Expert Panel Roundtable: Improving Equitable Outcomes in Maternal Care

We have a system that is not adequately caring for our mothers, particularly black mothers. This is a fact that needs to be heard far and wide, and we need all parties to take part in a conversation to figure out the best way to deal with this crisis.⁠

Featuring the 2021
HER Expert Panelists

Listen to this episode on the
MAMA Needs A Moment Podcast

Transcript:

Crissy Fishbane  

Welcome, everybody. For those of you that don’t know, we are HER Health Collective. We are working on four key initiatives this year, all geared towards our central mission of Health, Empowerment and Respect for every mom. We are focusing our discussion today on one of those key initiatives, the topic of equitable care for mothers.

 

According to the 2010 Amnesty International report, most women in the US are not dying during childbirth because of the complexity of their health conditions. Instead, they are dying because of the barriers they face in accessing high quality maternal care. This is particularly true for those who are poor or facing racial discrimination.

  

We are faced with a system that is not adequately caring for its mothers. This is a fact that needs to be heard far and wide and we need all parties to take part in this conversation to try to figure out the best way to deal with this crisis. Today we are honored to be joined by several of our 2021 HER expert panelists. They are going to be discussing improving equitable outcomes in maternal care and sharing insights from within their respective industries on this particular topic.

  

Today we are joined by Emily Chafee, a Fertility and Birth Doula; Blair Cuneo, a Physician’s Assistant and Functional Medicine Provider; Dr. Erkeda DeRouen, a double Board-Certified Family Medicine and Lifestyle Medicine Physician; Dr. Holly Durne, a Physical Therapist and APTA Orthopedic Certified Specialist; Dr. Lisa Folden, a Physical Therapist and mom-focused lifestyle coach; and Nicole Wallace, a licensed Clinical Mental Health Counselor and Educator.

 

Cindi Michaelson  

Here is our first question: In article 25 of the Universal Declaration of Human Rights, it states that health equity means that “everyone has the opportunity to have the highest attainable level of health and is recognized as an essential human right.” Even though this declaration has been in effect since 1948, statistics are showing that disparities exist. In your experience, how equitable is care in your specific industry across racial and economic lines and why do you believe this is the case?

 

Dr. Erkeda DeRouen   

I think that was a great question. It’s crazy that that declaration came out in the 40s, because we’re still fighting for it as one of the only industrialized Western countries without universal health care. There is a lot up for debate as to whether or not health care is a right versus a privilege. At this point in time with the way that our health care system is set up, it is set up more for the privileged. That’s been something that has been happening for centuries.

  

We can see now, even with the global pandemic, that there are health care disparities out there. African American people are dying about 2.8 times more from COVID-19 than the general population. I think, in this industry, we have to figure out a way to be more equitable. There’s a lot of information stemming from all of the racial discussions that we had last year- stemming from the George Floyd incident- where people are becoming more hyper-aware of the disparities. Now we just have to get to the work of how to be more inclusive and how to search for ways to help people get the care that they deserve.

 

Blair Cuneo   

Following up on what Dr. DeRouen just mentioned, I think there’s an increasing awareness that we’re not just talking about literal access to health care, because that is 100% important, but then also understanding what it means to be healthy. Maybe it is not access to that nurse practitioner or to that pharmacy, but it is environmental justice. It is social justice. It’s housing security. It is more than simply just the visit with the doctor when we’re thinking about why there are disparities in populations between who has health and wealth and who has access.

 

Nicole Wallace  

A lot of times when we think about people who are receiving government provided health care (Medicaid or Medicare), we think of it as an entitlement like “oh, they’re getting this free thing.” However, if you really look closely at it, oftentimes that entitlement comes with a lot of restrictions and pre-authorizations that don’t allow them to receive quality care. For example, when I entered private practice as a counselor, I learned from other counselors that were also involved in private practice that they often would not engage in taking government health care (Medicaid or Medicare) because the fees were not the same. The amount they would receive in monetary fees was not the same as what they would receive from private practice or if a client was paying out of pocket. Because of that, they didn’t see the benefit in working with those clients, which is really sad in some respects.

