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Dangers and deaths around Black pregnancies seen as a ‘completely preventable’ health crisis

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lailluminator.com – Sandy West – 2023-08-27 10:00:58

Dangers and deaths around Black pregnancies seen as a ‘completely preventable' health crisis

by Sandy West, Louisiana Illuminator
August 27, 2023

HOUSTON — Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child.

But, just five weeks after confirming her pregnancy, and the day after a gender-reveal party where she announced she was having a girl, she seemed unable to stop urinating. She didn't realize her amniotic fluid was leaking. Then came the excruciating pain.

“I ended up going to the emergency room,” said Hill, now 35. “That's where I had the most traumatic, horrible experience ever.”

An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN's office rushed her back to the hospital. But she lost her baby, Tabitha Winnie Denkins.

Black women are less likely than women from other racial groups to carry a pregnancy to term — and in Harris County, where Houston is located, when they do, their infants are about twice as likely to die before their 1st birthday as those from other racial groups. Black fetal and infant deaths are part of a continuum of systemic failures that contribute to disproportionately high Black maternal mortality rates.

“This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who's disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.”

It kind of felt like I was watching myself lose everything.

– Kay Matthews, who miscarried 35 months into her pregnancy

In fact, Harris County ranks third, behind only Chicago's Cook County and Detroit's Wayne County, in what are known as excess Black infant deaths, according to the federal Health Resources and Services Administration. Those three counties, which also are among the nation's most populated counties, account for 7% of all Black births in the country and 9% of excess Black infant deaths, said Ashley Hirai, a senior scientist at HRSA. The counties have the largest number of Black births but also more deaths that would not occur if Black babies had the same chance of reaching their 1st birthdays as white infants.

No known genetic reasons exist for Black infants to die at higher rates than white infants. Such deaths are often called “deaths of disparity” because they are likely attributable to systemic racial disparities. Regardless of economic status or educational attainment, the stress from experiencing persistent systemic racism leads to adverse health consequences for Black women and their babies, according to a study published in the journal Women's Health Issues.

These miscarriages and deaths can occur even in communities that otherwise appear to have vast health resources. In Harris County, for example, home to two public hospitals and the Texas Medical Center — the largest medical complex in the world, with more than 54 medical-related institutions and 21 hospitals — mortality rates were 11.1 per 1,000 births for Black infants from 2014 through 2019, according to the March of Dimes, compared with 4.7 for white infants.

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The abundance of providers in Harris County hasn't reassured pregnant Black patients that they can find care that is timely, appropriate, or culturally competent — care that acknowledges a person's heritage, beliefs, and values during treatment.

Regardless of income or insurance status, studies show, medical providers often dismiss Black women's questions and concerns, minimize their physical complaints, and fail to offer appropriate care. By contrast, a study of 1.8 million hospital births spanning 23 years in Florida found that the gap in mortality rates between Black and white newborns were halved for Black babies when Black physicians cared for them.

In 2013, Houstonian Kay Matthews was running a successful catering business when she lost the daughter she'd named Troya eight months and three weeks into pregnancy.

Matthews hadn't felt well — she'd been sluggish and tired — for several days, but her doctor told her not to worry. Not long afterward, she woke up realizing something was terribly wrong. She passed out after calling 911. When she woke up, she was in the emergency room.

None of the medical staffers would talk to her, she said. She had no idea what was happening, no one was answering her questions, and she started having a panic attack.

“It kind of felt like I was watching myself lose everything,” she recalled. She said the nurse seemed annoyed with her questions and demeanor and gave her a sedative. “When I woke up, I did not have a baby.”

Matthews recalled one staffer insinuating that she and her partner couldn't afford to pay the bill, even though she was a financially stable business owner, and he had a well-paying job as a truck driver.

She said hospital staffers showed minimal compassion after she lost Troya. They seemed to dismiss her grief, she said. It was the first time she could remember feeling as if she was treated callously because she is Black.

“There was no respect at all, like zero respect or compassion,” said Matthews, who has since founded the Shades of Blue Project, a Houston nonprofit focused on improving maternal mental health, primarily for Black patients.

