A mom who understands the pain of losing an infant shares her grief to help families in Cuyahoga County, where black babies are nearly four times less likely to survive to their first birthdays as white babies.
Bias in healthcare may have contributed to the death of her baby.
Cheryl Martin proudly holds a gold-framed picture of a baby with bright eyes gazing into the camera, his little fists held in front of his chest.
"This is Colin. He was born June 15th, 2001, 2 pounds, 1 ounce. This was my little fighter.”
He looks every bit the fighter. His flushed cheeks and the tube in his nose show the struggles he faced. Colin Martin never came home from the Cleveland hospital where he was born but recently a part of him has.
“This means like the world to me.”
Cheryl’s husband brought home a small gold star bearing the name Colin DeSean Martin. For nearly 20 years, it had hung outside the NICU, the place where he had fought to survive for nearly four months. “I am so happy to have my star home. They did release him from the NICU unit.”
Warning signs ignored
Around three months before her due date in 2001, Cheryl, who was working full time and pursuing a master's degree, was rushed to the hospital bleeding. There, she delivered her son. She says she had been vomiting and bleeding throughout her pregnancy, as she had with her daughter, also born prematurely in 1995.
"The ambulance EMS was always at my house. Firetrucks are always at my house. And then here it goes again. I don’t feel like those symptoms were addressed.”
Colin Martin endured heart surgery, seizures and an infection.
“What pains me was white moms talking about how their doctors had put them on bed rest or had given them certain medications for some of the symptoms that I had. That's what hurts so bad because had that had happened, maybe my son would be here. Maybe.”
Martin's pain is echoed in statements on posters hanging in the clinical areas of Cleveland’s three main hospitals University Hospitals, MetroHealth and Cleveland Clinic.
A pattern of similar experiences
One reads, "When it comes to delivering health babies, the color of skin should not matter...but it does." And another, "Why does it feel like nobody listens to me?"
The words were expressed by women of color who participated in a focus group study at the hospitals. University Hospitals OB/GYN Margaret Larkins-Pettigrew headed the First Year Cleveland team that interviewed 39 maternal care patients, evenly divided by race.
'I accepted being treated almost like a second class citizen.'
She says the white patients reported no negative experiences. Latina women had some, but for the black women, 100 percent reported problems. These included not being referred to support and resources, feeling ignored or slighted by staff or clinicians and having their husband or partner overlooked during appointments.
"The African-American women felt they were not valued," Dr. Larkins-Pettigrew said. "They were disrespected.”
Larkins-Pettigrew is one of only 5 percent of doctors in America who are black. She says often medical staff is unaware of its implicit bias. Her team used what’s called journey mapping to track the women’s self-reported pain points. This is now used in the anti-bias training at the hospitals collaborating with First Year Cleveland.
"Every step of the way through the journey, somebody was mistreated. A front desk person, who didn't look at them when they were talking to them, who made statements like, ‘You people’.”
Pushing for change
Larkins-Pettigrew says many black patients, weakened by years of being diminished, abused or ignored, try to work around bias, rather than push for a change in care.
The next time Cheryl Martin became pregnant, she found a different, white doctor, who helped her deliver a healthy baby boy. “He put me on bed rest from the very beginning because he took a look at my history. He even called me to check on me from time to time."
Martin, who supports grieving parents through her work with First Year Cleveland, also wants to prevent pregnant moms from suffering.
“You have to advocate for yourself. I wish that I would have thought of going to another physician. I accepted being treated almost like a second-class citizen.”
Martin envisions a world where her own daughter can become a mother, secure of receiving quality care and respect. And if that is not the case, that her voice will join a chorus of other empowered black parents demanding and receiving the change they deserve.