The War on Pregnant Women of Color (TPPJO® Official Published report 2019)

This is the first publication in an on going Investigation to document real stories from real people to be reported to the CDC to make a real difference by The Positive Pregnancy Journey Organization: In this article we investigate the story of Jennifer Obasohan, a pregnant Woman of Color facing medical disparities in standard care at Brigham and Women's ER in Boston, MA.







Under this Investigation and Published report we have interviewed Jennifer Obasohan, analyzed online public reports and social testimonials made regarding Brigham & Women's Hospital in Boston MA, We have cited our official steps to self advocacy, protection and empowerment for all WOC facing any disparsities in the moment, we have also finalized a statement regarding our encouragement to all US Emergency Departments Servicing pregnant women of color.


The Positive Pregnancy Journey Organization submit's each statistical report directly to the CDC for analysis, documentation and further investigation to use this information to bridge the gap in medical care to end medical disparsities across America.

CDC’s Division of Reproductive Health (DRH) monitors maternal and infant mortality, the most serious reproductive health complications. In addition, attention is focused on gathering data to better understand the extent of maternal and infant morbidity, adverse behaviors during pregnancy, and long-term consequences of pregnancy.


Public health surveillance is the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in public health practice. The public health approach to problem solving includes using surveillance data to identify problems and assess the effectiveness of interventions. Without accurate and timely data, public health programs suffer. This glossary is available of commonly used terms in public health surveillance and epidemiology.

The major surveillance systems in the division include the Pregnancy Risk Assessment Monitoring System (PRAMS), the National ART Surveillance System (NASS), and the Pregnancy Mortality Surveillance System (PMSS). CDC also collaborated with organizations to develop the Sudden Unexpected Infant Death (SUID) Case Registry, which seeks to improve population-based SUID surveillance in grantee states. Reports are generated from these systems on a routine ongoing basis. DRH also monitors teen pregnancy and the number and characteristics of women obtaining legal induced abortions in the United States. Point-in-time surveys are conducted to assess reproductive health in developing countries. DRH researchers sometimes analyze secondary data on such topics as ectopic pregnancy and hysterectomy.


https://www.cdc.gov/prams/index.htm

https://www.cdc.gov/prams/pdf/methodology/PRAMS-Design-Methodology-508.pdf


The National Quality Strategy (NQS), a national, not Federal, effort was established to serve as a catalyst and compass for a nationwide focus on quality improvement efforts. The NQS is the first-ever national effort backed by legislation to align public- and private-sector stakeholders to achieve one goal: better health and health care for all Americans. Stakeholders are working together in new and innovative ways to incorporate achievement of the three NQS aims as a part of their day-to-day efforts to make health and health care better and more affordable for people and communities. To help achieve the aims of the NQS, The Positive Pregnancy Journey Organization works to make care safer by reducing neglect, harm and disparsities caused in the delivery of care. The Positive Pregnancy Journey Organization’s efforts that work toward the achievement of the NQS aims:

• Quality goals and infrastructure

• Stakeholder participation

• Performance measurement

• Capacity building

• Strategy implementation

• Communications







Original Post shared from Jennifer Obasohan

#repost @jennyxannette "For my first Mother’s Day I wanted to bring awareness to #MaternalMortality. Black women are more than 3 to 4 times more likely to die of pregnancy or delivery complications than white women. I wasn’t quite aware of this information until I was put in such a situation at Brigham and Women’s hospital in Boston. I went there to be seen because my entire body was extremely sore. I had severe stomach cramps that was accompanied by a shooting pain up my back causing my neck to basically stiffen up on me. I had no idea what was going on with me but was more concerned for my baby. I was in the waiting room for 4 hours in pain. I checked in with a nurse named Laura Hoover a few times who told me that they were busy and that there are people who are more of a priority than me. My anxiety started to get the best of me. I felt my chest caving in and a panic attack on the rise. That’s when i talked to an ESA named John who thought it was ok to tell me that I was lying about my symptoms. John was busy listening to me and another patient talk about a women who was discharged and decided to fall out and have a fit about not feeling well and not being ready to leave. They took her back in immediately after discharging her. That patient made a comment and stated “i guess that’s what you gotta do to be seen around here”. I jokingly agreed. This is why John thought it was ok to say that I was lying about my chest pain. There was a security guard there who decided to step in and calm the situation down. After asking them to check my vitals i noticed he was being criticized by Laura and John. This man was getting yelled at for trying to get me help. After such mistreatment i took the names of these two employees and reported them to patient relations. I prayed to God to protect me and my baby and walked right out that sh*t hole. Black women please do not let your voices be silenced. Do not allow anyone tell you that you aren’t priority. That’s what they said about #KiraJohnson Johnson before she died. Let’s not forget #LashondaHazard #Blackmomsmatter let’s keep bringing awareness to medical mistreatment of black women and their babies."


