During Black Maternal Health Week last week, The Black Wall Street Times spoke with Kanika Harris, Ph.D., MPH, Director of Maternal and Child Health at The Black Women’s Health Imperative discuss the state of black motherhood.
New data from the National Center for Health Statistics shows that black maternal mortality has increased dramatically 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 problem,” says Dr. Harris.
To combat this public health crisis, Black Women’s Health Imperative, in partnership with the Association of Women’s Health, Obstetric and Neonatal Nurses, has just released a new study on how racism towards black patients and nurses during childbirth affects patient outcomes.
They plan to use the results of the study to inform a POST-BIRTH warning signs program that will reduce maternal mortality at all levels.
Dr. Harris points out that health care disparities are not just based on health, but on care. She points out that while the segregated black hospitals of the past may not have had the medical advancements of their white counterparts, the care and attention to her patients was there and it led to better outcomes.
How do we fix this?
Citing the American College of Obstetricians and Gynecologists (ACOG), which keeps a record of disrespectful, discriminatory and racist practices by medical institutions and staff, Dr. Harris believes this is a step in the right direction to screen nurses and medical personnel harming the most vulnerable. She explained: “Racism is like the air we breathe, it’s part of the conditioning of everyday life and you don’t realize how much your everyday actions can cost someone their life.”
To ensure quality of care at all levels, Dr. Harris also says that “if you hit hospitals in their pockets, they will start to respond.” Just like the argument for qualified immunityDr. Harris would hold responsible hospital systems and perpetrators who, like the police, took matters into their own hands, leaving black bodies as evidence of their indiscretions.
What is taught in medical school?
Dr. Harris spoke of her experience at a DC teaching hospital where she observed traditional medical instructors teaching substandard classes. She could see that these lessons would one day have a real impact on the next generation of doctors and, sadly, on their patients as well.
When talking about needed reforms, Dr. Harris is realistic and notes that black maternal health is not an isolated issue. She explains that housing discrimination, overt and covert racism, police brutality and so many other issues are not isolated to hospital staff and that the type of care some nurses provide often reflects a workforce who sees and treats black mothers differently.
In the race-matched study, Dr Harris said: “Nurses in the study mentioned that hospitals are rewarded when they have fewer staff on the floor.” So, in turn, care may not be readily available and responsive to a patient’s needs due to reimbursement or incentive bonuses to the charge nurse or maternity ward.
As a result, “you have an exhausted staff trying to help multiple families and pregnant mothers, and when you’re tired and exhausted, you can’t necessarily process your day-to-day assumptions and feelings about race.”
Giving credit to her colleague, Dr. Karen Scott, who said, “we need our own hospitals,” Dr. Harris wholeheartedly agrees. However, until then, Dr Harris acknowledges the power of choice of pregnant women, citing “nearly 80% of births can be performed safely outside of hospitals”, while acknowledging that the overwhelming majority of births occur still inside hospitals.
Community birthing centers bring real change.
“More community-led and community-designed birthing centers,” says Dr. Harris, could likely lead to increased positive outcomes for mothers and infants, as well as renewal in communities re-establishing their social network. “Birth centers would relieve hospitals a lot. We know it’s safe and reduces unnecessary medical treatment. Dr Harris continued: “We also know that mothers have a higher level of satisfaction and lactation after giving birth in a birthing centre.”
Dr. Harris believes that 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 programsDr. Harris says midwifery programs have never had the funding and support to get started in our institutions.
Dr. Harris also recognizes Doulas as trusted members of the community to provide clinical, logistical, emotional, and tangible support to future families. She explains, “Doulas have been a vital part of making Black families coming out of hospitals feel intact and whole. Doulas also create a buffer between hospitals and families who may not have the experience of bringing new life into the world.
glimmers of hope
Dr. Harris says her optimism comes from the attention to black maternal health and black collaboration to find solutions, “we find great joy and healing in working together. We are working to have more birth centers operational.
Dr. Harris says her work with other dedicated black women to find solutions has been a constant support. “We bring joy, solidarity, brotherhood, there is no competition, we do what is best for black mothers.”