In a recent webinar hosted by Ob Hospitalist Group (OBHG), two experienced OB hospitalists explored one of the most urgent conversations in modern medicine: how clinicians can confront bias, improve maternal outcomes, and create more equitable birth experiences for Black mothers.
The discussion, “Advancing Equity in Maternal Care: Addressing Bias and Improving Outcomes,” featured Drs. Nicole Rankins and Chasity Jennings-Nuñez, who blended candid personal reflections with practical strategies clinicians can apply immediately in labor and delivery settings.
Takeaway: The webinar, held during Black Maternal Health Week, focused not only on disparities in maternal outcomes, but also on how the OBHG hospitalist model can help clinicians provide compassionate, patient-centered care while maintaining professional fulfillment and flexibility.
In 2023, the maternal mortality rate for Black women was 50.3 deaths per 100,000 live births, significantly higher than rates for White (14.5), Hispanic (12.4), and Asian (10.7) women.
Source: National Center for Health Statistics
Bias is a normal and treatable condition
Dr. Rankins, an OBHG hospitalist and site director at St. Mary’s Hospital in Richmond, Virginia, opened the conversation by discussing the larger systemic factors that contribute to racial disparities in maternal care. She pointed to clinician bias, limited access to healthcare between pregnancies, and the chronic stress experienced by many Black women — a concept often referred to as “weathering.”
“Bias is always a difficult and challenging discussion, because it becomes accusatory and people feel like they’re being attacked or labeled or that they’re a bad person,” said Dr. Rankins, who also hosts the Birth With Power podcast. “When in fact, bias is actually a normal human emotion that we all experience. It’s what you do with that bias that makes the difference.”
An open approach: Both physicians stressed that outcomes improve when healthcare systems openly acknowledge disparities and actively work to address them.
Dr. Jennings-Nuñez, who practices in Los Angeles and has spent much of her career serving Medicaid populations, highlighted the role that social determinants of health play in pregnancy outcomes. Access to nutritious food, preventive care, safe housing, and insurance coverage all shape how healthy patients are when they enter pregnancy, regardless of where they live.
“They’ve said that your ZIP code tells more about your life expectancy than your genetics, and that is true.”
Dr. Chasity Jennings-Nuñez
Make time to listen, communicate, and get consent
The discussion repeatedly returned to one central theme: listening.
Feeling heard and seen: Drawing from patient surveys conducted in California, Dr. Jennings-Nuñez, an OBHG hospitalist at California Hospital Medical Center in Los Angeles and member of the faculty at Charles R. Drew University of Medicine and Science, described how many Black mothers report feeling unheard, dismissed, or disrespected during healthcare encounters. Patients also described difficulty navigating healthcare systems and obtaining resources such as breast pumps or glucose monitoring equipment.
For both physicians, improving maternal care often begins with relatively simple changes in communication.
“Sometimes it doesn’t take much,” said Dr. Jennings-Nuñez. “It just takes sitting on the stool instead of standing when we’re talking to people. It just takes taking two or three minutes to let them voice their concerns first before we start in on whatever we need to say.”
Dr. Rankins described small but powerful practices she now incorporates into every patient encounter: acknowledging every person in the room, asking patients about their birth preferences, reviewing birth plans together, and explicitly asking about fears or concerns.
Getting buy-in: Consent is an important goal in any encounter, said Dr. Rankins, as patients may feel powerless unless clinicians ask them directly for permission to touch them.
“It’s kind of embarrassing that it took me this long to realize,” she said, explaining that even when carefully narrating a cervical exam, “at no point in that conversation did I ask, ‘Is it OK for me to do this?’”
These relationship-building moments become especially important during emergencies, when clinicians must move quickly and patients need to trust that their care team is acting in their best interest, noted Dr. Jennings-Nuñez.
We asked the webinar attendees, “What does Black Maternal Health Week mean to you?” Some of their answers were:
- Empowerment
- Respect
- Equitable care
- Support
- Proper care
- Advocating
Systemic changes: She also explored how hospital systems can create measurable improvements in maternal outcomes, highlighting several initiatives implemented in California, including expanded Medicaid coverage for postpartum care, support for doula services, and standardized treatment protocols for obstetric emergencies.
These protocols, she explained, help reduce opportunities for bias by ensuring all patients receive evidence-based care.
“If you have to treat the blood pressure when it’s 160 over 110, it’s 160 over 110 no matter what your color is,” she said.
Rankins added that tracking and openly discussing clinical data — including cesarean-section rates and patient outcomes — can drive meaningful cultural change within departments.
Making an impact as an OBHG hospitalist
The webinar also offered an authentic look at why both clinicians chose the OB hospitalist model and how OBHG helps them remain passionate about their work.
Focusing on patient care: Both doctors described joining OBHG after years in private practice and academic settings. What they found was a career structure that allowed them to remain deeply engaged in labor and delivery while also gaining greater flexibility and balance in their personal lives.
Dr. Rankins described the freedom the hospitalist model gave her to raise children, care for aging parents, and pursue additional professional interests outside the hospital. Dr. Jennings-Nuñez emphasized the opportunity to work at different hospitals and serve diverse patient populations while continuing to teach residents and medical students.
Both clinicians also spoke candidly about the emotional impact of caring for patients who see themselves reflected in their physician for the first time.
“I walked into a patient’s room, and she looked at me and said, ‘You’re Black. I am so excited to see you.’”
Dr. Nicole Rankins
Takeaway: For clinicians considering a transition into hospital medicine, the webinar offered a compelling portrait of what draws many physicians to OBHG: meaningful patient relationships, collaborative team-based care, schedule flexibility, and the opportunity to influence maternal outcomes at both the bedside and systems level.
‘Just keep at it’
Throughout the conversation, both speakers emphasized that advancing equity in maternal care is not the responsibility of any one clinician or demographic group. It requires sustained collaboration, openness to growth, and a willingness to examine both individual behaviors and institutional systems.
“These things take time,” Rankins said near the conclusion of the webinar. “It’s not six weeks. It’s not six months. Sometimes it’s six years before things change. So you just keep at it.”
Missed the live webinar or want to revisit the discussion?
This webinar is now available on demand. We invite you to explore the recordings and share them with colleagues committed to advancing high-quality obstetric care.
Watch the Advancing Equity in Maternal Care Webinar On Demand Here
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