Why doctors want Canada to collect better data on Black maternal health

A growing body of data on the increased risks black women in the UK and US face during pregnancy has highlighted the shortcomings of Canada’s color-blind approach to health care, according to black health experts and patients.

According to official figures, black women in the UK and the US are four times more likely to die during pregnancy or childbirth than white women. A UK study recently published in The Lancet found that black women are 40 percent more likely to have a miscarriage than white women. This demographic tracking is not available in Canada.

“We don’t have this data for our country. So it is difficult to know exactly what we are dealing with,” said Dr. Modupe Tunde-Byass, a Toronto Obstetrician-Gynecologist and President of Black Physicians of Canada. “We can only extrapolate from other countries.”

Black babies are more likely to be born prematurely in Canada

Tunde-Byass said one of the few race-based studies examining pregnancies in Canada, conducted by researchers at McGill University in 2016, showed that 8.9 percent of black women gave birth to premature babies (premature babies), compared with 5.9 Percent of their white counterparts.

Across all demographics, overall premature birth rates are lower in Canada than in the United States, where 12.7 percent of black women and 8 percent of white women are premature. However, the differences between the two populations are roughly the same, challenging the assumption that Canada’s universal health system would produce similar results for all women.

CLOCK | Canada lacks data on the health of black mothers, one expert says:

Dr. Modupe Tunde-Byass, a Toronto obstetrician-gynecologist and president of Black Physicians of Canada, says Canada is lacking critical race-based data on maternal health and this is affecting the care of Black Canadian women. 1:09

“We kind of live in this bubble where we don’t believe that there are inequalities within our health system, even more so” [because] Our health system is free and universal for everyone, “said Tunde-Byass, adding that knowledge gaps have contributed to” unconscious biases within the health system “.

For example, she said that black women tend to have shorter pregnancies and are at higher risk of having premature births. This means that health professionals should be prepared for their pain symptoms as they can be an indicator of labor.

Myths about black women and pain

However, Toronto-based midwife Shani Robertson said the opposite often happens. “There really is a myth that black women are less in pain than white women.”

She said that when a Black woman experiences pain, there may be a misunderstanding that she should be able to tolerate it. “This can mean that black women are offered less pain medication, sometimes not even being offered pain medication, depending on what they are experiencing, that their experiences are not believed,” Robertson said.

Black and racial Canadians have been particularly hard hit by the COVID-19 pandemic. (Evan Mitsui / CBC)

Health Canada documented the phenomenon in a 2001 report, Certain Equal Treatment and Responsiveness Circumstances in Accessing Healthcare in Canada, which found criticism from black communities for “Black women feel painful for health professionals performing routine procedures disregard during the birthing process ”. “Which” have been traced back to the belief of health professionals that black skin is ‘hard’.

Robertson led the misunderstanding to the racist legacy of the American doctor Dr. J. Marion Sims, who is considered the father of modern gynecology and who experimented on black slaves without anesthesia in the 19th century.

Robertson said collecting race and ethnicity data, among other details about birth registration, as is already the case in the US and UK, could help address health inequalities.

Growing awareness of the importance of race-based data during the COVID-19 pandemic has led the Canadian Institute for Health Information to propose national research standards on race and ethnicity to “understand patient diversity and measure inequalities.”

Recently, the Canadian Society of Obstetricians and Gynecologists recognized the presence of systemic racism in health care and inequitable health outcomes.

Invisible, neglected and disrespectful

Toronto-based Kimitra Ashman said she was ready to give birth before 40 weeks of gestation, a time frame more common among white women. But she said she was released even though black women often have shorter gestational periods.

It was later induced.

“I don’t think it would have ended in an emergency caesarean section if they’d listened to me when I was 37 weeks old and said, ‘My body feels right. My pelvis opens. What should I do?’ I was told, ‘Oh no, no, no, no, it’s too early. Put your feet up. ‘”

CLOCK | Inability of the AI ​​to recognize racist language:

Artificial intelligence is used for translation apps and other software. The problem is that technology is unable to distinguish between legitimate terms and those that might be biased or racist. 2:27

The emergency caesarean section left her with a keloid, a type of raised scar that is more common on black and dark skin that can sometimes be avoided with the right surgical technique.

“I think if her training had made her aware of the special needs of a black woman’s pregnancy, I think the situation would have been avoided,” she said.

Instead, she said she had no sensation for two years and had a “raised scar that is very painful”.

Ashman said these weren’t her only experiences with prejudice in the health system.

“It started when I came to check in and a nurse at the front desk rolled her eyes. It’s built in when you go to appointments and people assume you don’t have insurance. Suppose you have no education you’re a single mother.

“I felt invisible, neglected and disrespectful.”

Eliminating Racism in Canadian Healthcare

Ashman went to see a black doctor for her second pregnancy. “I felt good,” she said. “I felt understood.”

Tunde-Byass said that black women experience health care differently than other Canadians. “So these are things that we have to acknowledge that exist in the structure of our system … and then find a way to reduce racism.”

Part of the problem is that there are not enough black doctors in relation to the population.

Sister Jenthia and Dr. Angela Branche gives Natalie Hall a coronavirus survival kit to increase participation in vaccine studies in Rochester, NY on October 17, 2020 as part of a door-to-door education program to the black community. (Lindsay DeDario / Reuters)

A U.S. study of Florida birth registers showed high death rates among black babies – but rates were lower when patients had a black doctor.

Margaret Akuamoah-Boateng had no complications when she gave birth to her second child in the small community of Alliston, Ontario earlier this year.

But she admitted she was still concerned about being treated by all white hospital workers. “And I just thought, ‘I’m looking for someone who has experience with black people just because I feel good when the doctor is black, or his staff is black, or he has ever operated on black people.'”

Her doctor brought a black doctor with him. “He didn’t have to be there, but it was great … it’s like having a relative there,” said Akuamoah-Boateng.

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For more stories about the experiences of black Canadians – from racism against blacks to success stories within the black community – see Being Black in Canada, a CBC project that black Canadians can be proud of. You can read more stories here.

source https://dailyhealthynews.ca/why-doctors-want-canada-to-collect-better-data-on-black-maternal-health/