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Imagine Birthing While Black Without Bias

Kira Johnson. 

Amber Rose Isaacs. Sha-Asia Washington. 

Denise Williams. Sabrina DeLaRosa. Jenayah Nelums.

Dr. Chaniece Wallace. Shamony Gibson.  

Yolanda Kadima.

These are just a few of the beloved Black mothers who have died in recent years during or after pregnancy or childbirth. In the United States, Black women are two to three times more likely to lose their own life while bringing life into the world. According to the CDC, almost two-thirds of pregnancy-related deaths are preventable. 

These mothers, who are precious resources to their families and communities, deserve to be here with us, living their lives and raising their children. 

Instead, the U.S. continues to be mired in an unconscionable Black maternal mortality and morbidity crisis. To truly address it beyond mere lip service, it will require an important conversation about racism and bias as a critical root cause of this inequity. 

Black maternal health disparities: explained

The evidence is clear. Bias in health care is pervasive and deadly.

Current solutions, such as anti-bias trainings, just aren’t working. There’s been zero accountability and, instead of transparency, we have too many hospitals and providers taking a “train and pray” or “tick the box” approach. 

Meanwhile, other efforts — such as maternal mortality review (MMRs) boards — attempt to analyze the problem after a death has occurred. 

Why do Black women have to die before the nuances and inadequacies of our care are analyzed? Why try to solve this issue from the grave?

A solution to a preventable problem

I say, let’s learn from living. 

I created Irth (as in Birth, but we dropped the B for bias) as the first-of-its kind review and recommendation engine for Black and Brown parents to find and leave reviews of their OB-GYNs, birthing hospitals and pediatricians. 

Irth is a nonprofit, grant-funded platform that makes our experiences of care public to leverage consumer forces to drive transparency and accountability. 

In fact, in our theory of change for Black maternal health care, hospitals and providers understand they are ultimately accountable to the communities they serve and that any federal, state, or local evaluation of quality or funding is centered on robust community feedback.  

On the front end, Irth empowers Black and Brown parents with crowd-sourced, peer reviews to see where other people like them reported receiving good care and where they did not. 

Our structured review process asks key questions identifying what makes a quality experience for a Black or Brown person as well as naming the specific provider behaviors that cause harm. 

Currently, the top negative experiences being reported by Irth users are:

  • My requests for help were refused or ignored 
  • I was yelled at, scolded, or threatened 
  • My pain levels were dismissed 
  • My physical privacy was violated

In fact, nearly 40% of Black Irth users say their requests for help were refused or ignored—making it the number one negative experience currently reported in the app. There are also frequent reports about stereotyping Black men and, among Latinx women, assumptions about English proficiency. 

There is a lot of work to do. And it won’t just be “trained” away. 

Data can help us improve Black women's maternal health

Any transformational systemic change is led by data. Similarly, data will be the lifeblood of the transformation of the healthcare system to a more equitable one. 

That’s why we turn Irth’s structured, qualitative reviews into quantitative data and use our Black patient experience database to work closely with hospitals, payers, and providers to inform how to deliver more respectful and equitable maternal and infant care to Black people. 

Irth’s data helps reveal patterns and blind spots in their own efforts to counter bias. The data also creates an accountability mechanism, while informing more strategic, laser-focused adjustments in care. 

This is Irth’s greatest power — that by harnessing the collective patient experiences of Black parents into data and then actionable strategies, we can drive equity and accountability. 

Why it’s time to believe Black women

We can’t build an anti-racist maternity system without centering the lived experience of those currently most burdened by the problem. 

They are the true experts. 

However, as long as health systems continue to go without a continuous mechanism for community feedback that is independent and from a trusted source, Black parents will be disproportionately denied their birthright to safe, respectful, and joyful birth experiences. 

Hospitals are starting to pay attention. 

In our hospital pilot in Detroit, Michigan, we’re learning how to turn Irth’s feedback into a community-centered quality improvement plan. 

Pilot projects with hospital partners in Philadelphia, Los Angeles and Louisiana are in development. We were honored to be included in the White House press release of partnerships and commitments when Vice President Kamala Harris announced the first-ever White House Maternal Health Day of Action

Irth was mentioned as part of our exciting partnership with the March of Dimes and its MaternalCARE work with the Department of Health and Human Services, where Irth will be used as part of the initiative’s community feedback mechanism. 

This month, the Apple App Store profiled my founder journey for Black History Month, and Irth was featured as an App of the Day. A recent piece by HP Garage, a MIT Solve sponsor, highlighted our work — along with others — building technology platforms to address Black maternal health. 

We are honored our work is receiving media attention. 

Health systems have a responsibility to ensure Black parents do more than just survive a birth — they deserve to thrive and have a five-star experience. This is their birthright and their human right. 

Irth is working to make that a reality. 

Kimberly Seals Allers is a maternal and infant health strategist and founder of Irth. An award-winning journalist, former senior editor at Essence magazine, and author of five books, Kimberly also hosts Birthright, a podcast about joy and healing in Black birth. Follow @iamKSealsAllers and @theIrthApp on Twitter, Instagram and Facebook to learn more.

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