To help combat these high mortality rates in Harris County, Robinson created a maternal child and health office and launched a home-visit pilot program to connect prenatal and postpartum patients with resources such as housing assistance, medical care, and social services. Limited access to healthy food and recreational activities are barriers to healthy pregnancy outcomes. Studies have also shown a connection between evictions and infant mortality.

For Hill, not having insurance was also likely a factor. While pregnant, Hill said, she had had just a single visit at a community health center before her miscarriage. She was working multiple jobs as a college student and did not have employer-provided medical coverage. She was not yet approved for Medicaid, the state-federal program for people with low incomes or disabilities.

Texas has the nation's highest uninsured rate, with nearly 5 million Texans — or 20% of those younger than 65 — lacking coverage, said Anne Dunkelberg, a senior fellow with Every Texan, a nonprofit research and advocacy institute focused on equity in public policy. While non-Hispanic Black Texans have a slightly better rate — 17% — than that overall state level, it's still higher than the 12% rate for non-Hispanic white Texans, according to census data. Health experts fear that many more people are losing insurance coverage as COVID-19 pandemic protections end for Medicaid.

Without full coverage, those who are pregnant may avoid seeking care, meaning they skip being seen in the critical first trimester, said Fatimah Lalani, medical director at Houston's Hope Clinic.

Texas had the lowest percentage of mothers receiving early prenatal care in the nation in 2020, according to the state's 2021 Healthy Texas Mothers and Babies Databook, and non-Hispanic Black moms and babies were less likely to receive first-trimester care than other racial and ethnic groups. Babies born without prenatal care were three times as likely to have a low birth weight and five times as likely to die as those whose mothers had care.

Tonjanic Hill's twins, though premature, are now preschoolers. “I believe God — and the high-risk doctor — saved my twins,” she says.(Brandon Thibodeaux for KFF Health News)

If Hill's miscarriage reflects how the system failed her, the birth of her twins two years later demonstrates how appropriate support has the potential to change outcomes.

With Medicaid coverage from the beginning of her second pregnancy, Hill saw a high-risk pregnancy specialist. Diagnosed early with what's called an incompetent cervix, Hill was consistently seen, monitored, and treated. She also was put on bed rest for her entire pregnancy.

She had an emergency cesarean section at 34 weeks, and both babies spent two weeks in neonatal intensive care. Today, her premature twins are 3 years old.

“I believe God — and the high-risk doctor — saved my twins,” she said.

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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News' free Morning Briefing.

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Louisiana Illuminator is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on Facebook and Twitter.

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Louisiana Illuminator

Biden touts gun safety record to advocates, as son found guilty on felony charges • Louisiana Illuminator

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lailluminator.com – Ariana Figueroa – 2024-06-12 05:00:32

by Ariana Figueroa, Louisiana Illuminator
June 12, 2024

WASHINGTON — President Joe Biden on Tuesday touted his administration's efforts to reduce gun violence as the second anniversary of bipartisan gun safety legislation he signed into law approaches.

“Never give up on hope,” Biden said during an annual conference hosted by the advocacy group Everytown for Gun Safety.

The speech came hours after the president's son Hunter Biden was found guilty in a federal court in Delaware of lying on paperwork related to purchasing a gun and unlawfully possessing that gun, according to media reports.

The federal jury found Hunter Biden, who has struggled with drug addiction, guilty on three related felony charges: lying to a licensed gun dealer, falsely stating on an application for a gun that he was not using drugs and for unlawfully having the gun for 11 days.

He could face up to 25 years in prison, though as a first-time offender his sentence is expected to be much less severe.

The president has avoided publicly commenting on his son's case and he did not mention the verdict in his speech.

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Gaza protest

Shortly after Biden began his speech, he was interrupted by a protester who accused the president of being “complicit” in the high death toll of the Israel-Hamas war. The conflict has killed 35,000 Palestinians since Oct. 7, according to the Health Ministry in the Gaza Strip run by the Hamas-controlled government. An agreement over a U.S. backed cease-fire deal remains elusive.

The crowd immediately drowned out the protester. A group of protesters was removed, according to a White House pool report.

Biden tried to calm the crowd.

“That's alright,” he said. “Folks, it's OK, look they care, innocent children have been lost, they make a point.”

