Black Maternal Health Week Is Here. This Is Why It Matters.
By: Janelle Bolden, MD
This week is Black Maternal Health Week and it couldn’t be a more important time to highlight the concerns regarding Black mothers. I am Black. I am a mom. I am also a Maternal Fetal Medicine (MFM) physician. I know firsthand the dire situation we are in. As an MFM I care for patients with complicated pregnancies, whether these be high risk fetal or maternal conditions. Black pregnant patients have higher rates of many poor pregnancy outcomes, including preterm birth, preeclampsia, and fetal growth restriction, to name a few. I practice in Chicago, Illinois and maternal mortality rates here are alarming. This is a multifaceted problem that requires a multipronged approach. However, it is clear that allowing Black moms autonomy over their reproductive health choices is crucial to the solution.
I recall a patient I cared for recently. Let’s call her Nora. She’s a young Black woman with a significant heart condition. She delivered her first child via cesarean section without any major concerns. However, she received care at an institution that didn’t discuss or offer birth control, including immediate postpartum long acting reversible contraception (IPLARC). When she returned for her postpartum visit, she was again pregnant and this time with twins. This is when I met her. She clearly met criteria for high risk obstetric care given her heart condition, twin pregnancy and recent delivery. She required multiple hospital admissions and many different medical teams to get her safely through her pregnancy. She was at risk for so many concerning outcomes. I recall several conversations I had with her about not only her health, but her life in general; her hopes and dreams for herself and her children. She wanted to parent her kids without grave concern for her short or long term health. She had so many plans and actually wanted to go to nursing school someday. She knew she needed safe, effective contraception so she could plan if and when she wanted to expand her family. Though her pregnancy was tenuous, Nora delivered healthy twins a few weeks before her due date by having another cesarean delivery. She had some pregnancy complications after delivery (high blood pressure, anemia) but ultimately did well. Importantly, throughout the course of her pregnancy, I was able to counsel her about several IPLARC methods and she had a contraceptive implant placed in her arm before she went home. This will allow her effective birth control for 3 years.
Nora, like so many Black moms, knew what was best for her specific situation. She needed professionals who she trusted with her and her babies’ lives. She needed autonomy to make the decisions she deemed best for her. She needed access to appropriate, equitable care.
Access to appropriate reproductive health care is vital for Black moms and Black maternal health. However, of almost equal importance is a doctor patient relationship that values mutual respect and trust as well as effective, compassionate communication and empathy. These are not attributes that develop overnight. These relationships must be prioritized, nurtured and believed in.
Historically, Black patients have had reason to be skeptical of the institution of medicine, given the dark history of gynecological medicine and experimentations and research conducted without consent on Black individuals. Medical providers need to reach out and cultivate these partnerships with their patients and also be aware of their biases. I am a Black mom who cares for Black moms. I need to do the same work and make sure that I communicate diagnoses clearly, give my patients all reasonable options and through shared decision making develop appropriate management plans. I need to listen to my patients and trust them too.
So, at this critical time in our society and during this Black Maternal Health Week, what can we all do to promote and improve Black maternal health? We need to educate ourselves on the facts. Read the Society for Maternal-Fetal Medicine’s (SMFM) position statement on Access to Abortion Services, Racial Disparities in Health Outcomes, and commit to health equity. Get involved in advocacy. Write to your member of congress to support the Black Maternal Health Momnibus Act. Write an op-ed in your local paper to spread the word in your community or write a blog for SMFM’s Reproductive Health Project for Maternal-Fetal Medicine. Donate to causes that specifically care for Black moms. One such group is Black Mamas Matter Alliance. Its mission is to “center Black mamas to advocate, drive research, build power, and shift culture for Black maternal health, rights and justice.” Finally, listen to Black moms. Trust Black moms. Believe Black moms. Our lives are depending on you.
