Well Woman Weekly: Stacey D. Stewart on Closing the Health Equity Gap For Black Mothers

Every Friday, we send out a weekly roundup of what’s new on Blood & Milk along with articles you may have missed from the archives. We also include an interview with an inspiring woman and this week we’re excited to Stacey Stewart. To get the newsletter, sign up here.

Stacey D. Stewart has been president and CEO of March of Dimes since January 2017. The mission of March of Dimes is to support healthy mothers and babies, and since becoming president and CEO, Stacey has focused on closing the health equity gap for Black mothers, who are significantly more likely to die in childbirth or face other pregnancy-related complications than their white counterparts. 

Stacey has led the way for March of Dimes to support efforts to close these gaps, such as advocating for implicit bias training for healthcare professionals and supporting legislation that works to close these health equity gaps. Prior to leading March of Dimes, Stacey was the U.S. President of United Way, the nation’s largest nonprofit organization. At United Way, Stacey led the organization’s work to become the premier leader in community impact as well as spearheading United Way’s efforts in education, financial stability, and health. She also helped foster global partnerships for U.S. United Way across 40 countries.

Stacey D. Stewart

Can you share with us what led you to this career path? Was there a specific moment in your life where you knew this is what you wanted to do? 

I can’t say it was a specific moment, more so it was my entire upbringing because my parents never shied away from challenges and always worked to ensure equity and access to opportunity. My father was a physician, so from a very young age, I developed a deep understanding of the importance of health and even further, equity in health. Many of my father’s patients were Black, and many were women, who were on Medicaid and Medicare and who suffered from many of the chronic health conditions that persist in the Black community, such as diabetes and obesity. Our health care system has failed Black Americans for centuries, and leading an organization on the frontlines of fighting to close the health equity gap is one of my proudest accomplishments. 

Black women are more than three times as likely to die from a pregnancy-related death than their white counterparts. What do you think needs to change (or start to happen) to improve health outcomes for Black mothers and their babies?

Deeply entrenched structural racism continues to have a direct, negative effect on the health of Black and Brown moms and babies. It’s not only structural racism in health care that fuels the health equity gaps and disparities, it’s deeply entrenched structural racism that has infected most systems in America, including housing, transportation, public safety, and class.

According to the CDC, 60 percent of maternal-related deaths are preventable and there are concrete, common-sense steps that can be taken that will begin to reverse course and improve health outcomes for Black moms and babies. We will continue to deliver Supportive Pregnancy Care programs, a form of group prenatal care; advance research that translates data and knowledge into solutions; amplify the voices of Black moms; and elevate all families with the knowledge needed to have safe, healthy, and supported pregnancies. Additionally, we will also continue to advocate for policies and legislation that protect moms and babies like the Black Maternal Health Momnibus Act of 2021, which is a series of 12 bills that is critical to filling the gaps in existing policies to improve health outcomes for Black moms by comprehensively addressing every dimension of the maternal health crisis in America.

We also must address, assess and remedy implicit and explicit biases to discontinue the cycles of discrimination within health care and improve patient-provider communications and treatment, and an implicit bias training program by March of Dimes provides education and resources to providers across the country to help professionals in the medical field recognize and remedy bias in health care. 

This does not have to be our reality and together, we can dismantle the systems that perpetuate health inequity. 

Black women encounter bias and discrimination in healthcare settings from providers, which contributes to a lack of quality care. Advocating for oneself is always difficult in an exam room but how would you advise expectant mothers, especially Black moms, to stand up for their needs and wishes?

The fact is that most women have babies in this country and do fine, but we also have some of the highest rates of women who don’t do fine and unfortunately, our current systems do very little to meet maternal health needs holistically and affordably. Women and people of color should not have to advocate for ourselves with our health care providers, but the reality is that it’s something we have to do. We are our best advocates and it’s absolutely critical that moms, moms-to-be, and families educate themselves throughout their pregnancy if they’re able to. 

We also need to radically reimagine what networks of support look like for moms and families. Advocates for care such as midwives, doulas, and lactation specialists have played extremely important roles in improving the maternal mortality crisis, especially among Black women. When we truly support women and provide them with access to supportive care, health outcomes are more positive; we must continue to advocate for supportive care to be accessible and affordable throughout pregnancy for all women, especially BIPOC women.

What advice would you give health care providers to make sure their teams are giving ALL women the best care? 

One of the many ways that March of Dimes has been fighting for the health of moms and babies is through implicit bias training in health care. The health care system must prioritize and require this training for health care providers. If we train health care workers from the beginning of their education, training, and practice, then we will be actively working to end systemic cycles of racism and discrimintaion.

March of Dimes provides implicit bias training for health care providers across the country to improve communications between providers and patients and improve the quality of care, with over 8,000 providers trained in 2020 alone. The American Hospital Association recognized this training as an important program with benefits to health care providers across the country to better identify and remedy implicit bias.

We know conversations around race and equity can be hard and uncomfortable, but we must engage in these conversations with sensitivity and care because every mom, every baby, every individual, deserves to have access to quality, affordable care regardless of their skin color. But implicit bias training is only one way that health care providers can strive to give all moms and people quality care, and is not enough alone to solve the deeply rooted issues of inequity and inequality within our health care system. 

