By Dina Weinstein

How to effect change on the local and national level for Black birthing people was the focus of the third annual conference organized by the Virginia Commonwealth University Office of Health Equity and the Health Humanities Lab at the Humanities Research Center in early Oct.

The History and Health Symposium, "Improving Health Outcomes: Health Disparities and Black Birthing People” highlighted research, the experiences of patients, and emphasized the power of practitioners and community organizations to impact the care of pregnant people and their families.

“When we talk about Black maternal health, we're talking about Black women and Black birthing people dying at three times the rate than their counterparts. And that's independent of their social economic factors. That's independent of the patient's wealth. We look at that and say, ‘What are the things that are causing it?’” said Tashima Lambert Giles, M.D., an obstetrician and gynecologist at VCU Health, one of the conference organizers and speaker on a panel about policy and clinical practice.

Lambert Giles said research shows this disparity is an effect of prejudice and systemic racism in health care.

“When we start to talk about systemic racism, it seems like a big scary topic, and it makes people think, ‘Oh, I'm not racist so I must not be doing anything to make this worse.’ But our goal here in the symposium is to show us how systemic racism trickles down into institutional racism. We don't even recognize that we are being a part of and perpetuating those outcomes,” Lambert Giles said.

The term Black birthing people was used in this year’s symposium because the organizers acknowledged that many people experiencing birth sometimes don't identify as women or mothers, while still having the ability to have babies. The term also includes the whole family unit.

“We want to make sure that we are being as inclusive as we can when we talk about our Black patients and not necessarily include just the women. The crises of maternal mortality and negative health outcomes engulf not just the person that's birthing, but their families,” Lambert Giles said.

The symposium was co-sponsored by numerous VCU departments including the School of Public Health, Institute for Women’s Health and the Department of Obstetrics and Gynecology together with community partner Birth in Color.

Sheryl Garland, executive director of the Office of Health Equity and VCU Health’s chief of health impact, said the symposium is an opportunity for the university and health system to support joint efforts to advance health equity – a goal in VCU Health’s Quest 2028 strategic plan – and ensure that everyone has a fair and just opportunity to be as healthy as they can be.

“In order to do that, we need to make sure that we are reducing these disparities and closing gaps in health outcomes wherever we can,” Garland said. “This is a multifactorial issue. There’s history involved in this.”

Among those histories are individuals' own personal perceptions about caring for women of color, societal issues, and mistrust on the part of many in the Black community regarding interactions with the health care institutions, Garland said.

“In order to address these issues and the disparities, we've got to have a better understanding of what those issues are and then come to some conclusions about how we bring various sectors together to resolve them,” she added.

Symposium participants also heard from new mothers Kiara Bonner-Lawrence and Sherita Aisha Hollingsworth about their experiences with high-risk pregnancies at VCU Health, as well as discussions on reproductive justice and birth equity.

The keynote speaker, Monica McLemore, Ph.D., professor and director of the Manning Price Spratlen Center for Anti-Racism and Equity at the University of Washington, elaborated on ways health professionals can engage in these areas at their institutions and in a broader stage, such as engaging with lawmakers. Several state and federal leaders on maternal health also contributed to these discussions, including Vanessa Walker Harris, M.D., the director of the Office of Family Health Services at the Virginia Department of Health, and Virginia Congresswoman Jennifer McClellan.

Partnerships between community-based health organizations and hospitals were also highlighted as a path to improve maternal health outcomes from a policy and legislative perspective. This also includes research. Chris Cynn, director of the VCU Health Humanities Lab, said researchers who work closely with community health providers and professionals can help amplify and advance community priorities. For example, the Health Humanities Lab is currently collaborating with Birth in Color, a doula collective featured during the symposium, on a project focusing on Black childbearing health.

“That project has highlighted a lot of different biases in the health care systems as well as VCU Health’s recent changes, making sure that everything comes from an equity lens and [fosters] the [inclusive] treatment of birth doulas,” said Kenda Sutton-El, founder and executive director of Birth in Color.

Birth in Color is one of the multiple doula groups VCU Health has worked with in the past 20 years. As certified professionals trained to provide non-medical pregnancy support, doulas are seen as valued care team members who help to decrease any barriers to care and advocate for their client’s needs.

And that is the primary goal for these community and research collaborations – to remove obstacles and make a positive impact in improving birth outcomes. Lambert Giles said she wanted to speak during the symposium to show how clinicians and medical professionals can play a role in changing these disparities.

“Our goal is that each person in our community can find where they fit in in this crisis and how they can make a positive impact,” Lambert Giles said.