The Kira Johnson Act was passed after the death of Kira Johnson from a hemorrhage during the birth of her second child. The end of Kira left Charles, her husband, devasted and forced him to become a maternal health advocate. In April 2016, Charles Johnson never expected to leave Cedars-Sinai Medical Center in Los Angeles without his wife after he had accompanied her to deliver their second child. Kira went to the hospital in perfect condition, and the pregnancy was expected since the couple already had a firstborn son called Charles V (Mahomes, 2020). The noted point is that Charles Johnson expected the scheduled cesarean section to be a routine surgical birth because Kira’s pregnancy was healthy and had no complications. Johnson noticed the catheter for his wife Kira turning pink with blood after their son, Langston, had been born healthy.
Kira died from internal hemorrhaging because the hospital failed to do the C.T. scan earlier. The hospital is blamed for the cause of Kira’s death because they left her with a hemorrhage, bleeding into the abdomen for over ten hours. Studies noted that the hospital surgical team found 3.5 litres of blood in Kira’s abdomen when they reopened her incision (Underwood & Booker, 2020). This shows that Kira lost over 70% of her circulating blood while waiting for the doctors to solve her concerns. Johnson learned that the birth experience of Kira was not unique after he shared the story publicly. He learned that this experience happens in the U.S. children daily, leaving partners widowed, children motherless, and families shattered.
Notably, Johnson decided to take action by forming a non-profit organization known as 4Kira4Moms after doing research and discovering the number of people losing their lives from childbirth complications and during childbirth. The organization became the voice for the voiceless who had suffered in silence due to a lack of a platform. The main goal is advocating for change. Johnson took a further step in 2018 by working with Congress to pass the Prevention Maternal Death Act (Mahomes, 2020). This Act permitted the funding of states with $12 million per year for creating committees that track, review and investigate maternal mortality incidents.
The bill was signed into law in December 2018 after being passed with unanimous support by the House of Commons and Senate. The primary purpose of this Act was to prevent maternal mortality and maternal morbidity that is severe among black postpartum and pregnant people as well as other underserved populations. The Act required healthcare organizations to offer training in maternity care to prevent and reduce bias, discrimination and racism in maternity care facilities (Mahomes, 2020). The Act also purposed to improve the maternal health outcomes of blacks by providing funds to community-based organizations that black women lead. The funding supports women suffering from mental health conditions and disorders of substance use. The funding also aimed to enable community-based organizations to address the social determinants of health like nutrition, housing and transportation. It also aimed to promote health education and literacy in the postpartum and prenatal periods.
The Act also aimed to improve maternal health by providing funds for establishing respectful compliance offices for maternity care in hospitals. The compliance offices are required to offer mechanisms for postpartum and pregnant patients to report cases and evidence of racism, disrespect, ethnicity and other biases while promoting accountability in healthcare (Underwood & Booker, 2020). The families that are intended beneficiaries of the Kira Johnson Act include black families, especially pregnant women. The Act targeted black women because they were experiencing a maternal mortality crisis in the United States. Black women were at risk of losing their lives during pregnancy and childbirth period.
However, the passing of this Act has enabled Black-led organizations to work tirelessly to make sure that moms across the country are prevented and protected from losing their lives when trying to bring lives into the earth. The Act decided to put investments in the black community by providing funds to community-based organizations leading in protecting black moms (Underwood & Booker, 2020). The policy is concerned with the role of mothers in the family, which is why the 4Kira4Moms organization and the Kira Johnson Act are combating the black maternal mortality rate by focusing on education, innovation, advocacy, and legislation. It has concentrated on empowering mothers and families with the tools and resources needed for mothers to thrive during and after childbirth. The Act considers the process of mothers giving birth to healthy children and remaining alive to raise these kids as an essential human right.
Family Impact Principles
The first impact principle that applies to the Kira Johnson Act is family stability, and the other is family diversity. Family stability is defined as a family’s features that support the healthy development of children and other members. These characteristics include stable relationships, parental mental health, a flexible, supportive, and nurturing home environment, and both parents’ presence (Lowe, 2021). The Kira Johnson Act supports the concept of family stability by trying to end maternal mortality among black women. This ensures that mothers are available to keep the family together. The early loss of any parent, especially mothers, increases the probability of insufficient childcare.
Notably, the death of one parent is cited as a common factor of family instability because when one parent dies, it causes grief for family members and also affects the functions of the family. The loss of a parent causes a change in roles, opinions becoming strong, people starting to behave out of character, and riffs rising in the heat of emotions. This also makes children develop high rates of vulnerability both in the short and long term, affecting stability. Besides, the loss of any parent, such as a mother or a father, worsens the economic status and stability since the contributor or provider’s income is cut off (Lowe, 2021). In essence, the Kira Johnson Act advocates for the stability of the family by ensuring that mothers remain alive during pregnancy and childbirth. Preventing maternal mortality through funding community-based organizations that protect black pregnant and expectant mothers from dying is a clear indication of enhancing family stability. Most families have fallen apart after the death of one parent, especially a mother because such loss causes increased pressure on grieving children. The death of a parent makes them isolated from others, as well as being required to take on the duties of the dead parents.
Essentially, the death of Kira Johnson affected the stability of the family because it started a chain of loss, which harmed the health of their firstborn child, education, and even future opportunities. This disrupts the family life while devastating the loved ones with grief. It started causing Charles Johnson nightmares while shifting much focus on preventing other black women from going through what Kina Johnson underwent. The devastation she experienced forced Charles Johnson to become an advocate of maternal health among black women (Lowe, 2021). The policy has ensured that families are stable by offering training and education in maternity care to healthcare professionals. This will prevent pregnancy and childbirth complications to prevent the death of mothers during and after childbirth. The Act will achieve this goal of preventing mothers’ deaths by investing $12 million each year for five years in tracking, reviewing, and investigating incidents of maternal mortality. The policy also supports family stability through funding community-based organizations that target to help black women.
