The Challenges and Solutions to Accessing Maternity Care in Louisiana
By Elizabeth Dawes Gay
Brianna beams as she holds Solei up to the camera. She’s excited to show off her new baby girl after counting down the days until her arrival. Her baby is healthy, and her birth went as she had hoped. But, the road to this moment wasn’t exactly easy.
Brianna is featured in Giving Birth in America: Louisiana, the newest film in Every Mother Counts’ series about childbirth in the United States. The film was shot in Louisiana in the aftermath of a 2016 tropical storm that caused dangerous flooding and lasting destruction. The storm compounded the challenges that many women in Louisiana regularly face while trying to have a healthy pregnancy.
Louisiana has one of the highest rates of maternal death in the United States and some of the poorest birth outcomes. Poverty and unemployment are high, and educational attainment is low. Almost half of Louisiana’s counties do not have a single Ob/Gyn and, in many parts of the state, it takes an hour or more to reach the nearest provider. Accessing health care can be both financially and physically challenging.
Extreme weather in Louisiana has worsened access to care, and strains the daily lives, resilience, and mental health of already vulnerable mothers and families. Climate change has increased the risk of extreme weather events, such as hurricanes and floods, in Louisiana and neighboring coastal areas. The billions of dollars in property damage and the disrupted daily lives for the women living in Baton Rouge are easy to recognize. It requires a closer look to see the trauma that the 2016 storm left in its wake.
The Storm’s Impact
Teneshia, also featured in the film, told Every Mother Counts:
“It feels like I went from everything to nothing…After the storm, I avoided my doctor’s appointments the first few months. I would just reschedule and reschedule and not go.”
Pregnant with her third child, Tenisha found it difficult to cope with both the storm and her circumstances. Her other two children are living with her mother while she finishes school. Teneshia, like many American moms, also struggles with depression. The storm damaged her apartment, and she returned to find it moldy and unlivable. For her safety, she was forced to find housing elsewhere. At one point, her situation was so overwhelming she contemplated suicide. Fortunately, Teneshia harnessed enough strength and resilience to eventually return to prenatal care and give birth to Tristan, a healthy baby boy.
Teneshia isn’t alone. Dr. Marshall St. Amant, MD, a maternal-fetal medicine specialist at Woman’s Hospital, notes the storm’s effects.
“The flood absolutely changed patients’ demeanor, patients’ pain, patients’ depression,” he says in the film. “We need to do a better job of understanding that lives are really challenged out there.”
So, what are the solutions?
One solution is to make healthcare more accessible. Dr. St. Amant addresses one of the hurdles that keep women away from needed care by bringing care to women in rural communities:
“We could stay in Baton Rouge and hope for the patients to drive an hour and a half to us. But so many patients would lose out on the opportunity to get care, because they just couldn’t afford the gas or have a car that would work. So we flip the tables, and we get in our car, and we drive down to them.”
Dr. Rebekah Gee MD, MPH, secretary of Louisiana’s Department of Health, adds that changing outcomes requires attention to social justice issues.
“In the state of Louisiana, access to health care is not the only social determinant of health. So, we have to think about equity and social justice. We have to think about other policies that support that support social systems, that support women and families.”
Supportive policies can increase resiliency and help Louisiana families better cope with challenges, including those brought on by climate change.