On the side of a wide highway in Cleveland, Miss., cars are lined up in a narrow parking lot, and more keep coming. They’re here for Pam Chatman’s giveaway.
Ms. Chatman stands in front of her store, Boss Lady4Kids, which has piles of new items, boxed up and stacked in neat rows. As music blares into the warm evening air, dozens of people, including parents and children, listen to Ms. Chatman as she explains the rules: two boxes each, no pushing.
She has everything from baby swing chairs and walkers to step stools, construction hats, pool floaties and children’s clothes.
Ms. Chatman, 57, is a community activist who created Boss Lady Economic Planning and Development Workplace Transportation to offer free rides to people living in the rural Mississippi Delta to their work at FedEx in Memphis. During the pandemic, she helped deliver vaccines. To address the maternal health care crisis in the region, she started delivering fruits and vegetables to expectant mothers. She’ll soon launch a service to help people in rural areas cover the cost of medications.
Here at her store, Ms. Chatman receives truckloads of new items from Amazon and other stores and gives everything away. She’s able to do this because of a partnership with 4 Good Community, an organization that helps get corporate donations to communities in need.
Some days children shop on their own, and Ms. Chatman encourages them to pick out things for others. Often they select essential items their parents need.
Ms. Chatman first created Boss Lady Economic Planning and Development Workplace Transportation to serve workers commuting to Memphis. Her efforts have since expanded to address the local maternal health care crisis and beyond.
“We live in rural poverty, Mississippi Delta, and we know that there are not a lot of resources,” she says.
She started giving out fruits and vegetables because people in the area struggle with obesity, diabetes and high blood pressure − all risk factors for pregnant women. Later, she heard from women who needed breast pumps, blankets and other items, so she partnered with an organization to source supplies.
“I’ve seen young African-American women that had babies that didn’t have any clothes on,” just a diaper, she says, so she started bringing in clothing, bathing items − anything an expectant woman might need.
The Mississippi Delta is a rural region in the northwestern corner of the state, bordered by the Mississippi River. It’s known as the birthplace of the blues and the civil rights movement. It’s also synonymous with cotton fields − and all the wealth and horrendous history that go with them.
It’s a place that has long had deep racial divides. A place where people struggle to survive and take matters into their own hands to help one another. Some people here describe it as resilient, but in many ways that community spirit is a matter of absolute necessity.
And perhaps the most glaring consequence of all that hardship is the fact that more infants die here than in any other state. Too many mothers die of pregnancy-related causes as well.
Nearly half the counties here are considered “maternity deserts,” according to a new report from the non-profit March of Dimes, which means there’s no obstetrician, family physician who delivers babies, nurse midwife, hospital or clinic. Michael Warren, the organization’s chief medical and health officer, said this is “the result of deliberate policy decisions and resource allocations.”
The state risks having even more maternity deserts, Dr. Warren said, because 17 per cent of its counties are one clinician away from having no one to provide obstetric care.
Women here travel long distances to get to the hospital, which means they may be less likely to attend prenatal appointments or even struggle to get to the hospital when it’s time to deliver their baby. The Globe met several women who had to travel to deliver their babies. One woman who had a high-risk pregnancy drove more than two hours to reach the capital, Jackson.
“It’s more than I’ve got to drive to get to care. It is truly a matter of life and death when it comes to these outcomes,” Dr. Warren said.
Courtney Edmond, a 38-year-old mother of three, held her baby boy Chosen on her lap inside Ms. Chatman’s store. She said she found out one month before she was pregnant with him that she had a blood clotting disorder. The doctor who diagnosed her health problem moved away not long after. And because she had a particularly high-risk pregnancy, she had to deliver the baby two hours away in Jackson.
“I went through pregnancy really kind of scared, being honest with you, for the first time ever in my life,” she said.
She said her cousin became pregnant with twins, but neither of her babies made it − and her cousin was never given an explanation of what happened to them. “Unfortunately, it’s a scary thing.”
Dan Edney, Mississippi’s state health officer, says the state has made strides in reducing maternal mortality, but very little progress on reducing infant mortality. State figures paint a mixed picture. Potential maternal deaths fell to 29 in 2024 from 57 in 2023, though the health department labels the counts provisional. Infant deaths have held steady at about 320 a year for a decade, even as the number of births fell, pushing the infant mortality rate from 9.2 per 1,000 births in 2015 to 9.7 in 2024.
Last year, Mississippi declared a public health emergency over the number of infant deaths.
“It all relates directly back to poverty … we’re the most impoverished state in the United States,” Dr. Edney said, adding that “everything’s on the table” for his office when it comes to improving the situation.
He said 80 per cent of the mothers and babies who die are in the Medicaid program, meaning they’re low-income individuals.
