For every maternal death, there are 50,000 maternal morbidities that occur, many of which are among Black women and women of color. Morehouse School of Medicine, in partnership with Optum, is conducting a study to understand these maternal near misses, a condition when a woman nearly dies but survives a complication during a pregnancy.
“We’re really interested to not only investigate what contributes to near misses, but also to investigate and center their lived experiences,” said Dr. Natalie Hernandez, an assistant professor in the Department of Community Health and Preventive Medicine and the interim director of the Center for Maternal Health Equity. “That’s why we’re using a story-telling approach to recognize that not only are we centering their experiences, but their voices are legitimate sources of data.”
The goal is to analyze the care BIPOC women receive to identify deficiencies in provision of care. Near misses “should be interpreted as free lessons and opportunities to improve the quality of life for women,” Hernandez said. In contributing to gaps in literature and science, the team hopes to change policies that regulate the system and create higher quality access to care.
How will the study work?
Women in Georgia, New Jersey, Louisiana and DC are being recruited for the study, as those are places with some of the highest rates of maternal mortality. Hernandez is looking for 120 participants, roughly 30 from each state. Women who aren’t located in those states but want to share their stories can do so, and those will be featured on the school’s site but not included in the study.
Participants will have the option of whether they want their story to be public or only included for the study, and the privacy conversation will happen before the interview.
The study asks questions based around a model that suggests “severe maternal morbidity and mortality are largely the result of three critical delays,” Hernandez said. The delays are decision to care, action in reaching an appropriate site of care, and diagnosis or appropriate treatment once they got to a facility to get care.
“A lot of people are not aware or underestimate the severity of the problem and its complications,” Hernandez said. “A lot of women have a poor understanding of the danger signs and potential scope of complications. There are also cultural beliefs, which is why we were really interested in Black or other women of color.”
Participants will share their stories starting from labor pains through delivery to when they were discharged from the hospital. Through these responses, Hernandez is looking at structural racism and implicit bias, and how those influence the way women are treated and the quality of care they receive.
The study will also collect demographic information and social determinants of health.
Following the interviews, mental health resources will be provided, and there will be physicians on call to make sure participants are okay. Everyone conducting the interviews has been trained in mental health first aid, Hernandez said.
Hernandez hopes to have the study completed by January. Interviews should wrap up before the holidays, and before the final study is published, the team will share top line results.
Though the study hasn’t officially launched yet, Hernandez is already receiving a lot of interest. She’s gotten stories sent to her email and long voicemails where women are explaining their situations. She’s also been connected to a Facebook group of women who have experienced near misses.
“We want people to know what the problem is, but also the resilience of these communities and these women,” Hernandez saiad. “We want people to reinvest in the communities. We want people to listen to Black mothers and other women of color. We want to reimagine health care access and incorporate women to have culturally responsive care.”