27 minute read
Maternal Health
M H
The Center for Maternal Health Equity Looks for Answers to a Persistent National Problem
Morehouse School of Medicine’s Dr. Natalie Hernandez, executive director, Center for Maternal Health Equity
By Peggy Pusateri
Tackling Racial Disparity in Maternal Health
If the past 35 years are an accurate indication, medical science still struggles to improve maternal health outcomes in the United States. In 2020, the nation recorded 861 maternal deaths and an unexpectedly high maternal mortality rate (MMR). In 1987, when the CDC began keeping tabs, the overall MMR, across all races and ethnicities, was 7.2 maternal deaths per 100,000 live births. Since then, the rate has climbed steadily, to an MMR of 23.8 in 2020. Researchers estimate about two-thirds of those deaths are preventable.
Noting possible reasons for the long-term rise, the CDC points to several factors, including computerization of birth and death records, changes in the way deaths are coded, and the addition of a pregnancy box on death records. What cannot be explained by more sophisticated recordkeeping is the unyielding disparity in maternal mortality rates between different racial groups: Black and other women of color fair far worse during and after pregnancy. In a period from 2014 to 2017, the MMR for non-Hispanic Black women was 41.7, compared to 13.4 for non-Hispanic white women. In 2020, while the rate for white women increased to 19.1, it spiked dramatically for Black women, to 55.3 deaths per 100,000 live births.
Approximately 50,000 additional women suffer serious pregnancy complications each year, and again, Black women represent a disproportionate share of those severe maternal morbidity numbers.
“There are significant and persistent racial disparities in maternal health outcomes,” notes Dr. Wanda Barfield, director of the CDC’s Division of Reproductive Health. “American Indian, Alaska Native and Black women are 2-3 times more likely to die, respectively, from a pregnancy-related cause than white women. Inequities are also present at all education levels. Black women with a college degree are five times more likely to die due to pregnancy-related complication than white women with a college degree.”
Enter Morehouse School of Medicine, with its ongoing commitment to eliminating health disparities. Founded in 2019 with a grant from the state of Georgia, its Center for Maternal Health Equity is leading the charge to reduce the number of maternal deaths and serious pregnancy complications, especially for women of color. The only academic institution tackling the problem of maternal health disparity in the United States, the center conducts research to uncover the root causes, engages in community advocacy, and trains health professionals.
Turning Research Into Action The center’s translational research seeks underlying causes of maternal outcome disparities. Research results shape the organization’s other efforts: community outreach and professional training, explains Natalie Hernandez, PhD, MPH, executive director of the center. One dynamic research
— Natalie Hernandez, PhD, MPH
effort underway is the Maternal Near Misses project, which gathers the stories of women of color who experienced near-death events during pregnancy, childbirth or postpartum. Already, that research has generated a new community outreach initiative.
“So far from these stories, we found out that there is a lack of clinical coordination,” Dr. Hernandez says. “That led to an idea to develop a patient navigation program in which we’ll be training women with lived experiences to serve as navigators to help with that clinical care coordination, to give (patients) the respectful maternity care that they need, to be the social support system that (the navigators) felt they were lacking during and after their pregnancies. So, already, the data is informing the programming the center is focused on.”
Conducted in partnership with Emory University, Georgia Institute of Technology, and Georgia State University, another Center for Maternal Health Equity research effort is testing a mobile technology application designed to improve postpartum care. The Prevent Maternal Morbidity and Mortality using Mobile Technology project (PM3) was co-created by Black, indigenous, and Latinx researchers. Additionally, a focus group of Black patients and their clinicians offered insight into patient needs as well as barriers to receiving postpartum healthcare. PM3 was designed by and for women of color.
“What we realized was that women were being sent home with discharge papers and that was it,” Hernandez says. “No one was following up with them. No one was really talking to them or providing detailed information about the risk that exists when you do go home, where most of maternal deaths happen in the postpartum period. We wanted to … deliver that information in a way that really focused on the women themselves.”
She points out that 40 percent of women do not attend postpartum care visits. Her center is testing the PM3 app in three rural areas of Georgia to see if it can change that statistic. Patients are given blood-pressure cuffs as well as wearable trackers that monitor sleep patterns and heart rates. Data is transferred to medical professionals, who keep an eye on patient vital signs between appointments; this is particularly important in rural areas where OB/GYN providers might be few and far between. The PM3 app sends postpartum care instructions, reminders and tips to women via mobile devices. Targeted messages include educational information, links to mobile health applications, and links to social services. Instead of searching online for answers, women get a one-stop shop with all the postpartum healthcare information they need.
