HOUSTON — Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child.

But, just five weeks after confirming her pregnancy, and the day after a gender-reveal party where she announced she was having a girl, she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain.

“I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.”

An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby, Tabitha Winnie Denkins.

“This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.”

In fact, Harris County ranks third, behind only Chicago’s Cook County and Detroit’s Wayne County, in what are known as excess Black infant deaths, according to the federal Health Resources and Services Administration. Those three counties, which also are among the nation’s most populated counties, account for 7% of all Black births in the country and 9% of excess Black infant deaths, said Ashley Hirai, a senior scientist at HRSA. That means the counties have the largest number of Black births but also more deaths that would not occur if Black babies had the same chance of reaching their 1st birthdays as white infants.

No known genetic reasons exist for Black infants to die at higher rates than white infants. Such deaths are often called “deaths of disparity” because they are likely attributable to systemic racial disparities. Regardless of economic status or educational attainment, the stress from experiencing persistent systemic racism leads to adverse health consequences for Black women and their babies, according to a study published in the journal Women’s Health Issues.

These miscarriages and deaths can occur even in communities that otherwise appear to have vast health resources. In Harris County, for example, home to two public hospitals and the Texas Medical Center — the largest medical complex in the world, with more than 54 medical-related institutions and 21 hospitals — mortality rates were 11.1 per 1,000 births for Black infants from 2014 through 2019, according to the March of Dimes, compared with 4.7 for white infants.

The abundance of providers in Harris County hasn’t reassured pregnant Black patients that they can find care that is timely, appropriate or culturally competent — care that acknowledges a person’s heritage, beliefs and values during treatment.

Regardless of income or insurance status, studies show, medical providers often dismiss Black women’s questions and concerns, minimize their physical complaints and fail to offer appropriate care. By contrast, a study of 1.8 million hospital births spanning 23 years in Florida found that the gap in mortality rates between Black and white newborns was halved for Black babies when Black physicians cared for them.

In 2013, Houstonian Kay Matthews was running a successful catering business when she lost the daughter she’d named Troya eight months and three weeks into pregnancy.

Matthews hadn’t felt well — she’d been sluggish and tired — for several days, but her doctor told her not to worry. Not long afterward, she woke up realizing something was terribly wrong. She passed out after calling 911. When she woke up, she was in the emergency room.

None of the medical staffers would talk to her, she said. She had no idea what was happening, no one was answering her questions, and she started having a panic attack.

“It kind of felt like I was watching myself lose everything,” she recalled. She said the nurse seemed annoyed with her questions and demeanor and gave her a sedative. “When I woke up, I did not have a baby.”

Matthews recalled one staffer insinuating that she and her partner couldn’t afford to pay the bill, even though she was a financially stable business owner, and he had a well-paying job as a truck driver.

She said hospital staffers showed minimal compassion after she lost Troya. They seemed to dismiss her grief, she said. It was the first time she could remember feeling as if she was treated callously because she is Black.

“There was no respect at all, like zero respect or compassion,” said Matthews, who has since founded the Shades of Blue Project, a Houston nonprofit focused on improving maternal mental health, primarily for Black patients.

To help combat these high mortality rates in Harris County, Robinson created a maternal child and health office and launched a home-visit pilot program to connect prenatal and postpartum patients with resources such as housing assistance, medical care and social services. Limited access to healthy food and recreational activities are barriers to healthy pregnancy outcomes. Studies have also shown a connection between evictions and infant mortality.

For Hill, not having insurance was also likely a factor. While pregnant, Hill said, she had had just a single visit at a community health center before her miscarriage. She was working multiple jobs as a college student and did not have employer-provided medical coverage. She was not yet approved for Medicaid, the state-federal program for people with low incomes or disabilities.

Texas has the nation’s highest uninsured rate, with nearly 5 million Texans — or 20% of those younger than 65 — lacking coverage, said Anne Dunkelberg, a senior fellow with Every Texan, a nonprofit research and advocacy institute focused on equity in public policy. While non-Hispanic Black Texans have a slightly better rate — 17% — than that overall state level, it’s still higher than the 12% rate for non-Hispanic white Texans, according to census data. Health experts fear that many more people are losing insurance coverage as COVID-19 pandemic protections end for Medicaid.

Without full coverage, those who are pregnant may avoid seeking care, meaning they skip being seen in the critical first trimester, said Fatimah Lalani, medical director at Houston’s Hope Clinic.

