Marking the start of Black Maternal Health Week, University of Massachusetts professors, students, researchers and community members attended the “Black Maternal Health Symposium” on April 11 at the Commonwealth Honors College.

Organized by Lucinda Canty, associate professor in the College of Nursing and Director of Seedworks Health Equity in the Nursing Program, the event focused on disparate Black maternal health outcomes.

With thirty years of experience in midwifery, Canty’s work focuses on maternal mortality, morbidity and creating safe spaces for Black women in healthcare. Canty stressed the importance of allowing Black women to voice their personal pregnancy experiences.

“It’s just very important for me to have research centered on those who are most impacted,” Canty said. “And for Black women, we don’t really have our stories…we don’t really have a lot of platforms to share our experiences.”

Last July, the Department of Public Health found that severe maternal mortality (SMM) rates nearly doubled from 2011 to 2020, and noted severe discrepancies in health outcomes for birthing people of color when compared with white birthing people. 

Understanding Black maternal health in the U.S. through the history of midwifery

According to Canty, the history of midwifery in the United States is a framework for the current state of Black maternal health. 

“[African women] were already providing midwifery care and they brought those traditions and things with them,” Canty said. “But even during slavery, the midwife felt empowered and she made sure who she was caring for felt empowered.”

By the early 20th century, childbirth became more medicalized, and the role of the midwife diminished. Federal legislation pushed many states to require midwife certification.

“When there was that transition from the home to the hospital, they took away that sense of community,” Canty said. “They took away someone who was from the community, providing care, and that left women – Black women, very vulnerable.”

Canty expanded that assumptions about traditional midwifery perpetuated dangerous stereotypes which associated Black midwives with providing unhygienic and unsafe care.

This transformation alienated traditional Black midwives and other people of color from the profession. As reported by the American College of Nurse-Midwives, Black midwives make up only seven percent of total CMs and CNMs in the U.S.

“When I go into the community, I just want to make sure that people are safe, that they feel heard and respected,” Canty said. “I focus on prevention. I don’t want to wait until there’s a crisis.”

The role of mental health in shaping maternal health outcomes

Perinatal depression is one mental health complication that can arise during or after pregnancy. In the U.S., nearly two in five women experience postpartum depression. Severe pregnancy complications such as preeclampsia and lower birth weight are also associated with prenatal post-traumatic stress disorder. 

Differences in cultural environments can impact patients’ ability to discuss mental health conditions, according to Gabrielle Abelard, a clinical associate professor in the nursing program. 

“…Those of us who are people of color in terms of where our backgrounds are and some of the trauma that has happened… there’s studies that show that this trauma is passed from generation to generation,” Abelard said.

Community perspectives: Springfield Family Doulas

Founders of the first and only Black, woman-owned doula service in the Springfield area, Laconia Fennell and Tanita Council of Springfield Family Doulas spoke about their practice.

For a community-based service like theirs, Fennell emphasized a greater level of trust between doula and patient, when compared with hospital-supported doula programs. 

“People that are hired in the hospital, especially in the hospitals that are around us, they’re not from Springfield, they’re not from their area,” Fennell said. “…So they don’t know the community, they don’t know the people.”

Centers for Disease Control data stated that doula-assisted mothers were two times less likely to experience a birth complication and four times less likely to have a low birth weight baby.

Doctoral students share research

Ciara Venter, a second-year doctoral student in clinical psychology, spoke about her research on Black perinatal mental health and postpartum depression in Black women.

Black women are at a disadvantage for receiving accurate diagnoses and effective treatment due to barriers like biased assessment tools, which fail to catch how symptoms present in Black women. Over half of maternal deaths among Black women occur postpartum, Venter said. 

“They’re trying to communicate to their doctors what’s going on and they’re not listening or they’re dismissive of it, attributing it to other disorders,” Venter said. 

Ruth Appiah Kubi, a second-year doctoral student in health policy and management, presented her research on African immigrant women’s experiences with maternal healthcare and barriers to perinatal care in the United States.

One focus of Kubi’s research is the impact of the clinician-patient relationship on women’s birth decisions and health outcomes.

One woman recalled that a nurse wanted to give her an epidural, although she was nearing the end of labor. The nurse resisted her sister’s warnings for five minutes. After that experience, the woman decided not to go to the hospital except in emergencies.

The participant asked herself, “If maybe I was white or Caucasian, would there have been that much resistance before doing what was supposed to be done?”

Black Women in Medicine

The National Society of Black Women in Medicine (BWM) is a student-led organization which provides resources and connections for Black female students to network with other students and medical professionals.

Oluchi Ukairo, a senior psychology major on the pre-med track and president of BWM at UMass, said “We really emphasize helping lifting up the Black women and Black girls on this campus.”

Bedphiny Deng, a senior biology major on the pre-med track and treasurer for BWM, noted that the organization recently hosted its first women’s symposium, which she described as “a great opportunity to connect with people like Dr. Canty and other Black professionals.”

Dr. Charmaine Nelson

Dr. Charmaine Nelson, provost professor of art history at UMass and founding director of the Slavery North Initiative, presented about the impact of sexual violence upon enslaved women in colonial Jamaica.

“The cumulative harms of sexual and physical violence, and material and nutritional deprivations, which were routinely visited upon enslaved females, led to psychic, emotional, sexual, and physical traumas which were passed down to their children in utero,” Nelson said.

“We have only just begun to understand the cross-generational impacts of these histories on Black maternal health today.”

Enslaver and overseer Thomas Thistlewood self-documented his crimes at the Vineyard Pen plantation in Jamaica in the 1750s. Sexual violence was “rampant and normal,” Nelson said. Thistlewood accepted sexual favors in exchange for “money, gifts, better treatment, and less violence.” The opportunity to commit sexual violence may have been a primary reason white men moved to Jamaica, Nelson said.

“Our female enslaved ancestors passed down precious knowledge about sexuality, fertility, pregnancy and maternity across generations,” Nelson said.

She mentioned archival evidence that showed enslaved mothers in Jamaica and elsewhere prolonged their breastfeeding period to delay ovulation, as a natural form of birth control.

Canty noted this dehumanization is still with us. “That’s why it’s so important to know our history,” Canty said, “no matter how painful it is, because we have to be able to stop the repeat of those things.”

“Give some Black women some TLC,” Canty said. “And not just this week, all year.”

Catharine Li can be reached at [email protected]. Alexandra Rowe can be reached at [email protected].