Bettering Black Maternal Health Outcomes: UR Nursing Alumna Dr. Kamila Barnes Discusses Nurses’ Role
By Gianluca D'Elia
Friday, April 12, 2024
Kamila Barnes ’11N (MS) ’13N (DNP) has seen the dangers of Black maternal health inequity firsthand in her work as a family nurse practitioner.
Dr. Barnes, the founder and owner of Barnes Health Affiliates, LLC, remembers seeing a patient who’d recently delivered her baby through a cesarean section surgery and noticed uneven bumps on her C-section scar. A different provider had told the woman that her experience was normal. But Barnes found that it wasn't that simple: an abscess was pushing through the wound.
“This was someone who could have developed sepsis, which could lead to death,” said Barnes, who is chair of the National Black Nurses Association’s Black Maternal Health Task Force and an associate professor of nursing at Hofstra University.
Situations like this are a difficult reality for many Black parents. In the U.S., Black women are more than twice as likely to experience severe pregnancy-related complications, and nearly three times more likely to die.
Research has shown that the legacy of racist policies in the U.S. continues to impact maternal health today. Public health researchers here at the University of Rochester Medical Center, for example, found that redlining policies of the 1930s and 40s — which effectively trapped people of color in low-income and segregated neighborhoods and denied them the ability to build intergenerational wealth — are associated with worse outcomes in pregnancy and childbirth among Black women today.
Every April, Black Maternal Health Week seeks to promote awareness and activism, and to amplify the voices, perspectives, and lived experiences of Black mothers and birthing people. Racial disparities in maternal health are intertwined with structural racism dating back to slavery, as well as implicit biases that continue to affect our interactions in health care settings today.
Barnes is a maternal health advocate who has worked to reduce maternal-child health disparities through her clinical, scholarly, and community service work. An alumna of the School of Nursing’s DNP program, her scholarly project focused on addressing health disparities among Rochester’s teen parent population.
In honor of Black Maternal Health Week, she shared her expertise and insights on how nurses are uniquely positioned to improve Black maternal health outcomes:
What are some of the most pressing factors that impact Black maternal health today?
One of the major issues is us Black women not being heard. When you read articles about Black maternal health, there are often anecdotes from family members and partners that say, “She complained of unusual leg swelling and pain, and was told that it's just how pregnancy is.” You read cases where they go to the doctor with bad headaches and vision changes, and they’re told, “Oh, you're just pregnant,” or “you're just anxious.”
Everything is also connected historically. It is well-documented that Black people were once deemed to not feel pain or experience symptoms in the same way as white folks, and we were deemed to have thicker skins. There has been an attitude toward Black women to not take our symptoms seriously, and that leads to mortality.
What guided you toward your own interest in maternal health advocacy?
I started my nursing career on a med-surg floor, working with a general population. When I decided to go back to school, I was trying to decide what to focus on, and I thought, “What are some things that keep me up at night?”
I started looking into maternal-child health disparities. I was surprised by the disparities that exist for Black women in maternal health outcomes. I understood that socioeconomic disadvantages and social determinants of health could affect outcomes, but there were significantly higher mortalities for Black women with a higher
education level and socioeconomic status in comparison to non-Hispanic white women who hadn’t graduated
high school.
I continued to dig deeper and explore why those differences existed, even when someone is highly educated or has insurance. I started looking into the history of systemic racism and implicit biases in health care, and the disadvantages outside of health care systems that we face in our communities. That became the impetus for dedicating my career to Black maternal health.
How can nurses advocate for Black maternal health through their roles?
It’s important for nurses to understand the power that they have in making changes to help the populations that they serve.
Without mentorship, some of us might go into the profession thinking, “I'm just going to go work somewhere, see patients, and go home.” Because I've been passionate about community work, it has afforded me the opportunity to have mentors. And because I've had mentors, I've had a better view of how powerful we are as a profession. We are over 4-million strong, which means that we even have a few nurses serving in Congress right now. Nurses can have a seat at different tables and be part of the decision-making process.
You don't have to aspire to be a vice president or a director, but if you start by saying, “I don't like the way things are going on my unit or in my clinic — how about I lead a patient safety initiative? How about I start a maternal health committee to focus on bettering outcomes or patient experiences?” That in itself is advocating for patients and communities. You can make small changes, even within your working environment, that can lead to better outcomes.
It’s also important to find a way to navigate the system you work in and to advocate for patients. We all go through ethics training, whether it's for nursing, social work, medicine, or any field in health. But we often forget those ethics when we start practicing for a variety of reasons — maybe we're scared to speak up, or scared we're going to be outcasted for speaking up. But without accountability, and without nurses who are always there with the patient as advocates, we're not going to see better outcomes.
How can we ensure that nurses understand this issue as early as possible, especially for those who are new to the profession?
The essentials of education for both undergraduate and graduate nursing programs include population health and addressing social determinants of health. Integrating small or large activities or assignments into the curriculum exposes students to ways they can use their roles to change health outcomes. If you’re administering the curriculum for a course, encourage students to identify a topic they’re passionate about and do a project that involves advocacy. We can also lead simulations on other topics outside of just medical treatment.
I recently took the initiative to plan a midwifery panel event for undergraduate students. It’s important for students to know information about pregnancy, pregnant populations, and vulnerable populations as well, no matter what specialty area you work in. You have to be able to know how to communicate within a team about things that are not normal. Even for those who aren’t considering a career in women's health, you are going to be taking care of a woman of childbearing age at some point in your experience.
Check out these local maternal health resources:
Categories: Diversity, Alumni, DNP, Nurse Practitioner Programs