Dr Veronica Gillispie-Bell Addresses Racial Disparities in Maternity Care

Veronica Gillispie-Bell, MD, MAS, addresses the recent data published by the CDC on the increase in maternal deaths and respectful maternity care in the US. Gillispie-Bell is the head of Women's Services at Ochsner Medical Center, Kenner, and the director of Quality for Women's Services for Ochsner Health. She also serves as the medical director of the Louisiana Perinatal Quality Collaborative and Pregnancy Associated Mortality Review for the Louisiana Department of Health.

Transcript

Can you summarize the CDC study on maternal death and respectful maternity care and discuss the racial disparities in the findings?

First of all, the big headline is about 1 in 5 women reported mistreatment while receiving maternity care for the women that were studied, or that replied to this survey. The rate was the highest amongst women of color, highest amongst Black women, followed by Hispanic women, followed by women who identify with multiple races. There was also a disparity in terms of public insurance, or not having insurance, that those individuals also felt mistreatment or reported mistreatment at a higher level than their counterparts. So overwhelmingly, the respondents did show that we need to do better in how we respect our mothers when they are in their maternity time.

Considering the high US maternal mortality and morbidity rate how do these findings contribute to the understanding of maternal health in the country?

I think for those of us that have been working on health equity—myself, I've been in the space of working on health equity for many years—these findings are not surprising to us. We know this. We know that in particular, for Black women, the cases have been more anecdotal, if you think about it in that way of individuals all the way from Serena Williams to myself, speaking of our experiences within the maternity, health care space, and not being heard. When you're not heard, that means you're not respected.

So these findings, I think, are not new for us. I do appreciate the CDC giving some hard data to actually show the numbers in a way that I think some others may be doubtful, or have only heard these individual cases. I think this is more collective to help show that there really is an issue with respect, and in the way that we are treating patients, particularly Black patients.

And what we see in terms of our health outcomes is twofold. One, we're not respecting our mothers, in particular, shown in these data are mothers of color. And so when they are saying that they are in pain, or they're saying that they have an issue or a problem, we as a health care system don't always respond to that problem.

Then on the other side, because there is so much of this data now and so many stories of not being respected when you come into the health care system, many Black women and women of color are choosing to not come into the health care system. They’re either delaying their time of coming in or choosing to not interact with with the structural health care system at all and that is resulting in some of our maternal deaths. Most notable that has been in the news is Tori Bowie [who said that] she was afraid to go to the hospital because of this type of treatment.