Published on April 22, 2022

Reflecting on Black Maternal Health Week

Black Maternal Health Week is observed each year from April 11-17. This week is founded and led by the Black Mamas Matter Alliance, an alliance led by Black women that advocates, drives research, builds power, and shifts culture for black maternal health disparities/inequities.

A book by Deirdre Cooper Owens, called “Medical Bondage; Race, gender and the origins of American Gynecology” says this – “After congress banned the importation of African-born slaves in 1808, American slave owners became even more interested in increasing the number of slave births in the United States. At the same time that the stature of the United States was rising globally, especially as an increasingly profitable slave-based nation, another one of the country’s industries, namely, reproductive medicine, was developing and expanding rapidly. It was not long before medical doctors and slave owners began to work closely to protect the reproductive health of black women who were held in bondage.”

It is important to recognize the ugliness of this history because it has modern-day implications that we should want to understand and know the root cause of the disparities we see today.

Erica Hill, the director of both the LMH Health Foundation Finance & Strategic Initiatives & LMH Health Equity, Inclusion and Diversity, said when it comes to Black infant mortality and Black maternal mortality, income and education level is not a protecting factor. In fact, the larger their income and the higher their education level Black women have, the more likely they are to die. 

Erica HillErica Hill

“In a recent panel discussion LMH Health presented, I asked our panelists the top three reasons black maternal mortality is so high,” Hill said. ”The resounding answer from the panelists was racism, racism and racism. The way to decrease the staggering statistics like low birth weight and overall black maternal health is to grow in knowledge and put less stress on the mothers themselves and look internally at our healthcare systems all over the nation. If the care we provide is so advanced, then why are Black mothers still suffering?”

Hill said cultural humility, defined as a lifelong process of self-reflection and self-critique, whereby the individual not only learns about another’s culture but starts with an examination of one’s own beliefs and culture (or identities), is so important when working towards our commitment to grow in building relationships and a better understanding others.

“I’m grateful that we are bringing awareness to and examining the Black maternal health crisis – it’s time to close the gap, or better yet, eliminate this disparity,” Hill said.

Lynley Holman, MD, a physician with Lawrence OB-GYN Specialists, said maternal mortality and racism are a public health crisis that particularly affects people during pregnancy and during birth. In 2020, maternal deaths rose, which, overall, is not surprising given the COVID-19 pandemic.

“We saw a significant rise in deaths, 55.3 up from 42.8 out of every 100,000 births, nationwide in Black, non-Hispanic women. There was not a statistically significant rise in White woman,” she said. “This is disheartening and it is a national public health crisis. In the most recent health equity report from Lawrence-Douglas County Public Health, it shows that 1 in 8 black mothers have a baby born weighing less than 5.5 pounds. Birth weights have continued dropping, but what can we do about it? That’s what we as healthcare professionals should be focusing on. We need to devote our attention to our patients and drive this number down.”

Dr. Holman said there are two things to note about Black maternal health. One, as Hill mentioned earlier, is that income and education status does not protect a Black mother. And two, Black women tend to have better birth outcomes in primarily Black populated countries with less high-quality care, rather than in our more sophisticated system. Likeliness of death at birth for Black women is not genetic. Despite what some may say or think, statements like these are absolutely false.

Dr. Lynley Holman

Dr. Lynley Holman

“So much of the medical structure is made up of white people working to solve problems for white patients,” Dr. Holman said. “We as White providers cannot just assume what is needed for optimal maternal health. We need to take direction from the patients themselves on how we can best serve them. As a woman of color, what are your concerns, what can our system and our doctors do to make you feel safe? These are the questions we need to ask, not statements we give blankly. I am not going to tell you not to eat XYZ, it may be a part of your culture to eat that way. Patients should tell us how we can serve them.”

She said though she and her team, and anyone in the healthcare industry, may not have the right answer 100% of the time, they should always be open to listening. Dr. Holman said in her clinic, feedback is a gift. Bringing your concerns up allows her team to learn what they can do to care for you.

“We have had patients ask before what we’re doing to address the social determinants of health. We have also had patients who are women of color express that they did not want to be called ‘girl’ or ‘sister.’ These slang terms are often attempted to be used as a way of connecting with a patient or even a friend or coworker, but really, in a clinical setting, it shows more implicit bias and can make a patient feel othered.”

Dr. Holman said in their clinic, they are often discussing what they can do to care for their patients, specifically women of color. She said it is not only discussed with her team at Lawrence OB-GYN Specialists but in larger meetings and trainings with the entire medical staff. It is important to actively be learning, growing and grooming the incoming nurses and doctors to act with cultural humility.

“It is a big problem, and as a healthcare professional, it is our problem,” she said. “So let’s find the problems and break them down.”

Traci Dotson, doula program manager with Doulas of Douglas County, said she and her team are committed to serving the Lawrence and Douglas County communities. They are rooted here where the team not only lives and works in the community but wants to make it a better place. She said as important as minority health is, minority maternal health is a whole different topic.

“It is important when caring for women of color that we are intentional about being trauma-informed and being aware of our own biases and the role they play with our systems and services,” Dotson said. “I had my son in college, I had to learn to navigate the different systems and received a lot of support from my professors, family and friends- which is why I was able to finish school. Fortunately, studying social work made me aware of support available in the community and helped me overcome my own resistance to asking for help. However, not everyone is as lucky to know about these resources and there's this stigma out there that makes us believe we have to face pregnancy and parenting alone. We work to serve and find support for those families who may not know where to turn.”

Dotson says she loves her job and enjoys helping all families, but to qualify for Doulas of Douglas County, you must be a Douglas County resident and identify as a person of color. Their team does not only help with currently pregnant moms but they also help before pregnancy, those who are trying to conceive, moms who just have questions, breastfeeding and much more. Whatever your question, the doulas can help.

“Many of the doulas have children of their own and have been through the birthing process. We are there for our moms and support whatever they want their birth plan to look like,” Dotson said. “We have been there for our patients strictly as a doula, we have also been the support persons when there was no one else. We have also been a translator before between mom and doctor.”

She said as many know, it takes a village to raise a child. Dotson said their goal is to be your village if you need it – even if it’s as an extra set of hands, help with laundry, allowing time for a shower or just a safe space to confide in someone.

Dotson said, “We are grateful for our community partners and for the opportunity to join forces in making Douglas County a better and safer birthing place for mothers who are women of color.”

For additional information regarding black maternal mortality, visit the link here.

Jessica BrewerStory by Jessica Thomas

Jessica is the Social Media & Digital Communications Specialist at LMH Health.

Reflecting on Black Maternal Health Week

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