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  The OSA Telegraph

current events

Black women and children Injustice in hospitals

9/14/2020

1 Comment

 
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"Institutional racism is a form of racism embedded as normal practice within a society or an organization. Many people of color experience it all the time in all aspects of their life..." - Aeryon Jackson, 10th Grade
A recent study done by Rachel R. Hardmen, found that Black newborns are more likely to die when cared for by a white doctor. Some may find this shocking, whereas some may already have been aware. On the other hand, in another article by Elizabeth Chuck, researchers found that the mortality rate for white babies was unaffected by the race of the doctor. These findings have brought light to the institutional racism that has long-existed in the medical field.  

Institutional racism is a form of racism embedded as normal practice within a society or an organization. Many people of color experience it all the time in all aspects of their life. The Centers for Disease Control and Prevention (CDC) has discovered that about 700 women die from problems concerning pregnancy or childbirth. However, the CDC’s data goes to show that black women do have it the worst, dying 2.5 times more often than white women.

Assistant Professor in the department of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF), Brittany Chambers, works on understanding how structural factors such as racism impacts maternal and child health outcomes. She partners with community members and organizations across the Bay Area to make sure that their voices are reflected in her research. For the past 7 years she has been working in the Black maternal health space and has spent a lot of time researching key issues that impact these outcomes.  

“What research shows is regardless of Black women’s access to resources such as higher education, we still have a higher risk of dying during childbirth. A lot of research is now moving towards understanding the root cause of these inequities which is racism,” Professor Chambers said. “ I have been leading work in this space to talk with Black women to understand how racism shows up in their communities and impacts their pregnancy experiences and birth outcomes. I will be using these stories to develop a racial equity training to improve Black women’s care experiences and outcomes.” Her research has underscored others and has shown that Black women are not being offered treatment options or being listened to during childbirth at the same rates as white women.

Professor Chambers has had personal encounters with institutional racism throughout her life. Her experiences started as a teen parent trying to navigate parental care. “As a teen I would hear nasty comments such as ‘you are too young to be having a baby,’ and when expressing pain during pelvic exams told, ‘you weren’t saying that when you got pregnant.”’ Similar experiences have happened when Chambers received care from non-Black doctors as an adult and when going with her children to their medical care appointments.

When asked  what she thought she  needed to be done in order to  take a step forward towards lowering the death rates of both Black infants and women, she responded that we need to center-in on Black women’s experiences and voices. “Black women have the answers to address this issue,” Chambers said. ”The problem is, most funders are not funding Black women researchers who use community-based participatory approaches to understand this issue.”

Ifeyinwa Asiodu, a public health nurse, researcher, educator, and lactation consultant has been registered for over 7 years. She is also an Assistant Professor at UCSF where she teaches within the Midwifery and Advanced Public Health Nurse specialties and Doctoral program. “I also conduct research which focuses on the structural barriers and facilitators to breastfeeding, chestfeeding, and the use of donor human milk in Black communities.” 

One thing Asiodu thinks needs to be done to lower the deaths of Black infants and women is listening to Black women and birthing people. Centering their voices, concerns, and experiences. That, along with acknowledging the role and impact of racism on Black women, birthing people, and their infants. 

“In addition, we, healthcare providers, health systems, insurance payers, and others need to work toward addressing systemic racism and anti-Black racism within their environments,” Asiodu said. “while completing self-reflection to identify the ways in which they themselves, perpetuate or dismantle racism.” Along with investing in community-led initiatives and diversifying the healthcare workforce, according to Asiodu, can go a long way to improving the issue of maternal mortality, morbidity, and infant mortality—ultimately achieving health equity.

 “I’m a Black woman physician,” said a Reproductive Justice Focused Board Certified OBGYN & OB Hospitalist, Associate Professor, and a Sexual, Reproductive and Perinatal Epidemiologist. “Less than 2% of all physicians are both Black and female, even in 2020. Very few Black women and Black women physicians are at the level of associate Professor. When I was hired in September 2019, I was the only Black women OBGYN at the level of Associate Professor. I was fired from my first job by a white male OBGYN because he was threatened by me—even though I was the number 2 highest producer in the hospital—as the only Black woman OBGYN and the most junior,” she continued. 

