The four-day online summit, which ends Friday, focuses on the impact of the novel coronavirus on pregnant women, mothers and children. It includes sessions that focus on parenting during the pandemic, building early literacy skills for children and managing perinatal mood disorders.
Even before the pandemic, D.C. had a higher rate of deaths related to pregnancy than the national average, and a wide gap in the mortality rates between Black and White mothers.
Health-care professionals who work in the region say the stay-home orders and economic distress triggered by the pandemic, and the disproportionate impact of the coronavirus on poor and minority residents, could worsen those disparities.
“We were just at a point of where we were having more conversations, specifically around birth disparities and the challenges, why the system is not working, and covid just drew even more light on that,” Ebony Marcelle, director of midwifery at Community of Hope, a health center in D.C., said in an interview.
“When caring for women who need more help, distancing does not help,” Marcelle said.
The rate for Black women is significantly higher: 71 deaths per 100,000 live births in D.C., compared with 63.8 nationally. The city’s infant mortality rate is 7.1 per 1,000 births, compared with 5.9 per 1,000 births nationally, according to the D.C. Department of Health.
Tollie Elliott, chief medical officer at the Mary’s Center health clinics, said in an interview that some patients have skipped appointments in recent months because they are concerned about getting sick — a decision that can be especially dangerous for pregnant mothers.
“Any time you have a disruption in prenatal care, it can lead to missed labs, missed information you’re supposed to give the patient,” Elliott said. “It can lead to a missed opportunity to make sure that you’re engaged with the patient, that the baby is moving appropriately, that the heart tone sounds normal.”
More than 20,000 pregnant women nationally have tested positive for the coronavirus, and 44 pregnant women have died of covid-19, the disease caused by the virus, according to initial data from the Centers for Disease Control and Prevention. Most of those women were Hispanic or Latina, which tracks with what doctors in the D.C. region say they have seen.
Pregnant women with the illness are more likely to be hospitalized, be admitted to intensive care units and receive ventilation than nonpregnant women.
Experts say mortality related to pregnancy is one of the major contributors to the Black-White life-expectancy gap in the District. Black women in the nation’s capital died 12 years earlier, on average, than their White counterparts, according to a recent study.
About half of Black women in D.C., and more than 1 in 3 Hispanic women, didn’t get prenatal care until their second or third trimester, according to a 2018 city report.
And many low-income women in the city find it difficult to get the postpartum care they need, even though mothers in D.C. can seek prenatal care at 39 facilities, over 60 percent of which accept Medicaid or Alliance, the District’s health insurance plan.
United Medical Center, the only hospital east of the Anacostia River, closed its maternity ward in 2017 after the death of Somesha Ayobo, a pregnant woman whose care was interrupted. The closure came months after Providence Hospital, which served low-income women, closed its maternity services.
Low-income women who live east of the river have since found themselves having to travel long distances to get pre- and postnatal care.
Aletha Maybank, the chief health equity officer for the American Medical Association, spoke at the summit Tuesday and attributed some race-related health disparities to bias among health-care providers — both in the District and nationwide.
“What covid does is just exacerbate all of that,” Maybank said. “It is the same explanations, the similar structural issues, the similar provider issues as it relates to injustices. And there’s just so much pressure on families, especially for Black women, who are usually holding many of their families together.”