Law nears second anniversary

Biden went back to his speech, and thanked the gun safety advocates and survivors “who have turned their pain” into advocacy.

“You've helped power a movement,” Biden said.

The gun safety law Biden signed in 2022 was the most comprehensive federal gun safety legislation in nearly 30 years. It stemmed from two deadly mass shootings less than two weeks apart in 2022.

One was at an elementary school in Uvalde, Texas, where 19 children and two teachers were murdered, making it the second-deadliest mass shooting since the Sandy Hook Elementary School massacre in 2012.

The other was in Buffalo, New York, where a white supremacist targeted a Black neighborhood and killed 10 Black people in a grocery store.

Worries about guns in school mount as permitless concealed carry law looms

The 2022 law provided $750 million for states to enact “red flag laws,” which allow the courts to temporarily remove a firearm from an individual who is a threat to themselves or others as well as $11 billion in mental health services for schools and families. The law cracked down on straw purchases, illegal transactions in which a buyer acquires a gun for someone else.

The bill also requires those who are under 21 and want to purchase a firearm to undergo a background check that takes into account a review of juvenile and mental health records. It also led to the creation of the White House Office of Gun Violence Prevention.

The Justice Department also announced Tuesday it has charged more than 500 people under provisions of the gun safety law to “target the unlawful trafficking and straw-purchasing of firearms.”

The statutes “directly prohibit straw purchasing and firearms trafficking and significantly enhance the penalties for those crimes, providing for up to 15 years in prison,” according to the Justice Department.

“Criminals rely on illegal gun traffickers and straw purchasers to obtain the weapons they use to harm our communities,” Attorney General Merrick Garland said in a statement.

More work to do

Biden acknowledged that more needs to be done on gun safety legislation and he called on Congress to ban assault weapons and require universal background checks and safe storage of firearms. In a divided Congress, any gun-related legislation is unlikely to pass.

The last time Congress passed major gun legislation was 1994, when then-President Bill Clinton signed a ban on assault weapons that spanned 10 years. When it expired, Congress did not renew the ban.

Biden also took a jab at his rival, former President Donald J. Trump, and said that he won't tell people to “get over” a mass shooting.

After a school shooting in Perry, Iowa, the presumptive GOP presidential nominee said during a campaign speech in Sioux City, Iowa, that while the school shooting that left two dead – an 11-year-old student and the principal – was a “terrible thing that happened,” his advice was to “get over it. We have to move forward.”

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Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on Facebook and Twitter.

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Pair of U.S. House Dems add to chorus calling for Alito, Thomas recusals • Louisiana Illuminator

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lailluminator.com – Ariana Figueroa – 2024-06-12 05:00:51

Pair of U.S. House Dems add to chorus calling for Alito, Thomas recusals

by Ariana Figueroa, Louisiana Illuminator
June 12, 2024

WASHINGTON — U.S. House Democrats echoed Senate colleagues Tuesday in calling for U.S. Supreme Court Justices Clarence Thomas and Samuel Alito to recuse themselves from Jan. 6 cases, and for congressional Republicans to support passing an enforceable ethics code for the entire bench.

Reps. Jamie Raskin, ranking member of the U.S. House Committee on Oversight and Accountability, and vice ranking member Alexandria Ocasio-Cortez brought together fellow progressive Sen. Sheldon Whitehouse with experts and advocates for a roundtable discussion on the “ethics crisis” facing the nation's highest court.

Recent revelations of flags sympathetic to the “Stop the Steal” movement flown outside Alito's home have reignited simmering concerns over justices' conflicts of interest as they decide politically divisive issues. This year, justices are set to rule on access to the abortion pill and whether former President Donald Trump enjoys immunity from criminal charges alleging 2020 election interference, among other cases.

Raskin and Ocasio-Cortez delivered searing remarks, admonishing decades of court actions beginning with the 5-4 decision in 2000's Bush v. Gore that ultimately decided the presidential victory for George W. Bush. The lawmakers continued on to recent events that Ocasio-Cortez characterized as “corruption that is almost comical.”

