To provide support to the widest possible community, Gerber uses the term “birthing people” in many contexts so as not to exclude surrogates, transgender and non-binary people, among others. This is not meant to exclude mothers and women from the conversation, but to include others as well. When appropriate, such as referring to research done by third parties, other terms are used. Gerber is proud to support all caregivers on their child-rearing journeys.
In 2021, maternal deaths spiked 40% in the United States from the year before. But for Black birthing people, the crisis is even more pronounced. Black maternal health has long been neglected in the US, with serious and lasting consequences. According to the CDC, Black women are three times more likely to die from a pregnancy-related cause than White women in the US. Black women are also more likely to suffer from perinatal mood and anxiety disorders (PMADs) such as postpartum depression. To better understand this crisis and the actions and solutions needed to address it, we spoke with Dr. Kerry-Anne Perkins, a board-certified OB/GYN and women's health specialist. She gave us an inside look at the challenges facing Black maternal health and how individuals can support efforts to improve the health and well-being of Black patients and communities.
- What initially drew you toward women’s health, and how long have you worked in this area?
Dr. Kerry-Anne Perkins: I have been a board-certified OB/GYN since 2015. What attracted me to this really is having a deep love for women and how miraculous they are, and wanting to make a change in our communities so that we learn more about our bodies, understand them better, treat them better and allow them to live their best lives. I am absolutely intrigued by educating people, especially women, because we've been silenced in so many ways. I dream of making things that are considered taboo not so taboo, and facilitating normal conversations about the changes that happen in women’s bodies. - What are some of the issues that specifically impact Black maternal health, rather than maternal health more generally? What impact do these challenges have on Black birthing people and their children?
Dr. Perkins: The first thing I would mention is that in the Black community, there is a great deal of mistrust around medicine and health care. And rightly so, because the history when it comes to Black people and in particular Black moms is really sad. When we think of the Black women who've been tested and experimented on, who have added so much to our understanding of medicine but were not treated appropriately, were not shown respect, we can understand why the Black community may be wary of putting their lives in the hands of health care providers. That mistrust is not improving, unfortunately, and if anything is worsening because some of that mistreatment is still happening to a degree. The greatest issue to address would be to build trust in the Black community that they will receive the care they deserve when seeking medical attention.
Another issue is that there are practices in the Black community, many stemming from that lack of trust, that lead people to ignore their symptoms or postpone medical care. If a patient shows up when their symptoms are already advanced, it’s much more difficult to help them, which can then lead to a vicious cycle of the patient not getting help and having worse outcomes. If we can’t change when people are visiting the doctor, we can’t change the trajectory we see now of people not getting the care they need.
Finally, we need more sensitivity from medical practitioners and a greater understanding of where members of the Black community are coming from. The more providers can do to connect with patients, the better care they can offer.
These issues contribute to poor outcomes for Black birthing people and children because of delayed care. Early intervention is what allows patients to avoid complications becoming more serious, or even becoming chronic issues or leading to death.
- What role does mental health play in the discussion around maternal health? [OR: How is Black maternal health connected to Black health more generally? What links do you see that should be addressed?
Dr. Perkins: Pregnancy causes hormones to fluctuate drastically, which can cause even the most stable person to be thrown for a loop. It’s a time that requires a lot of support. However, many people do not consider mental health to be as important as physical health, and that’s often true in the Black community as well. There’s a stigma regarding mental health, so it’s easier to talk to a professional about a physical problem than a mental one.
Add to that the issues we’ve already discussed, and you can see how it would be even more complicated within the Black community. It’s very difficult to broach a sensitive topic with someone you may not entirely trust. Because of that, psychiatric disorders or issues are underdiagnosed and undertreated in the Black community. This leads to an increased likelihood that Black mothers may have complications, especially in the postpartum state, and have really a difficult time at home without getting the support they need. We find that Black mothers suffer in silence, and sometimes that leads to their children suffering and their relationships suffering as well.
These are difficult conversations, and some people may feel targeted. A provider’s approach is very important. My general approach is to talk about the fact that there are times that everyone needs assistance. I may give examples that may or may not include a pregnant person. I start very generally talking about the need for support, and then I use that as my road to talk specifically about maternal health and the changes that happen when you deliver a baby. I discuss how my hormones may lead to us to feel overwhelmed or stressed or even sad at times when simple things such as not having the answers to why the baby is crying may leave us in a slump. If I were to come right out and say, ‘Hey, you’re suffering from postpartum depression,’ most people would push back. But if you approach people with love and care and tenderness and education, they tune in.
- What has your experience been as a care provider working with Black parents? How have your views on Black maternal health and the U.S. healthcare system changed since you started practicing in 2015?
Dr. Perkins: I’ve found that when Black mothers see a Black provider like me, you can feel the ease that comes across their bodies, their spirit and their countenance. Sharing a cultural connection makes them feel more comfortable and safer, and so to some degree that feels good because the more comfortable they are, the more likely they are to listen to you and have better outcomes.
I would say the flip side of that is that many of the Black parents I encounter are scared. They want assistance, but they’re dismayed by the care they’ve received or afraid to trust a new medical provider. They want their medical providers to understand them, but that’s not what they’re experiencing.
My views on Black maternal health in the U.S. have changed a lot. When I was in medical school, my thought process about care was very straightforward because it wasn’t yet influenced by experience. I was just ready to care for women! But as I left training and residency and I started practicing on my own, I started becoming more aware of all the different cultural impacts on medicine—and there are plenty. I realized that for me to provide the best care, I needed to meet the patients where they are and actually take my time to learn more about them so I can treat them well. With the Black community, over the years I've learned more about historical atrocities against Black maternal health and the pain that’s been caused, I’ve realized that there are so many variables leading to poor outcomes in this community.
We as doctors need to focus on finding solutions to these very complicated issues, because even though it’s difficult, every baby, every life matters. To keep homes together and to lower maternal deaths, to address the crisis we’re in now, we need to work together to find solutions and to raise our voices politically and to raise issues with healthcare administrators. It’s going to be challenging, and change won’t happen overnight, but it’s worth it.
- The difficulties facing Black maternal health can seem overwhelming. How do you stay focused on solutions when confronting such a difficult topic?
Dr. Perkins: It can definitely be overwhelming to look at the overall situation. There's a heaviness to it, and it's so much more than one person can solve. My approach is to reach as many people as I can so that they can learn and know and be empowered. If I were to make a difference with just one patient, I feel like I've done something. I have left a mark on that one person, which potentially can be passed on to another, whether it's their kids or their friends or family members or someone else in their community. So the way I stay focused is making change where I can, one person at a time. - What can allies do to support Black birthing people?
Dr. Perkins: The first thing people can do is to spread awareness. The more that we are aware that these things are happening, the more that can be done. We need every mind focused on finding solutions. I can't tell you how many people are absolutely shocked even to this day when they look at the data that shows the mortality and morbidity rates for Black mothers.
Also, we can show love to anyone who is pregnant, especially in the Black community. If you know someone going through this process, show support. Every individual can be an ally. If you’re part of an organization, bring awareness and support on that level as well. That could mean companies providing maternal support such as lactation spaces and mental health support.
Most important is creating systems that will provide opportunities for Black mothers or Black birthing people to get the support they need.
In response to the Black maternal health crisis, Gerber has partnered with Un-ruly and mater mea to create Overdue, an educational resource for expectant mothers. The platform seeks to educate and empower Black expectant mothers facing pervasive bias and inaction in the U.S. healthcare system. Learn more and see how you can raise awareness here.