Original Instagram post from the mother Jennifer (@jennyxannette)




ACOG and American Academy of Pediatrics guidelines recommend that obstetric patients with medical or surgical conditions that could reasonably be expected to have obstetric consequences should be evaluated by qualified obstetric providers.8 ENA and AWHONN endorse the referral of urgent and nonurgent patients with fetal gestation of 16 to 18 weeks or later with suspected labor or obstetric complications to the obstetrician or L&D department for evaluation.9
PA-PSRS has received a number of reports related to the management of pregnant patients in the emergency department. In many instances, reports submitted through PA-PSRS reflect a lack of effective communication between emergency and obstetrics department staff. When a pregnant patient arrives at the emergency department, there are really two patients. Optimal care of both patients can only be achieved through a systematic approach to care that involves open communication between emergency and obstetric services. Risk reduction strategies include having policy and procedures in place that ensure a systematic approach to the triage and initial assessment of the pregnant patient with consideration of the presenting complaint, gestational age, availability of testing and consultants, and fetal monitoring requirements. (Pa Patient Saf Advis 2008 Sep;5[3]:85-9.)

Source: http://patientsafety.pa.gov/ADVISORIES/documents/200809_85.pdf

Well-defined criteria exist for the assessment of obstetric patients in the OB department and the ED. Stabilization of the obstetric patient with any emergency condition, whether or not the condition is OB-related, is of the utmost importance; otherwise the effect on the fetus may be detrimental. However, as PA-PSRS reports indicate, inadequate communication between these departments can expose both the obstetric patient and fetus to risk. Policies and procedures for the care of an obstetric patient presenting to the ED can address a number of factors, including the nature of the complaint, the availability of consultants and testing, the gestational age of the fetus, the need for fetal evaluation, and transfer of the patient between ED and OB departments. In addition, open lines of communication between providers are necessary in order to provide optimum care for both patients when an obstetric patient presents to the ED.

Source: http://patientsafety.pa.gov/ADVISORIES/documents/200809_85.pdf





Official Interview

The Positive Pregnancy Journey Organization with Jennifer Obasohan on the lack of care, compassion and the overall disparities experienced at Brigham & Women's Hospital ER in Boston MA


Where did your neglect of care take place at Brigham & Women's Hospital?

"This took place at the ER. I was trying to bee seen by their walk in OBGYN floor but when i called and told them I’ve been in their ER waiting room for almost 4 hours they told me because of my gestational age it’s against their policy to see me and that i have to stay in the ER. Not sure what that policy is but doesn’t make sense. Pregnant women are not a priority in that hospital at all no matter what department."


When did this occur at Brigham and Women's ER?

"It happened April 26th"


How far along were you when this took place?

"I was 15 weeks"


What ended up happening at Brigham & Women's ER?

"I didn’t get discharged from Brigham’s. I didn’t even get seen. They were too busy arguing with the security guard who was sticking up for me to come over and talk to me. That’s how the Woman was able to come over to me and give me the number to the OBGYN floor before leaving. She even apologized for the mistreatment and she had nothing to do with it. Just a black woman tying to help but also keep her job. They did my my vitals but that was once i got in. After that i was waiting for 4 hours in pain. No one came over while i was crouching over holding my stomach. The guy just kept walking by. Didn’t ask me if i needed anything. I spoke to the nurse she told me that i would be seen in a few and was never seen."


Where were you ultimately treated and discharged from following the neglect at Brigham & Women's ER?

"So i just went to my primary care hospital which is Boston medical. It was further from where i was staying at the time which is why i just went to be seen at Brigham’s because it was 2 minutes away. Worse decision of my life. It happened April 26th. I didn’t post about it because i was filing a complaint with patient relations but when they didn’t get back to me i decided to take it to social media.


