Editorial: Equity in maternal healthcare

Unconscious bias is a bias that exists but is not consciously held or recognized. When unconscious racial bias manifests itself in medical settings, it can have life-or-death consequences.

Virginia recently expanded Medicaid coverage for postpartum care to 12 months, created Medicaid prenatal coverage for immigrant mothers, created a Medicaid doula benefit, and codified a maternal mortality review team. has advanced initiatives to improve maternal health outcomes. Despite progress, health disparities persist for pregnant people in Virginia.

There is growing evidence that racism throughout the U.S. health care system is a major cause of disparities in maternal mortality. According to a poll by the Commonwealth Fund, 55% of healthcare workers report witnessing racism impacting the quality of patient care.

A Lynchburg-area doula who supports women of color during childbirth shared her own experience, noting that Black patients often share that their doctors ignore their birth plans. She said: “I go to the hospital, but I don’t always claim to be a doula,” she says, when she finally pulls out a notepad to indicate that she is a doula. . …You can see the attitude of everyone in the room changing and the care changing. She said that in the Lynchburg area, “most of the medical staff that we work with are white men.” She reiterated, “I shouldn’t need to be there for them to treat my clients a certain way.”

Although unconscious bias cannot be eliminated, it can improve the quality of care in medical settings. HB1130 (Representative Hayes) and SB35 (Senator Locke) require licensed medical professionals to take evidence-based Unconscious Bias training. This training is part of a larger tapestry of policy changes that will enable all mothers to safely deliver healthy babies.