First of all …
I completed 5 tasks before I actually sat down to write these words. None of those tasks were for me-they were tasks for my family. Now, it was my intention to dedicate the first hour of my day every day this week to brainstorm and to write what I feel are the most important points around this topic, but life has a way of sometimes-well, very often - shifting my priorities and intentions.
Work. Kids. Family. As a woman, especially a Black woman, I find myself prioritizing everyone and everything before myself. It is a learned behavior, maybe even an expectation- one that is perpetuated within our community and by society.
South Carolina, in particular, has trends that mirror those of the developing and underdeveloped world. Some have called it Third World America, with infant mortality and maternal deaths in our community no better than war-torn countries abroad.
Worst in health outcomes. Worst in care received. Worst in health disparities. No matter our education, income, or support system. Black women are dead last.
Interconception care is a big, long word, but the meaning is unbelievably simple: prioritizing the care of women before between and beyond pregnancy and postpartum. It’s a part of a larger concept referred to as health across the life span which begins in infancy and ends with older adults. Many women only receive regular routine care in and around pregnancy.
I’m not immune to the culture and expectations of motherhood within our community. I have worked in Public Health for over a decade. I have seen individuals neglect caring for their personal health and self-care needs, and I have adamantly advised against doing so. Yet, I haven’t been to a primary care doctor in three years (coincidentally, my daughter is three years old). Even though I am educated and informed about the importance of the risks associated with neglecting primary care more than most people, I’ve neglected care for myself. My reasons are similiar to those of many of the women I know.
The truth is, there are tons of areas where we in healthcare and systems could make an impact. For black women, who enter routine care mostly and around the time of conception, a shift toward a focus on interconception care in our health systems and practices could make a huge and lasting positive effect on our health outcomes.
Last year, during a particularly brutal flu season, I made sure that all of my kids, my parents, and my spouse received their vaccine. So of course I made an appointment to get mine, right? Nope. While in the store grocery shopping, the pharmacist stopped me and asked if I had received my flu shot. I could have gotten one right there on the spot. Accessible.
That’s the key, I believe, in turning the tide for black women and health outcomes. Removing the barriers and allowing access more broadly throughout the systems that serve us and caring for mothers during well-child visits, particularly those with a history of chronic disease could help us improve the status of Black women’s health and well-being. Doing this with intentionality and using other common-sense approaches will open up purposeful care for women and meet them where they are. Accessible.
I resisted the urge to throw data and stats in this essay, to shore up my points and provide evidence, but it’s all over the news almost on a weekly basis. The difficult truth is that addressing these issues of health outcomes are hard to tackle, especially from only one lens. Our health systems cannot do it alone, and neither can our community without true collaboration.
As black women, we are taught to be servant leaders in our communities, at home, where we worship, and within our professions. I hope reading this reflection will encourage more people to advocate for more accessible care and to recognize the many responsibilities, experiences, and barriers that often result in Black women not receiving the care they need and deserve.
Maudra Brown, MPH CHES APM PHAM
Mother of Three. Wife. Southern Roots. Worldwide Perspective.