Prepared as a shadow report for the United Nations Committee on the Elimination of Racial Discrimination (CERD), this report evaluates the U.S. record on addressing racial and gender discrimination in sexual and reproductive health care. Highlighting racial disparities in maternal mortality and discrimination against non-citizen women in access to health care, the report focuses on the need for policy change as well as proactive measures to address the structural forms of discrimination that inhibit the ability of women of color and immigrant women to exercise their human right to health.
The rate of women dying in childbirth in the United States more than doubled from 1990 to 2013, and Black women are dying at rates almost four times higher than White women. Poverty, persistent disparities in sexual and reproductive healthcare and lack of health insurance are major factors contributing to maternal mortality, all of which have a disparate impact on communities of color.
The report also cites the exclusion of both documented and undocumented immigrants from public health insurance as another contributing factor to high maternal mortality among women of color. Even documented immigrants must wait at least five years to be eligible to enroll in Medicaid and undocumented immigrants are barred by law from buying private health insurance under the Affordable Care Act.
The report includes a number of recommendations that could address racial and gender based discrimination including; increasing coverage for low-income women in states that have “opted out” or Medicaid expansion; increased access to affordable contraceptive and family planning services; improved data collection and investigations of maternal mortality; elimination of the five year waiting period for documented immigrant eligibility for Medicaid and allowing undocumented immigrants to buy health insurance under the Affordable Care Act.