In North Carolina, Exemplary Maternal Care Benefits Black Patients
- Sabrina McCrear
- Aug 28, 2024
- 3 min read
Updated: Nov 29, 2024
State possesses 7 of 26 high-performing maternity hospitals with excellent outcomes for Black patients.
North Carolina had more hospitals than any other state to achieve a recent designation reflecting excellent outcomes for Black maternity patients, according to data analyzed by U.S. News & World Report. Earlier this year, seven North Carolina hospitals – Atrium Health Pineville, Novant Health Forsyth and Matthews medical centers, UNC Rex Hospital, WakeMed Cary Hospital and WakeMed Raleigh Campus – were honored during Black Maternal Health Week for their exemplary efforts to bridge health disparities and provide the highest quality of care. They were among 26 hospitals nationwide that U.S. News designated as Best Hospitals for Maternity Care and that also attained certain performance benchmarks for Black maternity patients.
“We're dedicated to dismantling disparities, ensuring every woman receives the quality care and support she deserves during birth and well beyond,” said Kinneil Coltman, executive vice president and chief community and social impact officer for Advocate Health Network—under which Atrium Health is managed.
According to data collected by U.S. News from nearly 700 hospitals nationwide, nearly a third of Black patients' births are delivered via C-section. However, the primary factor of high procedure rates remains undetermined. Studies suggest this may be a result of maternal complications or the preference of the patient and/or physician.
Dr. Louise Marie Roth, a sociologist and professor at the University of Arizona, was jarred by the results of a study she worked on two decades ago that examined predictors of Cesarean birth. “There was this really dramatic racial disparity,” she said.
According to the study, minorities' access to healthcare and socioeconomic status are strong predictors for pregnancy-related health risks that often require medically necessary C-sections, which could potentially lead to negative outcomes.
“[C-sections] are associated with worse maternal outcomes. It's associated with a fourfold higher risk of maternal death, and also a lot more complications that make it harder in the next pregnancy,” said Dr. Roth.
On the other hand, research also suggests that physicians are more likely to suggest and perform medically unnecessary C-sections based on their schedules or financial incentives from insurance providers and hospitals.
“There are hospitals where every doctor is in private practice, and they have to attend the births of their own patients in order to get their full reimbursement in those hospitals, they induce almost everyone and they have very high C-section rates,” said Dr. Roth. “And then if the induction doesn't go well, or it doesn't go fast enough, then they'll do a C-section.”
Although UNC Rex only has private physicians in their obstetric and gynecology department, the hospital’s C-section rate in low-risk, first-time Black mothers is 22.9 percent, about a quarter lower than the 30.7 percent national average seen in U.S. News data on such Black mothers.
“We don't leave,” said Dr. Tanneisha S. Barlow, UNC Rex Hospital’s chair of the department of obstetrics and gynecology. “We remain at the hospital throughout the entire duration of the patient's labor. We are present so if things go wrong we can move quickly.”
Additionally, their unexpected newborn complication rate is more than half that of the national average.
“My goal is to protect that mom and that baby because I actually have two patients, [and] I'm going to do whatever I can to make sure that they both go home,” said Dr. Barlow.
As a Black OB/GYN, Dr. Barlow is proud of her diverse staff. Her team includes two African-American physicians, an Asian and Hispanic physician, and two, white female physicians. She said, “This diversity plays a positive role as women often seek out physicians who share their backgrounds.”
Research shows Black women are more likely to seek out a Black OB/GYN due to experiences of discrimination and receiving low-quality care from physicians of a different background.
“There's a certain invisibility, I think, that just black women have in general, especially to white male physicians,” said Dr. Arianna Sholes-Douglas, OB/GYN and integrative women’s health and wellness specialist.
When she became ill as an attending in her own hospital she said, “I still don't feel like I had a voice or that people listened and truly saw me.”
Yet, at Atrium Health-Pineville Medical Center, the hospital’s C-section rate in low-risk, first-time Black mothers is 23.4 percent.
These North Carolina hospitals’ primary goal is to ensure they inform women of all of their options and give them the necessary support to make educated decisions about their bodies and children.
“We are constantly striving to develop the best comprehensive women’s health program focused on equitable care for women at all life stages – especially in our underserved communities,” said Dr. Katie Borders, senior medical director for the women’s care service line at Atrium Health.