 

Dr. Holly Durney   

In physical therapy that definitely rings true. We basically have to double our commercial patients to make up for the Medicare population in order to make money, so you’ll find a lot of private physical therapy practices don’t take Medicare or Medicaid because of that. I wanted to talk about the fact that it’s not necessarily the access for care in PT- we would accept all insurances. It’s more the knowledge that physical therapy is almost a luxury, like “of course I have pain. My back hurts. I work all day. I have five kids.” It comes back to what Blair said about understanding what it means to be healthy. It’s an issue of time and this feeling that “I don’t have time to take care of myself.”

  

With mothers in particular, bringing it full circle to what HER Health Collective is doing, there’s this lack of knowledge that you can do something about your pain and yes, insurance covers it. There is access to care but there may be some hoops to jump through. Hopefully, through today and through these types of conversations, we can expand the knowledge that there are things that can be done for not just women but for these populations.

 

Emily Chafee   

As a doula, I’ve really noticed that there’s two schools of thought with doula care. There’s the thought that everyone deserves a doula and there’s the belief that a doula is very much a luxury item. However, evidence shows that having a doula present is going to improve health outcomes with birth, with postpartum and in general. It’s really interesting to be in this conversation with other providers who are licensed. Doulas aren’t licensed, so anyone can be a doula. I’m in conversations right now to start accepting Medicaid in July, but the amount that they are going to reimburse is about 50% of our normal rate. We’re questioning if this is something that we want to do or can do as a small business. It just might not be attainable, and then that puts a whole other issue at play.

 

Crissy Fishbane   

Thank you so much, everybody. Here is our second question: According to the Black Women Birthing Justice 2018 report, “Battling Over Birth: Black Women & The Maternal Health Care Crisis,” we identified four sets of practices and attitudes that led to conflict between medical staff and black pregnant women: 1) refusal to listen to women’s wisdom about their bodies; 2) not respecting women’s boundaries or bodily autonomy; 3) stereotyping based on race, class, age and marital status; and 4) suppressing advocacy and self advocacy. We would love for you to discuss your thoughts on these findings. Have you witnessed these practices and attitudes in your own industry?

 

Dr. Erkeda DeRouen   

As a family physician, you can see working with different populations and in more underserved areas that there is a paternalistic aspect of medicine where they are not always utilizing and listening to a woman’s voice. Personally, I think that is something that’s currently happening. We see it in the news. We see what happened with Serena Williams. We see that Beyonce said that she had to advocate for herself for things. If you think about people who have all of these resources and are still having these issues of being ignored, you can only imagine what’s happening with the lay population.

 

My cousin was pregnant last year with her first child and there were some issues with not listening to her when she didn’t have fetal movement. She actually had a stillborn and that was terrible. After all of that, there were still complications when she went home. She was trying to advocate for herself and wasn’t getting help. I actually had to call and pull the “doctor card” with the office to speak to a patient advocate. When that happened, they realized that she had an infection. I know a lot of times different clinicians may roll their eyes when a patient is saying “I know my body,” but sometimes you need to listen to them because things can be abnormal.

 

Emily Chafee   

I have two aspects to add to this. First, from a personal standpoint, when I was pregnant with my son almost six years ago, I was not heard by my doctor. I was quoting ACOG (American College of Obstetricians and Gynecologists) research to him and he was going against it. He told me “No, you’re wrong. That 40% chance of a stillbirth in three weeks? That’s not a big deal. We’ll wait until we get there.” I called my cousin, a High Risk OB, and she said “absolutely not. Go in and say you have decreased fetal movement and demand that induction.”

 

If you don’t have those resources and that knowledge to be able to do that, how do you advocate for yourself when you don’t know what is normal? That’s really what I think doulas are good at. We are able to help clients find their voice and help them say “no, this feels out of the scope of normal” and encourage them to say something rather than somebody else being like, “Hey, hey, Doctor, hold up.” It is really powerful coming from a patient, but it can be really hard to find those words.

