Judy Marvin, M.D., senior medical director, Providence Women’s Special Practices
Black birthing patients in the U.S. are 4 to 5 times more likely to die in childbirth than their white counterparts. Closer to home, Black infants in Multnomah County die twice as often as non-Latinx white babies. These are a few statistics that a partnership between Providence and Multnomah County – called the Healthy Birth Initiative – is working to change.
Providence Women’s Services began partnering with the Multnomah County Health Department on the Healthy Birth Initiative in 2017. By working with pregnant and new parents in the Black community, the initiative is making inroads to help reduce mortality/morbidity and racial disparities during pregnancy and birth.
We need help from our provider colleagues. You are a key partner in your patients’ health, and we ask that you talk with your Black, pregnant (or who are planning to become pregnant) patients and encourage them to enroll in the free Healthy Birth Initiative program. The only requirements are that participants must be Black, pregnant and residents of Multnomah County.
Providence care teams and leaders in women’s and children’s health – including Mark Tomlinson, M.D., regional perinatal medical director; Kristine Bell, executive director, Women and Children’s Services; and Laurel Durham, regional director of Women’s Services – are committed to working with Multnomah County on the Healthy Birth Initiative. The program goal is to improve health outcomes for Black patients and their babies and to help reduce racial disparities.
In Multnomah County, the rate of Black infant mortality is higher than any other race, and it’s more than twice as high as non-Latinx white infants. Black infants are born with a low birthweight at a rate of 75% higher and are born prematurely at a rate of 47% higher than non-Latinx white babies.
At Providence Women’s Services, the HBI partnership has sparked some important, and at times uncomfortable, conversations as we acknowledge and work to improve unconscious bias that can negatively affect Black patients and their families. We now offer training to our providers and nursing teams about implicit bias and systemic racism in prenatal and birth care.
For example, we discuss the current social climate as it relates to racism, microaggressive behaviors and birth. We demonstrate by role-playing examples of problematic and microaggressive behaviors in care, learning how to ask questions about preferences, medical history and adherence to treatment in a way that is sensitive and culturally appropriate.
As part of the Healthy Birth Initiative, we connect with our Providence inpatient care teams to make sure they understand the role and importance of HBI birth nurses who support their clients during pregnancy, birth and postpartum. During COVID-19, Providence has ensured that Black birthing patients are allowed to have their HBI support person with them, while still adhering to strict COVID safety protocols.
Looking ahead, Providence Women’s Services is working to increase the number of culturally diverse doulas to help support our Black and other diverse patients. We also are making inroads to ensure HBI’s Multnomah County and Providence electronic health record systems are standardized and compatible with each other. LaRisha Baker, director of Maternal Child Family Health for the Multnomah County Health Department, and Dr. Tomlinson are members of Oregon’s Maternal Morbidity Review Committee, which examines all maternal deaths in Oregon and shares that information with the CDC to help examine and address trends.
While Providence’s portion of HBI focuses on supporting pregnant patients and their newborns, Multnomah County also provides HBI programs that focus on health education, male caregiver health and wellness, coordination of care with other community agencies, and ongoing classes and groups.
Thank you for supporting and encouraging your Black patients in Multnomah County to enroll in the Healthy Birth Initiative. With your help, we can continue to improve the care and outcomes for Black patients and their newborns.
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