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Stillborn in Iowa : Iowa’s Search for Answers to Shrink the Disparities for Mothers of Color

DES MOINES, Iowa -- Stillbirth rates in Iowa are among the lowest in the county, yet African-American mothers living here are still twice as likely to experience the heartbreak.

Every year in Iowa, 180 babies are born still, according to the Iowa Department of Public Health. One in every 121 expecting black women lose their babies to stillbirth compared to the one in 234 white women. A stillbirth is defined as a fetus dying after 20 weeks.

Medical professionals are not sure the exact cause of the disparity but say genetics, socio-economical factors and environmental stress can all be factors. Those factors were never determined for Ali Harris, a young mother who lost her baby at 40 weeks during labor in June of 2017.

"The doctor said your daughter didn`t make it. I'm sorry," she says. "I`m like what do you mean she didn't make it?"

Harris named her baby girl, Olivea.  She says her pregnancy was normal, never missing a doctor's appointment. The then 22 - year - old claims doctors never warned her of the potential risks she or her baby could face, until she was being induced. Doctors at Mercy Medical Center say they take into account the mother's race when assessing and monitoring a pregnancy.

"We clearly address it and make judgments on how closely we need to follow these babies based on not only their race but other medical problems that we may or may not find," says Dr. Neil Mandsager, Medical Director of Obstetrics at Mercy Medical Center. Mandsager was not Harris' medical provider. Harris says doctors warned her the complications of labor could fatally harm baby Olivea and claims they dismissed her concerns for a vaginal birth.

"I felt like if labor was going to be complicated lets pull her out now but he still kept pushing for a vaginal birth. I kept pushing back. I didn`t want to do a vaginal birth if that meant something was going to happen to my daughter," Harris says. "He was like 'oh you're young. You don`t want a c - section. You don`t want that scar.'"

Harris labored for 16 hours and dilated only to a three. She says she begged doctors for a cesarean when her baby's heartbeat would stop during contractions. "Something was telling me, my body was telling me something isn't right ."

Ultimately, doctors rushed Harris into emergency surgery but by then it was too late. Baby Olivea had no heartbeat. An autopsy revealed a healthy baby. Doctors are unsure why she died.

"We perhaps need to spend some extra time both education and in monitoring these pregnancies and babies," says Dr. Mandsager. As a result, Mercy Medical Center is considering doing patient experience surveys broken down by race to know to how to better serve mothers.

Harris  warns other mothers, "if at any point you feel uncomfortable with anybody on your staff or your doctors, you can tell them you don't want them to assist you any more." She adds, "Had I known that, I would have had a different doctor and I might be in a different situation that I am now."

What's happening to black mothers and their unborn babies is an age old question. "That data has been around for a long time and we haven't done very much to improve it," says Dr. Paula Mahone.

Mahone served as the former Medical Director for Perinatal Services at Methodist Hospital. She says doctors need to be looking at what this is happening. "There are a lot of times there is no standardization of examining the placenta, umbilical cord, amniotic fluid, the baby and the placenta," she says. The biggest reason hospitals don't search the answers? Mahone says it comes down money and interest.  "We have to have a critical mass of people interested and concern to work together to change it."

The issue has become part of the Count the Kicks campaign. Earlier this month it released a public service announcement, shifting its focus to better reach and educate mothers of color. The organization recently secured $150,000 in funding to help reach women most at risk for stillbirths and is currently fundraising money for the same purpose through maternal artwork.

"We are moving in the right direction but we still have more work to do," says Tinika Roland, the community outreach liaison with Count the Kicks campaign.

It's effort to reduce the number of stillbirth by educating mothers to count their babies kicks is working. Since its launch a decade ago, stillbirths in African - Americans in Iowa have dropped by 40 - percent according to the IDPH. It's now aiming to reduce that number by an additional 48 - percent. Advocates are meeting mothers where the are.

"We're reaching into the congregations because many African-American women, they don`t always receive their health care information from health care providers, we get it from out mothers and grandmothers," says Roland. "It's generational."

From the pulpit to a personal advocate, there a national push for more mothers of color to have one. Pregnancy coaches or doulas help expecting moms navigate through the journey and to find their voice.

In the eight years Emily Alberhasky as worked as a certified doula, she's helped serve fewer than five women of color. She's offered her services for free before but says there should be more done to help women of color. "It's not a woman of colors job to teach me. I have to learn and the only way I`m going to learn respectfully is to seek out the information that is very accessible actually."

The conversation is uncomfortable for some in Des Moines's birthing community. The Central Iowa Doulas Association says it is not doing anything specific to address the issue and backed out of an on camera interview with Channel 13 because "it's not the right person to talk about minorities and maternal care." However, the association released this statement :

"Central Iowa Doula Association works to connect mothers to certified birth and postpartum doulas. CIDA works to educate all moms about doulas and how they support all women before, during and after childbirth. Doulas are for all women no matter what type of birth they are planning; natural, medicated, or cesarean section. Members of Central Iowa Doula Association benefit from continuing education, networking, support, personal growth, and community awareness. Anyone interested in becoming a birth or postpartum doula can contact CIDA for more information."

Alberhasky hopes she can be part of the solution,  "women of color have felt uncomfortable for generations so I`m okay with being uncomfortable and having this conversation because I`m not okay with them staying in an uncomfortable place."

While Alberhasky learns how to better serve mothers of color, she's also mentoring black women to become doulas. A critical piece she says will improve the state's severely under represented birthing community. "Women of color deserve to have the support they need and women of color should know about this options as career paths and should feel empowered to them because they are under represented and they should have a voice," she says.

Mercy Medical Center offers free doula services to all expecting mothers who plan to deliver there however, the programs organizers say the service is not used as much as the hoped for.