It’s Black Maternal Health Week. Here’s everything you should know to protect yourself and those you love.
As a board-certified obstetrician and gynecologist, Kameelah Phillips, MD, knows what it takes to bring a child into the world, all while preserving the health of the mother. And as a mother of three, she’s done it herself, equipped with the knowledge and ability to be vocal about what she felt and what she needed. These experiences advise her work, and efforts to address the maternal health struggles that Black women face at a disproportionate rate in the United States, as many don’t have the same confidence in the doctor’s office to be outspoken on their journey to motherhood.
We tapped Phillips this Black Maternal Health Week to talk about the ways in which expectant parents can speak up for themselves (as so many have felt and been unheard or misunderstood when taking concerns to their obstetrician during pregnancy), and what makes a healthy relationship between a provider and a mama-to-be. In addition, she offers insight to a very dangerous condition that is impacting Black women, again disproportionately, and that is postpartum hemorrhaging, which is severe postpartum bleeding. Get the knowledge you need for a positive birth and postpartum experience—you deserve nothing less.
Watch a condensed version of our conversation above, or read the full discussion below.
ESSENCE: As a physician and a black mother, how important is Black Maternal Health Week and this effort to really save lives to you?
Kameelah Phillips, MD: It is the foundation of everything we try and do here. I don’t take for granted for one second that yes, although I’m a Black woman and I am a mother, I am very privileged because I’m also a physician. And with that privilege, not only for myself but for people who look like me, comes actually the responsibility to make sure that we make the birthing space inclusive and safe for all of us. And so that’s why every time I have the opportunity to discuss Black maternal health, especially this week, which really is every day, it really is a privilege because there are so many things that we can do to help keep women of color, specifically Black women safe. We just need to keep talking about it, talking about it, talking about it, educating on all the socials, on all the news channels everywhere. And we will achieve our goal of making the birthing experience equitable for everyone in this country.
So important. And I also wanted to ask you, people tend to think that if you get a black OB-GYN, that’s all you need. But what really does it take to have a perfect fit between a patient and a doctor during this very important time in a woman’s life?
Yeah, I think it’s really important that we remember this is a relationship. This is a relationship, and all relationships take time to engender trust, communication, honesty, and transparency. So although you may have a Black physician, it still means that you have to work on that relationship. I don’t want to assume that just because we are both melanated, that I’ve had your experience or vice versa. As I just mentioned, I’m a physician and I’m very knowledgeable and privileged in this space. As a news reporter, you are not. And so I want to make sure that I’m not assuming your experience and that I’m still listening to your concerns and not taking anything for granted about what is top of mind for you, just because we have the same skin color. So it’s about finding someone who you can have easy conversations with. Don’t hesitate to express your concerns and have an honest rapport, which is really paramount in finding a healthcare provider, whether she be of color or not.
Or a man as well. And lastly, what are ways that we can advocate for ourselves? I know so often we want to be able to listen to our doctors and feel confident in what they’re saying because they are obviously, like you said, the expert. You have the knowledge and there’s some things that we just don’t know. But when and how should we stand up and say, well, hey, this is something that I’m feeling, and I don’t want to bypass it. How can we best advocate for ourselves?
I think it’s important to, one, always tell patients when I walk in the room, I’m like, what are we talking about today? I encourage patients to write notes about their experience in between visits. So listen, healthcare, we know is broken, and so we only have a limited time to get through some of those things. So coming to a visit prepared, knowing what it is you want to discuss, so you’re sure that you hit the highlights, is something that I really encourage taking the time and not being afraid to say, wait, wait, wait. I don’t understand that. Can we back up? It’s not anything to be embarrassed about, it’s just we need clarification. And in any industry, for example, when I go into the banking space, I have questions. It is okay to admit that you have questions and you need to have this explained to you in one or two different ways until it sinks in.
The third thing that I would encourage people to do is if your doctor, for example, hands you a nugget of information that you might not be able to entirely process at that time, and you need some more time, just make sure that you’re going to vetted sources. And I would say that TikTok and Instagram and social media are not those vetted sources, even though we’re watching this right now. It is really important that you go to national societies and look at what the current recommendations are and then bring those to your doctor so you can have a really informed discussion. It happens to me even as a Black physician. I asked someone to start an intervention, and I saw her four weeks later, and she hadn’t started that intervention. We had to pause and have a conversation as to what the intervention was for, what the data showed, and how it would help her. She then started the intervention. So it really happens to all of us. Don’t feel in any way that you are missing something when you feel the need to advocate for yourself, but I would also say it is really the physician and healthcare provider’s role to be the advocate. I don’t feel like we should be relying solely on you in terms of the advocacy piece.
Now, Dr. Phillips is going to share insight into a very scary condition that impacts a growing number of Black women after giving birth.