“The Supreme Court as it stands today is delegitimizing itself through his conduct,” the New York Democrat continued in her opening statement. “Americans are losing fundamental rights in the process — reproductive health care, civil liberties, voting rights, the right to organize clean air and water because the court has been captured and corrupted by money and extremism.”

Raskin, of Maryland, said the “highest court in the land today has the lowest ethical standards.”

In his opening statement, Raskin characterized the court as “the judicial arm of the Republican Party,” drawing a throughline from Bush's appointments to the bench of Chief Justice John Roberts and Alito to Trump's appointments of conservative Justices Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett.

“Now this right-wing corporate court, carefully designed to destroy Roe v. Wade and marry right-wing religion to untrammeled corporate power, has been demolishing women's abortion rights and contraceptive rights, civil rights law, voting rights law, civil liberties, environmental law, workers' rights and consumer rights, enshrining government power over people and corporate power over government,” Raskin said.

Raskin and Ocasio-Cortez's roundtable came less than a week after progressive House Reps. Pramila Jayapal of Washington and Hank Johnson of Georgia rallied with activists outside the Supreme Court urging an ethics overhaul.

That same day, Senate Minority Leader Mitch McConnell of Kentucky posted to X: “As the Supreme Court term ends, the Left is once again bullying Justices who refuse to take orders from liberal Senators. The Court should take any action it deems appropriate to reprimand unethical conduct by members of its Bar. And Justices should continue to pay this harassment no mind.”

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‘Keep the pressure on'

Whitehouse told Democratic members of the Oversight and Accountability Committee that Senate Democrats are shining a “heavy spotlight on the mischief.”

The Rhode Island Democrat has championed an ethics bill titled the Supreme Court Ethics, Recusal and Transparency Act, which advanced out of committee along party lines in July 2023 but has not received a floor vote.

“We need to keep the pressure on until they join the rest of the government in having a real ethics code with real fact finding and some prospects for comparing the facts that are found to the rules,” Whitehouse said.

The bill was introduced during the fallout from a 2023 ProPublica investigation revealing that Justice Clarence Thomas received gifts from and traveled with a major Republican donor.

A recent analysis by watchdog group Fix The Court illustrated that over the past 20 years the value of gifts received and likely received by Thomas dwarfs that of his colleagues.

Supreme Court orders Louisiana to use congressional map with two majority-Black districts 

Whitehouse again pressed the court in May after the New York Times published that an upside-down U.S. flag hung outside Alito's Alexandria, Virginia, home just days after former Trump's supporters breached the Capitol. The Times later revealed another flag carried by Jan. 6 insurrectionists flew outside the justice's New Jersey beach house.

Along with Sen. Dick Durbin, who chairs the Senate Committee on the Judiciary, Whitehouse requested a meeting with Roberts to urge Alito to recuse himself from cases related to the Jan. 6 attack. Roberts declined, and Alito responded to the senators, declaring he would not recuse himself.

“Thank you Sen. Whitehouse for always flying the flag right side up,” Raskin said.

The court ‘will decide all of this for all of us'

Kate Shaw, University of Pennsylvania law professor, told the lawmakers that the court is “conducting itself in ways that are fundamentally inconsistent with basic separation-of-powers principles that are a core feature of our democracy.”

“This is crystal clear right now, as it is every June, as the country waits with bated breath to learn whether and how the court will upend huge swaths of American law,” she continued.

“This year questions include whether and how the court could further erode the capacity of agencies to regulate in ways that protect our health and safety and well being,” and major firearms decisions, Shaw said.

The court will also decide whether laws on the books will “be used to hold accountable individuals charged with the attack on the Capitol, including the former president,” Shaw said. “And the court is asserting that it and essentially it alone will decide all of this for all of us.”

Over two dozen opinions are expected from the Supreme Court by the end of June.

Two decisions related to two Jan. 6 cases remain pending — one involving a former police officer who breached the Capitol and is seeking to have an obstruction charge dropped. The decision could affect hundreds of Jan. 6 defendant cases, and the 2020 election interference case against Trump, who faces the same obstruction charge.

The court is also set to decide whether Trump is immune from four federal criminal counts alleging he schemed to overturn the 2020 presidential election results and knowingly spread false information that whipped his supporters into rioting on Jan. 6.

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Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on Facebook and Twitter.

