Maternal Mortality Rates and How Race is a Factor

By Dr. Nikki

While we may be hearing about it more lately, the maternal and fetal mortality rate in the black community is NOT a new issue. As a whole, the US has a higher maternal mortality rate than most other high-income countries. Now I want you to think about this… African American women (across the income spectrum and from all walks of life) are dying from preventable pregnancy-related complications at three to four times the rate of white women in the US! Severe maternal morbidity affects pregnant women across the board, but these severe life-threatening pregnancy-related complications (known as SMM) affect twice as many black women as they do non-Hispanic white women. African Americans have the highest infant mortality rate of any race in the United States which can be tied to preterm births. The death rate for black infants is twice that of infants born to white mothers. [1]

WHY IS THIS THE CASE?

Deeply-rooted structural racism in the healthcare service delivery plays a big role in these devastating outcomes. Receiving poorer quality care, as well as limited access to maternal care, results in increased levels of pain and stress which has massive physiological effects on the pregnant mom’s physical and mental well-being. These stress-induced physiological changes make black pregnant women more susceptible to conditions such as pre-eclampsia, eclampsia, embolisms, and mental health issues, threatening the mother-to-be’s life and her child’s as well. 

WHAT CAN BE DONE TO CREATE CHANGE?

1. Improve access to quality care. Oftentimes counties have what are known as maternity care deserts, where access to maternity health care is either extremely limited or completely absent. This limited access can be a result of a physical lack of care or an inability for a woman to utilize it. These “deserts” occur in rural areas, but can also exist in urban areas when hospital obstetric units close in and around cities. [2] Below is a map, from 2016, that shows the different levels of access to care throughout the United States. The red on the map indicates counties where there are zero hospitals and zero OB/midwife providers. If public transportation is limited, many pregnant women in these counties are unable to get the appropriate maternal care and even if public transportation is accessible, this places strain on surrounding obstetric facilities and can hinder the quality of care provided. Strengthening the systems that are already in place, as well as providing African American women tools to utilize the maternity health care system is essential.

2. Improve the quality of care provided to pregnant women. As one of the wealthiest countries in the world, the United States could and should be doing better (in my humble opinion) when it comes to maternal and infant mortality! Programs in which providers are trained to address racism and build a more diverse workforce have an enormous impact on the quality of maternal care for black women and other women of color. Accessibility of screenings and standardized assessments also allow for the prevention and/or prompt treatment of maternal and fetal health issues. 

3. Enhance support for families before and after birth. Community is essential during the prenatal and postnatal period. Resources such as birth education and doulas are pivotal in increasing support as well as improving birth outcomes. As a pregnant mother’s advocate, doulas can be instrumental in making sure moms are getting appropriate screenings and quality maternal care. Doulas also provide postnatal support and are in a position to make sure the baby is receiving appropriate testing and care. 

 WHAT CAN YOU DO?

You may be reading all of these alarming facts and thinking “This is horrible, but what am I supposed to do about it?” I found myself in that exact same place. I recently read the book “Untamed” by Glennon Doyle and in one specific chapter she talks about becoming a philanthropist. In this chapter, Glennon shares a quote from Archbishop Desmond Tutu that hasn’t left me, “There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” This brings up two immediate questions, one: how can I help black mothers-to-be right now? And two: how can I help stop the root cause of the issue? 

So here’s what I’ve come up with for a starting point. The Natural Way Birthing Project, located here in Fort Worth TX is a non-profit run by a black female doula named Nikia. The mission of the project is “to help lower infant mortality risk factors and nurture participating families through education, advocacy, and support during pregnancy and beyond.” The goal of Natural Way Birthing Project is to assist in educating, empowering and navigating resources for project participants and expectant families in the city of Fort Worth and surrounding Tarrant County. [3] Through the support of donors who want to see a change, Nikia has been able to provide 12 full scholarships and 15 partial scholarships for membership and training of birth educators and doulas, as well as provide each participant with a manual. She is also able to provide a free birth education class to expectant moms and their support person once a month. To learn more about this class click here. 

If you don’t live in the DFW area and would like to contribute at a more local level for your community, please check out Birthing Project USA to find a project near you. I am beyond excited to support these volunteers who are the hands and feet in our community and are truly doing the work. 