Texas had the lowest percentage of mothers receiving early prenatal care in the nation in 2020, according to the state’s 2021 Healthy Texas Mothers and Babies Databook, and non-Hispanic Black moms and babies were less likely to receive first-trimester care than other racial and ethnic groups. Babies born without prenatal care were three times as likely to have a low birth weight and five times as likely to die as those whose mothers had care.

If Hill’s miscarriage reflects how the system failed her, the birth of her twins two years later demonstrates how appropriate support has the potential to change outcomes.

With Medicaid coverage from the beginning of her second pregnancy, Hill saw a high-risk pregnancy specialist. Diagnosed early with what’s called an incompetent cervix, Hill was consistently seen, monitored and treated. She also was put on bed rest for her entire pregnancy.

She had an emergency cesarean section at 34 weeks, and both babies spent two weeks in neonatal intensive care. Today, her premature twins are 3 years old.

“I believe God — and the high-risk doctor — saved my twins,” she said.

原标题：民进党当局强推所谓“本土语课”，但开学两周教材仍没到位【环球网报道】作为“去中国化”的一环，民进党当局强制中小学从今年8月起必修课程增加所谓“本土语课”，其中可供选择的“本土语”包括闽南话、客家话、马祖本地人讲的闽东话等49种。不过据台湾《联合报》12日报道，台湾中学8月30日开学，有多所初中至今没收到台“教育部”发行的客语（客家语）纸本教材。报道称，由于民间出版社客语教科书直到开学都未通过台“教育部”审定，导致学校今年只能选择使用“部编”教材，因学生选修人数变化大，“部编”版纸本教材统计、印刷不及，初中至今仍只能使用影印版教材，高中则是在中秋节前陆续收到客语课本，不少教务人员对这种情况表示“罕见”。《联合报》说开学第三周了，台湾多所初高中开设客语必修，至今仍没纸质课本可用。一位不具名客语四县腔（四县腔分布于台湾中北部和南部，主要的代表区域有桃园市、苗栗县，高雄市、屏东县六堆地区）教务人员向《联合报》表示，今年到某初中教七年级共四个班，开学已一周多，学生却还没有课本，老师也没有。

三 | 她经过询问得知，新北市、桃园市都有类似情况，大家都是先上网下载使用，又或是自己找档案印成纸本“应急”。报道称，台北市某初中也开设客语四县腔必修课，学校至今还没收到纸本课本。该校教务主任透露，闽南语除了“部编”版，还有多家民间厂商可选择，但客语的出版市场是“小众”，仅有“部编”，以及一民间出版社出版客语教材，但该民间出版社的客语教材直到开学仍未通过台“教育部”审定，导致学校只能在开学前紧急选择“部编”教材。他推测，由于今年是“本土语课”第一年上路，教材量难抓，尽管7月底已向“教育部”申请教材，目前也还没收到。

四 | 对于这一消息，有岛内网友表示，“教育已被政客搞得大乱，台湾未来还有什么希望与竞争力？” ↓ 有人质疑，“连最基础的硬件都没准备好，到底在强推什么。”“配套方案都没齐就急着硬推，把师生都当白老鼠。” ↓ 有人讽刺，“这不是很正常吗？超前部署都是这样。” ↓ 而对于所谓“本土语课”，有网友认为，“方言这东西会听跟说就好，何必浪费人力跟大笔金钱去搞书本教学？”“教土本语言…真的很浪费师资。” ↓ 对于民进党当局强制中小学从今年8月起必修课程增加所谓“本土语课”， 有台湾教师表示，民进党当局所谓“本土语政策”就是要斩断中华文化和语言的根脉。对此，国台办发言人马晓光曾表示，民进党当局的这种举动实际上是害台湾，害了台湾的年轻一代，让他们丧失发展机会。马晓光称，哪来的所谓“台语”，都是从闽南客家来的，也是中华语言的一部分，是中华文化的一部分。民进党当局蓄意将台湾民众使用的闽南、客家方言、少数民族语言、普通话划分为“本土”和“外来”，包藏着他们处心积虑“去中国化”的祸心。企图利用语言作为工具，改变深植于台湾社会的中华文化认同、中华民族认同，是不可能得逞的。

五 | 从他们热衷追大陆剧、用大陆应用软件，就能看出他们是一帮“口嫌体直”的假道学、伪道学。返回搜狐，查看更多责任编辑：