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During last week’s Black Maternal Health Week, The Black Wall Street Times spoke with Kanika Harris, Ph.D., M.P.H., Director of Maternal and Child Health at the Black Women’s Health Imperative to discuss the state of Black maternity.
New data from the National Center for Health Statistics shows that Black maternal mortality rose significantly during the pandemic — and that Black women are three times more likely to die from pregnancy-related causes than their white counterparts.
“Time is up, this is not a new issue,” says Dr. Harris.
To combat this public health crisis, the Black Women’s Health Imperative, in partnership with the Association of Women’s Health, Obstetric and Neonatal Nurses, just released a new study on how racism towards Black patients and nurses during birth experiences affects patient outcomes.
They plan to use the study’s findings to inform a POST-BIRTH Warning Signs Program that will reduce maternal mortality across the board.
Dr. Harris points out that the disparities in healthcare are not solely based on health – but care. She points out that while Black segregated hospitals of the past may not have had the medical advancements of their White counterparts, the care and attention to its patients were there and it led to better outcomes.
How do we fix this?
Citing ACOG (American College of Obstetricians and Gynecologists), which is keeping a log of disrespectful, discriminatory, and racist practices by medical institutions and staff, Dr. Harris believes it is a step in the right direction to filter out nurses and medical personnel who do harm to those most vulnerable. She explained, “Racism is like the air we breathe, it’s a part of everyday life conditioning and you don’t realize how your everyday actions can cost someone’s life.”
To ensure quality of care across the board, Dr. Harris also affirms, “if you hit hospitals in their pockets, they’ll start to respond.” Much like the argument for qualified immunity, Dr. Harris would hold accountable the hospital systems and perpetrators who like police took matters into their own hands, leaving Black bodies as proof of their indiscretions.
What is being taught in medical school?
Dr. Harris spoke about her experience at a D.C. teaching hospital where she’s observed traditional medical instructors give substandard lessons. She could see those lessons would one day have a real-world impact on the next generation of physicians and unfortunately, their patients too.
When speaking on reforms needed, Dr. Harris is a realist and notes that Black maternal health is not an isolated issue. She explains that housing discrimination, overt and shadowed racism, police brutality, and so many other issues are not isolated from hospital staff and the type of care some nurses give often reflects a workforce that sees and treats Black mothers differently.
Black Maternal Health outcomes can be dictated by staff.
In the race-matched study, Dr. Harris stated, “Nurses in the study mentioned hospitals are rewarded when they have less staff on the floor.” So in turn care may not be readily available and to the attention of a patient’s needs because of reimbursement or bonus incentives to the in-charge nurse or maternity ward.
As a result, “you have a burnt-out staff that are trying to help multiple families and moms that are pregnant, and when you’re tired and burnt out you can’t necessarily process your everyday assumptions and feelings about race.”
Giving credit to her colleague, Dr. Karen Scott who stated, “we need our own hospitals,” Dr. Harris couldn’t agree more. However, until then Dr. Harris recognizes the power of choice for expecting mothers, citing, “close to 80% of births can be safely done outside of hospitals,” even while acknowledging that the overwhelming majority of births still occur inside hospitals.
Community Birthing Centers bring real change.
“More birthing centers that are community-led and designed,” Dr. Harris says could likely lead to an increase in positive outcomes for mothers and infants, along with a revival in communities re-establishing their social network. “Birth centers would take a lot of pressure off of hospitals. We know that it’s safe and decreases unnecessary medical treatments.” Dr. Harris continued, “we also know that moms have a higher level of satisfaction and lactation after delivering at a birthing center.”
Dr. Harris believes in training our own medical staff and midwives for the community we serve would also raise the standard of care for Black mothers. While HBCUs such as Winston Salem State University are well-known for their nursing programs, Dr. Harris states midwifery programs have never had the funding and support to get off the ground at our institutions.
Dr. Harris also credits Doulas as trusted members of the community to provide clinical, logistical, emotional, and tangible support to expecting families. She expounds, “Doulas have been a critical piece for Black-birthing families coming out of hospitals to feel intact and whole. Doulas also create a buffer between the hospitals and families who may be inexperienced with bringing new life into the world.”
Glimmers of Hope
Dr. Harris states her optimism comes from the attention garnered around Black maternal health and Black collaboration in finding solutions, “we find a lot of joy and healing in working together. We are working to get more birthing centers up and running.”
Dr. Harris cites birthing centers Birth Detroit along with her Washington, D.C. hometown’s Community of Hope, both of which are community-led and signs of progress and renewed hope toward Black maternal health.
Dr. Harris mentions her work with other devoted Black women to find solutions has been a constant support. “We bring joy, solidarity, sisterhood, there’s no competition, we’re doing whatever is best for Black mothers.”