Black mothers in Texas and Indiana say hospital staff ignored cries for care while they were in labor – NBC News

Report on Disparities in Maternal Healthcare and Alignment with Sustainable Development Goals

Recent incidents involving two Black women who were allegedly denied timely medical care while in active labor highlight significant shortcomings in the U.S. healthcare system. These cases underscore a critical failure to meet several United Nations Sustainable Development Goals (SDGs), particularly those concerning health, equality, and institutional justice.

SDG Framework for Analysis

This report analyzes these events through the lens of the following SDGs:

• SDG 3: Good Health and Well-being: Ensuring healthy lives and promoting well-being for all, including the target to reduce global maternal mortality.
• SDG 10: Reduced Inequalities: Addressing inequalities within and among countries by promoting the social inclusion of all, irrespective of race or ethnicity.
• SDG 5: Gender Equality: Achieving gender equality and empowering all women and girls, which includes ensuring access to reproductive and maternal healthcare.
• SDG 16: Peace, Justice and Strong Institutions: Promoting accountable and inclusive institutions at all levels.

Case Studies in Healthcare Inequity

Incident 1: Dallas Regional Medical Center, Texas

A patient, Karrie Jones, experienced a significant delay in receiving care while in the final stages of labor. The incident demonstrates a direct challenge to achieving universal health coverage and safe childbirth as outlined in SDG 3.

• Patient: Karrie Jones, a Black woman in active labor.
• Allegation: Medical attention was delayed while staff prioritized administrative intake procedures, despite the patient’s visible and audible distress.
• Evidence: Video documentation shows the patient in extreme pain, confirming she was in active labor while being subjected to questioning.
• SDG Implication: The delay in care represents a failure to provide safe, timely, and equitable healthcare, undermining progress toward SDG 3.

Incident 2: Franciscan Hospital, Indiana

A second case involved Mercedes Wells, who was discharged from a hospital while in labor and subsequently gave birth in her vehicle. This event further illustrates the severe consequences of healthcare inequality.

• Patient: Mercedes Wells, a Black woman experiencing contractions.
• Allegation: The patient was sent home after a six-hour wait without being examined by a doctor.
• Outcome: The patient gave birth on the side of a road eight minutes after leaving the hospital, a high-risk situation that could have resulted in maternal or infant mortality.
• SDG Implication: This outcome is a stark example of the inequalities addressed by SDG 10 and the failure to provide essential maternal care as mandated by SDG 3.

Systemic Failures in Relation to Sustainable Development Goals

SDG 3: Good Health and Well-being

These cases are symptomatic of a broader crisis in maternal health for Black women, which directly contradicts the objectives of SDG 3, particularly Target 3.1, which aims to reduce the global maternal mortality ratio. Statistics from the Centers for Disease Control and Prevention (CDC) reveal a profound disparity:

• Black women are three times more likely to die from childbirth-related causes than white women.
• The maternal mortality rate for Black women is 50 deaths per 100,000 live births, compared to 14.5 for white women.
• Delayed care is identified as a primary contributor to these preventable deaths.

SDG 10: Reduced Inequalities

The differential treatment of Black women in healthcare settings is a clear violation of the principles of SDG 10, which calls for the elimination of discriminatory practices and the promotion of inclusion. The experiences of Jones and Wells suggest that racial bias can directly lead to unequal and life-threatening health outcomes, preventing the achievement of equitable access to public services.

Institutional and Legal Context

Institutional Accountability and SDG 16

The responses from the involved medical centers reflect on the need for strong and accountable institutions, a core component of SDG 16. Both Dallas Regional Medical Center and Franciscan Hospital have issued statements committing to internal investigations. The involvement of Texas lawmakers to meet with hospital administrators further highlights the push for institutional accountability and reform to ensure fair and appropriate medical care for all community members.

Legal Framework and Its Limitations

The Emergency Medical Treatment and Labor Act (EMTALA) of 1986 provides a legal basis for patient protection, yet its application can be flawed.

