In the United States, persistent disparities in maternal healthcare disproportionately affect Black and Brown women, manifesting in higher rates of preterm births, postpartum depression, and 2-3 times higher maternal mortality rates. These issues underscore systemic challenges within our healthcare system. Amidst this landscape, Traci Johnson, MD, OB-GYN and Maternal and Fetal Medicine Specialist at University Health, spearheads a transformative program called EleVATE in partnership with Washington University in St. Louis. The program integrates behavioral health, reproductive justice, and racial equity components into healthcare, aiming to address trauma and toxic stress while catalyzing systemic changes to enhance outcomes for minority women.
Another critical concern facing these at-risk groups is maternal mortality, defined as a patient's passing during pregnancy or within the first year after that. "This is one of those things that everyone thinks happens to someone else. But the risk factors are without bias and can affect anyone, and you can't 'class out,'" Johnson emphasized. Educating the next generation, personalizing patient care, and raising awareness among new mothers about warning signs are crucial interventions. "What we see happening is that patients with the highest risk, such as Black and Brown mothers, are sometimes treated with predetermined biases. This can lead doctors to overlook risk signals and miss opportunities to intervene," Johnson explained. "The solution lies in treating each patient individually and remaining vigilant for all potential indicators."
As a physician of color, Johnson acknowledges the systemic challenges in healthcare accessibility and representation but underscores the universal need for personalized care that transcends demographic similarities. “Oftentimes, I get the question, how do I, as a patient, make sure that I will have a good outcome? Often, what comes up is that I should have a doctor who's just like me, and ethnicity, race, language, and religion, they should be just like me. And I would say, I disagree with that,” Johnson said. “As a physician of color, there's absolutely no way we can take care of 13% of the population when we are 4% of the physician population; there’s just not enough of us.”
The risks associated with pregnancy and postpartum are inherently complex, often exacerbated by dynamic circumstances. For healthcare providers, navigating these complexities requires a keen ability to discern medical symptoms among external stressors, a challenge magnified for minority patients facing additional pressures. "Consider an expecting mother presenting with chest pain and shortness of breath. Amidst discussing her recent loss of a grandmother, the doctor may attribute her symptoms solely to stress," Johnson elaborated. "However, overlooking broader possibilities like preeclampsia could lead to untreated and undiagnosed conditions, potentially resulting in adverse outcomes or maternal mortality." Emphasizing the importance of approaching each appointment with an open mind, free from bias, enables doctors to diagnose more accurately, paving the way for a brighter, healthier future for all.