“We must become the change we want to see in the world.” ~ Mahatma Gandhi

RESOURCES

1) (May 2, 2019) Eliminating Racial Disparities in Maternal and Infant Mortality. Retrieved June 24, 2020. https://www.americanprogress.org/issues/women/reports/2019/05/02/469186/eliminating-racial-disparities-maternal-infant-mortality/

2) (2018) Nowhere to go: Maternity Care Deserts Across the US. Retrieved June 24, 2020. https://www.marchofdimes.org/materials/Nowhere_to_Go_Final.pdf

3) Retrieved June 25, 2020. http://thenaturalwaybp.org

Sharp Curve Ahead

By Dr. Nikki

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This afternoon, my co-pilot pup, Rocky, and I went out for a walk along the Trinity Trail. As we strolled along, we came across a sign that said “Sharp Curve Ahead”. I found myself thinking ”Wouldn’t it be nice if we had signs like that for life??” You know, signs that said “job loss ahead” or “cross-country move ahead” or even “illness ahead”. One of the biggest unexpected “sharp curves” that come up in life are health issues. I wonder if we knew ahead of time that a specific disease was headed our way, would we live our lives a little differently? Oftentimes, we spend the first half of our lives chasing wealth to then spend the second half of our lives chasing health.

The good news is that while we may not have a sign telling us what lies ahead in regards to our health, we can make decisions on a daily basis to prolong our years with a healthier life! Here are five basics that we can all implement right away. While they may seem simple, I find myself needing reminders on all of these at some point throughout a given day, week or month.

1. Get sleep! Sleep is imperative for our brain and body to heal. It also greatly impacts our immune function and cognitive ability. 7 - 8 hours of sleep per night is a great goal!

2. Hydrate! Our bodies are over 55% water and we use it in every single cell, organ and tissue. It is essential for the regulation of all bodily functions. Aim for 50% of your body weight in ounces of water per day!

3. Taste the Rainbow! Getting a variety of fruits and veggies in our diet is essential. By including a “rainbow” of colors in produce on our plate, we are increasing the amount and variety of vitamins and minerals that we are consuming.

4. Stay Active! Maybe crushing a workout at the gym isn’t your thing, that’s ok!  Whether it’s going for a 20 minute walk, going for a bike ride, taking the stairs, trying a pilates or barre class or simply letting loose and dancing, movement is the key!

5. Find Your Tribe! As humans, we were created to be social. I know some of the introverts may be cringing right now, but it’s true! Make sure you have one or two people who you can bounce things off of and just do life with! It doesn’t need to be a quest for popularity, just a few people to hold one another accountable and lift each other up in times of need.

While I didn’t include chiropractic care in the 5 basic tips, regular chiropractic adjustments are extremely beneficial in maintaining proper function of the spine and nervous system. Since this is what allows our brain to talk to our body and our body to talk to our brain, it’s kind of important! To schedule your next appointment with Dr. Nikki, click here and if you have any questions about any of the other tips for staying healthy, we would love to hear from you!

You can go with this, or you can go with that!

One of my favorite ways to unwind and relax is cooking. There’s something therapeutic about creating a meal from scratch while listening to music and maybe enjoying a glass of wine! But what I’m even more passionate about is creating healthy meals that are full of life-giving nutrients. I think that it can sometimes feel overwhelming to attempt a meal that is healthy but also tastes good and still allows you to feel like you are indulging rather than punishing yourself. That is why I thought it might be helpful to share some of my simple substitutes that I use with everyday recipes to make them a little bit healthier without feeling like I’m totally depriving myself.

Butter. While it’s absolutely delicious, it also contains dairy. Many people experience digestive problems when consuming dairy products and often times eczema and other skin problems as well as allergies and sinus congestion can be exacerbated by dairy. If you’re really looking for that buttery flavor without the lactose, ghee is a great option. Ghee is also known as clarified butter, which basically means that butter is heated until the water in it evaporates and the milk solids separate from the fat by either floating to the top or sinking to the bottom. Those milk solids, which contain lactose, are removed and you’re left with ghee, a nutty and tasty butter alternative. [1] If you don’t care about the butter-flavor factor or you’re wanting to avoid lactose-free dairy product all together, then coconut oil is a great option! Simply replace the called-for butter with the same amount of coconut oil and keep on cookin.

Milk/Cream. As I mentioned above, dairy seems to be a problem child for a lot of people these days. Two of my go-to’s when a recipe calls for milk are almond milk or coconut milk. I typically look for an almond milk that doesn’t have any added preservatives or gums. Malk is a brand that I grab often, but there are a few options out there! Canned coconut milk is another solid option when you’re looking for something a little more creamy. I should mention that coconut milk may have a slightly “coconuty” flavor so if that is going to mess with your palate then you may want to consider another nut milk such as cashew. 