Thank you. I’m going to use this time to cover a really common postpartum complication that can be really devastating to women, and it is called postpartum hemorrhage. And there are a few points that I want to leave with you regarding postpartum hemorrhage so you can prepare for your birthing journey. So, a postpartum hemorrhage is any bleeding emergency that can occur after childbirth. This is actually a really important topic because a mother’s total circulating blood volume passes through the uterus in eight to 11 minutes at term. So that means blood loss can escalate really quickly, and we know that the United States is facing a maternal health crisis, and with that, postpartum hemorrhage is a leading cause of this.
But despite it being one of the more common birth complications, really little progress has been made in making sure women are safe from the impact of postpartum hemorrhage. And actually there is a study that found that Black mothers are nearly two times more likely to experience hemorrhage. So this is important. There are about 2 million women in the United States who live in what we call maternity care deserts. And so this puts many of us at significant risk, including lack of access to important screenings at hospital visits before, during, and even after pregnancy. So that’s why I want to spend a little time on postpartum hemorrhage. I just mentioned not a lot has been done, but there are some things that you can discuss with your doctor and potential interventions that you can discuss before you even get into labor and delivery. One that I want to discuss is called JADA.
So when postpartum hemorrhage or any abnormal postpartum uterine bleeding occurs, we have to act, and we have to act fast to manage bleeding. Thankfully, we have an intervention that can help us do just that, and that is the JADA System. When someone is bleeding, I can use the JADA System, which works by using a low level vacuum, which encourages the uterus to contract as it naturally should after birth. The time to control bleeding was just about three minutes. And in studies, about 94% of participants experience a successful treatment. The JADA system specifically is intended to provide control and treatment of abnormal postpartum uterine bleeding or hemorrhage when conservative management is warranted. And as it relates to safety in clinical research, there were no adverse events related to the device or the procedure, and there was a low rate of possibly device-related adverse events.
So it is important that people talk about what interventions are available in their delivery environment that can help reduce the risk of postpartum hemorrhage. And I would discuss JADA with your provider. The third point is that there are additional implications that are possible with postpartum hemorrhage that we don’t talk about. So often, when you have an obstetrical emergency, specifically postpartum hemorrhage, there are a lot of emotional and physical impacts that women and their families can experience that we don’t talk about. And these are both short and long-term outcomes, like extreme fatigue. You can imagine if you lose a lot of blood, you’re tired, and then we hand you this baby to take care of. That’s a huge hurdle. If you have a postpartum hemorrhage, people can have post-traumatic stress disorder after that, seeing all that blood, their partners, their families, that can lead to PTSD, and that is something that we have to talk about in terms of not holding on to birth trauma
Breastfeeding can also be impacted when women lose a large amount of blood. And because we know breastfeeding is its own journey, it’s really important that we try to avoid things that can interfere with breastfeeding. And this is one of them. And in very rare cases, there can be a loss of fertility due to hysterectomy from postpartum hemorrhage. So a postpartum hemorrhage, this type of complication can not only impact mothers and families, but also babies because it can impact bonding between a mother and their babies. So preparation is paramount and compassionate care is even more important when we’re talking about this. The other thing I would say is that it’s really important that healthcare professionals have open communication with their patients about potential complications while we’re in the office before things hit the fan. It’s important that together we formulate the right plan to optimize their pregnancy and birth experience.
And should complications like a postpartum hemorrhage arise, we can ensure you that our staff and I are informed on how to recognize it, how to quickly respond with appropriate treatments and how to keep you safe. So let’s start some of this before we even get into the delivery room. All women are screened around 24 to 28 weeks for your glucose test. Well, part of that glucose test is also checking an iron level. So you want to really make sure that you know what that result is, because if it is low or if it is borderline, this is the time that you can start to prepare and supplement.
This leads me to my final point, which is how important having a good diet is during your pregnancy. I always joke with patients that anything that goes into your mouth gets ripped out by the baby: calcium, iron, all your nutrients. So it really is important that as you grow this baby, you are also paying special attention to your own nutrition. So, diets that are really high in iron, so you can get your numbers up. And so if, God forbid there was a hemorrhage, you are still in a safe range that you can not experience fatigue. You can still breastfeed, take care of your baby and leave the hospital in good health.
What would be a sign that you may be dealing with postpartum hemorrhage that you need to be on alert about?
I tell people bleeding can vary after a delivery, but generally, your nurse and your doctor are responsible for recognizing a postpartum hemorrhage. And it’s one of those things that when it happens, women might experience just a gush of blood. We know from just menstruating what is too much. That sense should alert you. That spidey sense should alert you. Hey, let me call the nurse, let me call the doctor. Let me call a family member so I can make sure I’m getting the necessary and quick help that I need. It’s really a rapid bleeding that people experience typically after delivery of the baby and placenta, but can occur upwards of 24 hours while you’re in the hospital.
