Tackling Pregnancy-related Disparities in Women of Color

Imagine you’re pregnant. You want the best care for yourself and your baby, but you’re afraid to place your trust in doctors. You’ve heard stories about women of color, such as yourself, feeling disempowered by white physicians. You don’t know where to turn for help and don’t know what resources are available to you. You wonder if your baby’s life, and perhaps your own, is at risk.

Generally in this scenario, the woman and her baby are at high risk for complications including death. According to the Ohio Department of Health, Black women in Ohio are two and a half times more likely to die from a pregnancy-related issue than white women. This is true not only during their pregnancy, but also for an entire year after delivery.

To help reduce this staggering risk, a group of Case Western Reserve University School of Medicine students, including a group from CCLCM, with leadership from a Cleveland Clinic physician, established the Minority Maternal Health Initiative. This student-driven project connects medical students with pregnant patients of minority backgrounds to assist them in navigating their pregnancy as well as connecting them with community resources to help them meet their needs.

The program was initially conceived by Stacey Jhaveri, MD, Clinical Assistant Professor in the OB-GYN & Reproductive Biology Department, Cydni Akesson (’24), Mehetabel Markwei, MD (’22), Maria Moncaliano (University Program, ’24) and Sokhna Seck (’24).

“Right now our primary focus is providing race-concordant care to populations who are pregnant. The current program we have running is the Navigator program where we pair medical students with a pregnant person who has been referred to the program who needs resources. The student navigator’s job is to check in with them every month of their pregnancy and be both an advocate for them and another connection to the healthcare system that marginalized populations need,” Cydni says.

The group worked together to complete tasks such as registering the Minority Maternal Health Initiative as a clinical elective for students to receive credit toward graduation; recruiting students; running a virtual orientation to review requirements with the students; creating a manual and a shared drive with helpful documents; and assigning and helping students with navigating patients.

Linda Gooden, BSN, RN, OB Clinical Navigator at the Women’s Health Institute, helped refer patients to the group and determined the role the student navigators would take with each patient.

Sokhna and Cydni had started addressing infant mortality in Cleveland during their first year at CCLCM because they both knew Cleveland has such stark health disparities, especially for Black pregnant people.

Maria’s involvement with the project started during her time as the community outreach liaison with the Student National Medical Association/Latino Medical Student Association (SNMA/LMSA). She had been searching for ways to get students involved in the community, and Cleveland Clinic doctors introduced her to the Women’s Health Institute. Maria and her group members invited local organizations dedicated to maternal minority health including Sokhna’s organization, Addressing Infant Mortality in Cleveland (AIM in Cleveland).

“We wanted to make a student organization that focused on educating medical students about these disparities. Originally we were just inviting guest speakers, and that’s really where my interest around the subject started to grow. I just kept thinking, ‘Why is this such a prevalent problem in Cleveland when we have three of the biggest hospitals and networks that are so tied together?’ It just seemed like there needed to be more attention brought to the issue,” Cydni says.

“A program that connects medical students and patients to guide them throughout their pregnancy, whether it be connecting them with resources or answering questions they have, would genuinely make an impact,” Sokhna says.

Thus far, 41 patients have been helped through the program.

One particular patient was matched with a student because of their similar background—they’re both Hispanic.

Over the course of the patient’s pregnancy, the student and patient bonded and developed quite a close relationship. The student navigator accompanied the patient to all her appointments, which gave the patient a much-needed sense of advocacy and support. The patient’s outcome was positive.

The Minority Maternal Health Initiative’s overall goals are to address maternal/infant mortality, address local social determinants of health, provide race- and language-concordant care, and increase awareness of minority maternal health. They hope to increase the number of student navigators in the program and, by doing so, increase the number of pregnant patients they can help.