A Hard labor: How Diosa Ara is Challenging Racial Disparities in Maternal Care

Certain stories embed themselves into our consciousness, stark reminders of instances when the system has starkly failed a patient. One such incident unfolded during my third year of residency, on a weekend call I won't forget. Navigating through the quiet hallways of the antepartum unit, fatigued yet steadfast, I was ready to meet my patients for the day.

First on my list was Gabrielle - a pseudonym to maintain her privacy. Gabrielle is a young Haitian-American woman who was 23 weeks into her first pregnancy. Her pregnancy has been complicated by a multi-fibroid¹ uterus; its largest fibroid, an alarming 14cm. Fibroids disproportionately affect Black women, who are not only more likely to develop them, but also tend to experience them at a younger age, have larger and a higher number of fibroids, and suffer more severe symptoms.

Her diagnosis, degenerating fibroids, had already led to three hospital visits due to unbearable abdominal pain. Such a condition calls for hospitalization, not just to manage the distress but also due to the elevated risk of preterm labor. Yet, amidst these clinical complications, a silent, frequently overlooked bias was at play.

Racial disparities in healthcare emerged in Gabrielle's journey. Research indicates that the pain of black women may be underappreciated by medical professionals, casting a worrisome cloud over Gabrielle's experience. Her advancing labor – the true root of her suffering – went unnoticed.

Upon entering Gabrielle's room, the truth struck me immediately - she was in labor. Why wasn't she on the labor floor, where appropriate care could be offered to potentially delay labor and prepare her baby for premature delivery? Instead, she was caught in a cycle of continual pain medication, bringing no relief.

My examination confirmed my concern. At 5cm dilated; Gabrielle was in active labor. In a system operating as it should, this would have led to key interventions that could have made a difference in her and her baby’s health. Yet all these opportunities were missed.

Gabrielle gave birth later that day; her experience marred by the painful complication of a retained placenta.²

¹ Fibroids are non-cancerous growths that develop in or around the uterus, the womb where a baby grows when a woman is pregnant. They're also known as uterine fibroids or leiomyomas. ² A retained placenta is a condition that occurs when all or part of the placenta (the organ that nourishes the baby in the womb) remains in the uterus after childbirth. If the placenta isn't fully expelled within this timeframe, it can lead to serious complications such as severe bleeding (postpartum hemorrhage) or Throughout the day, as I cared for Gabrielle, one question nagged at me: How did the experienced medical team overlook the signs of her progressing labor? She wasn't hysterical, but she did display signs of distress: the pain etched on her face, her body's gradual movement up the bed to escape the torment – they were all unmistakable signs of labor.

Had English been her first language, or had her displays of pain been more expressive and "American", would her suffering have been acknowledged earlier? This is the subtle yet insidious nature of racism in healthcare. It isn't always about overtly malicious actions; it's the overlooked biases that cause us to miss the suffering of those who don't look like us.

Every day, we are used to ignoring suffering: the weariness in the eyes of the overworked cashier, the homeless mother with her two kids on the street, the receptionist hiding a black eye. This culture of selective blindness seeps into healthcare, leading to disparities that disproportionately affect communities of color.

Yet, should we be surprised? We live in segregated cities, send our children to segregated schools, and structure our lives to avoid confronting our biases. Is it then surprising that medical training alone isn't enough to overcome these prejudices that persistently intrude upon every facet of life?

As I was growing up, I started to understand that we inhabit a country where quality healthcare is more of a luxury than a right. I observed stark disparities in healthcare, particularly for women who had to endure them, which was both alarming and inspiring. As a Black woman, I experienced firsthand the challenges and systemic biases deeply embedded within the healthcare system. The underrepresentation of Black women in healthcare professions was also evident, and I recognized the transformative potential that representation could offer to the trust and comfort of patients. These experiences and insights didn't merely guide me towards a career in medicine, but ignited a passion within me. This passion is a profound desire to alter the narrative for women's health, particularly for Black women and those in marginalized communities.

The guiding principle behind Diosa Ara was borne from my vision: to establish an organization that acts as a beacon of hope and an agent of change in women's healthcare. Diosa Ara situated itself at the intersection of policy, education, and direct healthcare services, championing the rights of all women, with a special emphasis on Black women who have been disproportionately impacted by healthcare disparities. Every service we deliver and every policy we confront are grounded in my personal experiences and fueled by the imperative for systemic change.

Our mission is to use science and evidence-based medicine to empower patients, increase equitable care, and improve obstetrical and gynecological outcomes and experiences, with a infection. Treatment for a retained placenta often involves a medical procedure under anesthesia to manually remove the remaining placental tissue. Particular focus on improving outcomes for Black women and other women of color who are marginalized in the US healthcare system.

As a member of our shared community, you should be deeply invested in the mission of Diosa Ara. Here's why: Our approach to women's healthcare, particularly maternal health, is not only unique but also direly necessary in the current medical landscape. We prioritize personalized counseling, the provision of educational materials, and consistent support throughout pregnancy, tailored to each patient's specific risk factors. Moreover, we are at the forefront of managing obstetrical emergencies, providing 24/7 support in these critical moments.

What sets Diosa Ara apart from other entities in the maternal care sector is our concentrated focus on tackling what we believe to be the primary driver of these disparities - systemic racism within the medical field. We have formulated an approach directly aimed at addressing this issue. Since racism fundamentally manifests as an imbalance in power dynamics, we strive to equip our patients with tools explicitly created to rebalance this power dichotomy.

We realize that the negative maternal outcomes frequently arise from the prejudice experienced during the point of care, especially in emergency scenarios. Patients often find themselves vulnerable, with minimal opportunities to assert their needs or rights. To counter this, Diosa Ara ensures 24/7 support during emergency care, serving as an additional line of defense for our patients, ready to intervene when we identify significant deviations from standard care protocols. Our practices are grounded in evidence-based medicine and the latest practice guidelines, all designed to safeguard the standard of care.

By engaging with Diosa Ara, you don't merely grasp the systemic problems we are tackling; you become an integral part of the solution. By choosing our concierge medical and consulting services, you are making a direct contribution to the transformation of women's healthcare, with a particular emphasis on improving maternal outcomes for Black women and those in marginalized communities.

Your involvement has an immense ripple effect. The selection of Diosa Ara's services allows us to continue our work in rectifying power imbalances and combating systemic racism within healthcare. By leveraging our offerings, you're effectively partnering with us to ensure that high-quality, person-centered care becomes universally accessible.

Each client that joins us amplifies our ability to execute our mission. This is more than just a healthcare service – it's an opportunity to stand for justice, equity, and superior healthcare standards. In doing so, you are proactively participating in the advancement of a more fair and inclusive healthcare system.

As we come to a close, we would like to invite you to join us in this crucial endeavor. Choose Diosa Ara for your healthcare needs, engage with our concierge medical and consulting services, and become an active participant in reshaping the narrative of women's health. Your involvement is not only a commitment to your health but also a powerful contribution to our mission.

However, this isn't just about signing up for a service. We encourage you to amplify our mission's reach by sharing our story, telling others about the impactful work we do at Diosa Ara. You have the power to influence the trajectory of healthcare in our communities by spreading awareness and promoting informed discussions.

In closing, we invite you to contemplate this: In a world where healthcare equity is the standard, how different would our communities look? What could we achieve together when access to high-quality healthcare is not a privilege, but a basic right? Envision this future with us, for it is the guiding light that informs the path of Diosa Ara. As we stride forward, we carry with us a profound hope - a future where every woman, regardless of her background, enjoys the quality care she rightfully deserves. And with your involvement, we inch closer to turning this hope into reality every day.