• Guest Editorial

    Finding the Well for Better Maternity Care

    April 14, 2022, 2:55 p.m. Safiya McNeese-Ruffin, M.D. 

    “What makes the desert so beautiful is that it hides a well, somewhere.” — Antoine de Saint-Exupéry, The Little Prince

    Safiya McNeese-Ruffin, M.D.

    In the Illinois counties of St. Clair and Madison, especially along the Mississippi River, there are maternity deserts. In regions such as these, maternity care is limited or absent, either because of lack of services or barriers to a woman’s ability to access care.

    St. Clair County is the birthplace of one of the smartest people I know — my father — so I have always had an affinity for giving back to this area and was ecstatic when the opportunity to work here presented itself. I want to use my training as a family physician and my special interest in women’s and children’s health to help change these two counties into maternity havens.

    During my experiences as a physician, mom, sister, daughter and friend, I regularly have a front-row seat to many of the unheard struggles unique to women. My interest in women’s health continues to grow out of what I believe to be necessity.

    The “well” in the quote above represents, to me, the opportunity for innovation and creativity, the search for and creation of unorthodox solutions in a dire space or situation. In that context, I believe women to be the well in most households. They are the information keepers, encouragers, nurturers and caretakers. My passion for women’s health is rooted in my passion for family medicine and the goal of treating the whole patient.

    Keeping women in good health keeps their households and, ultimately, their communities in good health. The perinatal experience should be an exciting time full of hope, promise and enrichment. As a specialty, we family physicians play a key role in leading and guiding women through the maternity experience.

    For many of the women we serve, obstetrics services can be difficult to understand and navigate, especially when there is inequity in medical care access and opportunity. I have personally witnessed the delay of care when a complaint during pregnancy is not taken seriously, the removal of patients’ autonomy by omission of patient education and choices regarding treatment and management options, and the discouragement of best practices for mothers and babies, which only perpetuates and creates chronic illnesses in the long term.

    WOMBSS (Wrapping low-risk Obstetric services for Moms and Babies in St. Clair and Surrounding counties) is a quality improvement initiative projectI'm developing with support from several partners to provide a template to reform the standard perinatal course by more aggressively targeting increased recognition and management of complications related to maternal/infant health and incorporating tools and interventions to address social determinants of health. By advocating and integrating services such as SDOH screenings, resource manager consultations, “community baby showers,” home visits and doula services as norms in perinatal care, the program aims to improve outcomes; reduce pregnancy complications, hospital triage and ER visits; increase patient participation and satisfaction; and ultimately decrease maternal morbidity and mortality.

    As we recognize National Minority Health Month and specifically Black Maternal Health Week, I strive to do my part to create equitable spaces in health care. I also continue to be encouraged about similar work by others around the country and world. I believe family medicine to be an ultimate think tank and hub for transformation and advocacy for all patients.

    We are the well!

    Safiya McNeese-Ruffin, M.D., is the associate program director and director of obstetrics and women’s health at the Southern Illinois University School of Medicine Family Medicine Residency, Alton, and a 2021-2022 AAFP Health Equity Fellow.