Healthcare Access is a Key Factor Geography plays an important role in maternal health outcomes. Dr. Roland Matthews, professor and chair of Obstetrics and Gynecology at MSM, says rural hospital closures can make finding appropriate prenatal and postpartum care difficult. Where hospitals remain open, an obstetrics department might close, and many rural communities don’t have a single OB/GYN provider practicing in the area. A 2020 March of Dimes Report, titled Nowhere to Go: Maternity Care Deserts across the U.S., notes that seven million American women live in communities with limited or no access to maternity care. In 2017, roughly half of all counties in the nation lacked a single obstetrician. Each year, more than half a million babies are born in communities designated maternity care deserts.
Location is just one of the social determinants that impact maternal care access. Dr. Franklyn Geary, Jr., a professor of obstetrics and gynecology
The numbers tell the story
The overall, pregnancy-related mortality rate has tripled since the CDC began recording it in 1987. While improved record keeping explains at least some of the rate increase, what remains more elusive is the persistent disparity between racial groups: Black women, especially, continue to experience much higher maternal mortality and morbidity rates than do white women. 861In 2020, 861 women were identified as having died of maternal causes in the United States, compared with 754 in 2019. In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women.
Source: CDC, National Center for Health Statistics
Percent of pregnancy-related deaths
Causes of pregnancy-related death in the United States: 2014-2017
16
14
12
10
8
6
4
2
0 15.5
12.7
11.5
10.7 9.6
8.2
6.6
Source: CDC
5.5
Other cardiovascular conditions Infection or sepsis Cardiomyopathy Hemorrhage Thrombotic pulmonary or other embolism Cerebrovascular accidents Hypertensive disorders of pregnancy Amniotic fluid embolism 0.4
Anesthesia complication Percent
12.5
Other noncardiovascular medical conditions
Deaths per 100,000 live births
Maternal mortality rates, by race and Hispanic origin: United States, 2018–2020
60 55.3
50
40 44.0
37.3
30
20
10 17.4 20.1 23.8
14.9 17.9 19.1
0
Total Non-Hispanic White Non-Hispanic Black 2018 2019
2020
Source: National Center for Health Statistics, National Vital Statistics System, Mortality
11.8 12.6 18.2
Hispanic
at MSM and the associate dean of admissions, specializes in treating patients with high-risk pregnancies. He notes that medical risks are compounded by factors such as transportation, housing insecurity and education. Women in low-income brackets are more likely to struggle finding transportation to and from medical appointments or to lack childcare options, meaning they are more likely to miss appointments.
“Since I am taking care of patients who have high-risk medical problems, especially diabetes and hypertension, when they don’t come for an appointment, it’s very challenging to manage their blood sugars if they are diabetic,” Dr. Geary explains. “It’s difficult to manage their hypertensive medicines if they have hypertension.”
The Center for Maternal Health Equity has an initiative to address the geography problem, too. In February, MSM received a $1.725 million grant from the Amerigroup Foundation to fund several of the center’s initiatives. Among those initiatives is a rural maternal health residency program, which will place 100 residents in rural areas where health inequities are high.
Pandemic effect The first year of the COVID-19 pandemic brought worsening maternal mortality rates for Americans of color. Hernandez says the bad news was not unexpected, considering Sars-CoV-2 hit communities of color hard in terms of hospitalizations and deaths.
NEAR MISSES PROJECT
In May 2014, Nupur Modi Murali was a healthy 27-year-old expectant mother. She exercised regularly and was physically fit. Everything seemed to be proceeding smoothly, until she nearly died.
At 29 weeks of pregnancy, eclampsia triggered a seizure, and she slipped into a coma. As doctors at a Princeton, New Jersey hospital prepared for surgery, they asked her husband if he would rather they save her or the baby.
“I was almost dead at a very young age,” she recalls. “They didn’t know if I would come back, if I was brain dead. I went through five days in ICU in a coma.”
Stories like Murali’s happen about 50,000 times each year in the United States, and they happen all too often to women of color. Working to reduce maternal mortality and morbidity, Morehouse School of Medicine’s Center for Maternal Health Equity last summer launched its Maternal Near Misses project, collecting the narratives of minority women who suffered life-threatening complications during pregnancy, child birth or postpartum. An ambitious project, it aims to create the largest repository of such stories and to shape clinical health policy in communities where change is needed most. “A lot of people were focused on when women die; there are women who are alive that can really tell us what actually happened,” explains Dr. Natalie Hernandez, executive director of the center. “There’s so much value in sharing stories … and telling it in their own words. This is a way to recognize that patients’ experiences are legitimate sources of data.”
“Because COVID-19 was so high in Black and brown communities and, in particular, really affected Black women, we knew that would relate to some of the maternal deaths,” she explains.
Additionally, the pandemic compounded problems accessing perinatal and postpartum care, as the number of missed and cancelled appointments skyrocketed. For many patients, entire support systems were disrupted. Social distancing and the closure of childcare centers and schools were cited as possible factors in exacerbating challenges to maternal care access, according to the 2020 March of Dimes report. Economic factors took a toll, as well, with the shutdown bringing loss of employment, loss of health insurance and heightened food insecurity — all situations disproportionately affecting communities of color and all contributing to higher rates of maternal mortality and morbidity.
