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Inside the Fight to Dismantle Racism in Healthcare — One Implicit Bias Training at a Time

On April 12, 2016, Charles Johnson IV and his wife Kira headed to Cedars-Sinai Medical Center in Los Angeles for a routine cesarean section. Shortly after Kira gave birth to a healthy baby boy named Langston, Johnson noticed blood in her catheter. He alerted the hospital’s staff and was told that they’d give his wife some tests, including a CT scan.

“Charles, I’m so cold; Charles, I don’t feel right,” Johnson later recalled his wife saying. Hours passed as Johnson pleaded with personnel, and still no CT scan. When he approached a staff member again, Johnson was told that Kira was not a priority. It was past midnight when she was finally wheeled into an operating room. By that point, she had been hemorrhaging blood for more than ten hours, as a result of the c-section. The hospital staff was too late. She died at 2:22am, 11 hours after her baby was born.

This is the story that Stacey Stewart, the president of March of Dimes, tells me when I ask her about the Black mortality crisis. Kira is one of the many women of color whose health concerns have been minimized or flat out ignored by healthcare professionals. The alarming stats speak for themselves: pregnancy-related death for Black and American Indian/Alaska Native women over the age of thirty are 4 to 5 times higher than white women. Black women are 27 percent more likely to experience severe pregnancy complications than white women.

When the CDC dug into the education level of these moms, they discovered that it was a moot point. Maternal mortality rates among Black women with a completed college education or higher was 1.6 times that of white women with less than a high school diploma.

There’s something very wrong with the way that healthcare professionals are responding to women of color’s health concerns and March of Dimes — a nonprofit that fights for the health of moms and babies — is on a mission to change that. Even if it means educating one hospital staff member at a time. The organization has designed an Implicit Bias Training course specifically around the maternal health crisis, offering hospital members — from support staff to doctors — the opportunity take a closer look at racism within the healthcare system and their own complicity.

“It really is both an understanding of the larger macro issues around racism and how having such a bias factors into the health care setting,” Stewart said. “Then, it drills down to everyone being able to look at their own personal behaviors and their own personal ways in which they think about others, so that they can examine the level of implicit bias that they may harbor that they may not even be aware of.”

It’s important that all hospital staff members have access to this training because, Stewart noted, sometimes implicit bias can start as soon a patient walks into the waiting room. Any negative experiences with front desk personnel, Stewart explained, may cause a ripple effect. “As the word spreads, the whole community becomes sour to seeking the care that they may need.”

The training is available as a one-hour e-learning module or a 3-4 hour live training. Topics include identifying implicit bias, examining the role structural racism plays in relation to implicit biases in patient/provider encounters and strategies for tackling personal biases. Since 2020, March of Dimes has offered implicit bias training to more than 35,000 providers in more than 30 states and Washington, D.C. The organization is also creating a student bundle, which can be embedded into medical education programs and help mitigate implicit biases early on.

“The responsibility of every health care professional is to give the best care possible to every single person,” Stewart said. “There should be no issue that should interfere with that, especially one’s race or ethnicity or income level or ability to pay. Unfortunately, many of those issues seep into the quality of care. [It’s] causing some people to come close to death or to even die because they don’t get the attention that they need and deserve.


These history-making Black moms were (and are!) paving the way for women everywhere.

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