Host Keesha Ward opened the 2024 My City My Health Conference with a request from the audience: Don’t just write down what you learn here today. Commit to taking at least one action to improve health equity.
Health equity was the entire ethos of the My City My Health conference, which was founded in 2021 by health coach, advocate and podcast host Corey Dion Lewis and recruitment leader Larry Twitter Jr. The conference began with the goal of shifting health care to become more community- and equity-oriented.
The third iteration of the conference, on Nov. 15, began with a panel on Black maternal health. Jodi Long of KCCI interviewed Dr. Wanakee Carr, an obstetrician-gynecologist with the Iowa Clinic in Des Moines, about how the community can address disparities in Black maternal health.
Carr was born and raised in Des Moines and received her undergraduate and medical degrees at the University of Iowa. She’s also the only Black OB-GYN practicing in Des Moines, a title that means a lot to her — especially as she cares for Black women and mothers.
Here are five action items from the panel.
Start preparing for pregnancy and motherhood before you become pregnant
A 2020 report found that Black mothers in Iowa are six times more likely to die than white mothers. Carr encouraged Black mothers to protect themselves through preconception visits. These appointments can reveal potential risk factors and help prevent health issues during and after pregnancy.
“See your primary care provider or OB-GYN so you can have a little bit of an idea of what to expect throughout your pregnancy and postpartum course,” Carr said. “Optimizing your health prior to being pregnant is key to reducing those adverse outcomes.”
Be proactive about your health care
Early detection of potential health issues often prevents even worse outcomes down the line, Carr explained. A yearly visit with your primary care physician or gynecologist ensures someone is monitoring your health status closely and noting when things change.
Carr emphasized the importance of asking questions to stay informed of your health at these appointments, and she suggests finding a doctor you trust and feel comfortable with.
Know your resources
Studies from the National Institute of Health reveal that Black mothers tend to have lower rates of breastfeeding than other ethnic groups. Carr believes that Black mothers are often not given the support needed to successfully breastfeed, especially if they struggle with breastfeeding in the first few days of postpartum.
Knowing your resources for support can ease the struggles you might face after giving birth. For example, insurance companies often cover breast pumps. The Iowa Black Doula Collective helps Black mothers access doula support and offers support groups for navigating parenthood.
Help others find resources
Many Iowans live in health care deserts, especially in rural Iowa. Long wait times and insurance requirements can make it difficult to schedule doctor’s appointments, and many people of color feel weary with doctors who don’t understand their cultural backgrounds. Carr encouraged attendees to help family and friends research what care is available in their communities, as well as reaching out to organizations like Black Women for Healthy Living, who connect women with providers.
Support young people’s interest in medicine
Since 2000, at least 41 birthing units have closed in Iowa, especially in rural areas. Restrictions on reproductive health have caused many OB-GYNs to leave and students to pull their residency applications for fear of being unable to learn the full scope of care. Iowa’s OB-GYNs have an overloaded patient list and it often takes months to be seen as a result.
The key to counteracting this trend lies in encouraging young people to get into medicine, Carr said.
“I’m here because I knew I wanted to be a doctor early on,” she explained. “Get our young kids educated and interested in science with elementary and middle school programs that foster interest in health care. Then, support these kids while they’re in college. Financial aid is key.”
Advocate for legislation that supports reproductive health in Iowa
Lawmakers continue to debate legislation around reproductive health care both in Iowa and around the country. Carr encouraged attendees to talk with their legislators about the importance of reproductive health care for all women.
“We need to make sure we keep access to contraception,” Carr said. “Vocalize to your legislators on how important it is and how it saves lives. People think contraception is just to prevent pregnancy. But contraception saves lives, and we use it for a whole bunch of other stuff besides pregnancy.”
As the new legislative session in Iowa begins in January, Carr will also be watching laws around Medicare and Medicaid coverage. She explained that reimbursement rates need to be commensurate with private insurances so providers can afford to care for patients with state insurance.
“We’ll continue to advocate to make sure we’re expanding access,” she said.
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