Failing Mothers and Children

Infant mortality in Minnesota by mother’s race/ethnicity. Data are for 2012-2016. Source: Minnesota Center for Health Statistics

In the early 1900s, national improvements in hygiene, nutrition, living conditions, and health care were beginning to reduce infant mortality. The number of babies of all races who died in the first year of life dropped by more than 90 percent from 1915 through the 1990s.

Today, on the other hand, the country’s record on infant and maternal mortality is getting worse. Of the 35 wealthiest nations, the U.S. ranks 32nd for its infant death rate, generally caused by low birth weight. According to a New York Times Magazine article written by Linda Villarosa, who spoke recently at the St. Cloud Women’s Center, Black infants are more than twice as likely to die as white infants. A Black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education.

The U.S. also is one of only 13 countries in the world where the death of a woman related to pregnancy or childbirth is worse than it was 25 years ago. Black pregnant women are three to four times as likely to die as white women.

In contrast, countries like Cuba have dramatically reduced its mortality rates with a growth in community health care workers. In 1958, for example, Cuba’s infant mortality rate was 60 out of 1000; today it is 4.3, which is lower than the U.S. (5.8).

Partly in response to disparities, the numbers of U.S. doulas and midwives have been growing. The American College of Obstetricians and Gynecologists suggested a few years ago that “continuous one-to-one emotional support provided by personnel, such as a doula, is associated with improved outcomes for women in labor.”

In 2013, Minnesota became the second state, after Oregon, that require Medicaid to cover doula services for low-income mothers. In 2019, legislators (Rep. Alice Mann, DFL-Lakeville and Sen. Jim Abeler, R-Anoka) introduced bills designed to improve payments for doula services provided to women on Medical Assistance. Currently the limit is $488 per birth. The legislation did not pass.

Incarcerated Mothers

In 1915, lawmakers in a Minnesota House committee were urged by women lobbyists to create what would become the Shakopee Correctional Facility for Women. The first 23 women admitted to the prison were mostly guilty of “crimes against chastity” and were given rules about keeping sleeves down, socks up, and make-up off.

Author Sheila O’Connor (see related story) wrote a commentary in The New York Times that shared the story of her grandmother who was imprisoned in Minnesota for “immorality” in 1935 as a 15-year-old pregnant teenager. Then and today, many inmates are victims of sexual abuse who are running away from and reacting to their environment.

“For Black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress resulting in conditions, including hypertension and pre-eclampsia, that lead directly to higher rates of infant and maternal death.” — Linda Villarosa

“Consistent with my grandmother’s time,” O’Connor wrote, “juvenile detention facilities still lack adequate professionals able to care for the special needs of the large population of girls who have been victimized. Their reports of abuse by boys and men may have been recorded, but in the end it was the girls who were considered ‘in need of reform.’”

Today, treatment of incarcerated pregnant women is not much more evolved. A Star Tribune article in October by Liz Sawyer shared the story of a woman who was allowed to bond for only 36 hours with her newborn in the hospital before being returned to prison. The 31-year-old woman is serving four years for a drug conviction.

A bill proposed in 2019 by Rep. Jamie Becker-Finn (DFL-Roseville) to  establish  a bus program to enable access for child bonding with incarcerated mothers did not pass. Lieutenant-Governor Peggy Flanagan referred to racial disparities during a visit to the 610-inmate Shakopee women’s prison, saying, “our job is to stop that generational re-traumatization.”


In the print version of our January issue, we indicated a bill did not pass in the last legislative session to establish medical assistance reimbursement rates for doula services. The HF 259 legislation did pass as part of the HHS Omnibus bill.