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Barbara Ross-Lee, the first African American woman to lead a U.S. medical school and a nationally known advocate for addressing health inequities, led the panel. “Of all the health disparities, maternal mortality is among the most shameful,” she said. Photo: Sandra Kicman
By ELLEN GOLDBAUM
Published October 18, 2023
On Sept. 29, the Jacobs School of Medicine and Biomedical Sciences hosted “A Mother Pearl Young Legacy Forum” in honor of Pearl Young, one of the 10 victims of the racist mass shooting at Tops on May 14, 2022. It was organized by Allen DeWane, a relative of hers and a UB alumnus, and UB staff and faculty.
Sponsored by the Buffalo Center for Health Equity, the UB Community Health Equity Research Institute, and Acuity Productions, which DeWane heads, the forum was focused on the crisis in maternal mortality in the U.S.
Keynote speaker Barbara Ross-Lee, the first African American woman to lead a U.S. medical school and a nationally known advocate for addressing health inequities, said that the American health care system is seen as one of the most sophisticated, capable of delivering the highest quality medical care. Yet it consistently ranks poorly among the most industrialized nations in the world, a consequence of the many health disparities that exist in this country.
“But of all the health disparities,” she said, “maternal mortality is among the most shameful. Unlike the rest of the world, disparities in maternal mortality, especially in Black Americans, are increasing and getting worse. So starting today, we need a new strategy to solve old problems. The time for change is now and it depends on all of us.”
Thaddeus Waters, Amol S. Lele, MD, clinical professor of obstetrics and gynecology in the Jacobs School, is chief of maternal-fetal medicine, the specialty that focuses on high-risk pregnancy. As a health care provider who cares for the most vulnerable pregnant patients, he echoed Ross-Lee’s perspective.
“Our performance is absolutely abysmal,” he said, “and we’ve made no progress.” In 2021, the Centers for Disease Control and Prevention reported that 1,205 women in the U.S. died of maternal causes, up from 861 in 2020 and 754 in 2019.
Pregnant patients of color have three times the risk of death that white patients do, and the vast majority of maternal deaths are preventable.
Mental health issues during pregnancy are especially lethal, said Waters, who serves on the New York State Taskforce on Maternal Mortality and Disparate Racial Outcomes.
One effort to reverse these deadly trends is happening through a partnership between the Jacobs School, the School of Public Health and Health Professions and community organizations, funded by the Patient-Centered Outcomes Research Institute (PCORI).
The “Equity in Mental Health and Blood Pressure Post-Partum Care via Web-Enabled Remote Monitoring” (EMPOWER) effort brings community health workers, providers and doulas together to work with pregnant people to address two key contributors to maternal deaths: hypertension and mental health concerns.
Panelists discussed what led them to focus on maternal health, cited statistics and shared some of the factors that are known to contribute to more positive outcomes. Photos: Sandra Kicman
The inclusion of doulas in that project reflects their growing importance as members of the maternal health care team. Doulas are trained professionals who provide continuous physical, emotional and informational support to their clients before, during and after birth.
Danise Wilson, now executive director of the Reproductive Health Access Project and formerly executive director of the UB-based Erie Niagara Area Health Education Center, (AHEC), cited research showing that doulas consistently improve outcomes among pregnant patients of color.
After a New York State report found that Erie County and Kings County (Brooklyn) had the worst maternal health disparities in the state, AHEC started a pilot project with Medicaid covering the cost of doulas. The success of that project led to Gov. Kathy Hochul’s support for doulas for Medicaid-eligible mothers so that doulas can be reimbursed.
So far, UB’s AHEC has trained 40 doulas working in local hospitals with the following excellent results: 80% of mothers supported by doulas have had vaginal deliveries, 80% have had zero complications and 80% have breastfed their babies.
“You are vulnerable during labor,” Wilson said, “but with a doula you have someone there for you.”
The panelists noted that fathers also play critical roles throughout pregnancy and birth. Antoine Johnson, program manager of the Buffalo Fatherhood Initiative, part of the Buffalo Prenatal and Perinatal Network, cited research showing that when the father is involved during pregnancy and birth, mothers do better, the incidence of infant mortality is lower, and mothers are less likely to experience maternal depression.
“We highlight the unique and important contribution that fathers make, by helping men learn how to navigate fatherhood and feel more comfortable as men and fathers,” said Johnson. “Policymakers could include dads more.”
To reverse the current trends in maternal mortality, the panelists noted that change must come in three critical areas:
Rita Hubbard-Robinson, chief executive officer of NeuWater & Associates, LLC, treasurer of the Buffalo Center for Health Equity and associate director of UB’s Community Health Equity Research Institute, underscored the urgency of the problem.
“We can’t afford to lose mothers!” she said. “It’s heartbreaking. Babies losing moms at birth is unacceptable.”