“I was fired from my second job,” she continued.” By the CEO at the hospital which was a white woman because my Nigerian woman partner and I refused to be treated poorly - caring for patients in an unsafe environment. My partner and I were fired on the same day. The hospital illegally took out wages we made by supporting the births from the County at the “private white hospital” across town. I filed a lawsuit and I won all of my wages back. Big white institutions think we’re afraid to fight back. I’m not the one.”

Her work, research, clinical practice, and policy/advocacy examines the causes of deaths and near deaths, and creates solutions to prevent deaths and near deaths as an OBGYN and Applied Epidemiologist who works exclusively in community hospitals. She also tests new theories and measures to demonstrate how different types of racism exist in health care interactions, communication, counseling and decision making. 

When asked what she thought needed  to be done in order to lower the death rates of both Black infants and women, she responded with “disincentivizing killing Black infants and women.” Along with that, creating a policy where hospitals that receive Medicaid or Medicare funding only get 25% of their reimbursement if the death gap between Black and White is 2x or higher. 

With that being said, it’s obvious that there’s a lot of work that needs to be done to get justice for the Black women and infants that have to experience continuous institutional racism from the people that they intrust with their lives.

1 Comment
Bastet
10/19/2020 09:18:47 pm

The scholarship described in this article is long overdue. It is now well documented that black mothers and babies in the US are suffering injury, illness & dying at rates much higher than whites, Hispanics, Asians and people from all other races who give birth in this country.

Those in power still choose to treat this public health crisis as an urban legend. Politicians have recently begun including some related statistics in campaign speeches and sound bytes, in hopes of sounding "woke." But when it comes time to take decisive ACTION, most disappear into "more pressing" matters (ie: working hard to make sure that their rich donors get richer while the poor stay poor). And most of our politicians are clueless when it comes to actions that need to be taken in order to reverse the indefensible disregard for the lives of these women and their infants.

As a new, young nurse, I was very lucky: Dr. Haywood Brown (former President of ACOG) was a mentor to me. He specialized in caring for pregnant women battling substance dependency, abuse and poverty.

I, too, had been a teenage mother and experienced many rude comments, like those described above..so I THOUGHT I knew how it felt to be constantly, cruelly discriminated against. It wasn't long before I learned and acknowledged the privilege I enjoy...privilege bestowed upon me only through the lottery of birth.

Dr. Brown opened my eyes to a world I had previously refused to see. I received a crash course in systemic, generational racism, caring for women and children every day who were dealing with its devastating effects. I chose to spend most of my 25 year nursing career working with these courageous women.

I ended up pursuing a graduate degree in anthropology/archaeology and retired from nursing a few years ago. Now, I am able to talk about some of what I witnessed (without violating HIPAA).

As a white nurse, my white co-workers had no problem letting their racist flags fly in my presence (even though I called them out). How I reacted is a long story, and inappropriate for this forum. But I ended up being blacklisted, for refusing to accept "business as usual," taking decisive action, and refusing to capitulate or apologize.

I spent the last several years working in the deep south, in an area with some of the highest maternal/child morbidity/mortality rates in the developed world. Of course, black mothers and babies were (are) disproportionately afflicted.

I witnessed attitudes, actions, routines and sometimes even hospital policies that I strongly believe are major causative factors throughout most of the healthcare system. I fought to change what I could (working with black co-workers whenever possible). In the end, I realized the 400 year old tentacles of systemic racism are far too entrenched for a few well meaning staff members to fix.

Allow me to express my profound gratitude to the brave women warriors mentioned in this article who are fighting back against these ancient, embedded, stubborn forces that continue to kill and maim our black sisters and their precious babies. The struggle is still in its early stages. The data sets they are providing are powerful, valuable tools that we can refer to, when educating those holding positions of power: those who are best equipped to start the seismic shifts required to achieve racial justice in our healthcare system.

Until then, I (and other allies) will continue to sound the alarm...what is happening to black mothers and babies in the US is not JUST an emergency; it's a full blown crisis. And every day we fail to make leaps forward, precious lives are being lost. Considering that the US is the wealthiest country in the history of the world, it is unconscionable that black women & their infants continue to die from mostly preventable, treatable pregnancy & childbirth related complications in this country.

If I can be of any assistance to the vital work that these researchers are immersed in, please let me know.

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