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This story is part of the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. The reporting is supported through a National Fellowship from the USC Annenberg Center for Health Journalism.
Click here to read highlights from the story
- Wisconsin’s Black infant mortality rate remains more than twice the rate for white infants. Nearly 850 Black babies died before their first birthdays from 2015 through 2024.
- Five women in the Wisconsin Legislative Black Caucus call the crisis deeply personal, citing their own experiences with premature births, frightening pregnancies and unequal treatment in health care.
- Black Caucus lawmakers last session introduced a seven-bill Birth Equity Act addressing doula care, maternal mental health, dental care, postpartum support and other needs — but none of the bills received a committee hearing before the Republican-controlled Legislature adjourned.
- Republicans who control the Legislature have declined to advance similar legislation for years.
- Black Caucus lawmakers say reducing Black infant deaths requires policy changes and greater trust in the medical system, including culturally competent care.
For decades, Wisconsin’s Black infant mortality crisis has been measured in painful numbers: babies who die before their first birthdays, families left grieving and an enormous racial disparity that never relents.
Wisconsin regularly ranks among the worst in the nation when it comes to the rate at which Black babies die before reaching age 1. In 2024, the most recent year for which the Wisconsin Department of Health Services has publicized data, the state had an infant mortality rate of 12.5 deaths for every 1,000 live births among Black babies. For white babies, that rate was 4.8.
Between 2015 and 2024, nearly 850 Black babies died in Wisconsin before turning 1, according to state data. Over the first half of that decade, nearly 25% of the deaths of Black infants were caused by being born into this world too early and too small to survive.
But for the five women in the Wisconsin Legislative Black Caucus who have pushed awareness of the issue year after year, the crisis is not abstract or statistical. It is personal.
Wisconsin’s notorious peril for Black pregnancies is a fear and a pain they have known in their own bodies, and one they have returned to the Capitol session after session determined to change.
One legislator delivered her daughter nearly eight weeks early. Another, state Rep. Margaret Arney of Wauwatosa, was born prematurely alongside her twin. State Rep. Sequanna Taylor of Milwaukee was told she was unlikely to carry her pregnancy to term, but not why. And this year, one of the lawmakers carried that same fear throughout her first pregnancy.
“Being a senator that knows all the data I think has made it more nerve-wracking,” said Sen. Dora Drake, D-Milwaukee, while holding her pregnant belly during a listening session with the Cap Times in July. Drake delivered her baby without complications in early September.
Wisconsin continues to face one of the nation’s highest rates of Black infant mortality in the nation, a crisis these five women say cannot be separated from the lived experiences of the families and babies behind the numbers.
But session after session, they say they have run into resistance from Republican leaders who have declined to give any one of their proposals even a committee hearing.
“We encountered nothing but struggles in this building,” said Sen. LaTonya Johnson, D-Milwaukee.
Last spring, Rep. Shelia Stubbs, D-Madison, worked with members of the Foundation for Black Women’s Wellness in Madison to develop the latest version of the Birth Equity Act — a package of seven bills aimed at improving birth outcomes and connecting expecting and new mothers with resources that increase their chances of carrying healthy pregnancies to term and managing the postpartum period with greater support.
The proposals were based on what the foundation has heard from community members about what would help Black mothers, babies and families the most.
“These bills came directly from Black women,” Stubbs said.
- Assembly Bill 1082 would have created a sales tax exemption for breastfeeding equipment.
- Assembly Bill 1083 would have barred the state from seeking recovery or reimbursement of birth expenses from a new mom covered by the state’s Medicaid program.
- Assembly Bill 1084 would have ensured the Medicaid program covers services by a dentist or dental therapist and stipulated that pregnant patients should be able to receive timely dental care during pregnancy.
- Assembly Bill 1085 would have required Medicaid plans to cover care provided by a doula before, during and after delivery.
- Assembly Bill 1086 would have required Medicaid to cover maternal mental health screenings and required the state’s health department to develop — in consultation with advocates and providers within the Black community — a set of standards to ensure cultural competency in maternal mental health screening practices.
- Assembly Bill 1087 would have allowed for a pregnant person to enroll in a health insurance plan outside of a standard enrollment period after becoming pregnant to ensure prenatal care is covered by a health plan.
- Assembly Bill 1088 would have required hospitals to provide a postpartum home visit to a new mom and baby, if requested, within the first few weeks after giving birth. The bill also would have required health insurance plans to cover these visits. The visits could be conducted by a doula, midwife, nurse-midwife or other licensed health care provider who is certified to provide postpartum care.
