Access to midwives and doulas could reduce the maternal mortality of Black women
Vanessa Bassett specifically chose her OB-GYN because she wanted a doctor who could relate to her, someone who has had similar experiences.
“I am a Black woman, so I come with different health concerns,” she said.
While Bassett was pregnant with her second child, her Black OB-GYN was invested in her health — but she was not available for the birth. After a rough labor and delivery with non-black doctors and nurses, she nearly died.
“The craziest part about it is, I’m going through all this and my husband is in the corner of the room, holding our, you know, baby who’s 30 minutes old thinking that I’m going to die,” Bassett said.
This story is not new or strange to women of color, especially Black and Indigenous women.
According to the Centers for Disease Control and Prevention, Black women are three times more likely to die from a pregnancy-related cause than white women. It is why many of these women turn to midwives and doulas to support them.
The nonprofit Black Physicians of Utah partnered with the University of Utah’s Department of Obstetrics and Gynecology and Department of Equity, Diversity and Inclusion to view the award-winning documentary “Aftershock.” It tells the story of Shamony Gibson and Amber Rose Isaac, two Black mothers who died after giving birth in 2019 and 2020. Doctors dismissed their symptoms which led to their preventable deaths.
After the screening, a panel discussed the themes of maternal mortality in the film. Bassett traveled from Denver, Colorado to tell her story, which could have ended similarly to Gibson and Isaac.
About 20 minutes after the birth, Bassett began to feel very cold. Her teeth were chattering and her mom started asking for more blankets. The nurse came in and didn’t notice that something was wrong. In hindsight, Bassett said she was going into shock.
After a routine push on Bassett's uterus by the nurse, a large mass of blood clots came out of the vagina.
“The nurse calmly picked it up and weighed it. And then she did a code white. And I knew it was bad,” Bassett said.
People rushed into the room. She was told the fastest way to clear her uterus of the blot clots was to scrape them out. In the end, she lost two liters of blood and was lucky they were able to stop the bleeding. Even her mom had no idea that she almost lost her daughter that day.
Jeelan Fall, a certified nurse midwife and women’s health nurse practitioner, said Bassett’s outcome could have been different had there been African American providers, including a midwife or doula present.
“There was a nurse that came in the room and didn’t realize anything was going on with you. Probably because she was not engaged with you or did not care about you as an individual,” Fall said.
But, not everyone can afford a midwife or doula. HB84 and SB192, which are under consideration in the waning moments of the legislative session, would help with the cost barrier as they extend the coverage for postpartum women and doula services under Medicaid.
A lack of midwives and doulas to advocate in the delivery room can lead to unnecessary C-sections. While C-sections can save lives, they are still major surgeries.
Michelle Debbink, a university assistant professor in maternal-fetal medicine and department vice chair for equity, diversity and inclusion, was involved in a study that found Black and Hispanic people experience higher rates of C-sections even when they have the same low risk as non-Hispanic white people. Debbink said those rates are driven by a diagnosis of that isn’t very helpful.
“We are creating inequity with an imperfect tool that we continue to use,” she said.
Another problem, experienced by Bassett and people of color in general, is implicit bias. This is a form of bias that is automatic but unintentional. Fall said one of her greatest fears as a Black provider is that other providers, and people in general, feel like they’re not contributing to “the big fat elephant in this room, which is racism.”
She mentioned that the University of Utah is trying to combat implicit bias in health care providers and students with Project ARIISE.
This problem is why Black Physicians of Utah was created in the first place. Alice Akunyili, assistant dean of academic affairs and the moderator for the panel, said Utah couldn’t keep physicians. So the nonprofit was founded to keep them in Utah, but they soon realized they needed to incorporate other health care providers as well.
“There is a need to have health care providers here for that population. The reality is that having Black physicians makes all physicians better,” she said.