Black and Native women are two to three times more likely to die during pregnancy – just one of many unsettling pieces of data that point to the current disparities in Black maternal and children’s health. And for Black mothers who experience them firsthand, their disturbing stories display the reasons why these gaps exist.

Dr. Corinne Brown-Robinson is the vice chair of the HealthPartners OB-GYN Department, medical director of the HealthPartners Ultrasound Department and medical co-chair of the HealthPartners Children’s Health Initiative. Above all, Dr. Brown-Robinson’s most important title is Mom, and her experiences on both sides of the chart illustrate the bias and attitudes driving these gaps in care. In this episode, Dr. Brown-Robinson talks about how we got here, why compassion and trust are crucial in closing the divide, and how mothers-to-be can help ensure they get the care they deserve. Listen to the episode or read the transcript.

The stories behind the statistics

You don’t have to look far for statistical proof that Black women and newborns are less likely to survive childbirth than if they were white. Studies from both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists have found that there is a difference in how women of color, namely Black women, are treated at every level. And while socioeconomics and environment contribute, the blame clearly belongs to bias and institutional racism.

However, what the statistics don’t reflect are the experiences like those Dr. Brown-Robinson has had, both as a respected OB-GYN and as a mother to twin sons. As Dr. Brown-Robinson discusses on the podcast, it’s scary when a patient asks you to please don’t let them die during childbirth or when friends ask you how not to die as Black women. And it’s even worse when you and other Black colleagues encounter biases and dismissive attitudes firsthand during the birthing process. Unfortunately, countless decades of bad experiences, mistreatment and mistrust between Black patients and doctors make stories like these all too easy to find.

Combating a history of mistreatment by building trust

On the podcast, Dr. Brown-Robinson talks about her own harrowing experiences after giving birth. But while she has the ability, experience and position to advocate strongly for herself, many patients don’t. It’s those that don’t feel empowered to speak up for themselves that concern Dr. Brown-Robinson because they’re the same patients that endure mistreatment and build mistrust – leading to worse health overall.

It's aggressions, both micro and macro, that are experienced over a lifetime among people of color. They can be passively normalized or aggressively sought out, leading to patients coming into a health care setting vulnerable, hurt and ready to be dismissed with terms like “combative,” “non-compliant” or “belligerent.” It can also lead to a culture where measured self-advocacy can be mistakenly seen as aggressive.

That’s why, as Dr. Brown-Robinson reflects, it’s important for clinicians to know this context. Patients come in with their history, biases and every bad experience they’ve had with health care. All of that affects the patient and clinician relationship, which is why it’s so important for them to create relationships and build trust.

Keys to survival: Self-advocacy and representation

While the tide is slowly turning towards closing these gaps in care, it’s cold comfort to a current mother-to-be. Fortunately, Dr. Brown-Robinson has advice to help ensure good care. The key is for new mothers to advocate for themselves and ask questions – don’t leave any visit without having all questions answered and concerns addressed. Also, during labor and birth, it’s crucial to know the levels of escalation, who to ask for and what questions to ask when you don’t feel that you’re getting the best care. It’s also important to know who to call and who can be your advocate when you need one.

It’s also worth including a doula in your birth plan. Data has shown that Black mothers who have doulas as part of their care team have better chances at healthy outcomes at all stages of the process. With a doula, you can have an ally with you during all stages of birth – someone who can echo your voice and serve as another set of eyes and ears.

For more about Dr. Brown-Robinson, her stories as both a new mother and an OB-GYN, and why even talking about maternal health disparities shows progress from just a few years ago, listen to this episode of Off the Charts.