 

Dr. Holly Durney   

As a physical therapist, the main diagnoses I get a referral for are urinary incontinence, prolapse, and some postpartum. I would say that knowledge, in general, is poor among women that there’s something they can do about urinary incontinence. It’s not just because you had a baby that you’re going to have incontinence issues, which is common. I read a few studies prepping for today’s roundtable and was shocked and, at the same time, not surprised by the racial disparities amongst African American and Asian women in lack of knowledge and not knowing that there’s anything they can do about incontinence.

 

I find, regardless of race, I have struggled to get referrals from OBs to tell and empower women that, yes, there’s something you can do, but this is even more true amongst the African American population. I can’t tell you the last time I received a referral for an African American woman for pelvic floor dysfunction. Now, again, it’s a smaller percent of the patients that I see. That’s my personal experience and I hope to continue to improve that.

 

I think that having the knowledge that these women can advocate for themselves to their doctors is important. Even if they are advocating and the doctors aren’t listening, we need to let them know that there is something to advocate for in the first place. I think that’s somewhere that we could make a change. Piggybacking off of what’s been said already, helping women know that there is something that they can do to advocate for themselves, like “Hey, I just need a physical therapy referral, or I need a doula, or I need to talk to someone about this” is really important.

 

Nicole Wallace   

I think in recognizing that we have to encourage clients to advocate for themselves, we also really have to do a better job on the side of clinicians and those of us who give care. I’m a mother, a biological mother of four and a mother of five. I’ve experienced birth three different ways and each time was very stressful. I did feel concern that when I would advocate for myself, I had to question whether or not I would be heard or understood. It was not just because I’m a woman and a lot of the people who you’re dealing with in the process of having a baby are male physicians who may not always be in touch with what you’re experiencing.

  

It was also to have to go through that and question myself: “Is it because of my race and the color of my skin? Am I going to be heard? And are they going to listen to me? Are they going to understand the special needs and concerns that I may have?” That is stress inducing all over again, because you’re having to play this game with yourself of “are they hearing me, but are they hearing me because I’m a woman? Are they not hearing me because I’m a female of color?” I think we really have to educate our providers around the importance of having those difficult conversations, to stop and check in with the people you’re providing service for and make sure that their emotional wellness is intact and that you’re recognizing that might be an issue for them.

 

Blair Cuneo   

Adding to that, it comes down to not only the provider making the assumption of whether or not someone has the opportunity to go see someone like Holly, but also the assumption that there is going to be the patient awareness in the first place. It takes the provider to keep pushing to have no colorblind approach and have targeted conversations like “there are studies showing that this is underreported in these populations. You know what? Our team needs to intentionally be capturing if we’re missing this in our practice.” It also takes understanding that in some communities, there’s become a normalization amongst peers and family that everybody has had to deal with certain assumptions from providers. Again, we need to intentionally challenge clinicians to capture what’s being missed, not just make assumptions.

I think using your privilege for good and using your emotional intelligence to listen, connect and advocate when you can is important.

- Dr. Erkeda DeRouen

Cindi Michaelson   

Thank you so much. There was a lot of wonderful insight there, as well as an appreciation for sharing any of your personal stories. Moving on to question number three: One key recommendation offered by numerous stakeholders is to recruit and train more birth workers and health care professionals of color. Do you see this being a needed change in your particular industry? And in your personal view, how would a more diverse and representative health care industry improve maternal care and outcomes for women of color in this country?

 

Blair Cuneo   

I thought this question was great because I thought of it from two perspectives: being at the receiving end of care and then also delivering care. I feel like whenever I am in a difficult situation or approaching a problem, I want some reflection of myself or something that I’m familiar with before entering into a vulnerable space. Especially with being a mom- the questions, anatomy, child rearing, all of the balls to juggle- it can be more comforting if the provider on the other side of that table or zoom call is someone where you see a similarity or a connection. I can only assume how much that means to someone, and maybe even can provide a more welcoming space right off the bat.

