This episode of the Mommy Labor Nurse Podcast is all about the realities of black maternal health here in the US, and what we can do to spark change!
We’ve done some feed posts over on IG about this topic before to help raise awareness, but I knew I wanted to take more of a deep dive over here.
It’s a topic that can be really heavy in some ways, but it’s one that needs a LOT of light! If we’re going to spark any kind of change surrounding racism in healthcare (and specifically in black maternal health) I truly believe that awareness is the first step.
The Black Mamas Matter Alliance is sponsoring the third annual Black Maternal Health week this year with the goal to:
- Raise awareness about the problems
- Enrich the dialogue surrounding black maternal health
- Promote solutions, policies, and research
- Increase community involvement
…all surrounding the disparities in black maternal health care. And my goal with this episode is to be a part of that conversation!
So, joining me today is my dear friend Jasmine Johnson, an MD, wife, mom of two, and maternal-fetal medicine fellow at the University of North Carolina Chapel Hill. She’s also the founder and content creator for the blog and Instagram account @mrsmommymd.
Here’s a peek into what we talk about!
Let’s talk about statistics surrounding the black maternal mortality rate – why is this such a staggering number? (7:55)
To kick off this q&a Jasmine sets the stage for the conversation by talking about some of the current statistics and realities. She shares about how this research isn’t necessarily new, but the awareness it’s getting IS new, and how she’s so glad about that!
Across the board, the US has the highest maternal mortality rate when you compare us to other developed countries, but when you separate it by race and ethnicity you see a seriously staggering disparity in deaths among American Indians, Alaskan Natives, and black women.
She discusses that what’s most notable is the fact that these stats haven’t budged since the early 2000s, and that really hits the nail on the head that there is something going on in our country that’s putting communities of color in vulnerable positions.
When you tune in you’ll hear more specific stats and the way that these trends illustrate a bigger, systemic problem.
You personally are a black mom of two, have you ever felt like you were treated differently during your maternal care? (15:41)
Jasmine talks about how blessed she feels to have had medically low risk pregnancies and excellent obstetric care. But shares a bit about the differences in navigating her two pregnancies due to the highly varied circumstances. Here’s a little bit about what she says:
“I had a pretty socially high-risk situation, just having my first my son in college and all of the instability there, kind of navigating being a single mom…having had one child in Detroit, uninsured, single black mother and then having one child as a medical student, with insurance, married, I felt the stigma and the differences of what care and trying to navigate the system is in those different situations [felt like].”
She goes on to say,
“In those situations. I’m the same Jasmine but my care was different. And the experience I had was different. And honestly, that kind of lit a fire in me so that when I became a physician, I didn’t feel short-sighted in the fact that like, Oh, you know, even though I’m able to give this type of care at this hospital, there are so many people just because of where they live, the resources they have, no matter how health literate they are, they are limited in getting evidence-based, excellent care.”
Tune in to hear more about Jasmine’s personal experience and the way it informs her practice as an MD today!
Have you ever witnessed anything in your practice, or in your schooling? Or anything from colleagues? (20:34)
Jasmine starts this question off with the simple statement that racism in medicine is everywhere. And that it’s dangerous because it’s so subtly ingrained in the system.
She shares a specific anecdote about a device rep with a postpartum hemorrhage management system where he made a blanket statement about how black moms bleed more to a conference room full of Labor and Delivery workers in the hospital – which is totally untrue!
She recounts the story about how she pushed back, and here’s a little bit of what she said,
“Black moms do not bleed more. There is nothing about black people’s blood that makes them bleed more. It is because there’s racism, it is because they are ignored, it is because they aren’t treated in a timely fashion. It has nothing to do with their blood not clotting as much. And so, I just want to make sure that no one leaves this room thinking that what you just said is true.”
When you listen in, you will hear her recount more examples of false statements and inadequate care for black women, and how what’s taught and implicit biases are contributing to these disparities.
Are there any actionable steps that providers can take to address this issue? (27:22)
First, she challenges providers to take a look at their own implicit biases and educate themselves on what they are and how they play out.
We need to reflect and pushback on statements, and make sure that our practice is always evidence-based. She sites some examples of changes to evidence-based care, and outdated practices (specifically in maternal healthcare) that really disadvantage black mamas.
Some of these include outdated recommendations on when to treat anemia in black vs. white moms, and the way that VBAC eligibility was assessed in black vs. white moms as well.
She also touches on the importance of disaggregating data on things like Cesarean rates and other birth interventions based on rates to make sure there is equity across the board.
Are there any actionable steps that black moms can take? (31:47)
I love how she started the discussion of this question:
“I love giving people action items, but I always preface this, like for the black moms listening out there. There is nothing wrong with you. There is nothing wrong with black women that explains these statistics.
And so, we can’t be responsible for fixing this problem solely. But I think that until we have this like big mass change that we’re looking for, I’m definitely making sure that our moms feel empowered to speak up.”
Here’s a few pieces of advice she touches on:
- The importance of switching doctors and transferring records if you don’t feel like your provider is listening
- Sparking a conversation with your provider about THEIR thoughts on the disparities in black maternal health care, and ways their practice and hospital is responding to these issues
- Know your own medical history very well so that you can self-advocate
- Partner with a doula if at all possible! If cost is a concern, look into organizations that partner black women with doulas
- Have a support person with you to be a second set of ears, and ask a second set of questions. During the COVID pandemic, don’t be afraid to call or FaceTime someone in so that they can be a part of your care conversation
Related: 23 Ways to Advocate during Pregnancy
About Jasmine Johnson, MD
Jasmine Johnson, MD is a wife, mother of two, and Maternal-Fetal Medicine fellow at the University of North Carolina – Chapel Hill. Dr. Johnson received her undergraduate degree from the University of Michigan, medical degree at Indiana University School of Medicine, and completed residency in Obstetrics and Gynecology at the University of North Carolina – Chapel Hill.
In addition to her clinical work, Dr. Johnson is the founder and content creator of the blog: The Mrs. The Mommy. The M.D.
She currently serves on the Society for Maternal Fetal Medicine – Health Policy and Advocacy Committee and co-chairs the Diversity Task Force for the Department of Obstetrics and Gynecology at UNC.
Dr. Johnson’s research interests include health disparities within the obstetric population, and quality improvement efforts to help reduce maternal mortality and severe maternal morbidity. Jasmine continues to strive to be a fierce evidence-based advocate for the Black community.
You can connect with Jasmine in a couple of different places:
Here are some of the resources she mentions in the episode:
This is the birth plan/convo starters she mentions from the NY Times: