“No one should die giving birth, yet it still happens”

The AAMC Center for Health Justice’s Maternal Health Incubator last month kicked off with this jolting reminder. The 2-day event convened diverse individuals to collectively understand the data needed for addressing maternal health inequities effectively.

While listening to the stories of many women of color throughout the event, I was reminded that they too, like any other expectant mom, wish to experience the sacredness of giving birth. However, women of color are burdened with existing health care disparities and biases daily, making childbirth stressful and in some cases dangerous. One woman shared she lacked access to social and clinical support during her pregnancy as she dealt with instability in housing, food, employment and faced domestic violence and sexual assault, while another woman in a rural setting traveled miles away to deliver her baby safely.

As a woman of color and an expectant mom myself, 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 officer of March of Dimes, explained we need to create action by bringing data to life.

So where and how do we start? Here are 10 things that stayed with me:

1. Remember, behind every statistic is a real person.

Every individual deserves personalized care. Rather than treating an individual as a case, humanize the individual’s experience.

2. Listen, but with humility, empathy and compassion.

Patient stories are qualitative data. Lean in and listen to them. We can’t make systemic changes or advocate for better maternal health policies if we don’t recognize what our patients and community actually need, or how they perceive or want care.

3. Women’s health is not an enigma.

Often times women are not believed, and are brushed off as “hysterical,” shared Anushay Hossain, author and journalist. Give women full agency, encourage them to articulate what they need, create safe spaces for them and include women of color in research practices and studies. Listen to AHA’s podcast with Hossain to learn more about ways we can uncover gaps in maternal care.

4. Call racism as it is.

Racism has a historic, generational impact on health, and it makes us uncomfortable to discuss. In order to shift the system to better support women of color, we need to push through the discomfort. Terry Wright, M.D., health and racial equity strategist and public health scientist, suggested we integrate 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, more challenging questions.

Eugene Declerq, Ph. D., professor of community health sciences the Boston University School of Public Health and professor of Obstetrics and Gynecology at Boston University School of Medicine, suggested looking at longitudinal data to understand the nuances that exist in maternal health disparities, and link its generational impact to maternal mortality. Explore latest data from Birth by the Numbers here.

6. Biases have the ability to permeate.

According to AAMC’s recent polling of over 1,000 birthing individuals, nearly one-third felt that their quality of pregnancy, birth, and postpartum care was affected by experiences of bias or discrimination.

Biases exist within all of us, we can’t deny it. But we must learn to understand and train to address them.

For example, hospitals and health care providers can use March of Dimes’ Implicit Bias Training, called “Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare™,” to better understand structural racism, assess one’s own implicit bias and create action steps to mitigate it. Additionally, hospitals can use the short film, Toxic: A Black Woman’s Story, to initiate conversation within care teams and beyond about the many underlying factors, such as toxic stress, racial inequities, unconscious bias, microaggressions, impacting the health of Black women and their birth outcomes. AHA’s non-profit member hospitals and health systems can purchase the film for a discounted price here.

7. Involve those closest to the issue to be a part of the solution.

AAMC’s poll reported four in 10 respondents have no access to postpartum paid leave from work, and Hispanic birthing people are screened for mental health at lower rates. Recently, access to formula has been challenge for many new moms, re-exposing the disparities that exist in breastfeeding rates among Black and Native American and Alaska Native mothers.

Empower diverse women to join the table and share what better care means to them; their perspectives will help tackle the issue from different angles. In this AHA blog, learn about Institute for Healthcare Improvement’s Better Maternal Outcomes project, where health care organizations and their community partners in four cities — Atlanta, New Orleans, Detroit and Washington, D.C. — tested and scaled locally driven initiatives to address the challenges and opportunities for and with Black women.

8. Set expectations for high quality of maternal care, and hold systems and yourself accountable.

Understand what constitutes high quality of maternal care for your patients, community and organizations. Define those parameters, but more importantly hold each other accountable for meeting them.

9. It takes a village to raise a child, strengthen that village.

Establish cross–sectorial collaboration within and outside of clinical walls to offer women a range of support services. Support them socially, emotionally, economically and through policy.

10. Work with and through the system.

Maternal health equity 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 if a patient has access to wifi or broadband to virtually access a provider or his/her chart, we need to work together, across units, to offer equitable care for all women.

Leveraging data and patient stories can empower all of us to advocate for equitable policies, more culturally competent care, and a safer birthing 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.

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