For the Culture: Local midwife works to combat racial disparities in pregnancy mortality rates

Local News

TAMPA, Fla. (WFLA) – The only Hispanic-owned midwife practice in Hillsborough County is working to combat the racial disparities in childbirth care and pregnancy mortality rates.

“I was mistreated, I was abused, I was traumatized,” said Zul Ruiz. “The doctor came and broke my water, he didn’t ask me. He did the caesarian and he went home. I never saw him again.”

That’s how Ruiz remembers giving birth to her child. What she thought would be an exciting and memorable experience, ended up tainting her views on having babies inside hospitals.

“Then I started out finding race issues, how black women are dying at a higher rate than other races in childbirth,” Ruiz said.

Ruiz said she also witnesses biases within hospitals.

“There are a lot of things that are not done for the benefit of the mom because you are working at a high volume system,” she said. “Then there’s this thing that black women hold pain more and those are things that comes from ideas that come from slavery, so biases happen. Like they start treating her right away like she’s high risk, or they ignore her pain.”

Ruiz began to think of other ways women could give birth aside from inside a hospital.

“Through the years, I said this is not okay, there has to be another way,” she said.

Her experience, accompanied by her realization of race issues within the healthcare system, led her to become a midwife. According to the American College of Nurse-Midwives, a midwife is a trained healthcare professional that helps low-risk mothers before, during, and after pregnancy.

“With a midwife we are with the mom the whole pregnancy, she knows me,” Ruiz said.

A 2018 Center for Disease Control study refers to racial disparities in childbirth care as a “national problem.” The study cites implicit biases, history, or pre-existing conditions in women of color and lack of standardized protocols by hospital staff as some of the reasons there are racial disparities in pregnancy mortality rates.

According to the CDC, about 700 die in the United States each year as a result of pregnancy or complications. Women of color are two to three times more likely to die during pregnancy than white women.

Dr. William Sappenfield is the director of the Florida Perinatal Quality Collaborative. This organization researches maternal and child health issues. They also research issues relating to pregnancy mortality rates and the disparities associated with them.

“We have not gotten rid of the disparity but we have greatly reduced the disparity here in Florida,” Sappenfield said.

The organization gathers data from hospitals across the state to conduct research. Their research shows that in the last 10 years in Florida, the pregnancy mortality rate for Black women dropped from 47 percent to 30 percent. It dropped from 13 percent to seven percent for Hispanics.

Although the mortality rate is dropping in Florida, Sappenfield says there’s still a lot of work to be done.

“We need to make sure we listen to African-American women as we do to Latina women, as to Haitian women as to white women,” he said. “We need to make sure all women are in a high-quality system and that protocols are in place when red flags occur.”

Sappenfield says the decline in PMRs in Florida is due to health professional lowering hypertension deaths. Pre-existing conditions like hypertension and diabetes are more prevalent in Black and Hispanic women, according to Dr. Sappenfield. He says these conditions are what can lead to complications during pregnancies and even death. However, he still recommends that women give birth in hospitals whether low- or high-risk because complications can happen at any moment.

For women with low-risk pregnancies, there are several other options besides giving birth in a hospital. For example, at-home births.

As the owner of UMA Midwifery, Ruiz is the only Hispanic-owned midwife practice in Hillsborough County. She works with and monitors low-risk pregnant mothers throughout the entire pregnancy and delivers the babies at home.

“I feel more comfortable, more excited,” said Jonalee Santagama.

That’s the impact Ruiz has on one of her clients. Santagama is expecting her fifth child. Her first four children were born in hospitals.

“I went through some things in my first birth that caused me to have back issues,” Santagama said. “I felt like I wasn’t being listened to or heard even though I voiced my opinion.”

That’s why she and her husband turned to Ruiz to welcome their fifth bundle of joy.

As a Hispanic woman, Ruiz is able to connect with her minority clients in a closer way, and being bi-lingual she is able to connect with her Hispanic clients on a personal level.

“I’m not being judged by my ethnicity or my race,” Santagama said.

Ruiz says she respects and cares for all healthcare professionals, but with her practice, she wants to provide alternate options for low-risk pregnant mothers, all while building a bond and caring for her clients one delivery at a time.

“I want that they take charge of their health. Not just in pregnancy. I hope everything I’m teaching them stays with them over life,” Ruiz said.

For more information about UMA Midwifery, click here.

For more details on the FPQC, click here.

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