Raising Awareness During Black Maternal Health Week with Dr. Larelle Bookhart
Black women are three times more likely to die from a pregnancy-related cause than White women. The Centers for Disease Control and Prevention report that multiple factors contribute to these racial disparities in maternal health, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias. What’s tragic is that more than 80% of all pregnancy-related deaths in the U.S. are preventable.
Black Maternal Health Week is recognized annually from April 11-17 to bring attention and action in improving maternal health outcomes for Black mothers and birthing persons across the country. To commemorate this week, we spoke with Dr. Larelle Bookhart, Assistant Professor in the UIC School of Public Health Division of Community Health Sciences about the work she’s doing to advance Black maternal health and what changes she would most like to see to improve health outcomes.
Dr. Bookhart commented on the importance of Black Maternal Health Week, sharing that Black mothers, Black birthing people, have the highest maternal mortality rate in the United States compared to other races and ethnicities. This week brings awareness to the work being done to support Black maternal health ranging from ensuring comprehensive insurance coverage to making sure that black birthing people are getting high quality care and that there is funding for research and programs, to thinking about the legislation that needs to be in place to support these needs.
“All of these things are important, but also important is that I am a Black momma and I'm doing this work. Given Black people’s history in this country, it's important to make sure that we don't continue to die unnecessarily, and that we're able to have healthy pregnancies.”
On January 28, 2017, Dr. Shalon Irving, an African American scientist and epidemiologist at the CDC, passed away from complications after giving birth to her daughter. In the wake of the decision to repeal Roe vs. Wade, Dr. Bookhart reflected on the tragedy of Dr. Irving’s death and emphasized the dual importance of focusing on women’s rights to not have a child if they so choose while also ensuring the right to parent our children in a safe and healthy environment, which requires that mothers are present.
“To lose one’s life during pregnancy or the postpartum period affects so many lives. [Dr. Irving] was an absolute scholar. Hers was a loss to the field of public health, but it was also a tragic loss for her child, who no longer has a mother, for her husband, who no longer has a wife, for her mother, who no longer has a daughter, and the community that surrounded her.”
Dr. Bookhart is a Registered Dietitian and an International Board Certified Lactation Consultant. Her areas of interest include nutritional risk factors (from pregnancy through early childhood) for adverse health outcomes and health care system factors that may reduce health disparities. She previously worked as a county-level director of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Halifax County, NC where she led and managed the program, while also providing direct nutrition services and counseling, breastfeeding counseling, and lactation management support.
“In my experience as a WIC director I helped people navigate some of those structural and social determinants of health. If a mother is worried about where she's staying, whether or not she's going have food to eat, and whether or not she's going be able to feed her child it makes it even harder for her to have a healthy pregnancy and post-partum period.”
Dr. Bookhart has conducted research at the national and local level, including both qualitative and quantitative analyses to understand how health care system policies and practices may modify breastfeeding outcomes, particularly among historically marginalized populations. In her work she advocates for breastfeeding to maximize associated health benefits to birthing persons and their children.
“Most of the incidences of maternal mortality occur during the postpartum period, so we want to make sure that mothers and birthing persons are supported during that transition and are able to meet their breastfeeding goals.”
When asked about what improvements she’d most like to see in Black maternal health, Dr. Bookhart emphasized advancement of policies tied to structural and social determinants of health such as affordable housing, insurance coverage, the labor market, and increasing support for diverse birthing and postpartum health care professionals. She is currently collaborating with doulas, specifically Black doulas, to develop a training to address the factors across the social ecological model which include what she calls “under the skin”, or individual level factors, and “above the skin”, which are factors related to the structural and social determinants of health such as structural racism and housing instability.
“My work is really a product of my participation in the UIC Bridge to Faculty Program combined with mentorship from Dr. Arden Handler, who's been very instrumental in advocating for postpartum Medicaid expansion in Illinois making sure that doula services are covered. Illinois is really a shining star in this country in terms of being progressive as it relates to so many of the policies that might affect maternal health”