all posts, women's health

on racial differences in maternal care

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Photo by Nicholas Githiri on Pexels.com

I’m combining all my other blogs’ content to this site. Please bear with me as I post older content. 🙂

Way back a few months, Fi and I visited my parents, and as a result she got her fill of dog exposure. Studies are still looking into the impact of early dog exposure (e.g. the first year of a baby’s life) on the child’s risk of asthma, allergies, and eczema later in life, and preliminary data seems to suggest that dogs have a positive effect in decreasing the risk of all three.

One study even found a higher correlation of eczema reduction for black children as opposed to white children from dog exposure, which could be useful as black people statistically have a higher risk for eczema (especially women).

These kinds of studies highlight the need for analysis of subgroups (e.g. race, gender, type of birth) to really understand who is being affected specifically. However, subgrouping is only useful so long as the studies are done through non-biased non-reductionist lenses. If accomplished, such specificity would allow for more applicable research to come out that could help promote better health, wellness, and medical decisions.

Which reminds me, I also listened to a webinar from the Black Mamas Matter Alliance. It covered a lot of material, but there was one particular point that stuck out to me (besides the need for a lot of policy reform across the country). It was the need for doulas, particularly those who live in the communities they serve (called community-based doulas).

Doulas act as support people for mothers, providing nonjudgmental (and non-medical) advice to moms from pregnancy to postpartum, making sure moms understand their rights and options. A doula from one’s own community would invaluable as they would understand the dynamics behind the community, as well as having firsthand experience with how the medical/clinical facilities are.

The webinar also talked about the need for insurance coverage for doulas (especially under Medicare), so that more mothers can afford them. I couldn’t agree more, especially as doulas correlate with better outcomes and statistics for the mothers overall.

The webinar is up on the BMMA site if you want to listen to it.

And lastly, I also read a book by a black midwife called Listen to Me Good, which was a book about a less well known figure in women’s history named Margaret Charles Smith. She was a midwife in Alabama who worked from the 40s to the 80s.

She never thought she’d become a lay midwife, as the hours were terrible and the pay even worse, especially for a black woman in the south. She learned traditions of birth and postpartum care through her grandmother and other “wise women”, and then later got standardized training through the nearest hospital, which allowed her to assist more women in a systemically recognized and medically approved fashion. She still continued to serve women as best she could without putting her neck on the line (she also helped deliver white women’s babies, which was a contentious point at the time).

The book also reflects on the various struggles black women faced in trying to work as midwives in Alabama, first due to explicit racism, but in later years, also due to systemic racism and prejudice through the worlds of healthcare and medicine, as doctors sought to get rid of lay midwifery (and devalued nurse-midwifery too in some areas). Many women, like Miss Smith, continued to try to care for women regardless, as they were the only option for hundreds of miles, and because white doctors were generally not interested in making the trip to aid poor black women give birth.

It really puts into perspective that even today, black women in America are still three to four times more likely to die during childbirth (or the first week immediately after) than white women. Food for thought.

One thing that could help bridge this increasing gap is better sensitivity training and education for medical practitioners. I was curious about different traditional practices and beliefs around postpartum care which led me to some interesting studies. One such study covered a few Central American countries and their beliefs around both the perinatal and postpartum periods.

I do think it’s important to know of the different roots behind postpartum treatments to help understand why a family may act/react the way they do to particular medical practices in western birth facilities (like hospitals). This is the way, in my opinion, to create a culture of care that uses a mom’s background/culture along with the medical evidence based practice to put the best interests of moms first, rather than of healthcare premiums.

 

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