It’s time we talked about pregnancy and the impact COVID-19 has on women’s health and experiences, especially Black women. Did you know that Black women are at an increased risk for mortality in pregnancy? In her recently launched e-book, Black Maternal Mortality: Our Fight Back, Dr. Andrea Alexander not only discusses Black women’s risk profile but also the COVID-19 vaccination, and many maternal health topics. We caught up with the OB-GYN and Black maternal health advocate to discuss the inspiration behind her new book, what pregnant women should know during the time of the global pandemic, and much more!

Tell us about your recently launched e-book, Black Maternal Mortality: Our Fight Back.

In July of this year, a young lady by the name of Sha-Asia Washington passed away from an emergency c-section. Just with that along with turmoil that comes with being black in America in 2020 more specifically, I was pushed into action mode to do something. I feel like a lot of times now a days, we feel that it may posting hashtags and posts on social media is enough, I just felt like I was passed that point. I think awareness is important, but I wanted to put the work behind my word. I didn’t want to just post hashtags and mentioning names per say, I wanted to actually help my people. Being a Black OB-GYN with a passion for Black maternal health, I was kind of pushed into writing this book. That is kind of where the inspiration was from.

As an OB-GYN and Black Maternal Health Advocate, do you mind sharing tips on how to deal with the anxiety of Black maternal mortality?

This is something that I address in the book because Black trauma is very real. One of the things that I like to stress to people is that your feelings are valid, they are not made up. A lot of times, as Black women, we can feel like we’re making things up because we are sitting traumatized and trying to process seeing people who look like us. Our friends, sisters, and family die and everyone else is just living their life. When that happens, it kind of just feels like our feelings are invalid almost. I always stress that no, your feelings are valid first and foremost. Be gentle with yourself. I like to practice grounding exercises: five things you can see, four things you can feel, three things you can hear, two things you can smell, one thing you can taste. I like to do breathing exercises, where you take long slow breaths, pause at the top for two seconds, and exhale. As you’re exhaling, picture breathing out all of the negative energy and feelings that you have. Identify your triggers. I know for me; caffeine makes me feel anxious and so do hot rooms. Crowded areas, unclean rooms, those things make me very anxious. I try to minimize those triggers and it makes me feel a little more stress free. I encourage that as well. Join support groups. It is important because like I said, it makes your feelings more valid seeing that other people share the same feelings that you may have. Limit caffeine as much as you can, exercise, and getting enough sleep. If all those methods fail, then don’t be afraid to seek help from a therapist. I think a lot of times we put stigma on mental health but a part of being healthy as an individual is having a health mental stamina as well. If you need to see a therapist then I encourage patients to go, see a therapist.

Can you share why Black women are at increased risk for mortality in pregnancy?

There is not one answer specifically to this question. One of the things we’re seeing in research is that Black women have increased levels of homocysteine in their blood and decreased level of folic acid. A lot of that is secondary to the diet practices that we have in our community, which of course is passed down from racism, right? We were fed the foods with the least amount of nutrition. A lot of that is from our diet but being in America, we don’t have the healthiest food options available anyway. Of course, with systemic racism being present in women, infants, and children – we don’t have access to foods that are rich in folic acids to help decrease our homocysteine level. That is one of the things genetically. Socially, obviously we cannot negate the fact that institutionalized racism plays a huge role. That’s not just in medicine. Institutionalized racism plays every aspect of our American government. It affects education, the fact that there is not funding towards HBCUs, and trying to get Black children into colleges makes for less Black physicians. There was study that showed the more Black physicians that you have, the better care that Black and Brown patients will receive. Likely because there is lack of implicit bias. If we don’t have government funding in education, at some point we’ll see a decrease in the efficacy of quality of care given to our people. There is a lot of aspects that affect this trend specifically. With so many Black women going into entrepreneurship, we’re getting pregnant at later ages. Unfortunately, we’re older, sicker, and fatter but that certainly isn’t the only issue that contributes to increased mortality. There are other things that contribute to it as well.

What are some things pregnant women should know during their pregnancy in the time of the global pandemic?

In regard to COVID, the research has shown that pregnant women are not at increased risk at contracting the disease. If they do, they are at increased risk for severe illness -0 which means you being admitted to the hospital or you being admitted to the ICU. There is also increased risk for desaturation, needing to be placed on oxygen, mechanical ventilation. If you do have severe illness, you are at increased risk for mortality. I think they said you are at a threefold increased risk of severe illness and a 70% increased risk of mortality if you do have severe illness. That is the main thing that people should know. That is why we strongly encourage avoiding contracting the disease. Frequent handwashing, wearing your mask, and socially distancing are all things definitely help.

What are you currently working on and what can we expect to see from you in 2021?

Right now, I’m currently working on getting more information out on my book. I think that awareness and education is what will help us stabilize the Black maternal mortality rate. I’m planning on taking my boards in 2021, which is a lot earlier than I am supposed to but this is something that I really want to get under my belt so that I can start focusing on research on Black maternal health and things like that.

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All images courtesy of Dr. Andrea Alexander