Rice. While it is a gluten free complex carbohydrate, it is a grain and may be hard for some people to digest. Other people may looking to cut out high carb foods or simply get more veggies in their diet. Cauliflower rice is a wonderful alternative! You can make it using a head of fresh cauliflower and a food processor or you can buy it pre-made in the freezer section of your local grocery store. If I’m making a dish that is typically served over rice, I’ll simply substitute the cauliflower rice for regular rice. The addition of cauliflower rice to a meal is a great way to load up on antioxidants and fiber! [2]

Pasta. Often times pasta is one of the major foods that are mourned when someone is deciding to cut gluten and/or other processed carbs out of their diet. The good news is there are several plant-based options! Zucchini noodles (also known as Zoodles) are one of my favorites. You can make them yourself using a spiralizer and fresh zucchini or you can purchase them pre-made in the produce section at most major grocery stores. Along the same lines, you can also spiralize sweet potatoes, butternut squash or beets. If you’re not up for spiralizing or paying the extra money to purchase pre-spiralized veggies, another option is spaghetti squash. Simply cut the spaghetti squash in half and roast in the oven until soft. Scrape the inside out with a fork and it will somewhat resemble angel hair pasta. If a recipe involves serving something over pasta, give one of these veggie options a try!

Sugar. It’s one of the most addictive food items in the American diet and you’ll find it hidden in things you would never suspect! Linked with obesity, heart disease, obesity, high blood pressure and high cholesterol, it’s something I like to avoid whenever possible. Luckily there are some great alternatives to sugar. Honey and maple syrup are probably my favorites. Not only are they full of minerals and antioxidants but you are able to achieve the same amount of sweetness you would with sugar, but using less! [3] If you’re looking for something that is granulated rather than liquid, monk fruit is a great option. Something unique about monk fruit sweetener is that is doesn’t contain fructose or glucose because the sweetness actually comes from an antioxidant in the fruit rather than the fruit itself. [4] Monkfruit sweetener is typically sweeter than sugar so be sure to add to taste when using it!

As you can see, once you have a toolbox of healthy alternatives it is fairly easy to make substitutions while cooking. If you’re apprehensive, it’s easiest to make one change at a time rather than switching everything at once!

We really just scratched the surface of healthy cooking so, if you have a favorite food or meal that you would like to make healthier, we would love to hear about it and give you guidance and possibly include it in part 2 of this blog post. Leave a comment below or message us on social media with any requests or questions. 

Resources

1) Is Ghee Dairy-Free? What to Know About This Butter Alternative (Retrieved July 8, 2020) https://spoonuniversity.com/lifestyle/is-ghee-dairy-free

2) April 14, 2017. The Top 8 Health Benefits of Cauliflower (Retrieved July 8, 2020) https://www.healthline.com/nutrition/benefits-of-cauliflower#section2

3) June 24, 2019. Are Sugar Substitutes Like Honey And Maple Syrup Actually Healthier Than The Real Deal? (Retrieved July 9, 2020) https://www.chatelaine.com/health/healthiest-sugar-substitutes/

4) June 14, 2019. Monk Fruit Sweetener: Good or Bad? (Retrieved July 9, 2020) https://www.healthline.com/nutrition/monk-fruit-sweetener#benefits

Sharp Curve Ahead

This afternoon, my co-pilot pup, Rocky, and I went out for walk along the Trinity Trail. As we strolled along, we came across a sign that said “Sharp Curve Ahead”. I found myself thinking
”Wouldn’t it be nice if we had signs like that for life??” You know, signs that said “job loss ahead” or “cross-country move ahead” or even “illness ahead”. One of the biggest unexpected “sharp curves” that come up in life are health issues. I wonder if we knew ahead of time that a specific disease was headed our way, we would live our lives a little differently? Often times, we spend the first half of our lives chasing wealth to then spend the second half of our lives chasing health.

The good news is that while we may not have a sign telling us what lies ahead in regards to our health, we can make decisions on a daily basis to prolong our years with a healthier life! Here are five basics that we can all implement right away. While they may seem simple, I find myself needing reminders on all of these at some point throughout a given day, week or month.

1) Get sleep! Sleep is imperative for our brain and body to heal. It also greatly impacts our immune function and cognitive ability. 7 - 8 hours of sleep per night is a great goal!

2) Hydrate! Our bodies are over 55% water and we use it in every single cell, organ and tissue. It is essential for the regulation of all bodily functions. Aim for 50% of your body weight in ounces of water per day!

3) Taste the Rainbow! Getting a variety of fruits and veggies in our diet is essential. By including a “rainbow” of colors in produce on our plate, we are increasing the amount and variety of vitamins and minerals that we are consuming.