 

From the other perspective, as a provider amongst peers, I don’t want to be in an echo chamber. I don’t want to just be hearing what has worked for the majority of the patients that I’m seeing. I don’t know what I don’t know. When I am in a group of peers who are bringing about different perspectives from their background, experiences and training, it’s going to help me operate in a more thoughtful way. If I am engaging with someone who has a different color of skin or a different socioeconomic status, I’ll feel more empowered to say “let’s talk about this,” without feeling uncomfortable. I’m allowed to not know. The thing I love about where I work is that it’s a partnership and I’m not supposed to have all of the answers. I’m supposed to create a setting in which there’s that openness and conversation and not a blind ignorance of thinking I know best.

 

Dr. Erkeda DeRouen 

I totally agree with what Blair said. In medicine and as physicians, I recently read that black people make up 5% of all physicians. Just imagine what percentage of that is taking care of women who are having children. Those numbers have not changed since 1978. It’s been 40 years and the numbers have stayed the same. Black men’s numbers have actually decreased from about 3.4% to 2%. There is definitely a need for more diversity because, as Blair said, when we are creating these guidelines and learning about competence of different cultures, it is important to have different people from different backgrounds in the room in order to create that and to show those blind spots.

  

With that being said, if only 5% of all doctors are black, then there’s 95% who aren’t. That means that we have to have allies out there, people who are willing to learn and willing to engage with their patients. If you don’t know something, it’s okay to say you don’t know. Ask. Don’t make assumptions. We know that every community, even your own family, isn’t a monolith. You may have a different perception of something than your parents or your sister. Ask patients why they’re feeling this way, ask about their background and their home life and what may be going on. Maybe you can meet and figure out ways to engage them better. I think that we are having these conversations more and people are starting to realize that we can make a lot of movement in a positive direction if we just learn from one another.

 

Emily Chafee    

I think it’s also important to note that there was a study recently that said black babies are more likely to survive, not just thrive, but actually survive when they’re taken care of by a black pediatrician. There’s two black pediatricians in this area. There’s one black home birth midwife and one black midwife. I think there’s maybe one or two OBs that are black, and that’s to cover the Triangle. We live in a very diverse area, yet the representation is not there in the medical community. I think in the doula community, it’s getting there. I think the conversations are really happening in the doula world. There’s almost a requirement that you acknowledge that the colorblind (“I don’t see color”) attitude is not acceptable anymore. I hope that is translating to getting more black doulas. Same with IBCLCs (lactation consultants). There’s only two, I believe, black IBCLCs in this area and that is not enough.

 

Dr. Erkeda DeRouen   

Exactly. You bring up great points, even with lactation issues, because there are cultural differences. Certain environments may push to not breastfeed and certain people have certain perceptions on that. We also bring up another interesting point, as a lot of the studies and things that we are talking about are about our African American population. There are even fewer studies in the Latinx community and in the indigenous community and we don’t need to forget them. In my previous job, I worked in a federally qualified health center where 50% of my patients were either undocumented or uninsured. So that’s a whole other realm of mothers coming in with all of these perceptions that you may not know about, beliefs or fears that they may not be comfortable sharing with you.

 

Dr. Lisa Folden   

I absolutely agree. Coming from the background of a physical therapist, we have similar numbers- 5% or less of physical therapists are black here in this country. Something has to be done. I have always found this to be odd. Where I earned my degree in West Michigan was pretty segregated, I guess. When I moved from Michigan to Charlotte, North Carolina, I was aware of the diversity that I would see. I knew I was going to be in one neighborhood with all kinds of different people and I looked forward to that. 

 

I made the assumption that, when I made that transition, I would automatically be confronted with more people of color in my profession. I was shocked to find that was not the case. I was completely floored. You make the assumption, if you move to a place where there are more people of diverse skin tones, backgrounds, racial and ethnic makeups, that you’re going to be able to find that in your field and I did not. As a professional, it was disappointing.

  

I also found it very interesting that I would have clients directly contacting me because I was black. It was like, “I was looking for a black physical therapist” and I’m like, “Well, I am black. Let’s talk about what you’re coming for and make sure I can actually help you.” There’s clearly a need and it’s expressed to me directly, as a black woman, when clients reach out to me. I work with women postpartum, in my practice, and it’s definitely requested. I do feel like it’s an uncomfortable topic for some people or a little taboo. I am happy to be a provider to bridge that gap and make them feel more comfortable, making sure I can actually help them with what they’re coming to me for.

