validation for the patient to make sure that the right steps are being taken and that she is receiving the same level of care as all other postpartum women?
Certainly, a checklist alone would not be enough to protect the life of the black mother. A checklist will not sensitize our lawmakers to value her life and pass laws that provide affordable and adequate healthcare to all women. A checklist will not keep rural maternity wards open. A checklist will not eliminate unplanned pregnancies. A checklist will erase pre-pregnancy conditions, such as high blood pressure, diabetes, and obesity. A checklist will not eradicate poverty. A checklist will not provide the patient with a pregnancy support system. A checklist will not erase explicit or implicit bias in medicine. A checklist will not mentor more physicians of color. A checklist will not replace the art of medicine—if it did, robots could be physicians.
The list of what a checklist cannot do is extensive. Still, the added level of information and heightened alertness gained from the use of a checklist may empower the black mother to ask the necessary questions, seek allies, and escalate care when necessary. Moreover, it may help ensure some equity of care for all postpartum women.
Checklists might be essential tools in the struggle to achieve health care equity when basic standards of care are applied to every patient, every time, with the goal of decreasing errors and harmful events. As we redesign how we care for mothers in the postpartum period, a patient-centered checklist may be a vital tool to lowering black maternal mortality.
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I am hopeful that we will come up with novel and perhaps, unconventional solutions to the problem of black maternal mortality. Yet, we may be able to use some of the already working tools to save the life of a black mother. Undoubtedly, the search for solutions will be an expensive and time-consuming endeavor. But, isn’t the life of the black mother worth the investment?
Veronica Maria Pimentel, MD is a Maternal-Fetal Medicine Specialist in Hartford, CT working with a diverse patient population, including the inner city black and immigrant community. She is also an Assistant Professor of OBGYN at the University of CT School of Medicine.
