It’s Black Maternal Health Week, but Dr. Ariana Lewis says the health of pregnant and postpartum Black women is an issue we should be talking about year-round.
“It can't just be a couple of people who care about this for one week in April,” said Dr. Lewis, an OBGYN at University Health. “We’re going to acknowledge it all the time. We as a society have to work to make this change.”
The Issue
Nationally, Black women are three times more likely than white women to die from pregnancy-related causes. In Texas, Black women are twice as likely as white women to experience serious pregnancy-related health conditions like preeclampsia, sepsis and hemorrhage, according to the Texas Tribune.
While factors like decreased access to health care, transportation, education and financial means contribute to health disparities, wealthy and highly educated Black women are still at a higher risk of maternal mortality compared to their white counterparts.
According to a recent report by the World Health Organization, the United States is one of only 13 countries worldwide with a rising maternal mortality and is the only country with an advanced economy where the maternal mortality ratio is getting worse.
“The underlying risk to health is racism, not race,” Dr. Lewis said. “It’s clear that providers are just not caring for black women the way that they should.”
Why the Disparity
The big reason behind this health disparity is institutionalized racism in the U.S. and within the health care system generally, with micro-aggressions and misdiagnoses adversely impacting Black women.
“Implicit bias or implicit racism is, unfortunately, ingrained in the thought processes of some providers in this country,” Dr. Lewis said. “And unfortunately that leads to significantly increased poor outcomes for Black women.”
Sometimes, when Black women complain of pain, their health care providers either don’t believe them or downplay that pain.
A woman may have pain that goes undiagnosed, “And then it turns out she had a severe postpartum hemorrhage, DVT or some kind of blood clot that ultimately led to her poor outcome because her complaints weren't taken seriously,” Dr. Lewis said.
What Can We Do?
The first thing health care providers can do is acknowledge their own implicit bias. “Making people aware that even if you're not racist, you may have a tendency to manage people differently based on how they look,” Dr. Lewis said.
The second is having protocols in place. For example, if a patient has a high heart rate, providers need to provide the same level of care and concern across the board regardless of that patient’s race.
The third is advocating for and ensuring access to women’s health care. According to the Texas Tribune, almost two-thirds of Black women are on Medicaid when they give birth.
Currently, Medicaid coverage for new moms expires six weeks after they give birth. Advocates and health care providers are pushing to extend this coverage to 12 months because “postpartum is a period of risk and complications as well,” Dr. Lewis said.
Dr. Lewis said it’s also important to acknowledge that “Not all physicians are bad. For the most part, everyone has good intentions. But naturally it can be ingrained in people and it’s a societal problem.”
CareforMom Program at University Health
Getting proper care and checkups for yourself and your baby in their first year of life is incredibly important. Because their Medicaid coverage expires six weeks after birth, University Health wants to provide continued coverage through CareLink.
Starting May 1, 2023, we are introducing the CareforMom Program for women who give birth at University Health while on Medicaid. No application is required, and members of this program will have no financial obligation.
The purpose of this program is to enroll Bexar County residents who qualified for Pregnancy Medicaid or CHIP Perinate and give birth at University Health. This program is only available to those who are Bexar County residents at the time of delivery.
For more information about the CareforMom program, please call CareLink Member Services at 210-358-3350.