1. The law mandates that emergency departments must stabilize patients who appear to be in active labor.
2. However, the determination of “active labor” is subjective and left to the discretion of medical professionals.
3. This subjectivity creates a potential gap where bias can influence decision-making, leading to patients being turned away improperly.
4. Legal liability for the hospital is contingent on proving that staff were negligent and did not adhere to a reasonable standard of medical care.

Conclusion: A Call for Systemic Change

The reported incidents are not isolated but are indicators of a systemic crisis that impedes progress toward global development goals. Achieving SDG 3, SDG 5, and SDG 10 requires a concerted effort to dismantle systemic inequities within the healthcare system. Restoring trust and ensuring that every person receives equitable, high-quality maternal care necessitates robust institutional accountability, policy reform, and an unwavering commitment to eliminating racial disparities in health outcomes.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The article’s central theme is the denial of adequate and timely maternal healthcare, which directly impacts the health and well-being of mothers and their newborns.
• SDG 5: Gender Equality: The issues discussed are specific to women’s health, particularly maternal care. The experiences of the two women highlight gender-specific vulnerabilities within the healthcare system.
• SDG 10: Reduced Inequalities: The article explicitly frames the incidents as examples of racial disparity in healthcare, stating they “highlight long-standing disparities in health outcomes for Black women.” It contrasts the treatment and health outcomes of Black women with those of other racial groups.
• SDG 16: Peace, Justice and Strong Institutions: The article touches on legal frameworks like the Emergency Medical Treatment and Labor Act, hospital accountability, and the involvement of lawmakers. This relates to the need for effective, accountable, and non-discriminatory institutions to ensure justice and fair treatment for all.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
   • The article directly addresses this by citing the high maternal mortality rate for Black women in the U.S. (“50 deaths per 100,000 live births”), which is significantly higher than for other groups and a major barrier to achieving this target.
2. Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age.
   • The article mentions that “Black babies are likelier to die and to be born prematurely.” The dangerous circumstances of Mercedes Wells giving birth on the side of a road, minutes after being sent home from a hospital, highlight the risks that contribute to preventable newborn deaths.
3. Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services.
   • The experiences of both Karrie Jones, who was allegedly delayed by paperwork while in active labor, and Mercedes Wells, who was sent home minutes before giving birth, are clear examples of a failure to provide access to quality and essential emergency medical services.
4. Target 5.1: End all forms of discrimination against all women and girls everywhere.
   • The article presents the women’s experiences as potential cases of discrimination. Jones’ mother is quoted asking a nurse if she treats all patients this way “or just the Black ones.” Wells states, “they don’t care at all for Black women in health.”
5. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome… by eliminating discriminatory… practices.
   • The stark difference in maternal mortality rates between Black women and white women is a clear inequality of outcome. The article suggests that delayed care, as seen in the videos, is a discriminatory practice that contributes to this disparity.
6. Target 16.6: Develop effective, accountable and transparent institutions at all levels.
   • The hospitals’ responses—stating they are “reviewing this situation” and “conducting a thorough investigation”—and the involvement of Texas lawmakers who are “meeting with hospital administrators” are actions related to making healthcare institutions more accountable and transparent.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicator 3.1.1: Maternal mortality ratio.
   • This indicator is explicitly mentioned in the article. It provides precise data: “50 deaths per 100,000 live births” for Black women, compared with “14.5 deaths for white women.” This data is used to quantify the scale of the health disparity.
2. Indicator 3.2.2: Neonatal mortality rate.
   • This is implied when the article states, “Black babies are likelier to die and to be born prematurely.” Measuring the neonatal mortality rate, disaggregated by race, would be a key way to track progress on this issue.
3. Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed.
   • This is implied through the personal testimonies in the article. Mercedes Wells’ statement, “It was really a horrific situation to be treated like a dog,” and her feeling that “they don’t care at all for Black women in health” are qualitative data points for this indicator.

4. Table of SDGs, Targets, and Indicators

Source: nbcnews.com