Delegate hopes to end Virginia’s high Black maternal mortality rate

Destiny LeVere Bolling lost her unborn child, Noah, during the height of her campaign for state office in 2023.

The Democratic delegate of Henrico won the race, but not without a life-altering loss.

“I was only five months, but the crib was already set up,” LeVere Bolling said.

LeVere Bolling called her OB-GYN when painful cramps kicked in. She was advised to rest and take over-the-counter medication for the pain, she said. Just a few days later, LeVere Bolling’s husband rushed her to the hospital when her water broke prematurely.

“They had me sit in there for like 25 minutes and I’m literally bleeding through my dress,” LeVere Bolling said.

LeVere Bolling stayed for an overnight observation after doctors informed her she had suffered a large fluid loss. The next morning, at 19 weeks, baby Noah’s heart stopped beating.

“The part that I regret is not fully listening to my gut during that week when I was having those cramps,” LeVere Bolling said. “I just relied on the doctor’s medical advice.”

Black women die during childbirth at three times the rate of white women nationwide, according to the Centers for Disease Control and Prevention.

Black Maternal Health Week, held from April 11-17, works to raise awareness that Black women are dying from childbirth at a disproportionately higher rate.

“It’s a scary and real thing and it’s not just a data point that we throw out there,” LeVere Bolling said. “We’re talking about real lives who just want to grow their family and are dying.”

Most Maternal Deaths Were Preventable, Doctors say

Factors that shape Black motherhood include racial bias in health care, underlying health conditions and lack of quality care, according to the CDC.

In Virginia, the Black maternal mortality rate is about two times greater than white women, according to VCU Health. Infants born to Black women pass away up to three times more than other races in Virginia.

Many patients are concerned about the grim reality of current statistics, according to Dr. Tashima Lambert Giles, an OB-GYN at VCU Health.

More than 80% of maternal deaths nationwide were preventable, Lambert Giles said.

Cardiac diseases are the leading cause of Black maternal mortality, including hypertensive disorders in pregnancy, she said. Hypertension, hemorrhage and sepsis are leading complications that impact maternal mortality.

The CDC introduced in-depth hospital curriculums, called bundles, to aid in the treatment of many preventable issues such as sepsis.

“Bundles have done a great job in decreasing overall deaths, but it's not utilized in all patients at all times,” Lambert Giles said. “The question becomes: ‘why?’”

Bias could be the answer, according to Lambert Giles.

VCU Health maternal inpatient surveys show lower satisfaction in quality of care for Black patients, including perceived respect from staff when compared with white patients.

“Hard conversations have to happen if we are going to make effective change,” Lambert Giles said.

Virginia’s ‘Maternity Care Deserts’

Over 40 districts in Virginia were named maternity care deserts by the March of Dimes Perinatal Data Center. The organization defines maternity deserts as areas where services are limited, absent or hard to access.

Beth O’Connor, executive director of the Virginia Rural Health Association, works to alleviate the maternal concerns of women in rural areas.

Black maternal mortality rates in Danville, Virginia are 10 times worse than the national average, according to O’Connor. The impact of living in a maternity care desert as a Black woman can produce “horrific outcomes.”

Medicaid is the primary insurer for 50% to 60% of rural newborns, according to a 2022 report by the National Rural Health Association. Reimbursement payments are about half compared to commercial insurance providers.

Lack of reimbursement impacts a hospital’s ability to cover other costs, including staffing and malpractice insurance, according to O’Connor.

More than 26% of rural hospitals had financial challenges in 2021, according to a Virginia Hospital & Healthcare Association report.

Rural women are gravitating toward doulas and midwives as a replacement for traditional maternal care, including giving birth at home, according to O’Connor.

Birth in Color RVA is a leading reproductive justice organization founded in 2018 by Kenda Sutton-El, a doula trainer and advocate.

A doula is a nonmedical professional who “bridges the gap between client and provider,” Sutton-El said.

The organization has trained 150 doulas and was a key community partner to help establish LeVere Bolling’s doula reimbursement bill this legislative session.

“If you feel like your provider is not listening to you and downplaying the situation, switch providers and go to someone else,” Sutton-El said. “It could mean saving your life.”

Women are the Fastest Growing Incarcerated Population

Birth in Color RVA recently partnered with the Arlington County Jail to provide pregnant women with birth support throughout their sentence.

Women are the fastest growing segment of the U.S. incarcerated population, according to 2021 research published in the Journal of Women's Health. Black and Native American women are consistently overrepresented in state and federal prisons, according to 2024 data by the Prison Policy Initiative.

Del. Shelly Simonds, D-Newport News, introduced a recent bill that brings corrections representatives into the state maternal health conversation.

Four percent of women reported that they were pregnant at the time of admission to state prison, according to Simonds.

Simonds referenced the case of Shayvonne Vick, a Black woman who spent 19 months in Norfolk City Jail on a wrongful murder charge after being arrested when she was seven months pregnant. Vick was acquitted after a two-day trial and 25 minutes of jury deliberation.

There is no official federal or state census of how many pregnant women are incarcerated, or their overall maternal health, a data gap that the U.S. Department of Justice acknowledges and is addressing.

The first doula-supported prison birthing experience in Virginia was provided by the Virginia Prison Birth Project in 2019.

“This makes me emotional thinking about it,” Sarah Zia said, a certified professional midwife and prison doula who created the organization in 2019. Zia built relationships with the Charlottesville corrections community as a yoga teacher for the facility.

Zia has witnessed women shackled after giving birth, before even being allowed to use the restroom — regardless of sensitivity from cesarean section and epidurals, she said.

Virginia state code as of 2020 prohibits restraint during delivery unless there is a determination of potential harm or substantial flight risk. Zia notified staff of the law and “never has that happened since,” she said.

The Virginia Prison Birth Project has expanded to Henrico and provided doula support for about 35 women, according to Zia. The Richmond Health Equity Fund awarded the organization with a grant in January to provide 25 Richmond residents with doula support.

“The ultimate vision is to end prison birth. Like I said, this is a society problem. It needs a society solution,” Zia said. We can't just throw them up and lock away the key.”

It will take more than one law to end the higher Black maternal mortality rate, but Del. LeVere Bolling is determined to ensure Black voices are heard in the state, she said.

“Virginia might not be the place to solve all of these systemic issues, but we're for sure the place to start,” LeVere Bolling said.

VCU InSight journalist Nia McMillan contributed to this report.

Was this article informative? Help us write more like it.

Trustworthy, non-partisan local news coverage is a vital component of our democracy – it’s why the press is the only private institution mentioned by name in the Constitution. But it costs money to keep a newsroom like ours at the Henrico Citizen alive, and we no longer can rely upon advertiser support alone.

That’s why we’re asking readers like you to support our independent, fact-based journalism. We know you value it – you wouldn’t be here otherwise. Help us keep this critical source of fair coverage alive in Henrico County by making a contribution today: https://henricocitizen.fundjournalism.org/contribute/.

Show your support.