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Saturday, June 10, 2023

Not Separate, But Still Unequal: Black Maternal Care

Hope for the good health of pregnant women springs eternal. The Black Mamas Matters Alliance has designated April 11 to 17, 2023 Black Maternal Health Week. Their awareness campaign is an excellent time to take a closer look at how a common maternal health disparity endangered the life of a mother and child.
Generally, maternal racial health disparities are thought to be the problem of poor, Black women without adequate access to prenatal care. However, the Centers for Disease Control (CDC) says, affluent, Black expectant mothers with access to quality care, still have a three times greater chance of receiving biased prenatal treatment than poor, white uninsured maternity patients.
“I nearly died giving birth,” exclaimed tennis legend Serena Williams, during a CNN interview. “Being heard and appropriately treated was the difference between life or death for me.” She credits the hospital’s medical staff with excellent care but only after insisting the medical providers administer the diagnostic test that Williams says saved her life.
In the elite world of professional sports medicine, care providers are highly paid to understand the importance of listening to their patient’s thoughts and requests for care. Patient feedback can be a powerful diagnostic tool, but only if the care provider is willing to listen and take into consideration their stated concerns.
Like most professional athletes, Serena Williams received concierge medical care, also called boutique medicine— a health care delivery model that is growing popular among those who can afford it. People who opt for concierge care can pay a premium for a doctor/patient relationship akin to having a personal physician. Care is available 24/7, in a setting vetted to listen carefully, promptly address and attend to all their patient’s needs.
In addition to excellent on-demand health care services, concierge medicine makes smart business sense. The optimum good health of star athletes, like Williams is collectively a multi-billion-dollar imperative for wellness. Sports concierge medicine is intended to shield all players from inadequate, unmonitored care. But boutique medicine does not always protect a Black woman from bias treatment should the circumstances require care outside the concierge’s network of providers.
As expectant mom Serena neared delivery, her care was shifted to unfamiliar medical territory— a hospital maternity ward. The delayed diagnosis and treatment of a life-threatening condition could have killed her and her unborn child.
During childbirth, Williams told CNN that she began feeling short of breath during childbirth. She requested a CT scan to check for blood clots. Her request was dismissed as not needed. She shared her history of clots as justification for the scan. Her request was again denied. “I was in a panic, out of breath. I could hear them [health care providers] initially saying my confusion was caused by painkillers. I felt like they didn’t want to hear me or take my symptoms seriously.”
No one knows their bodies, inside and out, better than athletes. A persistent feeling something was wrong gnawed at Williams’ deference to the medical staff. She persisted until the scan was given. Dangerous blood clots were found in her lungs. Emergency surgery was performed and Serena delivered a healthy daughter.
In 2022, the Biden administration published “The White House Blueprint for Addressing the Maternal Health Crisis.” The report begins, “The United States is facing a maternal health crisis.” The sixty-six-page report singled out the “systemic barriers, and a failure to recognize, respect and listen to patients of color” as the primary source of maternal health disparities. Adding, “this has meant that Black and American Indian women, regardless of income or education, experience a greater share of the gravest outcomes.”
World Class athlete or pink-collar worker, Black women face health disparities at virtually every stage of their pregnancy. To increase awareness and address systemic challenges to a healthy pregnancy, here are five things that can be done as a community or individually to decrease disparities in maternal health care:Increase diversity in health care. Encourage and incentivize medical school to increase diversity in enrollment, mentor minority staff for leadership roles and encourage active participation in policy making decisions
Improve Cultural Competency. Develop and provide training to help health care providers understand and respect the cultural values and beliefs of their patients
Address Structural Racism. Dismantle biased systems through development and enforcement of policies that mandate equal care and treatment
Collect, analyze and distribute data. Support the elimination of biased care
Encourage community engagement. Reach out to people most affected by racial health disparities to understand their health needs. Co-partner with the community to co-create solutions to biased care

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