I want to start by saying that yes, I’m white. I’m also not a mother. I did, however, spend a chunk of my previous career doing NICU transfers from low level hospitals to high level hospitals. Chatted with some of the best neonatologists in the country. In hundreds of transfers, I don’t think I ever transported a white baby.
Medical racism, structural racism, and lifetime accumulated experiences of racism are killing black people. Particularly in pregnancy, racism-related stress makes for worse outcomes regardless of education, income, and zip code*
Black people know that they will face medical racism and outright discrimination at hospitals. In hopes to have their complaints taken seriously by hospital staff, some will chose a lower-level community hospital in their own neighborhood with a higher percentage of black staff, rather than a fancy academic medical center where they feel more likely to be sent home or not listened to. Of course, some people DON’T choose their local community hospital, but it’s the only one in the area - a type of healthcare desert.
I think you can guess which type of hospital receives more funding. Which has all the latest technology, surgical teams on 24 hour standby, more doctors with more letters after their names, higher level NICU care (there are four levels), proper nurse/patient staffing ratios, and.....better statistical outcomes overall.
Punitively taking away funding, which equals staff, resources, equipment, etc. from already struggling community hospitals will only make matters worse. When a community hospital rightly transfers a sick mother and/or baby to the academic medical center with the level III or IV NICU miles away, which hospital is going to get the monetary “bonus” for saving them?
This is the exact same thing as No Child Left Behind, which was an absolute disaster for already struggling, underfunded schools serving disadvantaged populations. This is going to lead to worse outcomes for black mothers and babies.
*in some cases, higher education, income, and socioeconomic status actually leads to WORSE outcomes than for poorer patients, due to what’s called “John Henry Syndrome”. America is a fucked up world.