The Black Directors Health Equity Agenda held their annual conference in Atlanta, October 3-4, 2022 at the Whitely Hotel and Morehouse School of Medicine. The two-day conference was marked by panels and discussions addressing health disparities in the African American community with special attention being paid to hospital boardrooms, patient care and issues like maternal mortality. African American women are three times more likely to die in childbirth or within a year following childbirth, regardless of class or educational status.
“Aftershock” director and producer Tonya Lewis Lee; Black Women’s Health Imperative President and CEO Linda Goler Blount, MPH; Natalie D. Hernandez, Executive Director of the Center for Maternal Health Equity at Morehouse School of Medicine; and Dr. Rachel Villanueva, Immediate Past President of the National Medical Association, participated in a robust discussion about maternal mortality and bias against Black and Brown patients, and strategized about what could be done to improve outcomes.
Moderated by Lauren R. Powell, Vice President of the US Health Equity and Community Wellness at Takeda Pharmaceuticals USA, the activist-oriented discussion made it clear that the rate of maternal mortality impacting African American women means we are in a crisis and radical change must happen.
Audience members shared their personal stories, with one gentleman discussing how his mother died in childbirth and how that economically devastated his family. Another audience member praised the activism of the panelists while suggesting the need for more data and the inclusion of more voices in the discussion like practitioners.
Following the panel, I had an opportunity to connect with Villanueva, who has made combatting health inequities and maternal mortality her life’s work. Like many others who set their sights on medical school, Villanueva “just wanted to be a doctor,” but was called to do this difficult work after seeing such a great need.
“I really liked women’s health and maternal health because you could really follow women through their whole life course. I’ve had some patients that were patients of mine before they went to college and now they are having babies. Just having that continuity with a person really is a very special relationship that not all physicians can have,’ says the Clinical Assistant Professor of Obstetrics/Gynecology at the NYU Grossman School of Medicine.
The ability to stay with patients for the duration of their care should not be taken lightly considering African Americans were often barred from seeking treatment at some hospitals and Black doctors were also barred from practicing. “We were not allowed to practice medicine or take care of patients and the disparities existed a long time ago. I think that really fueled my desire to make a change, to understand that we’re dealing with stuff we’ve been dealing with for 50-plus years or a hundred years when you’re talking about disparities in maternal health,” adds Villanueva, who “wanted to be part of the solution.”
Villaneuva’s signaling that maternal mortality and Black women is not new is important since the fact that maternal mortality and Black women is a trending topic might suggest it’s a recent phenomenon. Bias against Black expectant mothers is not new; what is new is the high-profile people who are talking about it publicly and making it newsworthy in the process.
We’re seeing more and more information about maternal mortality with the success of Lee’s critically acclaimed documentary, “Aftershock,” and with more people taking an interest in the subject after Serena Williams, often regarded as the greatest athlete of all-time, discussed how she almost died in childbirth because her doctors didn’t listen to her complaints. If one of the greatest athletes walking the Earth almost died in childbirth, then what does that mean for the rest of us? It means expectant mothers can learn from her – to advocate for yourself.
After giving birth, Williams began to lose feeling in her legs. And her pain increased. Having suffered from blood clots in 2011, Williams sensed something wasn’t right. Despite the hospital staff, including her doctor, insisting she was fine, the world champion insisted they test her for blood clots since she had been forced to go off of her medication during the birthing process.
After the test, they found the clots, rushed her into surgery and saved the tennis phenom’s life. Had she not advocated for herself, she very well may not be here to raise her beautiful daughter Olympia.
Villanueva agrees that patients have to advocate for themselves or have someone advocate for them. One of those steps is choosing the right doctor. “I think you really need to have someone who understands you and makes you feel comfortable,” the women’s health advocate says. “I think (it’s about) finding someone you can be comfortable with who answers your questions, who takes the time to listen, who you feel does not dismiss what you’re saying and gives you credible information,” she adds.
While Villanueva thinks it’s a good idea to find a doctor who looks like you because research shows that it helps tremendously with communication and care, not having a Black or Brown doctor is not a dealbreaker, especially for those who don’t have access to Black doctors. “If you don’t feel comfortable with a doctor, maybe not the first time, but after you’ve had a session or two, then maybe it’s time to look for somebody else,” Villanueva adds.
The immediate past president of the National Medical Association, the largest and oldest national organization representing African American physicians and their patients in the United States, also wants changes in policy. She references the recently passed Momnibus Act, a bill that directs multi-agency efforts to improve maternal health, particularly among racial and ethnic minority groups, veterans, and other vulnerable populations. It also addresses maternal health issues related to COVID-19. “The Momnibus, that really looks at the roots of all the social determinants like mental health, research, data collection. It (the act) is not only social services; it is really getting down to data. It says to make sure we understand the problem well, and let’s make sure we have the data and the research so that when people ask for it, and people are data-driven, we can give them answers,” the reproductive justice expert adds.
The women’s health expert wants the medical community to understand that taking care of patients doesn’t just happen in the hospital. “All those social determinants, all those structural issues, all those barriers to access – those are things that we really need to be able to take care of patients and to eliminate those disparities and to ensure people have optimal health,” she notes. “The benefit of conferences like these is to raise awareness, raise money and to build strategies that will help eliminate maternal mortality.”