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Campaign cash for child care? Louisiana lawmakers decline to endorse it. • Louisiana Illuminator

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lailluminator.com – Julie O'Donoghue – 2024-06-12 05:00:35

by Julie O'Donoghue, Louisiana Illuminator
June 12, 2024

Five years ago, the Louisiana Board of Ethics told a political candidate she could use her campaign money to cover child care costs as long as the expense was related to her efforts to get elected. But state legislators declined to insert that policy into law this year.

They scuttled Senate Bill 153 to ensure candidates could use campaign dollars for election-related child care. 

The proposal passed the Louisiana Senate 31-3 but died in the House and Governmental Affairs Committee. Committee members said too many questions about the bill remained. 

The legislation's failure doesn't necessarily mean candidates can't use money raised for their campaigns to pay child care expenses. It just means the issue will be left up to the ethics board, which could reverse its 2018 decision at any time. 

“In some cases, it's better to have these individual decisions made, as they are, through [the ethics board],” House Republican Caucus Chairman Mark Wright of Covington said.

Former Rep. Ted James, D-Baton Rouge, wishes the Louisiana Legislature had made a definitive statement on the issue. As a candidate for Baton Rouge mayor and single father, James has sometimes wished he had child care for his 6 year-old daughter while campaigning. He has not used any election money for child care yet, but juggling his daughter during nighttime and weekend events can be difficult, he said.

“I think that the Legislature could have and should have put some clarity to it,” James said. 

What's a legitimate campaign expense in Louisiana has been interpreted liberally over the years. Candidates are allowed to use their funds for Mardi Gras parades, restaurant dining, flowers for constituents, charity golf tournaments, fuel and vehicle maintenance.

Several elected officials buy Saints and LSU football tickets with campaign money every year. They also collectively spent over half a million dollars in campaign funds to attend D.C. Mardi Gras, a four-day event that includes dozens of parties, in 2022. 

“If folks can use campaign money to buy Saints, Southern and LSU tickets, I certainly think [child care] should be permissible,” James said.

In the past, the ethics board has also waffled over whether campaign money can be used to cover child care costs.

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The board issued two opinions to male candidates in 2000 indicating they could use campaign funds to cover child care to attend fundraisers. Based on that decision, a group of men who ran for office, including U.S. Sen. John Kennedy, tapped their campaign accounts to cover child care for years. 

Then, in 2018, the board, with a different lineup of members, told legislative candidate Morgan Lamandre she could not use campaign money for child care. One member, former House Rep. Charles Emile “Peppi” Bruneau, told Lamandre her primary responsibility was to provide for her children, not to be a political candidate. 

After widespread criticism of the decision and Bruneau's remarks, the board backtracked a few months later in 2019 and voted 6-4 to allow Lamandre the child care expense. 

Senate President Pro Tempore Regina Barrow, D-Baton Rouge, sponsored the Senate bill this year to clear up any confusion that might remain. She said 31 other states already have a law on the books that allows campaign cash to be used for child care.

“I'm trying to codify what the [ethics board] ruling says,” Barrow said.

During debate on the bill, a handful of legislators implied child care should not be an allowable campaign fund use. 

“Are you aware we have a general prohibition against using campaign funds for personal expenses?” Sen. Blake Miguez, R-New Iberia, asked Barrow during debate on the Senate floor.

“Yes,” Barrow said. 

“So why are you bringing the bill?” Miguez replied. 

Miguez, who voted against Barrow's legislation, said allowing campaign funds to be used for child care would open “Pandora's box.” During the Senate debate, he listed utility bills, lawn care, car leases and “car notes” as costs that candidates might try to cover with campaign funds if child care became an allowable expense.

Legislators already use campaign money to cover car leases. Gov. Jeff Landry also put his campaign money toward paying “a portion of a note on a motor vehicle” for years until the ethics board told him to stop in 2022. 

“Don't you think that's very important to have [a candidate's] animal taken care of while they're out there campaigning?” Miguez asked Barrow during debate on her child care bill. 

“I know that you're not equating pet animals to children,” Barrow replied. 

“I'm not. I'm just giving you some specific examples of where this could go,” Miguez said.

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Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on Facebook and Twitter.

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