 

I guess, for me, it starts with just trying to let people know that my field even exists, the same as other disciplines. It’s important to get the word out that we’re here, that we exist, and show how you can get into this industry because it’s really important to have that diversity. Everything that has been said in this conversation, in my opinion, has been spot on. We do better when we have more diverse people at the table.

 

Crissy Fishbane   

Thank you. Here is our next question: We would love to know what changes, both positive and negative, have you seen in your specific industry with regard to equitable care for mothers? On the back end of that, in an ideal world what would need to change in your specific industry to see more equitable care across racial and economic lines?

 

Nicole Wallace  

I think, for me, one of the changes that I’m really happy with is when I see that primary care and OBGYNs are asking questions about depression and risk behavior of women and all clientele now. That’s become part of the makeup of your appointment. I didn’t really see that 5-10 years ago. I’m really excited about that because I think it does allow equitable care for people who may not be thinking, when they’re coming into their doctor for their hurt back or their shoulder, to initiate that conversation. It opens that door. As a counselor, I’m really excited to see that and to see that referrals are being made based off of those questions.

 

Blair Cuneo   

That is really interesting because the reason that began is purely financially driven. Those depression and anxiety screening questionnaires became a requirement in order to get the top dollar of reimbursement from insurance. Maybe the motives of the practice manager implementing it might have been financially driven, but it did come down to who is advocating that there has to be more attention to things like depression, anxiety, and postpartum depression. I did have to chuckle at first when you mentioned it because I’m so happy it’s there but it was explained to me as “you better make sure they get this done so that we get our full reimbursement.” 

 

For 10 years I was doing primary care, internal and urgent care. I worked at practices who would limit the amount of Medicare patients or refused to accept Medicaid, not just because of cuts in reimbursement. I also worked for a provider who was quite blunt about the population that she wanted to be treating. She wanted to be treating a wealthier, higher socioeconomic class. Needless to say, I’m no longer with that practice for a lot of reasons.

 

The consumer has the power and a lot of times it’s about where you’re putting your money in supporting who you want to support. I think the positives are with us as a consumer and what we are demanding, whether that’s within the insurance model, in selecting a doula, or empowering access to education for more BIPOC professionals. For me, on the larger scale of how these changes can come across of getting access to the finances and education, it comes down to universal health care, universal preschool, dedicated maternity/paternity leave. I think that some of the ideas of elevating will come from the idea that we are only as good as the lowest of our lows and we need to look at disparities with not only health, but where we’re living, the quality of our homes, and what we’re exposed to (such as our water sources). That is where the big fundamental changes will happen, but I understand that it has to be where the money and where the voices are.

 

Dr. Erkeda DeRouen   

I think what both of you were hitting on is looking at the social determinants of health and how each of those affects your overall health. If you have a better education, you may have more resources in order to get these things. If you are living a more healthy lifestyle through diet and exercise, if you’re taking care of yourself, if you’re taking care of your mental health, if you are in a nice environment. We know through several studies that if you live in a more urban environment versus more rural, you’re more likely to have asthma. If you are working, then all of these kinds of things and extra stress, on top of motherhood, can affect you. I think it’s more about people who are caring for others by looking into what factors would make them live better, healthier lives in all realms.

  

You hit on another thing with universal health care. The political determinants of health are also intersected with the social determinants of health, so it’s necessary to make sure that we have this advocacy out there where we are pressuring our legislators to move forward. A lot of times that bigger voice needs to come from health care workers instead of Big Pharma and the insurance companies. Figuring out how we can leverage that to advocate for these women is very important.

 

Cindi Michaelson   

If no one has anything to add, we will move on to our next question: Many times people who want to affect change feel that their voice won’t make a difference. We’re here to say that’s not the case. You can make a difference. Are there any books, documentaries or other resources that you would highly recommend to someone who would like to begin making changes and raise awareness of this issue in their own community?

