Black women are facing a maternal mortality crisis in the U.S., being three times more likely to die from pregnancy-related complications. Bethany Van Baak, BSN, RN, of Overlake Medical Center in Bellevue, Washington, offered a five-step action plan for how ED nurses can help stem the tide of this epidemic of maternal deaths at her session, “Nurse Action to Reduce Inequities for Black Women.”
Bethany Van Baak offered a five-step action plan for how ED nurses can help stem the tide of maternal deaths.
The first step, she said, is to understand what drives these health inequities for Black women. A long history of medical abuse and a belief that race and health outcomes are connected set the stage, but recent research suggests extended exposure to systemic racism can actually take a physical toll, a phenomenon called weathering.
After considering these factors, step two is to reflect on your own implicit bias and how it may impact patient encounters. This is reflected in data showing Black women receive less pain medication in the ED due to a belief they have a higher pain tolerance, something Van Baak said even she has done herself.
Using evidence-based nursing care models and recommendations from Black-led organizations can help mitigate these disadvantages for Black patients. Van Baak shared standards from the Black Mamas Matter Alliance and the Association of Women’s Health, Obstetric and Neonatal Nurses as examples. The key is making it the center of patient care, rather than a seminar. “It has to be more than one hour once a year,” she said.
Step four in achieving health equity is conducting ethical research based on the participation and lived experiences of Black women. “Studies about Black populations absolutely have to be developed, led or initiated by Black people,” said Van Baak. Frameworks like the Research Prioritization for Affected Communities help center scientific investigations on the actual problems facing a community, rather than ones that might be perceived by the outside researchers.
Van Baak highlighted the need for good data on the issue of maternal mortality among all women in the U.S., as there is no single national system to collect this information. She also noted how political movements against diversity, equity and inclusion efforts are hurting research, with billions in grants being canceled and important sources of data being altered or removed, as visible on the CDC website.
Once ED nurses have mastered the first four steps of this action plan, they can go back to their health care systems and be advocates for change. Van Baak said each person must decide what level of leadership they are comfortable with and what aligns with their interests.
Ultimately, the power of nurses is to build relationships within and across organizations. “The trust and accountability needed for advocacy cannot happen outside of real relationships,” said Van Baak.
Those interested in learning more can explore the Maternal Health Emergency Department Toolkit developed at the University of Illinois at Chicago.