But none of the bills introduced last February received a public hearing before the Republican-controlled Legislature adjourned its session early, Stubbs said.
That included bills assigned to the committees she said were best suited to consider them, like the Assembly Committee of Health, Aging and Long-Term Care where she holds a seat.
The proposals were aimed at shrinking disparities and improving maternal and infant health in Wisconsin through a variety of approaches ranging from insurance-covered doula care to ensuring pregnant women get adequate dental care.
“Of all of the bills we introduced, absolutely none of them received a hearing, which is very shameful (and) unacceptable in the state of Wisconsin,” Stubbs said. “So even serving on a committee that’s most appropriate to have these bills, we still couldn’t get these bill hearings.”
Republican Rep. Clint Moses, who chairs the Assembly health committee and holds gatekeeping power over which bills receive hearings, did not respond to multiple requests for comment for this story. Committee chairs often decide which bills receive hearings in line with party leadership priorities.
For Drake, the lack of movement comes down to a simple conclusion.
“It’s not a priority for them, honestly, and that’s really the bottom line,” she said.
A crisis measured in lives
Wisconsin’s Black infant mortality crisis has persisted for generations. And the women pushing for change say the disparities cannot be explained by income or individual behavior.
Arney, a Democrat from Wauwatosa, knows that personally.
“This is a generational issue,” Arney said. “I am a twin. My twin sister and I were born prematurely. Our lives were at risk.”
Her mother was college-educated, she said, but that did not erase the risks associated with being a Black mother in America.
“It’s more than just social class,” Arney said.
Johnson, the senator from Milwaukee, said she has encountered resistance to policies specifically designed to address racial disparities based on an argument that helping Black families reduce disproportionate harm is discrimination itself.
“A lot of the feeling in this building is that if something is targeted specifically, then it’s somehow discriminatory,” said Johnson, the lawmaker who delivered her daughter two months early.
But, she said, the nature of the crisis demands a targeted response.
“It’s not discriminatory that it’s kids who look like us that are dying, but it’s discriminatory because we want to fix it?” Johnson said.
The lawmakers pointed to policies that have passed as examples of what can happen when the Legislature works together.
Johnson cited Act 102, signed by Gov. Tony Evers earlier this year, which extended the period of time Medicaid covers postpartum services. About 76% of Black women who give birth in Wisconsin are on Medicaid, making this law particularly important to fight to save Black babies, she said.
“That bill will disproportionately impact Black women, which in this case is a good thing,” Johnson said. “That will be one piece of legislation that will start to uncover the core of what’s really taking place.”
But the lawmakers say broader changes — including greater access to doulas and culturally competent care — are still needed.
“Several of us were working on trying to have that coverage provided, because the research shows that having doulas and midwives helps mitigate some of those harmful factors,” Drake said.
Having that kind of support was important to her personally, she said, because “that was something that I really wanted to ensure I had someone I could trust.”
When the statistics become your own
Before Johnson’s daughter was born — a few days shy of 32 weeks — a midwife recognized that Johnson and her pregnancy could be in danger.
“My midwife went to the doctor and said ‘Look, she’s high risk. She needs another level of care other than what I can provide,’ and I didn’t get it,” Johnson said.
Johnson spent two weeks in the hospital before her daughter was born, receiving steroid shots to help develop her baby’s lungs, she said.
Her daughter was born on June 3 and went home on June 22, Johnson’s birthday.
Johnson quickly returned to work, without giving herself time to recover from giving birth because she felt driven to make sure she could pay the bills as a single mother.
“So when (my daughter) got home, she had a place to come home to,” Johnson said.
But she later learned something about her pregnancy that she said doctors had not told her at the time: She had contracted an infection that caused premature delivery.
“There was things I didn’t realize about my own pregnancy until I got a copy of the medical records,” Johnson said. “My experience was so horrible. I remember saying I would never have another baby.”
Her daughter survived and is now in her 20s.
“The fact that my daughter made it to her first birthday was a luxury that a lot of these Black babies are not afforded,” Johnson said.
Rep. Taylor’s experience was different, but it left her with many of the same questions and a similar, lingering pain.
During her pregnancy with her youngest daughter, Taylor said, her doctor told her she was unlikely to carry her baby to term. He never explained why.
“They were so cold,” she said. “I know as doctors they can’t be emotional because they deal with so many people. But to tell me ‘There’s nothing you can do to help. This baby won’t go to term. Go home. If you start bleeding or something, come back…’’’
The interaction left Taylor feeling unable to connect to her pregnancy because she was so convinced she would lose it.
