Assembly Required with Stacey Abrams: Episode Summary Episode Title: How To Fix America’s Maternal Health Crisis and Fight For Reproductive Freedom
Release Date: October 24, 2024

Introduction and Context

In the premiere episode of Assembly Required with Stacey Abrams, host Stacey Abrams delves into the pressing issue of America's maternal health crisis and the intertwined fight for reproductive freedom. Abrams sets the stage by highlighting the exorbitant costs of childbirth in the United States, especially for those without adequate insurance. She cites alarming statistics, noting that "one in eight Americans who have medical debt say it was at least partially caused by the bills associated with pregnancy and childbirth" (00:08), underscoring the financial burden faced by many families.

Disparities in Maternal Health

Abrams emphasizes the stark racial disparities in maternal mortality rates. Referencing law professor Michelle Goodwin's testimony, she shares devastating statistics: nationally, Black women are "three and a half times more likely than their white counterparts to die during or shortly after pregnancy" (00:08). This disparity intensifies in certain regions, with mortality rates for Black women in some counties being "5 times, 10 times, 15 times more likely" than for white women (00:08).

Access to Healthcare and Medicaid Expansion

The conversation shifts to the broader healthcare access issues exacerbating the maternal health crisis. Abrams highlights that "in the US, 25 million people are uninsured" (00:08), with projections indicating an additional 1.7 million becoming uninsured annually over the next decade. The lack of Medicaid expansion in several states disproportionately affects Black and Brown communities, limiting access to necessary pre-pregnancy and prenatal care. Urban and suburban hospitals in states like Georgia, Tennessee, and Texas are closing their maternity wards, further restricting access to essential services (00:08).

Personal Experiences and Legislative Efforts

Jennifer McClellan, a guest on the episode, shares her personal experiences navigating the maternal healthcare system. As a former state legislator and current Congresswoman from Virginia, McClellan discusses the impact of restrictive abortion laws on maternal health. She recounts her high-risk pregnancies and the lack of access to quality prenatal care, which almost led to her own death (10:30). McClellan highlights legislative efforts like the Pregnant Worker Fairness Act, which mandates workplace accommodations for pregnant and postpartum workers, illustrating how state-level policies can lead the way in addressing these issues (14:53).

Medical Training and DEI

The episode delves into the critical role of medical training and Diversity, Equity, and Inclusion (DEI) in combating maternal mortality disparities. McClellan recounts instances where Black women's health concerns were dismissed by healthcare providers, emphasizing the need for culturally competent care. "We need to reevaluate how we are training our medical professionals," McClellan asserts (22:04). She underscores that DEI initiatives are essential for ensuring medical equity and preventing preventable deaths due to biases and systemic inequities (25:17).

Childcare and Postpartum Support

Addressing the postpartum phase, McClellan introduces the Child Care Assistance for Maternal Health Act. This legislation aims to alleviate the stress on new mothers by expanding access to affordable childcare during the critical postpartum period. "We are going to focus on investing in expanding childcare for that period," she explains (27:34). McClellan shares her personal challenge of balancing her own postpartum recovery with caring for a newborn, highlighting the broader societal need for supportive childcare systems.

Political Engagement and Voting

Abrams and McClellan discuss the importance of comprehensive political engagement beyond federal elections. McClellan emphasizes that "everything on your ballot is important" (31:08), including local positions like judges, mayors, and school board members, all of whom influence healthcare access and maternal health policies. She urges listeners to participate in all elections to ensure that government officials reflect and address community needs (33:07).

Reporting on Abortion Access and Preventable Deaths

The episode introduces Kavita Serana, a ProPublica reporter, who shares investigative reports on preventable maternal deaths linked to restrictive abortion laws. Serana recounts the tragic stories of Amber Thurman and Candy Miller—both women who died due to complications arising from limited access to abortion and timely medical care (34:26). These cases highlight the lethal consequences of vague and restrictive abortion laws, as well as the broader impact on emergency medical care for pregnant women (40:31).

Conclusion and Calls to Action

In wrapping up, Abrams reinforces the multifaceted approach needed to address the maternal health crisis. She encourages listeners to:

• Vote conscientiously: Engage in all levels of elections to support candidates who prioritize healthcare access and maternal health.
• Stay informed: Follow reputable sources like ProPublica and The 19th to understand the nuances of reproductive rights and maternal health policies.
• Advocate actively: Reach out to local officials, ask specific questions about healthcare policies, and hold leaders accountable for their stances on critical issues.

Abrams also highlights resources such as PBS.org and the Black Maternal Health Caucus for those looking to deepen their understanding and take meaningful action (43:24).

Notable Quotes:

• Stacey Abrams (00:08): "The US is one of the most expensive countries in the world in which to have a baby, and that's presuming you have insurance and no complications."

• Jennifer McClellan (10:30): "Living through almost dying really gave me an appreciation for how many patients don't have that peace of mind either because they don't have access to quality prenatal care."

• Jennifer McClellan (22:04): "We need to reevaluate how we are training our medical professionals."

• Kavita Serana (34:26): "These laws are vague and confusing and they have led to many delays in care that have been documented."

Key Takeaways:

1. Economic Barriers: The high cost of childbirth and associated medical care in the US disproportionately affects uninsured and underinsured populations, contributing to medical debt and financial strain.

2. Racial Disparities: Black, Native American, and Pacific Islander women face significantly higher maternal mortality rates, exacerbated by systemic racism and inadequate healthcare access.

3. Healthcare Access: Medicaid expansion and the availability of hospitals and specialized care are critical factors in improving maternal health outcomes, yet political resistance in key states hampers progress.

4. Legislative Action: State-level policies, such as the Pregnant Worker Fairness Act and the Child Care Assistance for Maternal Health Act, play a vital role in supporting maternal health and should be actively supported and expanded.

5. Cultural Competency in Medicine: Enhancing DEI in medical training is essential to address biases, improve patient-provider relationships, and ensure equitable healthcare delivery.

6. Political Engagement: Comprehensive voter participation at all levels of government is necessary to influence policies that impact maternal health and reproductive rights.

7. Investigative Reporting: Rigorous journalism, like that of ProPublica's Kavita Serana, is crucial in uncovering the real-life impacts of restrictive laws and informing public discourse.

By addressing these multifaceted issues through legislative, educational, and community-driven efforts, significant strides can be made toward resolving America's maternal health crisis and ensuring reproductive freedom for all.