I stayed with them for some hours where they monitored me and the baby for a bit. They were very helpful. They kept me hydrated through iv’s and where they reassured me the baby was doing just fine. I was seen at Boston Medical where they stated I was coming down with norovirus that’s why i was having the body aches and the stomach pain."



TPPJO Overview of the Malpractice and

Neglect Jennifer experienced:

There is a detrimental medical care gap that people can fall into when pregnant, especially as a pregnant mother of color seeking emergency care without immediate proof of miscarriage or a life threatening condition before 16-20 weeks pregnant depending on where they are located in America.


THIS is the category that Jennifer fell into at 15 weeks gestation, abdominal pain, no bleeding, no release of waters or contracting: without the standard emergency conditions plus being a woman of color, she was over looked and as the hours passed, untreated and made to feel less than important.


This is unacceptable.


As the growing baby is not considered viable for life outside of the womb in most labor and delivery departments before 20-22 weeks gestation, this means that if the mother does not appear to be in a life threatening situation they will not be transferred to the labor and delivery floor and may not receive the proper life saving prenatal care that they may need in a timely matter being stuck in an overfull ER. 1 out of 4 women of color are experiencing the deep end of this ultimate malpractice that is not only leaving mothers untreated, but creating preventable maternal and fetal deaths in the emergency departments across America.


This gap is leaving expecting mothers waiting in the emergency department for hours without proper care, acknowledgment, assessment, compassion or solidarity. This is a direct representation of the medical disparities WOC (Women of Color) face every single day in America. THIS is the exact problem that MUST change.


Thankfully Jennifer is aware of the current devastating real life stories circulating the internet regarding the malpractice WOC are facing this day in age and she used this to empower herself and ADVOCATE- When the third hour had passed and she was still waiting in pain in the hallway, she stood up for herself and was still neglected care or reassurance of proof that the pain she was experiencing was or was not an emergency circumstance.


She removed herself from the situation and left without being seen and sought care from a different section of the hospital where she was finally assessed, treated and discharged.


Pregnant Women must advocate for themselves under any and all circumstances where they are in need of medical care, TPPJO is available for patient advocacy.


We deem any lack of proper care for pregnant people absolutely unacceptable and will do everything in our power to see an end to the gap and the disparsities.


BRIGHAM AND WOMEN'S HOSPITAL

ER Wait Watcher

Source: https://projects.propublica.org/emergency/hospital/220110





When should I go to the ER for pregnancy issues?


There are some situations during pregnancy that call for an immediate visit to the emergency room, instead of urgent care. If any of the following occur, you should head to the hospital right away:


-You have severe abdominal pain

-You think you’re having a miscarriage

-You have signs of preterm labor in your second-trimester

-You have severe headaches, especially if accompanied by blurred vision

-Heavy vaginal bleeding

-Pain or pressure in your chest

-Loss of consciousness

-Any other situation that seems as though it could be life-threatening

-If you’re experiencing a life-threatening emergency, call 911.

-When you’re pregnant, your top concerns are the health of you and your precious baby. When a health concern comes up, sometimes you just can’t wait to see your primary care physician or ob-gyn.


In many cases, urgent care is a great option for pregnant women. Not only is it far less expensive than the ER, you’ll also be seen a lot faster


When can you go to urgent care while pregnant?


Whether you’re expecting your first child or your third, pregnancy can make you feel a bit, well, delicate. Every cramp, fever, or chill may put you on high alert. The reality is that many pregnant women head to the ER for non-emergency situations. In fact, research done on the overcrowding of emergency rooms found that less than 3% of ER visits required vital intervention. Essentially, this means that the majority of people — including pregnant women — can be treated at urgent care, instead of the emergency room.

That’s not to say you shouldn’t go to the ER for serious symptoms during pregnancy but knowing where to go and when can save you time, money, and a lot of hassle. Here’s an overview of when a pregnant woman should go to urgent care during each trimester of pregnancy


source: https://www.solvhealth.com/blog/going-to-an-urgent-care-while-pregnant


WHAT TO DO IF YOU ARE FACING MEDICAL DISPARSITIES:


If you are a Pregnant Mother of Color in an Emergency situation facing medical disparities in any hospital located in the USA-


Contact The Positive Pregnancy Journey Organization for free ASAP:

Thepositivepregnancyjourney@gmail.com

Email and or Reach out on our website in the chatbox located in the bottom right hand corner that is available 24/7 for professional support.


Document your experience.

Record.