Taylor, who is from Milwaukee, did carry her daughter to term. But after delivery she was rushed to emergency surgery because she couldn’t successfully deliver her placenta, a complication that can lead to serious infection.
Taylor now wonders whether her medical team failed to adequately screen her for complications because they already assumed her pregnancy would fail.
The fear of not being heard
For the lawmakers, the problem is not only access to care. It is whether Black women are believed, listened to and treated with dignity when they seek it.
“There’s this notion of who gets to have access to health care,” Drake said, adding that she has experienced that dynamic herself.
Two years ago, she went to a hospital in Milwaukee with a broken arm. When she told the staff she had state insurance — the coverage provided to her as a Wisconsin legislator — the hospital assumed she meant Medicaid.
During Stubbs’ pregnancy, a nurse mistakenly gave her the test results of another Black patient.
“It wasn’t stressful carrying my child,” Stubbs said. “It was stressful going to the doctor.”
Arney said she has seen the same pattern play out over generations.
Years ago, she participated in a focus group of Black women discussing their experiences giving birth. Arney said she was fortunate. Her sister, who is a doctor, was there. She had a doula, a midwife, an obstetrician and her husband supporting her.
Nearly every other woman in the group, Arney said, described a traumatic birth experience.
“Different years. Different times. This is what I’m talking about with the generational thing,” Arney said. “It’s like these kinds of things are not moving. This is not budging. This needs attention. It needs focus and it needs urgency.”
A crisis of trust
The lawmakers say those experiences have contributed to a broader lack of trust between Black women and the medical system.
“People can go through history on how hospitals and medical professions have used Black women’s bodies for experimentation,” Drake said. “This is not hidden. This is known. This is documented.”
One of the more egregious examples of this is by 19th-century physician James Marion Sims, the so-called “father of gynecology” who developed techniques in the field by performing dozens of experimental surgeries without anesthesia on three enslaved women without their consent. The women — Anarcha, Lucy and Betsey — have been memorialized in the Mothers of Gynecology sculpture in Montgomery, Alabama.
That pain haunts the medical profession and is a traumatic history providers must intentionally work to move beyond, reestablishing trust among Black women, the lawmakers said.
This work, Arney said, must go beyond individual providers.
“I know there’s some health systems that are trying to take this on, but I hate to say it’s baked into our culture that there’s this callousness towards Black women,” Arney said.
That distrust can make pregnancy itself more frightening, regardless of the resources you have sought for yourself. The data and statistics surrounding Black birth outcomes in Wisconsin have remained in the back of Drake’s mind throughout her pregnancy. Despite the fact that she is a college-educated professional social worker and a member of the Wisconsin Senate. “Those are still the realities we have in our state,” she said.
Inside the Capitol
The women of Wisconsin’s Legislative Black Caucus say the political resistance to their proposals is part of the same struggle.
Stubbs said her white Democratic colleagues have been supportive, often signing on as co-sponsors to her legislative proposals and allowing the Black Caucus to lead on issues they view as particularly tied to the Black community.
That support matters, she said, because the Black lawmakers bring lived experience that their white colleagues don’t have in the same way.
“It’s helpful, because nobody knows our struggle the way that we do, and they’re not going to understand,” Stubbs said.
But there is a limit to simply standing behind the Black Caucus, she said. It’s not enough to simply sign onto legislative proposals or attend press conferences during Black History Month or in June, when Juneteenth falls.
“Sometimes it’s harmful to just be like ‘You got it,’ you know?,” Stubbs said of the type of support she gets from other Democrats.
Stubbs said she has also had conversations with white lawmakers who choose not to believe the evidence showing racial disparities in health outcomes.
“In that building, we have many of our colleagues that don’t believe in diversity, equity or inclusion,” Stubbs said. “We have a federal government that doesn’t believe in that. So we’re fighting already systems that don’t believe in us.”
Some lawmakers, she said, see the Black Caucus’ efforts as blowing an issue out of proportion.
“They don’t want to believe the data,” Stubbs said. “They think it’s us coming one more time with another inequity, but it’s a fact, and so it is our responsibility as a state to address this.”
The five legislators say they have heard about the pain and trauma of this crisis from constituents. They have lived it themselves; in premature births, frightening pregnancies, traumatic deliveries and the persistent pain of being made to feel less than.
That’s why the fight is much more than a political one, they said.
The stakes are measured in whether a baby gets to come home.
“We have these stories,” Stubbs said, “and we are telling them because we want to save the next life.”
Erin McGroarty is a health and policy reporter for the Cap Times in Madison. She can be reached at emcgroarty@captimes.com.
How a fight to save Wisconsin’s Black babies keeps hitting a dead end is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.