About 105,000 women of childbearing age in the state are not insured, according to Dr. Warren, who was citing state statistics and added that some will qualify during pregnancy, but signing up for insurance is a process. And because many women do not have access to proper health care before they become pregnant, Dr. Edney said, their pregnancies are often high-risk because they are diabetic, have hypertension or are obese.
Dr. Edney said his office has been looking at a range of possible solutions, including tackling maternity care deserts by extending temporary access to health care through mobile units. There’s no neonatal intensive care unit in the delta, so they are working on opening one.
“This is a rural area with a small population, a lot of poverty. It’s a desert, you know, but our job is to water that desert and get it to bloom.”
He said the goal is to have very few, if any, obstetrical deserts two years from now. And his office is also working to help women get some of those pre-existing health issues under control earlier in their pregnancies, as well as provide more education.
“We have more challenges and, yes, we have fewer resources, but we’re also really smart in Mississippi. We’re very resourceful and we’re resilient.”
Dr. Edney said reducing maternal and infant mortality is top priority. He believes the issue is on the political radar, but he’s “given up on having Washington” lead the way. He said his office is grateful for partners, including federal partners, but it’s up to people in Mississippi to solve these problems.
In lieu of adequate government support, grassroots initiatives spearheaded by community activists, like Ms. Chatman, have emerged as lifelines for those living in rural poverty in Mississippi.
In absence of some of those crucial resources, women such as Ms. Chatman have taken it upon themselves to help people. When asked what would happen without her support, she said, “I’m scared.”
She shook her head when asked if she would consider getting involved in politics. She said politicians are constantly leaving stickers on her door that say: “Please call me. … We want to talk to you because the people trust you."
“I’m not getting involved in that cause, you know,” she said. “I don’t know you.”
“I don’t like politics,” she said. “I’m doing their work … people need help. Let’s get it done.”
But while she ignores most politicians who come to her door, she has a lot of time for Bennie Thompson, the lone Democratic congressional representative in Mississippi. Mr. Thompson was first elected to public office when he was 20 years old, as an alderman, and since 1993 has represented most of the Mississippi Delta and Jackson in Congress. Ms. Chatman has known him since she was a child and has been affected by the changes he has made. He is up for re-election in the Nov. 3 midterms.
“When I tell you they’re fighting tooth and nail, it has been nasty,” Ms. Chatman said of the election campaign. “We have these town hall meetings now where they’re trying to redistrict and be able to cut him out so they can get more territory. But people have been coming out, and I mean, both Black and white, and they’ve been fighting for him, but it’s been a fight.”
At a large career fair in Greenville, a town about a 35-minute drive south of Cleveland, Mr. Thompson told The Globe that, despite his efforts, funding for health care and other resources are blocked by his Republican colleagues.
“You know, this is a conservative state, and even though conservatives profess to be Christians, they don’t extend that to health care. They think health care should be available to people who can afford it and that those who can’t afford it are deadbeats, which is not the case. They’re human beings.”
He said he’s the only politician in their delegation that supported the Affordable Care Act under President Barack Obama. Since then, he’s watched three hospitals in his district close. Mississippi is one of 10 states that has not accepted Medicaid expansion dollars, US$1.2-billion per year.
Mr. Thompson told The Globe that his efforts to direct funding to regional health care and other key resources have been blocked by his Republican colleagues.
In recent years, the congressman has seen three hospitals in his district close.
“One of the richest countries in the world. We still have children dying as if they’re in Third World countries. We can send people to the moon and bring them back but we can’t allow in so many instances healthy babies to be born.”
In a deeply red state, Mr. Thompson tries to push for everything he can, but he’s up against a lot of opposition. “I’m called a tax-and-spend liberal,” he said. “My governor called me a terrorist.”
“But you don’t give up. Hope springs eternal. And, you know, people like Pam and other folks are bright spots in a dark environment − and voting is the great equalizer.”
Outside Ms. Chatman’s giveaway, a mom from the area spoke with The Globe about the challenges she’s had with pregnancies here and about life in general in the Delta. The Globe is not naming her because she’s fearful of professional repercussions.
She said that after her second pregnancy she was terribly sick and went to the hospital several times, where she was told she had anxiety. She felt ignored. She managed to reach her gynecologist who urged her to go to the hospital because she had postpartum preeclampsia, which is characterized by high blood pressure and may involve damage to organs such as the kidneys.
She didn’t see things getting better. Everybody is in survival mode, she said, so when there are giveaways like this one, people need to take what they can get.
Racism plays a part, too, she said. The local high schools were desegrated only 10 years ago. She said that when that happened, most white students transferred to private schools.
After the giveaway ended, Ms. Chatman sat inside her store, filled with new packages. She said she’s at it seven days a week because there’s so much need.
“We’re the boots on the ground. We know what the needs are because we live it.”
With data analysis by Mahima Singh