Play PodcastPlay Download PodcastDownload

Transcription:

Deborah Howell (Host): Welcome. April 11th through the 17th is Black Maternal Health Week. And today we'll do our best to find out more about this special week and raise awareness about Black maternal mortality. I'm Deborah Howell. And my special guest today is Lori Grimm, Director of Perinatal Services at Deaconess, the Women's Hospital. Lori is also a Registered Nurse. Welcome Lori.

Lori Grimm, RN, MSN (Guest): Thanks Deborah. I'm excited to be on the call to discuss more about Black Maternal Health Week.

Host: I've been looking forward to this one. So you've been with the women's hospital for over 20 years. Congratulations on your long run.

Lori: Well, thank you. It's been a very, wonderful place to work. I helped open the doors back in April of 2001, and I started as a charge nurse in labor and delivery, and I've done several different things along the way. And today I'm the Director of Perinatal Services.

Host: Wonderful. Now April 11th through the 17th is Black Maternal Health Week. Can you tell me what that means and what the general goal of the week is?

Lori: Black Maternal Health Week was an initiative that was designed by the Black Mamas Organization to help highlight the outcomes of Black women in the US. Because in the US Black women are three times more likely to die during childbirth or the year following than white women in this country. And so their main focus is to heighten awareness and provide education to communities about the disparities of maternal outcomes and help people get engaged in this effort to try and reduce Black mortality.

Host: Absolutely a very worthy goal. How did it originate?

Lori: The Black Mamas Matter Alliance is a national network of Black women-led organizations, and it's made up of multidisciplinary professionals who are working to ensure that all Black mamas have the rights, respect, and resources to thrive before, during and after pregnancy. And I think some of the main goals that they really focus on is trying to change policy. You know, are the rules in place to help provide access to care. Insurance, is it equitable to where all women are having access? They want to cultivate research. They want to look at how is the healthcare provided to other groups of people that's different to the Black women in the Black communities, so that we can engage these folks in meaningful healthcare and strategies to improve their outcomes.

And obviously they want to shift a culture and redirect and reframe the conversation on Black maternal health and help engage everybody in this effort to improve outcomes of all of our women in our county.

Host: Absolutely.

Lori: Actually, this is the I'm sorry, this is actually the fifth Black Maternal Week. And it was officially recognized by the White House on April 13th, 2021.

Host: Long overdue, but welcome. So how does AWHONN support black maternal health?

Lori: Well, AWHONN is the Association of Women's Health on Obstetrical and Neonatal Nursing, which is a professional organization that promotes maternal and neonatal care standards across the country. And AWHONN, consulted a group of experts to help develop a toolkit to kind of address and approve health care equity for all women.

And they have developed the Respectful Maternity Care Toolkit that helps provide a roadmap for healthcare organizations and providers to strengthen and learn more about breaking down barriers to improve health equity and address social disparities in maternal health. And so there's a whole 10-step process with this.

So I think one of the things that healthcare organizations do is struggle on how to start this project. How do you start engaging methods to reduce the barriers to equity and improving access to care? So it's really nice that they have put this in place that it helps provide an organization, a roadmap. This is how you start. This is when you get ready for implementation and walks you all the way through 10 steps to where at the end of this, you have done, it's probably a year's worth of work within your organization and your community to try and make efforts to improve the care that's delivered in that facility for not just Black women, but all women in the country that come to their facilities to deliver.

Host: Such important information to have, and so wonderful to have a roadmap or a template. Now, what are the stats on maternal mortality and especially to Black women?

Lori: Well, according to the Center for Disease Control and Prevention, approximately 700 women die each year in the United States as a result of pregnancy or delivery complications. And this is the highest in any developed world. So obviously the US really needs to get on board with tracking ways to decrease this mortality.

Because maternal mortality is one of the key indicators of a healthy population, which really makes sense. If you don't have healthy women and healthy moms, then those babies aren't well cared for, and they aren't there to be part of that process to raise healthy young people in our community to keep your country healthy.

So according to the literature that's there, Black women are three to five more times likely to have a maternal death than a non-Hispanic white woman. And that is regardless of their income or their education level.

Host: Unbelievable. In the year, 2022, well you're working on it. Can you tell me how the state of Indiana is handling this high mortality?

Lori: So Indiana has really been embracing the whole perinatal journey of improving outcomes of babies. And in 2018, they started to recognize that some of the problems we have with infant mortality is also related to the maternal morbidity and mortality. In 2018, the Indiana Maternal Mortality Review Committee was legislated byG overnor Holcomb as a division of the Fatality Review and Prevention Division.

