Brooke Dorsey Holliman never thought she’d be a statistic for her own research.
After giving birth to her second baby just over a year ago, the joyous moment erupted into chaos when her doctor surgically removed the placenta that had failed to follow the newborn out, triggering massive hemorrhaging.
“I remember thinking: How is this happening to me? I do research on this; I was so prepared,” said Dorsey Holliman, PhD, an associate professor in the University of Colorado School of Medicine Department of Family Medicine at the CU Anschutz Medical Campus.
As she ebbed in and out of consciousness, the color draining from her face, Dorsey Holliman remembers locking eyes with her husband, who stood cradling their newborn daughter across the room, tears streaming down his cheeks.
“There was this unspoken connection,” she said, describing a shared sense of fear and sadness. “We both thought I was gone.”
Community coalition fuels work
That was just over a year ago. At the time, Dorsey Holliman – who was resuscitated twice and spent five days in the hospital recovering from the event – was in the midst of an ambitious project aimed at lowering the unequally high number of Black maternal deaths in this country.
Armed with some new and unexpected personal motivation, Dorsey Holliman managed to meet the chief goals of that two-year project this past December. She and her partners gathered mothers, researchers, medical providers and organizational leaders from across the Denver-metro area, forming a powerful team eager to join a medical campus-fueled venture to make a difference.
Together, the newly formed advisory board and Black Maternal Research Coalition (BMRC) set a prioritized research agenda focused on moving Dorsey Holliman’s work to the next level.
“There was this unspoken connection.
We both thought I was gone.”
– Brooke Dorsey Holliman, PhD
The project, Enhancing Maternal Birth-Outcomes Research by Advancing Culturally-Informed Engagement (EMBRACE), was funded by the Patient-Centered Outcomes Research Institute.
Death rate: ‘I think that it’s scary’
As an expert in qualitative and mixed-methods research, Dorsey Holliman has long focused her work on inequities in healthcare, including maternal health. In the United States, maternal death rates have consistently and dramatically exceeded other industrialized nations.
For Black mothers, the chances of dying or losing their babies are starkly higher than women of other racial backgrounds. In 2020, out of 100,000 births, 53 Black women died compared to 19 white women. In Colorado, Black women are 3.4 times more likely to die a pregnancy-related death. And those statistics lack the infant and near deaths like Dorsey Holliman’s.
“I think that it’s scary,” she said of being a pregnant Black woman in America, adding that women frequently ask her if they should even take the risk or resign to not having a baby. “And it’s something that you wouldn’t anticipate with the state of modern medicine in the United States.”
Research path: getting to the next level
Dorsey Holliman, a director in the Adult & Child Center for Outcomes Research & Delivery Science (ACCORDS) at CU Anschutz, said EMBRACE’s aim is to implement evidence-based interventions that work for Black women.
“A lot of the advocacy that’s happening now is the boots-on-the-ground, grassroots efforts of Black women. But in order to get to the next level, it seemed really important to bridge that gap and have pediatricians, OBs, educators, researchers, everyone at the table to discuss perspectives and discuss solutions.”
While awareness of the disparity has grown, solutions remain largely a mystery. “In doing my research and talking with Black women, it seems like a lot of the problem is really structural and has to do with healthcare systems,” Dorsey Holliman said. “I had some great doctors and nurses that I connected with, but it wasn’t enough.”
Nationally, conversations have centered on implicit bias and on Black mothers not being heard by their providers. Tennis great Serena Williams went public for the cause after she nearly died giving birth. Williams said care was critically delayed, because doctors didn’t initially listen to her concerns about a history of blood clots.
“I had some great doctors and nurses
that I connected with, but it wasn’t enough.”
– Brooke Dorsey Holliman, PhD
Dorsey Holliman, who did express concern about the use of induction drugs and her long labor, which exceeded 48 hours, said conversations with medical colleagues afterward suggested earlier intervention could have made a difference in her outcome.
‘CU Anschutz cares about this’
Not feeling heard, experiencing racial discrimination, and not being offered mental health services after losing a baby were some of the common themes during focus groups held as part of the project.
“The stories that I heard were so powerful. And these women had ideas on ways to solve problems,” Dorsey Holliman said, noting having group prenatal care where women can support each other was a popular proposal.
With a sustainable foundation in place for the venture, it’s now a matter of finding continued funding to move it to a larger scale, Dorsey Holliman said. “The coalition is motivated to continue the work and committed to making a change,” she said, adding that having the CU Anschutz Medical Campus connection has helped fuel that energy.
“The message is: CU Anschutz cares about this topic,” Dorsey Holliman said. “And the university is positioned in a community where there are a lot of Black and other minority communities in the surrounding area, so that was a powerful association for people. It helped people say: I want to be a part of this.”
Sharing that she and her husband are afraid to have another baby, Dorsey Holliman said she hopes EMBRACE helps lift the cloud of fear that hangs over Black women, even if it’s just one change at a time.
“Five years from now, I would love to be able to say that, based on evidence, following a specific intervention can save Black women’s lives. That’s my ultimate goal.”