SCOTT DETROW, HOST:
According to a new study published in the Journal of the American Medical Association, maternal death rates remain the highest among Black women, and those high rates have more than doubled over the last 20 years. To talk about how to address this ongoing problem, I spoke to Karen Sheffield-Abdullah. She's a nurse midwife and a professor of nursing at the University of North Carolina Chapel Hill. She says listening is just one solution to fixing this problem.
KAREN SHEFFIELD-ABDULLAH: I did grand rounds at a particular academic institution, and I was speaking in particular about the importance of listening to Black women when they speak. And so there was a particular attending who identified as a white female physician of 20 years who said, Karen, how do we even have the conversation surrounding stress and mental health for Black individuals in particular? And what I explained was, for Black individuals, our pain is notoriously underassessed and underaddressed, and we really need to think about these higher-profile individuals like Serena Williams, like Allyson Felix, like Beyonce, like Tori Bowie - but, as we think about Serena Williams, knowing that she had a history of a blood clot from 2010.
DETROW: Yeah.
SHEFFIELD-ABDULLAH: And then after her delivery, she was complaining of symptoms, and she wasn't listened to. And so what happened was this person then took that story anecdotally, and that very week after the grand rounds, she saw a Black patient in the office who came in with really vague complaints of calf pain. And she said it wasn't really high suspicion for a blood clot or what we call a DVT or deep vein thrombosis, but she said, you know what? I listened to what Dr. Sheffield-Abdullah had to say and specifically the story regarding Serena Williams. And I went ahead, and I ordered an ultrasound. And indeed, this individual had a blood clot.
And it is a direct correlation to the fact that that grand rounds where it was elevated that we need to listen to Black women that I changed the way in which I practice. And I want to be able to get that message back to Dr. Sheffield Abdullah. This person came to the office kind of downplaying her complaint of calf pain, but that particular provider listened, did the testing that needed to be done, and that's a potential life saved.
DETROW: Why do you think doctors have such a hard time listening? What do you think the root of this broad problem is?
SHEFFIELD-ABDULLAH: If we think about their schedules and how many patients they are slotted to see in a given day, they don't have the time to sit down and do the deeper dive to really sit and listen to what is going on for this particular individual, what's happening socioculturally, what's happening psychosocially, what's happening with their mental health, what's happening with their ability to be able to access certain resources. And so if we're not able to assess that, we're not giving optimal care.
DETROW: So listening to you, I hear a way forward on the individual level, on the ground level for doctors and medical professionals of, just listen more. Believe patients more. Seek out subtle clues. What are the broader systemic fixes to this?
SHEFFIELD-ABDULLAH: Certainly we could think about diversifying the health care workforce so that the individuals who are taking care of the community look like the community they're serving, right? So diversifying the health care workforce, inclusive of physicians, midwives, doulas, mental health care providers - and I truly believe that if we were to ask the Black community, what do they need, they would tell us. And rather than us as academicians and researchers and physicians pontificating from our silos about what we think a community needs, how about we spend the time asking the community what is it that they need? - because they know better than we do. And the CDC is clear. Four out of five of pregnancy-related deaths are preventable. We need to do better, and we can.
DETROW: That was nurse midwife Karen Sheffield-Abdullah. You can hear more of this conversation on Sunday's ALL THINGS CONSIDERED.
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