How to advocate for yourself at the doctor

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In recent years, it has become increasingly evident that Black mothers face significant disparities in their access to and quality of health care.

A 2021 Centers for Disease Control and Prevention report showed that Black pregnant women die at rates two to three times higher than their white counterparts. Additionally, they are more likely to experience pregnancy and birth complications such as preterm birth, preeclampsia and postpartum hemorrhage.

“When a Black birthing person comes to seek care, it’s very likely they’ve had an experience in the past where their concerns were not addressed, their pain was dismissed and their needs were not met,” says labor and delivery nurse Kate Novotny, RN, BSN, RNC-OB.

Establishing a trusting relationship with a provider can help improve outcomes and mitigate trauma that Black women may have from previous medical experiences or generational trauma they may carry, says labor and delivery nurse Jessica McGhee, RN, BSN.

“It all starts with that first prenatal visit,” McGhee says. “If the trust is built from there with their provider, it’s more likely they will have a better outcome or experience.”

McGhee and Novotny share tips to help Black women receive the compassionate, responsive and ethical care they deserve.

1. Know your rights

Black women deserve to be treated with dignity and respect in every health care encounter. As a patient, you have the right to:

  • Ask questions.
  • Voice concerns.
  • Actively participate in decision-making regarding your health care.
  • Pause to take time to consider options.

2. Be an active participant

During medical appointments, ask questions, seek clarification and engage in shared decision-making with your health care providers. Remember, you are an expert on your own body and have a say in your health care decisions.

The B.R.A.I.N. tool can serve as a helpful framework for making informed health care choices. When faced with decisions, ask the following questions:

  • B – What is the benefit of this course of action?
  • R – What are the risks associated with this option?
  • A – Are there any alternatives available?
  • I – What does your intuition say about this choice?
  • N – What are the potential consequences if you decide to do nothing?

3. Build a support network

Seek support from individuals who understand and empathize with your experiences. Some helpful local resources include:

4. Seek culturally competent care

When selecting health care providers, prioritize those who have experience addressing the unique health care needs of Black women. Seek recommendations from trusted sources to find health care professionals who will provide compassionate and responsive care.

Committed to change

To address the systemic issues that have impacted Black mothers and babies, Nebraska Medicine is building an ecosystem of support through partnerships and initiatives.

McGhee helps train Black doulas through the Doula Passage Program, sponsored by I Be Black Girl, and offers childbirth education classes to expecting mothers.

“As a maternal nurse advocate, I want to provide quality education that begins in early pregnancy and extends into postpartum,” McGhee says. “I want these women to be informed and empowered during their birth journey.”

Novotny is part of the Nebraska Medicine chapter of the Birth Equity Initiative through the Nebraska Perinatal Quality Improvement Collaborative. As a member of the Labor and Delivery leadership team, she also provides continuing education on the importance of anti-racist maternal health care.

“In 2024, it’s not enough for a health care provider to treat all their patients the same – it’s our responsibility to know that the health care system has historically placed Black birthing people at greater risk,” she says. “It’s our responsibility to work harder to offset those risks.”

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