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Black women were 2.5 times more likely to die from childbirth than white women and 3.5 times more likely than Hispanic women. The rate of younger women dying increased too, with Black women holding higher death rates than other ethnic groups.
“Black families have always been worried about becoming part of that morbidity statistic, and that stems from a long history of Black patients’ experience of being dismissed and not heard in health care,” said Dr. Neel Shah, chief medical officer of the Maven Clinic, a women’s and family health tech startup in Tribeca. For example, Black patients’ pain complaints tend to be dismissed more often than their white counterparts, Shah said.
Such disparities in patient experience, along with access led by differences in socioeconomic conditions, lead to worse outcomes for Black mothers. In addition, Black women are more likely to suffer pregnancy loss or birth complications compared with other races.
Tackling disparities in Black maternity, fertility and family health requires approaches from many angles, experts said.
“We as providers have to tackle our own cultural biases first,” said Dr. Fahimeh Sasan, founding physician and chief innovation officer at Kindbody, a reproductive health clinic in NoMad.
There’s an assumption, for example, that Black women are more fertile.
“There’s no such thing, of course,” Sasan said. “And that’s where medical providers, clinics and hospitals can step up to change the way they treat Black patients.”
Black women having trouble getting pregnant have been less likely to be referred to a fertility doctor, or referred later, than white women
Bolstering provider education goes behind the concept of providing culturally competent care, experts said. Other core moves include hiring doctors who speak the same language as their patients and can identify with them culturally.
At Maven, at least 40% of its physicians are people of color. At Kindbody, half of its doctors are people of color, and it boasts an all-female OB-GYN roster.
“Having that level of compassion from doctors with an understanding of where you’re coming from is important,” Sasan said. She added that patients feel more comfortable confiding in their doctor when the professional looks like them, and noted that it can be difficult to discuss fertility and other sensitive topics with strangers.
Technological advances can help address some historic lapses in patient experience for Black women, such as having their fertility or pain complaints taken seriously.
“Our fertility is such a black box, and the tools we had to measure it have been inadequate,” said Aparna Divaraniya, founder and CEO of Oova, a Midtown company whose product helps women track fertility hormone levels. Just as Oova’s hormone-tracking tools provide objective numbers, there are other technological developments that women can take to their doctors to be taken seriously, she said.
“Now concerns are not just complaints,” Divaraniya said. “Women can be empowered with data to have real conversations with doctors about their fertility health.”
Telehealth also helped break down barriers to maternal and reproductive care that Black women typically have faced. Patients no longer have to be physically proximate to a provider or be beholden to tight schedules in the digital space.
“If you need a lactation coach at 3 a.m., we can do that now,” Shah said.
But even as access channels have widened, systemic hurdles remain for Black women looking to connect to those services.
“It still comes down to money. If socioeconomic disparities exist among Black communities, then they’re less likely to have access to things like doulas or lactation consultants,” Sasan said. Many of these support services have typically been cash-only, or not covered by insurance.
Kindbody is launching a free doula pilot program, which would go a long way in benefiting underserved communities, she said.
Despite challenges, local women’s and reproductive health players are optimistic that things will improve for Black women in this country.
“We are in a place where the situation seems to be getting more inequitable,” Shah said, “but I believe as we keep trying and more innovations come in, we can eventually reverse the trend.”
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