Family diversity is another principle of family impact. It is defined as the different types of families and family life existing in society, as well as various characteristics that differentiate these families from each other. Family diversity is grouped into social class, ethnicity, culture, and life-stage diversity. This policy deals with structural racism and maternal health deaths experienced by black women in the United States (Taylor, 2020). Studies have noted that the maternal mortality rate of American women is about 17.4% per 100,000 live births, which makes the United States have the highest number of mortality. Out of these rates, the number of black women dying as a result of maternal mortality is more than any other race in the USA.
Black women are more likely to die two to three times during and after childbirth compared to white women. These women are more at risk of experiencing severe maternal morbidity than white women because of their family diversity. Studies have cited that poor maternal health outcomes among women from black families are not caused only by social determinant factors like educational attainment, access to healthcare, or poverty but mainly because of structural racism (Kozhimannil et al., 2011). Structural racism is considered the main and most potent cause of death among pregnant women, and it is associated with the historical system of devaluing and oppressing women from ethnic backgrounds. The practice is subtler in today’s healthcare practices and policies, hence raising the high number of maternal mortalities during and after childbirth.
The Kira Johnson Act is determined to ensure that this historical system of racism does not affect the maternal health of black women by investing funds in community-based organizations led by black women. It also calls upon the government to invest in healthcare education and training to improve the knowledge and practices of healthcare professionals working in maternity care facilities (Taylor, 2020). The Act is addressing the root cause of increased maternal mortality rates among black women by investing in culturally competent organizations that are leading in improving black women and birthing individuals’ outcomes. The Act is focused on closing the black maternal health gap that has existed for many decades in the United States.
Policy Equity Assessment
The Kira-Johnson Act has set explicit and implicit goals to solve the racial/ethnic gaps in maternal health. The goal aimed at reducing and preventing the increased mortality rates among pregnant black women in the United States. The first goal of this policy is to provide support to communities with high rates of maternal mortality, maternal health disparities, severe maternal morbidity, and adverse outcomes of perinatal childbirths (Mahomes, 2020). The other goal is to offer programs and resources that align with practices of bettering the maternal health outcomes for mothers from communities with high rates of maternal mortality and adverse childbirth and perinatal outcomes. Promoting maternal substance use disorder and mental health treatments and support is another goal of this Act. The treatments should align with the practices for bettering behavioral and maternal mental health outcomes for women with high rates of maternal mortality rates (Kozhimannil et al., 2011). The policy also aimed to address the social determinants of maternal health among black women and ensure that black women receive support from perinatal health workers during pregnancy and childbirth.
The Kira Johnson Act can meet the needs of the overall eligible population, like the racial/ethnic groups, because it provides funding to community-based organizations. The organizations use funds to better the maternal health outcomes of black postpartum and pregnant women and birthing individuals from other communities that are underserved with resources (Taylor, 2020). The Act also facilitates the creation of committees in different states that help tackle the high maternal mortality rates by tracking, reviewing, and investigating the cases. It can achieve this goal since it provides states $12 million each year to fund such activities. The Kira Johnson Act uses evidence-based research to tackle the issue of inequalities among black communities. The Act requires healthcare professionals and community-based organizations to use evidence-based research and practices to provide resources and programs for improving the maternal health outcomes of pregnant women from black communities (Kozhimannil et al., 2011). The policy also reduces inequalities by using institutionalized mechanisms which enable patients and families of such patients or perinatal healthcare workers supporting the patients receiving maternity care services to report cases of racism and bias related to racial and ethnic discrimination.
Policy Recommendations
The policy should start advocating for more black women to be placed in leadership and power positions. This is because having more black women in position will make it easy to tackle maternal mortality because this issue affects their women and community. This will enhance the creation of more feasible solutions that can reflect how to address racial bias in black maternal mortality. The policy should also focus on increasing education opportunities for black women and supporting them in becoming healthcare providers in maternal clinical care or reproductive health. This will entail including black women in the education sector so that they participate in policy and legislation changes when it comes to distributing educational resources.
The racial bias during interactions with patients will reduce significantly when black women are given a chance to practice as healthcare practitioners. Having physicians with similar societal and cultural upbringings, like patients seeking maternal care, reduces racial bias. This shared background between the physician and patients creates a great understanding through similar lived experiences. The last recommendation is to include the training doulas from the communities with plans to practice such training. My proposal to better the maternal well-being of black women in the United States is to have programs aimed at various maternal health and caregiving positions, like doulas, obstetricians, and physicians.
References
Taylor, J. K. (2020). Structural racism and maternal health among Black women. The Journal of Law, Medicine & Ethics, 48(3), 506–517.
Underwood, L., & Booker, C. (2020). Black Maternal Health Momnibus Act of 2020. In 116th Congress.
Lowe, N. K. (2021). Black Women’s Lives Matter. Journal of Obstetric, Gynecologic & Neonatal Nursing, 50(4), 363–368.
Bogenschneider, K. (2011, June). Family policy: Why we need it and how to communicate its value. In United Nations Expert Group Meeting Assessing Family Policies: Confronting family poverty and social exclusion & ensuring work-family balance.
Kozhimannil, K. B., Trinacty, C. M., Busch, A. B., Huskamp, H. A., & Adams, A. S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric Services, 62(6), 619-625.
Mahomes, A. D. (2020). ” You Should Have Said Something:” Exploring the Ways That History, Implicit Bias, and Stereotypes Inform the Current Trends of Black Women Dying in Childbirth. USFL Rev., 55, 17.
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