 

Nicole Wallace    

The Black Mamas Matter toolkit was just recently released and I put together a handout that you are including in the show notes that has that and a few other resources. I think that toolkit takes a deep dive into our healthcare system, the politics of our healthcare system and how it’s reflected in communities, urban and rural, that may not have the socioeconomic benefits that others do. I would suggest, if you’re going to look at something for some info, that might be a good place to start.

 

Blair Cuneo   

Something that I’ve found helpful for my learning, my unlearning, and my awareness is “The Ally Nudge” from Dr.Cadet and also “Anti-Racism Daily” from Nicole Cardoza. Also, Every Mother Counts, which I think worked with the Black Mamas initiative on an open letter that put some weight behind the Momnibus Act, legislation that addresses many of the arms of what we’re talking about today for closing the gap in maternal health disparities.

 

Crissy Fishbane   

Those are all excellent resources. We are actually excited to be launching a fundraiser for everymothercounts.org as a part of our current initiative. Based on everything that has been discussed today, it’s clear that you are all passionate about creating more equitable care across racial and economic lines. Do you have ideas on how to make this a more widespread concern for people outside of the books and the resources? What is another way? What are some actions that a person could take to have an impact on bringing awareness to this issue and influencing change in their direct sphere?

 

Emily Chafee   

I think one thing that people can do is talk about their own experiences. I feel that so often we only say the good parts of our birth or the good parts of our pregnancy. Regardless of skin color, I think bringing up the fact that there are issues at play. Going back to talking about not respecting women’s boundaries or bodily autonomy, if we as mothers say “this happened to me and it wasn’t okay,” that’s going to allow someone else to say “that happened to me, too, and it isn’t okay. I’m allowed to feel the way that I feel and do something about it.” Then maybe it trickles down to somebody else who says “If this happened to two people that I know, I’m going to advocate for myself and when I see something like that coming, I’m going to say, ‘I don’t want to do that.'” Hopefully we start sharing these experiences and build a better atmosphere one person and one birth story at a time.

 

Dr. Holly Durney    

I think that’s great and that’s what my mission has been. Knowledge is power and, specifically in what I do, little things like urinary incontinence tend to truly limit women for the rest of their lives and are so easily fixable most of the time. Women just don’t know there’s anything they can do about it. I’ve been taking any opportunity that I have to do a Zoom call, whether it’s with Camp Gladiator or Burn Bootcamp or whatever, it doesn’t matter. When they ask “can we record this?” the answer is of course! Just tell women however you want to tell them that there’s something they can do. For me, again, across racial boundaries, just having these stories of: no, it’s not normal. Yes, there’s something that you can do. Yes, you have access to it through insurance. And all you need to do is physical therapy and you have direct access. You can go see a physical therapist yourself. You don’t even have to go back to the doctor, if you don’t want to. (Of course, the physical therapists should send you back to the doctor if it’s something that isn’t appropriate to their work.)

 

Knowledge is power, even just simple knowledge, whether it’s a conversation, a story shared, or a patient anecdote. In my particular profession, these things tend to be embarrassing so they’re often not spoken. I’m that blunt, “this is how it is” type of person and want to normalize the conversation between women, friends, and family members. I think that is how we can individually impact our patients and friends. You never know who they’re going to talk to or when the conversation is going to be overheard. Both within the profession and in our daily lives, we need to be able to give women knowledge and empower them to help themselves.

 

Dr. Erkeda DeRouen   

I agree. From what everyone has been saying, I think that the theme is basically providing education, advocacy and support. We need to let people know that there are resources out there that they may not know about, like physical therapy or doulas or things like postpartum care and mental health. Those resources are out there. They may have issues after birth or during their pregnancy or in between. There needs to be education about different phases in life. A lot of times women believe that they’re alone when, in fact, these experiences are quite universal. There needs to be advocacy to increase access to all of these different things. A lot of people may do well in group visits, so there needs to be opportunities for that and opportunities to increase the workforce.

 

We also need to have ways to support one another, like through HER Health Collective, where women are coming together to try to share their experiences. There are a lot of times where certain things may happen in a woman’s life and they think they’re the only ones- a miscarriage, postpartum depression, preeclampsia- and they’re not talking about these things. When women come together and start talking about it, they realize there’s a lot more people going through that than they imagined. Having these conversations is important. They can come together and brainstorm on how to impact other people in their community as well.

