“No one should die giving birth, yet it still happens”
Last month, the AAMC Center for Health Justice Maternal Health Incubator kicked off with this shocking reminder. The 2-day event brought together several people to collectively understand the data needed to effectively address maternal health inequalities.
As I listened to the stories of many black women during the event, it occurred to me that they too, like every other expectant mother, wish to experience the sacredness of childbirth. However, women of color are burdened on a daily basis by existing health inequalities and prejudices, making childbirth stressful and in some cases dangerous. One woman shared that she did not have access to social and clinical support during pregnancy as she had to deal with instability in housing, food, work and domestic violence and sexual assault, while another woman in an environment rural has traveled miles away to deliver her baby safely.
As a black woman myself and an expectant mother, this resonated with me on many levels. I couldn’t help but wonder, how can we help women of color feel safe in their maternal care? Keynote, Zsakeba Henderson, M.D., senior vice president and interim chief medical and health care officer at March of Dimes, explained that we need to create action by bringing data to life.
So where and how do we start? Here are 10 things I have left:
1. Remember, behind every statistic there is a real person.
Each individual deserves personalized care. Rather than treating an individual as a case, it humanizes the individual’s experience.
2. Listen, but with humility, empathy and compassion.
Patient histories are qualitative data. Come closer and listen to them. We cannot make systemic changes or support better maternal health policies if we do not recognize what our patients and our community actually need, or how they perceive or want care.
3. Women’s health is not an enigma.
Women are often not believed and dismissed as “hysterical,” shared author and journalist Anushay Hossain. Give women full freedom of action, encourage them to articulate what they need, create safe spaces for them, and include women of color in research practices and studies. Listen to the AHA podcast with Hossain to learn more about ways we can uncover gaps in maternal care.
Racism has a historical and generational impact on health and makes us uncomfortable discussing it. In order to shift the system to better support women of color, we need to overcome the discomfort. Terry Wright, physician, health and racial equity strategist and public health scientist, suggested integrating these conversations as part of the medical school curriculum to holistically equip the next generation of maternal health care providers.
5. Explore new datasets to ask different and more challenging questions.
Eugene Declerq, Ph. D., professor of community health sciences at Boston University School of Public Health and professor of Obstetrics and Gynecology at Boston University School of Medicine, suggested examining the longitudinal data to understand the nuances that exist. in maternal health disparities and linking its generational impact to maternal mortality. Explore the latest data from Birth by the Numbers here.
6. Prejudices have the ability to permeate.
According to the recent AAMC survey of over 1,000 people in childbirth, nearly a third felt that the quality of their pregnancy, childbirth and postpartum care was affected by experiences of prejudice or discrimination.
Prejudices exist within all of us, we cannot deny it. But we have to learn to understand them and train to deal with them.
For example, hospitals and healthcare professionals can use March of Dimes’ implicit bias training course, called “Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare ™”, to better understand structural racism, assess their own prejudices implicit and create action measures to mitigate it. Additionally, hospitals can use the short film Toxic: A Black Woman’s Story, to strike up a conversation within care teams and beyond about the many underlying factors, such as toxic stress, racial inequality, unconscious bias, microaggression, impact on women’s health. black and their outcomes at birth. AHA nonprofit member hospitals and health systems can purchase the film at a discounted price here.
7. Engage those closest to the problem to be part of the solution.
The AAMC survey reported that four out of 10 respondents do not have access to paid postpartum leave from work and Hispanic people who give birth are screened for mental health at lower rates. Recently, access to formula has been a challenge for many new moms, re-exposing existing disparities in breastfeeding rates between Black and Native American and Native Alaskan mothers.
Allow different women to join the table and share what better care means to them; their perspectives will help to approach the problem from different angles. In this AHA blog, learn about the Institute for Healthcare Improvement’s Better Maternal Outcomes project, in which healthcare organizations and their community partners in four cities – Atlanta, New Orleans, Detroit, and Washington, DC – have tested and scaled down guided initiatives. locally to address the challenges and opportunities for and with black women.
8. Set expectations for high quality maternal care and hold systems and yourself accountable.
Understand what constitutes high quality maternal care for patients, the community and organizations. Define these parameters, but above all hold each other responsible for their respect.
9. It takes a village to raise a child, strengthen that village.
Establish cross-sectoral collaboration within and outside the clinical walls to offer women a range of support services. Support them socially, emotionally, economically and through politics.
10. Work with and through the system.
Equity for maternal health is a public health issue and each of us has a role in it. Whether it is establishing a better continuum of care for the individual within the clinical team, offering support services, or even simply determining whether a patient has access to Wi-Fi or broadband to virtually access a provider or their medical records, we must work together, in all units, to offer equal care to all women.
Leveraging patient data and stories can enable all of us to support fair policies, more culturally competent care, and a safer birth experience for women of color. Email me at saisha@aha.org and share how you are bringing data to life to achieve maternal health equity.
Aisha Syeda, MPH, is a senior program manager for AHA’s strategic initiatives.
