Worcester Business Journal

wbjournal.com | May 13, 2024 | Worcester Business Journal 13 W and executive director of Lifeline for Families at UMass Chan Medical School in Worcester. "We've been in a mental health crisis for decades, and now we're in a mental health emergency," said Byatt. In some cases, those on public health insurance need to have three therapy visits before they can be seen by a psychiatrist, meaning those experiencing mental health illness and crisis during pregnancy and postpartum have lengthy waits to get help – time that they don't necessarily have, she said. In fact, data from the CDC in 2022 reported 23% of maternal deaths from 2017-2019 were related to mental health conditions with more than 80% of pregnancy-related deaths being preventable. ough rates of maternal morbidity and mortality are increasing across races for different reasons, for people of color, it's due to systemic and structural racism, said Diop from DPH. "e providers within the healthcare system will decide, based on your skin color, who is worthy of quality care, who should get enough information about health, who should be treated with dignity, who should be respected, whose questions should be answered right," said Diop. One of the effects of systemic racism embedded through the healthcare industry is Black women are oentimes not listened to, their concerns brushed off, even when there are lethal repercussions, said Marlina Duncan, vice chancellor for diversity and inclusion and chief diversity officer at UMass Chan. "People maybe don't feel empowered to speak up because they think, 'Well, if I do, does it matter? You know, I know the risk. I know that I'm really just trying to come here and survive and give birth," Duncan said. "at should never be the way that we approach any sort of health care, but especially with giving birth." Persistent misconceptions regarding Black pain, including beliefs that Black people have a higher pain tolerance and thicker skin than white people, factor in why Black birthing people oentimes receive inadequate care, she said,. "We know that race is a social construct, but it's still playing out as something biological when it comes to patient health care," said Duncan. Taking action A paramount component of attenuating maternal morbidity will be cultivating a diverse workforce of professionals from different racial and ethnic backgrounds, and Odetola said expanding representation among healthcare providers and workers starts long before the hiring process. "at starts with undergrad," she said. "at starts with high school, getting kids who were younger from diverse backgrounds interested in medicine, interested in nursing … You got to get started getting them interested in middle school, high school, and then accept them into undergrad schools that are solid." When it comes to professionals already in the workforce, Odetola said implicit bias needs to be addressed, suggesting medical schools incorporate addressing structural racism into clinical training, including debriefing with a superior and analyzing how implicit bias may have played a role in interactions and treatments. "You do that over and over and over again," she said. "You address perhaps biases that you yourself may not be aware of … It goes beyond just a one time thing, or just a course of two or three courses or training programs. It has to be continuous." More comprehensive research on the experiences of Black birthing people, especially qualitative research, needs to be conducted, Duncan said. "We do need the research to really back what are people experiencing, especially what are Black birthing people experiencing," said Duncan. "What does that look like for them? And I don't think we have a lot of research on that." With hard data on hand, Duncan said, those in positions of power can see where needs are and can subsequently garner the resources to address them. It takes a village "What we're seeing when we talk about maternal morbidity goes beyond the four walls of the hospital or goes beyond the clinical setting," said Odetola. More doulas could be integrated into the community, Hamblin said. Massachusetts made moves to make doulas more accessible to the public when MassHealth announced in December it would start covering doula care, specifically to help close the gap when it comes to health inequities. A strong advocate for doula care, Hamblin said patients supported by doulas show lower rates of cesarean sections, increased rates of breastfeeding, and are associated with decreased preterm birth. Employers can do their part by offering paid maternity leave, allowing women to better take care of themselves and be around the support they need during that postpartum period when complications can occur, she said. e issue of Black maternal health calls on the community as a whole, said Hamblin. "As a Black physician and a Black OB/GYN, as a mother, Black women are not broken. ere's nothing wrong with Black women. Black women experience the downstream effects of racism," she said. "It's abhorrent, and no one should stand for it." Marlina Duncan, chief diversity officer at UMass Chan Medical School Nancy Byatt, executive director of Lifeline for Families Severe maternal morbidity in Mass., by race 0 50 100 150 200 250 Black Asian & Pacific Islander Hispanic White '11 '12 '13 '14 '15 '16 '17 '18 '19 '20 The rate per 10,000 deliveries resulting in unexpected negative outcomes impacting short- and long-term health Love Odetola, visiting assistant professor at College of the Holy Cross Sources: Massachusetts Department of Public Health; Boston Globe

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