 

Nicole Wallace   

I definitely agree that the woman to woman connection is going to change this situation for the better in many aspects, especially at HER Health Collective and other support groups within our community. If we can get the word out about these types of resources, I think it’s such a benefit. As a mom, after each pregnancy, I sought out a support group because I knew I needed that. However, I would not often see myself represented at many of the groups. I might be 1 of 50 moms there and the only one who was not white. I think we need to look around our groups and ask ourselves “Where are those moms? How can we connect with those moms? Is our group doing enough to reach a diverse crowd?”

 

As we talked about here, diversity should be valued. Maybe there’s that mom out there who doesn’t have the finances or the internet. We need to see if we’re advertising enough and getting out there enough to let women know that there are people out there for them. There’s good work being done, and stress can be reduced by spending time with others who are going through your same situation. These groups should be valued.

 

Blair Cuneo   

Adding to Nicole’s comment about stress reducing and gathering to share the experience, I loved learning that when women are venting, it actually elevates our oxytocin which will calm down our stress hormone. That does not happen when men get together and vent. That is why, when we are sharing these experiences, it’s for our health benefit.

 

Crissy Fishbane   

Thank you for sharing that. Here is a question: What is the role of white birth workers in advocating for equity?

 

Emily Chafee  

I think that, as a white doula, my job is to validate and not say what somebody else’s experience is. I’m able to present facts and present education. I’m able to let people vent to me and increase their oxytocin. I’m able to let this be a learning experience. I try to be really transparent, but I don’t know what it’s like to be a black woman. I don’t know what it’s like to have all these obstacles because of my race. I don’t try to stray away from those hard conversations, but I also encourage the conversations to happen as needed. I really try to find different providers and make sure that when I’m listing providers, I don’t just list one or two. I try to list a wide variety. When I’m listing support groups, like my list of breastfeeding support groups, I try to find a wide variety to make sure that everyone feels seen. I think that’s a really powerful way to show that I’m able to help advocate for change.

 

Dr. Erkeda DeRouen   

On a bigger spectrum, I agree with what was said. I think using your privilege for good and using your emotional intelligence to listen, connect and advocate when you can is important. Realistically in the US, although we would not like for certain voices to be heard more than others, sometimes they are. Trying to figure out how you can be of service and help one another, even if that’s just by validating their experience, is good.

 

Cindi Michaelson

We’re extremely grateful to all of you who have participated today and in this very important discussion. It’s only through continued education, outreach and discussions that we will be able to shed light on the broken and inadequate care that’s plaguing moms. Thank you so much for taking the time out of your busy schedules to join us and the rest of professionals and moms that are on this roundtable. I hope you all enjoyed it.

HER Health Collective roundtables provide an opportunity for us to bring our panel of experts together to discuss important issues that are relevant to mothers in our community. The following experts contributed to this Roundtable discussion: 

  • Emily Chaffee – Certified Birth & Postpartum Doula, Massage and Bodywork Therapist, Certified Educator of Infant Massage, Fertility Specialist, founder & owner Carolina Birth & Wellness
  • Blair Cuneo – Certified Physician Assistant, Carolina Total Wellness – The Institute for Functional Medicine Certified Practitioner
  • Dr. Erkeda DeRouen – MD – Family Medicine – Lifestyle medicine board certified physician – Associate Medical Director Telemedicine, focus: health equity and diversity and inclusion in the telemedicine and start up space.
  • Dr. Holly Durney – PT, DPT, OCS – Pivot Physical Therapy & Smart Athlete Physiotherapy
  • Dr. Lisa Folden – DPT – Healthy Phit Physical Therapy & Wellness – Mom Life Coaching
  • Nicole Wallace – Counselor – LCMHC- Transformation Counseling & Consulting; former Wake County educator and school counselor

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Medical Disclaimer: All content found on the HER Health Collective Website was created for informational purposes only and are the opinions of the HER Health Collective experts and professional contributors. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.  If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

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