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Keeping Black Moms-to-Be Healthy

Striving to Overcome Racial Disparities Surrounding Maternal Health

Are you a mother? Close your eyes and think back to before you started your family. Okay, you can open your eyes, but still, try to imagine: Things are going really well lately. It seems like everything is falling into place. Finally, the relationship with your partner is getting serious. In fact, talk of marriage and kids in the future is occurring more often. As you think about what this really means, you realize that it has also been more than two years since your last annual exam with your obstetrician/gynecologist. You’re excited to meet with your physician and update her about what has been going on in your life, but you’re also nervous. As much as you want to expand your family in the future, you may also have valid fears and concerns about the possible challenges that lie ahead.

As an African American female, I have been on both sides of the table – as a physician and as a patient. I want to call attention to the racial disparities in maternal health and encourage minority women in the Richmond community to work with their healthcare providers to achieve outcomes that are better than our current reality. Every woman deserves the best chance at a healthy pregnancy and childbirth, and we can work together to create a better outlook. 

Women of Color are at a Much Higher Risk of Death During Childbirth 

It’s an unacceptable truth that Black women are dying in childbirth at a rate three to four times higher than other groups of women. Elevated risks of maternal death have also been reported for Native American women and some Asian and Hispanic population subgroups. As alarming as these statistics are,
I assure you that there are OB/GYNS in our region working hard to break down barriers and provide the best care possible to women of color. In addition, we are working collaboratively across specialties to turn the tide toward well-being.

How Women of Color Can Improve Their Maternal and Reproductive Health

While the medical community is fighting to curtail the risk factors for women of color, it is also important that you become an advocate for your own health. As a team, we can work together to reduce racial and ethnic disparities and improve your maternal health outlook. Here are some ways you can contribute to your reproductive health:

1. Schedule your annual exam and stay up to date on appointments.

Early access to healthcare in order to optimize health prior to pregnancy is critical. Come to your appointments prepared to update your medical, surgical, and family history and to discuss any changes that have occurred since your last visit. If you are transferring care to another provider, have your records sent before your first visit. 

Your care team will make sure you are up to date with any pertinent screenings and tests available and make recommendations for maintaining a healthy lifestyle.

2. Address existing conditions Black women face.

If you are considering pregnancy, it is important to diagnose and treat conditions, such as hypertension, asthma, diabetes, autoimmune disease, and obesity before you conceive. It is also important to address any concerns about infertility.

If you are not ready for pregnancy, it is equally important to explore and consider your contraceptive options.

3. Prepare to have a conversation with your OB/GYN.

Your doctor wants to talk with you, not at you. Our goal is to create an environment for shared decision-making. We strive to practice evidence-based medicine and will share the relevant risks and benefits of treatment options. We’ll also review treatment alternatives with you.

At the same time, you should feel comfortable sharing any personal information that might impact your decisions regarding treatment so that we can explore any concerns and come up with the right plan of care for you. This kind of authentic conversation is especially important as you begin to establish an environment of trust between yourself and your healthcare team.

Effective communication is a cornerstone to quality care and patient safety. If there is a language barrier, please let your provider know so you can have a translator available at your visit. 

4. Ask questions and advocate for yourself.

Before your appointment, write down any questions you have. Then, when you see your provider, you can address those questions, discuss concerns, share your fears, and express your desires. If it would help, feel free to bring along a family member or friend to be your second set of ears. Once you leave, also use the decision aids provided (pamphlets, websites, etc.) and continue the conversation. We encourage you to engage and work with doulas, churches, community-based social services, and civic organizations that you trust.

Committed to Improving the Maternal and Reproductive Health of Women of Color

For women of color who are hoping to start a family, I want to reassure you that there are many OB/GYNs who are deeply and personally committed to improving your chances. We hope the next time you leave an OB/GYN appointment, you feel empowered and supported. Knowing to ask the right questions to get the most out of your visits is the first step in improving upon the factors of racial health disparities that are modifiable. While my colleagues and I work to increase quality and safety and addressing implicit bias, we will also work with you to show you how to better your own health. We are excited to partner with you as you move into the next chapter
of your unique book of life.

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What Is Birth In Color RVA?

Birth In Color RVA is a community of practitioners engaged in the promotion and practice of culturally centered reproductive health support in and around Richmond, Virginia. Aligned through membership and purpose, we offer women, families, and communities the place and space to be supported and affirmed through information and choice. The network directly provides pregnancy, birth, and postpartum support to expecting parents and families, opportunities for skill development for fellow practitioners, community engagement and advocacy initiatives to address relevant needs.

To support Birth in Color RVA, go here. 

As an OB/GYN at Virginia Physicians for Women, Monica Washington, MD, strives to make sure women understand each season of their lives and that they’re comfortable with their plan of care. Born and raised in Pittsburgh (and, yes, she is a Steelers fan!), she fell in love with Richmond after coming to VCU for medical school. Dr. Washington and her husband are raising two young boys.
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