North Carolina’s health department is using the tragedy of pregnancy-related deaths statewide to push a destructive woke agenda in medicine.
North Carolina’s health department is using the tragedy of pregnancy-related deaths statewide to push a destructive woke agenda in medicine.
T he North Carolina Department of Health and Human Services won’t let tragedy go to waste. A newly released report implicates “discrimination” in 70 percent of pregnancy-related deaths in the state and recommends a suite of leftist policies to remedy this alleged epidemic of hatred. Yet a quick diagnosis — free from political bias — reveals that the report and its conclusions are ideology masquerading as science.
The state’s “Maternal Mortality Review Report,” published in February, identifies 76 “pregnancy-related” deaths in North Carolina in 2018 and 2019. A pregnancy-related death is defined as a “death during pregnancy or within one year of the end of the pregnancy from a pregnancy complication, a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiologic effects of pregnancy.”
The causes of those 76 deaths are plainly spelled out in the report. Mental-health conditions (drug overdoses and suicides) accounted for a plurality of deaths (24), while injury (i.e., homicide) was the second-most-common cause (8). The rest of the deaths were related to chronic conditions or complications associated with pregnancy.
Where’s the discrimination? It’s nowhere to be found — so state bureaucrats are forced to invent it. That sorry task fell to the North Carolina Maternal Mortality Review Committee (MMRC), a 20-member multidisciplinary committee that reviews each pregnancy-related death and determines whether “discrimination” was a contributory factor. “Discrimination” is defined as “treating someone less or more favorably based on the group, class, or category they belong to resulting from biases, prejudices, and stereotyping. It can manifest as differences in care, clinical communication, and shared decisionmaking.”
The report offers no details on how MMRC members determine whether discrimination was a contributing factor, but another source offers a hint. MMRC protocols were spelled out in commentary published in the Maternal and Child Health Journal in 2022. It recommends that a multidisciplinary committee (e.g., doctors, forensic pathologists, and “community advocates”) at the state or city level review maternal deaths that occur within one year of pregnancy and determine whether discrimination was a factor. For example, in reviewing the death of a mother who died from a pulmonary embolism, the MMRC might note that “the ED charts do not offer any information on attempts to connect this birthing person with a primary care physician” or that “the review of the case did indicate that the person was uninsured at the time of the second ED visit.”
In other words, the commentary’s recommendation is that a committee of people with limited knowledge about a “birthing person’s” circumstances and her death offer a hunch about whether she might have been treated poorly because of her “group class, or category.” If that sounds unscientific, that’s because it is. None of this exercise is about improving maternal outcomes. Rather, it’s about providing justification for ultraliberal policies grounded in the tenets of “diversity, equity, and inclusion” and critical race theory.
The North Carolina committee’s report concludes with an extensive list of recommendations, including mandatory implicit-bias training within the health-care system, the use of language outlined in the CDC Health Equity Guide (e.g., “people/persons who are incarcerated or detained” instead of “inmate” or “prisoner”), and the design of “legislation to decrease access to guns.”
The commentary in the Maternal and Child Health Journal, meanwhile, advocates mandated “antiracism” (i.e., ongoing racial discrimination to address past racial discrimination) training for perinatal-care providers and invites policy-makers to explore other options to “recognize and rectify historical injustices.” For example, health facilities, the commentary suggests, should review drug-testing policies and procedures to “ensure that they are equitably applied across racial, ethnic and payer groups.” The Mass General Brigham Hospital Group recently deployed the same logic in its decision to scrap the practice of default reporting to state welfare agencies whenever a baby is born with drugs in his system. In other words, hunches about “discrimination” are being weaponized in support of a DEI agenda that will make women and babies less safe.
The red flags in the “maternal mortality review” process would have been apparent from the outset if North Carolina lawmakers were willing to see them. For example, Rachel Hardeman, the primary author of the piece in the Maternal and Child Health Journal, was born and raised in the United States but received her medical training in Cuba. Hardeman, at the time of her studies abroad, was “sympathetic” to Cuba and now extolls the Cuban health-care system as a “a more responsive, humanistic model of health care that focused on preventive care and the doctor-patient bond.” She was also the co-author of a debunked study that claimed that black mothers and newborns receive better care from black doctors.
Hardeman has a right to her radical worldview, but the health-care establishment can and should refuse to accommodate it. Science and reason — not DEI and hunches — offer the best hope for patients.