And this is a multidisciplinary committee made up of healthcare professionals, mental health care providers, social workers, community leaders, as well as epidemiologists and law enforcement. And every maternal death; and that's a death during or pregnancy or within one year of the end of the pregnancy is considered a maternal death.

And all of these are reviewed in this committee. So everybody gets the same information and the case review is prepared and that committee then reviews all of those. And the real crux at the end of the day is trying to determine what were preventable deaths and then make recommendations on policies to improve and address the issues that were identified as contributing factors to those deaths.

Host: Got it. Now, Lori, what changes have you seen in the care of Black women and especially Black mothers over the past 20 years, if any?

Lori: Well, I will say that over the last 20 years, I've been a nurse a lot longer than that, but over the last 20 years, we have seen more women and more diverse providers in our communities. You know, back in the day when I started as a nurse, there was, it was all males, so the obstetricians and the maternal care advisors, they were all men.

So over that last 20 years, we have seen more women entering the profession as well as more diversity. You know, now we see more Black women. We see more Islanders, native Americans. We're seeing a lot more diversity in the care providers, I think, which is very important because it allows the patient populations to then better identify and develop trusting relationships.

Another thing that happened was the Affordable Care Act has enabled more women to have access to health care insurance which then increases their access to prenatal care. And that's really important because if there is a time when a woman is really going to engage in healthcare, it's when she's pregnant.

So, so many things are available and resources are available to a woman when she's pregnant, that it's really important that they have access to those resources. And I think lastly, I would say we have seen an increase in engagement to diversity, equity, inclusion in this country over the last, you know, three to five years.

And I think now we're seeing this as an essential component of health care. And so as we see this engagement in all levels, we're seeing more grassroots programs such as our community has the Wildflower Lactation Group, which is a group of Black women who help support breastfeeding. And then Little Timmy's project is another one in this state. It's a very grassroots program that is trying to reach more people who need resources, not only the healthcare aspect, but how to connect to WIC and other state resources that are already there. And they take donations to supply diapers and bottles and clothing, not only for the baby, but also to the women. So if they're going back to work, you know, do they have clothes to wear, to work? You know, just all the little things that help impact the ability for somebody to be successful.

Host: This is such wonderful information. Are there any special needs of Black mothers you feel need to be addressed from a healthcare standpoint?

Lori: Absolutely. I think that the Black women in our communities disproportionately lack access to necessary and reproductive health care, including contraceptive options and sexually transmitted infection screening. And this leaves them very vulnerable to many risk factors around pregnancy. Not only an unintended pregnancy, but can lead to a very high risk pregnancy.

And research has found that 22% of Black women receive a lower quality of care than white women due to the fact that they face racial and socioeconomic discrimination. So I think that these are things that must be addressed so that we have more inclusive care for women of childbearing age.

Host: Absolutely. And that is a goal across. Is there anything else you'd like to add to our coversation?

Lori: I would just like to add that at The Women's Hospital, we are a perinatal center for the state of Indiana, and we're engaged in many activities across the state and initiatives to help improve the outcomes of both moms and babies in our country, in our state and in Indiana, excelling at providing direct care resources for NICU and the neonatals and neonatal patients and the MFM are available.

But now we're starting to realize that what we really need to order to make a real change is not only engage our affiliates on the standards of care and best practices, but we also need to engage them in, in these endeavors, such as the Respectful Maternity Care Toolkit from AWHONN. Because just having the resources and knowing the care to provide only helps if the patients are there to receive the care and engaged in the care.

So I think this is something that we, as a hospital continue to drive, to help improve outcomes for both moms and babies in our state. And we're really excited at this opportunity to add this additional layer into the efforts that we're doing in the state of Indiana.

Host: It is very exciting. And well obviously such excellent information, so good to have you on with us. Thanks for being with us today, Lori and happy Black Maternal Health Week to you and everyone at The Women's Perinatal Cente.

Lori: Thank you very much.

Deborah Howell (Host): And that wraps up this episode of the podcast series from Deaconess The Women's Hospital, a place for all your life. For more information, please visit www.blackmamasmatter.org. And please remember to subscribe, rate and review this podcast and all the other Deaconess Women's Hospital podcasts. For more health tips and updates, follow us on your social channels. This is The Women's Hospital, a place for all your life. I'm Deborah Howell. Thanks for listening and have yourself a great.