she said she doesn’t have proper health care. As a Black woman, Johnson expressed the barriers that she and her own children have faced in accessing quality care. 

“This is a real thing, not just something that we’re talking about hypothetically. [Black men and women] don’t receive proper health care. We don’t receive the same treatment; we don’t receive the same access. And then when you look at it, you can tie it back to economics; money, not getting paid, not having enough money to take care of yourself, and then not having the right job to give you this fancy health care coverage,” said Johnson. 

Johnson’s campaign manager, Aditya Krishnaswamy, highlighted the campaign’s efforts to address issues of racial and economic justice within the current healthcare system.

It’s affecting Black people, it’s affecting Black women, and it’s affecting us rural Georgians, and there’s a reason we have such a high maternal mortality rate. It’s because we don’t have access to the resources we need,” Krishnaswamy said. 

Maternal mortality affects Black women and women living in rural areas of the state at a much higher rate. In 2019, the Georgia House Study Committee on Maternal Mortality found that Black women in rural areas have double the maternal mortality rate of rural white women. Additionally, women who live in rural areas face fundamental barriers to health care including access to transportation, supportive organizations, and social services. 

OB/GYNs Are Scarce in Rural Northeast Georgia

This data compares the number of OB/GYNs for the six counties in Northeast Georgia with the four most populated counties in Georgia. Even by a physician to population ratio, rural Georgia counties are vastly underserved by OB/GYNs.

In Northeast Georgia specifically, there are many counties with little to no access to a specialist, according to a service map on the Georgia Senate website. Statewide, 75 of Georgia’s 159 counties have no OB/GYN. The lack of providers in rural counties means that two-thirds of rural births in the state occur outside of the home county. Each of these statistics illustrates the barriers that pregnant people in rural counties face in receiving quality prenatal and postpartum care.

I believe that regardless, everyone should have access to quality health care,” said Johnson. 

She hopes the inequities that have fueled Georgia’s maternal mortality crisis will be addressed with new state legislation. By promoting Medicaid expansion and rural health care expansion, Johnson thinks that those who have been denied access to equitable health care based on race, gender, economic status, and location will have a chance to get coverage. 

Caitlin Phillips is a senior majoring in journalism in the Grady College of Journalism and Mass Communication at the University of Georgia.

 

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