Request copies of test print outs.


Request formal written letters of refusal to treatment or proper assessment to establish well being and safety.


Public Reviews/Testimonials for Brighams & Women's Hospital in Boston MA






UPCOMING IN THIS ON-GOING FEDERAL INVESTIGATION TO ERADICATE MEDICAL DISPARITIES:


What happened to Lashonda Hazard?

(THE WAR ON PREGNANT WOC-TPPJO® Official Published report 2019)









Source: https://www.cdc.gov/vitalsigns/maternal-deaths/




CDC Levels of Care Assessment Tool

Definitions and monitoring of levels of care vary widely among states. To address this issue, CDC developed the CDC Levels of Care Assessment Tool (LOCATe). This web-based tool helps states and other jurisdictions create standardized assessments of levels of maternal and neonatal care. CDC LOCATe is based on the most recent guidelines and policy statements issued by the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine.


How CDC LOCATe Data Are Used

CDC LOCATe produces standardized assessments that allow participating states to see levels of care by facility, as well as the distribution of staff and services throughout the state. CDC LOCATe data can be combined with public health surveillance data, including vital records and hospital discharge data.

These data allow for more detailed analyses that support understanding of:


Maternal and infant health outcomes by level of care.


The relationship between the volume of services provided by a facility and maternal and infant health outcomes.



CDC LOCATe is designed to be used by public health decision makers. This tool can create opportunities for informed conversations among stakeholders who work in the area of risk-appropriate care. Examples of these stakeholders include state and local public health departments, state perinatal quality collaboratives (PQCs), hospital associations, and health care providers working in maternal and neonatal care. The results from CDC LOCATe are a starting point for discussions about how states can improve health outcomes for women and infants.


Participating States

As of February 2019, a total of 15 states (California, Colorado, Delaware, Georgia, Illinois, Iowa, the southeast perinatal region of Michigan, Mississippi, New Hampshire, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wyoming) and Puerto Rico are participating in CDC LOCATe.


Perinatal regionalization, or risk-appropriate care, is an approach that classifies facilities based on capabilities to ensure women and infants receive care at a facility that aligns with their risk. The CDC designed the Levels of Care Assessment Tool (LOCATe) to assist jurisdictions working in risk-appropriate care in assessing a facility's level of maternal and neonatal care aligned with the most current American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) and American Academy of Pediatrics (AAP) guidelines. LOCATe produces standardized assessments for each hospital that participates and facilitates conversations among stakeholders in risk-appropriate care.



https://safehealthcareforeverywoman.org/



A Message to all Health Care Facilities:


The 76-page report, Improving Quality and Achieving Equity: A Guide for Hospital Leaders is structured as a guide for CEOs, high-level managers in hospitals, and other leaders in the fields of safety, finance and risk reduction in hospitals. The report is also meant to be used by anyone working within this industry who feels that leaders in their hospital are not taking sufficient action to address inequities in health care. The final draft of this document was reviewed by a panel of experts in hospital safety and quality.


The introduction to the guide states that the report's main goals are to present the evidence for racial and ethnic disparities in health care and provide the rationale for addressing them; highlight model practices; and recommend a set of activities and resources that can help hospital leaders initiate an agenda for action to reduce these disparities. Chapters are divided into topics such as why disparities need to be addressed; what are the root causes of health disparities; what actions are already being taken to combat disparities; and what resources exist to tackle inequities. Several case studies of equity initiatives that have been undertaken at individual hospitals are detailed, including discussions of what was successful about each initiative and what will be necessary to sustain it.


A strong focus of this report is that medical institutions need to move beyond documenting health disparities to doing something about them. The report recommends specifics steps and strategies that hospitals can use to begin ameliorating racial and ethnic health disparities; although tracking disparities is required in order to address them, it is a necessary but insufficient element. Strategies recommended here include the use of culturally-competent disease management models, bilingual health coaches and navigators, and the implementation of community outreach programs. Lastly, the report emphasizes that addressing health disparities must not be viewed as a subset of delivering quality health care, but as an essential component of delivering quality health care.


Download PDF here: https://www.rwjf.org/en/library/research/2008/01/improving-quality-and-achieving-equity.html


Visit March for Moms:

http://www.marchformoms.org/


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@marchformoms @4kira4moms @blackmamasmatter @mtv @cdcglobal @cdcgov @acog_org @filmpac @jennyxannette

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