Black maternal health at the forefront of advocacy

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Black women are three to four times more likely to die in childbirth than their white peers.

Black women are more likely to die of maternal complications than any other race.

Statistically, Black women are three- to four times more likely to die from childbirth than white women and have the highest rates of maternal mortality.

“This statistic is very much so, and unfortunately true,” said Dr. Cheryl Onwuchuruba, an obstetrician and gynecologist at Novant Health. “One of the biggest disparities is that women of African descent aren’t being listened to and being heard. So, the problem becomes that if you don’t hear what someone is trying to tell you as they are trying to advocate for themselves, then how do you do a thorough workup? How do you catch things earlier, whereas you may listen to others.”

According to Onwuchuruba, Black women have long been overlooked because of various factors.

“For too long, black women have been listed as being, more histrionic or more compliant or just harder to treat or having higher pain tolerance than other women from other racial backgrounds,” she said. “And so, what that led to is that in obstetrics, things can go from zero to 100 very quickly. A lot of times when we have good say is because something was diagnosed and caught early.”

Onwuchuruba cited an example of someone who lost their uterus after pregnancy because a physician did not take the patient seriously. Factors like income and age also play a role.

“Younger patients are definitely at an increased risk for preeclampsia,” she said, “and so not really lumping somebody into thinking that they’re just having normal pregnancy complaints, right? Thinking that it is normal, rather than having them come in and be seen, and the next thing you know, someone’s having an eclamptic seizure.”

Said Onwuchuruba: “A person’s socioeconomic status is a factor. Where do people live? Where do they come from? What are they having to do to get to these appointments? Do they have access to good nutrition, a good diet, and a stable ability to come to the office or to the hospital?

“And then the problem that becomes this compounding problem… if you have someone who is unable to have reliable transportation, and maybe the difficulty coming to appointments, then maybe when they're calling in that they are having x, y, z, complaint, maybe you’re not taking it seriously, because you looking and say ‘Oh, well, they missed their last appointment.’ Maybe you think they’re just trying to get out of work. And so, you kind of push it to the side, and then all of the sudden you’re in this emergency situation.”

Novant Health in recent years has tried to eliminate stigmas by making access to quality care readily available for all.

“Some of these things we’re trying to do is one, for instance, is having more access to OB Urgent Cares. So, these are specialized clinics that are open during off hours, rather than being during the day, like how our offices are. They are open from like 5-9 p.m. and then on the weekends, so this now kind of gives a place for patients with specific obstetric complaints to be seen without having to try to traverse the hospital emergency room scenario.”

Onwuchuruba cited an example of a community baby shower that allowed her to see lower-income patients and answer their questions. It starts with listening to the patient, regardless of economic status, race or age.

“A patient of mine from a few years ago had come in just because the fetal movement just felt a little bit different for her than it had been previous to her pregnancy,” she said. “At that point, she had had great prenatal care … and so when she called in and said, we just didn't quite feel right, we told her to come right to the hospital. And sure enough, as soon as she got to the monitor, we literally did an emergency C-section straight from triage. Thankfully, because of that, her daughter is now doing great and thriving. She did spend a couple days in the NICU getting support, but that is definitely someone who had we brushed it off, or told her to wait, honestly, her baby would not have been alive when she arrived at the hospital.”

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