How is March of Dimes supporting infant and maternal health during the pandemic? Have you had to change strategies at all? 

Our organization’s history is rooted in supporting vaccinations, globally and domestically. In fact, March of Dimes was the first organization to back the development of the first successful polio vaccination, a now eliminated disease in the U.S. Throughout the global pandemic and health care crisis we are in, March of Dimes has funded research around the COVID-19 vaccine to ensure that it is safe for pregnant and lactating people and we have focused on advocating for equitable access of the vaccine with communities of color.  We are pleased that the CDC, alongside the American College of Obstetricians and Gynecologists and the Society of Maternal-Fetal Medicine recommends that pregnant people be vaccinated against COVID-19 which can help protect you and your baby from contracting the disease.  

Many nonprofits, large and small, were faced with uncertainty because of the pandemic, and it required a bit of pivoting from our usual strategies in order to continue our work. We expanded our virtual engagement opportunities, held online supportive pregnancy group sessions, and supported over 50,000 families with the March of Dimes My NICU® Baby App. We transformed our March for Babies fundraiser to a virtual campaign called Step Up! where people counted steps, safely at home or wherever they could, by using smartphones or fitness watches while collecting donations for their steps. The funds raised during that campaign helped support research for COVID-19 treatments that are safe for pregnant and lactating moms, promote advocacy efforts to help families directly impacted by COVID-19 and provide resources and training for NICU doctors and nurses. The pandemic shed light on the wide-ranging impact of the health equity gap, and March of Dimes is continuing to save the lives of moms and babies even in the face of a global pandemic. 

What programs does March of Dimes offer to serve maternal and infant health needs? 

Because the maternal health equity gap is so complex, our work at March of Dimes is designed to have as much impact as possible by having a variety of programs that serve specific maternal and infant health care and needs. In addition to our implicit bias training mentioned above, we have a group prenatal care and education program, Supportive Pregnancy Care, to support parents-to-be through health literacy, health equity and social support. Additionally, we have a premier NICU Family Support™ program that offers family education, staff training on family-centered care, and support with partner hospitals across the country. To support research that drives the work we do, we have a grant program that works to fund research in maternal-child health to create appropriate interventions and solutions for maternal and infant health disparities.

As for improving access to care, I want to share that March of Dimes has partnered with global consumer goods company, Reckitt, and their Enfa portfolio of brands to launch Better Starts For All. The Better Starts for All initiative is increasing access to care in maternity care deserts through mobile health services, provider coalitions and virtual education. Families can get resources and learn more at BETTERSTARTSFORALL.COM

March of Dimes also works on several campaigns throughout the year to bring awareness to the maternal and infant health crisis and one of our leading campaigns is March for Babies: A Mother of a Movement™, which is a bold vision that lifts up communities for health equity and millions of Americans engage in this campaign every year to transform maternal and infant health. This is only some of the work we are doing, but I hope it gives you an idea of the multifaceted approach we take in our fight for the health of all moms and babies. You can also find out more about the work our incredible team is doing on our website, www.marchofdimes.org

Significant racial and ethnic disparities persist in rates of preterm birth, low birth weight and infant mortality for babies born in the United States. How is March of Dimes helping with this issue in the communities? 

At March of Dimes we are leading data analysis, research, public policy, and consumer education; we’re mobilizing action through national and local collaborations and encouraging advocacy for maternal health; and we’re delivering direct impact through various health programs and professional training. Our main goal at March of Dimes is to end preventable maternal health risks and death, and end preventable preterm birth and infant deaths so all moms are healthy and all babies are strong. 

The U.S. has the highest preterm birth rates for developed countries. Moreso, preterm birth rates follow other trends in maternal health in that women of color, especially Black, Brown, and Indigenous women, experience much higher rates than their White counterparts. Black babies are twice as likely as white babies to die in their first year of life due to birth defects and prematurity/low birth weight. These statistics highlight the true, complex nature of the racial inequities within our maternal care system that are embedded within every aspect of pregnancy—and that is exactly why we do the work we do to dismantle the systems that perpetuate the health equity gap.

This year’s report card will be released this fall as our researchers finalize the report. 

How can someone donate to the March of Dimes? Since it is a non-profit organization, have you seen any dramatic changes in funding since the pandemic? 

Thank you so much for asking. We are a nonprofit organization that relies on donations and funders, and these contributions help us protect moms, babies, and families by eliminating health care inequities and improving access to equitable care. To make a donation, you can visit www.marchofdimes.com/giving

Through the help of those who donated to our organization last year, we were able to provide critical medical supplies to health care workers providing over 5,000 meals for frontline workers and NICU families, almost 16,000 masks, 80+ tablets delivered to hospital partners, 225 breast pumps, over 2,000 NICU bags including essential supplies and over 450 blood pressure cuffs distributed to at-risk women. All of this was made possible through donors who believed in our cause enough to donate at an incredibly uncertain and difficult time and we are so grateful. 

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