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We Are All Accountable Together: Black Maternal Health

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January 25, 2023
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By: Andrew Mulkerin and Ed Neuhaus

A UPMC doctor is sharing her thoughts on racial disparities in maternal health care and what providers, nurses, hospital staff and community members can do to help reduce the disparity and create more positive birth experiences – and more positive health outcomes—for Black women in particular.

These issues are on top of Maternal Health Awareness Day on Monday and will be a talking point during Black Maternal Health Week in a few months (April 11 to April 17).

Dr. Rickquel Tripp

Rickquel Tripp, MD, MPH, CDR USN, is an attending physician in emergency medicine at UPMC Magee-Womens Hospital and UPMC St. Margaret and holds the title of vice chair of diversity, equity and inclusion for UPMC Medical Education. She participates in UPMC Health Equity NOW, an organization-wide group of providers and staff committed to reducing maternal morbidity and mortality among women of color, racially and ethnically diverse populations, and vulnerable communities across UPMC’s footprint .

Tripp says there is an epidemic across the country of black mothers dying. That’s why Black Maternal Health Week and other similar initiatives are being implemented so that providers can shine a spotlight on this important issue.

“The Pittsburgh Equity Indicators Report pointed out that in Pittsburgh, we are even worse than comparable cities when it comes to black maternal health. And so that really started the creation of UPMC Health Equity NOW,” Tripp said.

At UPMC Magee’s annual Perinatal and Neonatal Healthcare Conference last fall, the group screened the film “Aftershock,” which highlights the stories of black mothers who have died in postpartum care or during childbirth.

Most deaths among black mothers occur during childbirth and postpartum care, Tripp noted.

“That’s where we start to look at implicit biases among providers, looking at whether a provider might not believe the concerns, especially of black mothers, or there might be mismanagement of care,” Tripp said. “Postpartum hemorrhage is the No. 1 cause of maternal death around, and especially for black mothers.”

This is an issue that resonates with her personally.

“Especially me, being a black woman and a mother, if I’m pregnant, I have to think: Am I going to survive this? Instead of thinking about how happy I am to have this baby, it’s ‘Will I live to see my baby?’

The history of OB-GYN care in America has included experiments on black female slaves. These women did not receive anesthesia, intentionally and deliberately, and did not give their consent.

“When that’s the foundation, you can’t really blame black women for coming in and not automatically trusting their providers,” Tripp said. “As a black woman, I’m saying to a provider, ‘Hey, can I trust you? Let me make sure that the things you are saying are really true. Do you really have my best interest at heart?’”

Actions for a solution

Tripp recommended the following steps to address inequities in maternal care and to understand and challenge the implicit biases that may affect how we treat others.

  • – Get Implicit Association Test, created by Harvard University’s Implicit Project, to begin to understand implicit bias. “Knowing that I might have a bias, especially about this particular group, helps me to move forward and mitigate my biases,” she said.
  • – Consider Upstander Training, an educational opportunity – used and offered nationwide – that provides actionable tools to take when you witness bias, prejudice, discrimination or microaggressions.
  • – Feel comfortable asking questions and advocating for patients and loved ones who may be subject to implicit bias in the health care setting.
  • – Advocate for doulas, a growing aspect of the birth experience at UPMC Hospitals. “Doulas are there to be that advocate,” Tripp noted.

Efforts to improve health outcomes for Black women continue throughout UPMC, including educational opportunities that can help people recognize and address unconscious bias.



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