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A Louisiana senator defends his statements on the state's Black maternal health

“If you have a senator who is willing to dismiss one-third of his constituents," said one advocate, "what happens when they walk into a hospital to get treatment?"
Image: Sen. Bill Cassidy
Sen. Bill Cassidy, R-La., at a Finance Committee hearing on June 10.Tom Williams / CQ-Roll Call, Inc via Getty Images file

Sen. Bill Cassidy, R-La., is under fire for comments he made about the state of Black maternal health in an interview with Politico last week.

Cassidy said that while Black people make up a third of the state’s population and experience higher rates of pregnancy-related deaths, “if you correct our population for race, we’re not as much of an outlier as it’d otherwise appear.”

“Now, I say that not to minimize the issue but to focus the issue as to where it would be. For whatever reason, people of color have a higher incidence of maternal mortality,” Cassidy told Politico for the Harvard Chan School of Public Health series Public Health on the Brink.

Cassidy also attributed the disproportionate rates to how the state defines pregnancy-related deaths. 

“Sometimes maternal mortality includes up to a year after birth and would include someone being killed by her boyfriend,” Cassidy said. “In my mind, it’s better to restrict your definition to that which is the perinatal, if you will — the time just before and in the subsequent period after she has delivered.”

Louisiana has some of the highest Black maternal death rates in the country. A report from the state’s health department shows that four Black mothers die for every white mother and two Black babies die for every one white baby. In the United States, Black mothers are three times more likely to die in childbirth than white mothers.

Black reproductive justice advocates are decrying Cassidy’s latest comments. 

Marcela Howell, president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda, a national reproductive health advocacy group in Washington, D.C., said Cassidy’s comments reveal Louisiana is not taking proper action to address the issue. 

“That may be why the numbers are so poor,” Howell told NBC News. “Because he, like other elected officials in his state, don’t really care to address those factors that are causing Black maternal mortality.”  

Cassidy, a gastroenterologist, later wrote on Twitter that his quotes were taken out of context. Cassidy added that individuals are using his statements to “create a malicious & fake narrative,” adding that the discussion focused on his work addressing racial bias in health care, including the inequities facing Black mothers. 

Cassidy is a co-sponsor of the Maternal Health Quality Improvement Act, a 2021 bill that would direct the Department of Health and Human Services (HHS) to allocate funding to support maternal health. The bill was included in an omnibus spending bill, which passed in March.

Still, Howell insisted that Cassidy’s remarks underscore a much larger issue — the medical racism facing Black communities in all areas of the nation’s health care system. 

Louisiana, in particular, tends to rank poorly when it comes to overall health of the population. Last year, the United Health Foundation ranked Louisiana last of 50 states when it comes to overall health, citing the high prevalence of smoking, drinking, obesity and the high percentage of low birth weight babies compared to the national average.

“If you have a senator who is willing to dismiss one-third of his constituents, what happens when they walk into a hospital to get treatment? Howell said. ”Not just for maternal issues, but for any kind of issue they are going to be dismissed.”  

Why are Black maternal mortality rates high?

Black pregnant women continue to face disproportionately high pregnancy-related deaths, with data from the Centers for Disease Control and Prevention indicating a 26 percent increase in the maternal mortality rate for Black women since the start of the pandemic. 

Though researchers do not have an explanation for the disparities, the research suggests it's a culmination of institutional racism and other health factors, such as the increased risk of obesity and hypertension in Black women. Howell also added that stress and a lack of access to quality prenatal care further exacerbates this issue. 

“It really does boil down to how public health officials relate to Black women who are giving birth,” Howell said. “Statistics about Black maternal mortality are high across the board, no matter what your educational level is, no matter what your insurance level is.” 

In 2018, tennis star Serena Williams opened up in an interview with Vogue magazine about encountering severe health complications after giving birth because doctors neglected to listen about her existing medical conditions.

“When you have someone like Serena Williams having problems giving birth, and not being treated properly by nurses and doctors when she complains about not feeling well, then you look at the doctor of someone who is poor in Louisiana, and has the same kind of problem — they are probably treated even worse,” Howell said.

Cassidy is also facing backlash on social media. Rep. Gwen Moore, D-Wis., criticized the official Friday for his comments. 

Cassidy, she said, “doesn’t seem to care that Black women are disproportionately dying in his state,” Moore tweeted. “His indifference is sickening to read but it helps explain why America continues to struggle with a maternal health crisis.” 

Angela D. Aina, a co-founder and the executive director of the Black Mamas Matter Alliance, a nonprofit group advancing Black maternal health rights, also denounced Cassidy’s remarks.  

“The Black Mamas Matter Alliance finds Senator Cassidy’s statement to be woefully misinformed, and in direct opposition to the actual data that exists on maternal health in the U.S.,” Aina said in an email to NBC News. “We call on all policymakers and healthcare providers to look at the data and most importantly, listen to the many Black women practitioners, scholars, researchers and advocates who have not only the expertise and background, but also the lived experience, to know what is required to improve maternal health outcomes for all Black mothers and birthing people.” 

Howell said Cassidy’s comments solidify the importance of Black reproductive organizations in stepping up to combat this crisis facing the community. 

“If we want to have better outcomes, we have to address it ourselves,” Howell said. “That’s always been true with Black women — we have to be our own best advocates, and that’s what’s happening.”

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