Although more than 80 percent of maternal deaths are preventable, women of color have the highest rates of pregnancy-related death, according to a new report from the Centers for Disease Control and Prevention (CDC).
In totality, 30 percent of Black women reported experiencing some form of mistreatment.
The most common types of mistreatment reported were:
- Receiving no response to requests for help.
- Being shouted at or scolded.
- Not having their physical privacy protected.
- Being threatened with withholding treatment or made to accept unwanted treatment.
BlackDoctor.org spoke with Dr. LaTasha Perkins, a family physician based in Washington D.C., who has expertise in this area plus personal experience with her own high-risk and difficult pregnancy, to discuss what Black women need to know about these alarming statistics, what can be done to combat them and how she advocated for herself during her own pregnancy.
The recent report from the CDC highlights that about one in five women experienced mistreatment during maternity care and almost a third face discrimination. Could you dive into the main findings of this report and its effects on the BIPOC community?
There are two more things that kind of came out – one in five women of color (Black, Hispanic or multiracial women) actually experienced this treatment so it’s a little bit higher than that one in five. Also, about 45 percent of women aren’t comfortable bringing up concerns that come up during pregnancy or labor.
According to the report, the top reasons women don’t feel comfortable bringing up concerns include:
- Thinking, or being told by friends or family, what they were feeling was normal.
- Not wanting to make a big deal about it or being embarrassed to talk about it.
- Thinking their healthcare provider would think they’re being difficult.
- Thinking their healthcare provider seemed rushed.
- Not feeling confident that they knew what they were talking about.
As a physician, that’s not something I want to hear that almost 50 percent of women who are pregnant don’t feel comfortable having a conversation – having their concerns, especially with something that’s as life-changing as birthing your child. It’s important that we understand what the mistreatment is… Are they even aware of the things that come across as negative or significantly affecting their patients? We need to focus on once we have these numbers, figuring out why this is happening and trying to come up with solutions. My biggest pet peeve at this point when it comes to maternal health, particularly Black maternal health, we’re collecting data, which is extremely important, and getting awareness, which is also important; but now that we’re aware, it’s time to come up with some solutions. I would like to talk about some things that we need to think about when it comes to solutions.
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From your standpoint, what do you envision as far as solutions for these women and for healthcare providers when they’re treating their patients?
There are multiple levels to it. There are levels to everything, but particularly when it comes to this, there’s a systemic level at the federal government level. The Biden administration had this almost 70-page blueprint for maternal health that they released last June and it came off the heels of this act called the Momma’s Act that was in the House of Representatives. I think it was introduced by Congresswoman Robin Kelly. But it was talking about those things that need to be done on the government level – things like making sure coverage is there and so on. The systemic level is important to think about because we’re coming into an election year and you need to see what the incumbents are doing and then also ask the questions of the new people who are running for office… pay attention to what they’re saying when those questions are asked of them. Do you care about maternal health? Do you care about our lives? That’s the systemic part when it comes to the medical system and clinicians being aware of their biases is definitely important… Also understanding patients culturally when it comes to labor pain is a big part of delivering. Pain is subjective – it is very cultural. Even if I don’t scream and shout when I tell you I’m in pain, you should trust me when I say I’m in pain. I think that’s an example of how clinicians need to look at their bodies and check their bodies and check what they’ve been taught, but also cultural humility is important. I’m using humility instead of competency because humility is learning… You have to continue to grow…When you’re pregnant, there needs to be a tribe [of] friends and family – understanding what you’re planning…The biggest thing for me as a physician is keeping the doctors on the team… In our community, we have to make sure the conversation is inclusive and that we hold the medical system to a level where they move to fix this because our lives matter. That’s the levels I want us to think about systemically (both governmental and medical), but also within our community the conversations that we’re having – just make sure that every pregnant woman has a team and a tribe that’s around her supporting her and making sure that she lives – her baby lives.
A lot of your passion around the topic of implicit bias comes from being a Black physician and knowing what women of color go through. Is there any data that can support how physicians of color or women physicians might impact the maternal mortality rate of women?
There is definitely data that shows that a Black child is more likely to survive and also a mother is more likely to do better with a physician of color and have less of negative experiences. The maternal mortality rate goes down when you have a physician that