4) Stay Active! Maybe crushing a workout at the gym isn’t your thing, that’s ok! Whether it’s going for a 20 minute walk, going for a bike ride, taking the stairs, trying a pilates or barre class or simply letting loose and dancing, movement is the key!

5) Find Your Tribe! As humans, we were created to be social. I know some of the introverts may be cringing right now, but it’s true! Make sure you have one or two people who you can bounce things off of and just do life with! It doesn’t need to be a quest for popularity, just a few people to hold one another accountable and lift each other up in times of need.

While I didn’t include chiropractic care in the 5 basic tips, regular chiropractic adjustments are extremely beneficial in maintaining proper function of the spine and nervous system. Since this is what allows our brain to talk to our body and our body to talk to our brain, it’s kind of important! To schedule your next appointment with Dr. Nikki, click here and if you have any questions about any of the other tips for staying healthy, we would love to hear from you!

Picking Your Prenatal Team

Pregnancy is an absolutely life-altering season of life. While I haven’t experienced it myself, I have the continuous privilege of observing women during this season, as well as being a part of their pregnancy experience. When a woman finds out she’s expecting, it is a very exciting time, it also is an occasion where her and her family will be faced with numerous decisions!

Most of us have heard the phrase “It takes a village to raise a child” and it’s absolutely true… starting while they’re still in the womb! One of the most important decisions a woman faces in pregnancy is the village of people who will be supporting her throughout pregnancy and birth. While this prenatal team will look different for each individual woman, there are three crucial components that I think should be considered.

The first member of the prenatal team is a midwife or OBGYN. While both professionals deliver your baby, the environment and approach will vary greatly! I discuss some of these differences in the video below. There’s no right or wrong decision, it just depends on what each individual woman needs and feels comfortable with.

The next member of the prenatal team is a doula. If you haven’t heard of a doula, definitely check out my video! I’m lucky enough to work with a number of doulas, with all different personalities and styles. If a woman knows that she needs someone to push her, there’s a doula for her! If a woman knows that she needs to be nurtured and mothered, there’s a doula for her too!

The third member of the team is the prenatal chiropractor. Did you know that there’s a group of us chiropractors who actually specialize in chiropractic care during pregnancy? We have completed additional training and certification through the ICPA in a technique called the Webster method and often times have the credentials FICPA or CACCP after our name. Chiropractic care is extremely helpful in maintaining proper function of the spine and nervous system throughout all stages of pregnancy. A woman’s body goes through a great deal of changes and it’s important that her body is able to adapt to these different stressors appropriately! Just a few of the benefits that research has shown include decreased back pain during pregnancy, decreased labor time, and decreased post-natal pain. I’ll be doing an entire video and post about this topic, so stay tuned!

With all of these professionals, we are dealing with a human to human interaction. I mention this to say that it’s really important that a woman jives and feels comfortable with the different people who she’s turning to for her prenatal care and advice. Tension, conflict, or a lack of trust can result in emotional stress as well as physical stress, and ain’t nobody got time for that, especially a hormonal pregnant woman! Asking for recommendations from friends and family members or looking for professionals who have great online reviews is a great place to start. From there, interviewing a few different people ensures that it’s a great fit for momma-to-be and her family!

If you’re looking for recommendations for members of your prenatal team, please don’t hesitate to ask! I would love to help you find your ideal team.

Are Your Glutes Sleeping on the Job?

Because a majority of us sit behind a desk all day, our glutes are asleep. Much like the phrase "use it or lose it", our brain forgets that our booty muscles are there. When we perform movements or exercises that would normally utilize our glutes, other muscles have to step in and compensate for the sleeping giant. What does this mean for overall function of our body? It means that smaller muscles are placed under a great deal of stress in order to keep our body performing as optimally as possible. At some point, those accessory muscles can't keep up and we start to experience a variety of symptoms.

Some of the most common symptoms associated with weak glutes include:

- Low back pain and instability

- Hamstring strains

- Knee Pain

- Hip Pain

- Chronic ankle instability

So what can you do to wake your booty up? There are a variety of exercises that target the glutes and help to re-establish the connection between your brain and your behind. Examples of these exercises include single-leg squats and single-leg Romanian deadlifts. It is important to make sure your form is correct when performing these exercise, so it is best to utilize the guidance of a trained professional when first starting out. 

Another important step to turning on your glutes is to visit your family wellness chiropractor. Chiropractors directly influence the function of nerves by ensuring that the spine and pelvis are moving properly. When a nerve is functioning optimally, the brain is better able to communicate to muscles and every other part of the body.

To find out whether your symptoms are related to weak glute muscles, schedule an appointment with Dr. Nikki at Renew & Restore Wellness today!