different ranks and specialties; for example, it may empower a junior physician or a nurse to remind the leading physician of a particular step he or she may have forgotten or overlooked under a stressful condition. Detecting and verbalizing such oversight may make all of the difference in saving the life of a mother and her baby.
Pregnancy frequently is a time of immense joy for the mother and her family. Still, pregnancy is one of the most stressful times in a woman’s life. Undoubtedly physical, stress is often emotional, financial and even spiritual. Black women, in particular, experience a disparate burden of socioeconomic and racial stressors, which are often heightened during pregnancy. We still do not fully understand the negative impact that stress has on the life of the mother and fetus. But, we do know that stress is a major risk factor for preterm birth. Stress may partly explain why black mothers have worse pregnancy outcomes than white mothers.
This disparity in pregnancy outcomes is in and on itself a potential source of stress for some expectant black mothers. I recall a patient who upon learning that she was carrying a boy became overwhelmed with joy soon followed by fear. She spoke of the triple risk of attack on the life of a black man in America, an unfortunate and unjust problem that her unborn child was at risk of enduring.
She confessed, “I have to worry about getting preeclampsia and delivering him early. I also have to worry that he is twice as likely to die after birth compared to a white baby. And then, as a young man, he will likely be perceived as a threat to a society who will see his life to be as valuable as that of a white kid.” Her words made my heart jolt with empathy and with frustration because we have so much work to do in our society to make sure that indeed all humans are created equal.
Unfortunately, a checklist will not add social capital to the life of her unborn child or to her own life. Still, if a checklist can help a pilot safely land an airplane and an obstetrician safely stop a hemorrhaging uterus, is it likely that a postpartum checklist will help healthcare providers take the symptoms of a black mother more seriously, quickly diagnose problems, and save her life? What if this checklist were to be shared directly with the patient during her postpartum visit? Could this checklist serve as