Reflecting on Black Maternal Health Week

Black Maternal Health Week is celebrated every year from April 11-17. This week is founded and led by the Black Mamas Matter Alliance, a Black women-led alliance that advocates, advances research, builds power, and changes the culture for Black maternal health disparities/inequalities.

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 nation, another of the country’s industries, namely reproductive medicine, was developing and expanding rapidly. It wasn’t long before doctors and slave owners began working closely together to protect the reproductive health of black women in captivity.”

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

Erica Hill, director of LMH Health Foundation Finance & Strategic Initiatives and LMH Health Equity, Inclusion and Diversity, said that when it comes to black infant mortality and black maternal mortality, income and educational level are not protective factors. In fact, the higher their income and the higher their educational level, black women are more likely to die.

Eric HillEric Hill

“In a recent panel discussion hosted by LMH Health, I asked our panelists the top three reasons black maternal mortality is so high,” said Hill. ”The forceful response from the panelists was racism, racism and racism. The way to decrease staggering statistics like low birth weight and overall maternal health for blacks is to increase awareness and put less stress on mothers themselves and look inside our health care systems across the country. If the care we provide is so advanced, why do black mothers continue to suffer?

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

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“I am grateful that we are raising awareness and examining the Black maternal health crisis – it is 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 is a public health crisis that particularly affects people during pregnancy and childbirth. In 2020, maternal deaths increased, which is generally not surprising given the COVID-19 pandemic.

“We saw a significant increase in deaths, 55.3 versus 42.8 per 100,000 births, across the country in non-Hispanic black women. There was no statistically significant increase in white women,” she said. “This is disheartening and it is a national public health crisis. Lawrence-Douglas County Public Health’s most recent health equity report shows that 1 in 8 African-American mothers has a baby weighing less than 5.5 pounds. Birth weights have continued to fall, but what can we do about it? That is what we, as health professionals, should focus on. We need to dedicate our attention to our patients and reduce this number.”

Dr. Holman said there are two things to keep in mind about black maternal health. One, as Hill mentioned earlier, is that income and education level do not protect a black mother. And two, black women tend to have better birth outcomes in predominantly black-populated countries with lower-quality care, rather than in our more sophisticated system. The probability 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

“A lot of the medical establishment is made up of white people working to solve the problems of white patients,” said Dr. Holman. “We as white providers cannot just assume what is needed for optimal maternal health. We need to follow the direction of 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 must ask, not statements we give blank. I’m not going to tell you not to eat XYZ, it may be part of your culture to eat that way. Patients need to tell us how we can care for them.”

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She said that even 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 that feedback is a gift. Talking about her concerns allows her team to learn what they can do to take care of you.

“We’ve had patients ask before what we’re doing to address social determinants of health. We’ve also had patients who are women of color express that they didn’t want to be called ‘girl’ or ‘sister.’ These jargon terms are often intended to be used as a way to connect with a patient or even a friend or co-worker, but in reality, in a clinical setting, it shows a more implicit bias and can make the patient feel different”.

Dr. Holman said that in his clinic they often discuss what they can do to take care of their patients, specifically women of color. She said she not only discusses it with her team at Lawrence OB-GYN Specialists, but also at larger meetings and trainings with the entire medical staff. It is important to be actively learning, growing, and preparing incoming nurses and physicians to act with cultural humility.

“It’s a big problem, and as a health professional, it’s our problem,” he said. “So let’s find the problems and analyze them.”

Traci Dotson, doula program manager for Doulas of Douglas County, said she and her team are committed to serving the communities of Lawrence and Douglas counties. They have their roots here, where the team not only lives and works in the community, but wants to make it a better place. She said that as important as minority health is, minority maternal health is an entirely different issue.

“When caring for women of color, it is important that we are intentional about being trauma-informed and aware of our own biases and the role they play in our systems and services,” Dotson said. “I had my son at university, I had to learn to navigate the different systems and I received a lot of support from my teachers, family and friends, so I was able to finish school. Fortunately, studying social work made me aware of the support available in the community and helped me overcome my own resistance to asking for help. However, not everyone is lucky enough to know about these resources and there is this stigma that makes us believe that 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.”

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Dotson says she loves her job and enjoys helping all families, but to qualify for Douglas County doulas, you must be a Douglas County resident and identify as a person of color. Her team not only helps currently pregnant moms, but also helps pre-pregnancy, trying to conceive, moms who just have questions, breastfeeding and much more. Whatever her question, doulas can help.

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

She said that as many know, it takes a village to raise a child. Dotson said her goal is to be her town if she needs it, even if it’s like an extra pair of hands, help with laundry, 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 to make Douglas County a better and safer place of birth for mothers who are women of color.”

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