Already at higher risk of complications, Black women were less likely than white women to have access to the telehealth options that became commonplace since the pandemic’s onset.
“Services that were readily available for other populations, like telemedicine or telehealth, weren’t situated in a lot of lower income communities, so they didn’t have those opportunities to still have access to care,” Dr. Hernandez explains.
The Center for Maternal Health Equity stepped in to help find solutions, partnering with the University of North Carolina at Chapel Hill and numerous other organizations, including the National Birth Equity Collaborative, the National Perinatal Association, and the Georgia Health Policy Center. Through the federal CARES Act of 2020, UNC-Chapel Hill received a $4 million grant to increase access to maternity health services in communities already struggling with high maternal mortality rates and hit hard by COVID-19.
The center’s first assignment for the Maternal Telehealth Access Project (MTAP) was research to understand the challenges women faced in accessing telehealth services and the difficulties providers were experiencing. Next, Hernandez and her team directed grant funding to entities already dedicated to the
The effort gathers stories from a number of states with high maternal mortality rates. Project staff expect to collect 120 narratives by the end of 2022 and continue accepting them indefinitely. Dr. Hernandez says the center hopes to index the testimonies in the National Library of Medicine. Long-term, the idea is for the stories to inform future clinical policy and training for medical professionals.
The Power of Being Heard From the narratives recorded so far, a common theme emerges: the frustration of not being heard or believed. When healthcare providers dismiss patient concerns, a dangerous delay in care can result. A video produced by the center features women asking doctors, nurses and other providers to listen to patients, trust them to know their own bodies, and believe them.
Murali understands that frustration. Eight years after her near-death event, she and her son are both healthy. But the story could have ended differently, and maybe it didn’t have to happen the way it did. There were signs. Murali saw them. Sometimes medical professionals saw them, but each time, the red flags were dismissed.
“At my 26-week appointment, I clearly remember my blood pressure being 120 over 80. Normal, right? But here’s the thing: Everything that may seem normal for someone may not be normal for them,” she explains. “My blood pressure until 26 weeks was always about 105 or 110 over 65. The nurse, when she marked it down, said, ‘Hmm, it’s a little higher than I’ve ever seen it for you,’ but the doctor said, ‘No that’s still normal.’”
It wasn’t normal, not for Murali. Because her pregnancy was not considered high-risk, she wasn’t due for another checkup for a month. Over the next three weeks, alarming symptoms surfaced.
There was severe edema. Her face was swollen, and at 26 weeks, she had already gained 45 pregnancy pounds. By 29 weeks, she gained 35 more.
And there was dizziness. One Sunday she went for a walk with her husband and would have fallen if he hadn’t caught her. “The whole world was spinning upside down for 10 minutes,” she says. When she called an emergency line to report the problem, a nurse assured her that dizziness is normal during pregnancy and that Murali probably was just hungry.
Then, at 29 weeks and 4 days, came a headache so severe it left her numb. “The headache was so bad I was slurring. I couldn’t talk,” she remembers. She tried to sleep that night but couldn’t. Spots began to flash across her vision. At 7 a.m., extremely confused, she got up for the day. She couldn’t remember how to make coffee or toast; she put her hand — not bread — in the toaster. She forgot how to walk or get down the steps of her home.
At her OB/GYN office that day, medical staff discovered her heart rate was 200 over 150, and there
I want to spread this out as much as possible so that what I went through, somebody else doesn’t go through it, because it definitely leaves a PTSD scar forever.”
— Nupur Modi Murali was protein in her urine. Recognizing she was at extremely high risk of heart attack or stroke, they told her she needed to be admitted to a hospital immediately. But, instead of calling for an ambulance, a nurse suggested Murali’s mother drive her.
“By the time we got to the hospital, I’m half dead,” she recalls. “I can’t respond. I can’t get out of the car.”
Most of what happened after that she learned from her husband and mother. After she went into a coma, doctors delivered her son, who weighed only 2.2 pounds, and kept Murali on a ventilator. For a couple days, she didn’t respond to questions, and medical staff didn’t know if she had brain activity until she emerged from the coma.
Reflecting on her story, she sees all the things that could have been done differently. A nurse or doctor could have called an ambulance instead of suggesting her mother drive her to the hospital. Emergency call-line staff could have taken her severe dizziness more seriously. OB/GYN professionals could have seen a red flag that she had gained 45 pounds by 26 weeks, and they could have scheduled weekly, instead of monthly, appointments once her blood pressure rose.
Murali has told the narrative many times. It’s a big part of her life story. Yet when she learned of the Maternal Near Misses project, she was eager to tell it again.
“I want to make an impact. I hope my voice is heard. I want to spread this out as much as possible so that what I went through, somebody else doesn’t go through it, because it definitely leaves a PTSD scar forever.”
health of mothers and infants. MTAP grants went to large organizations, such as hospitals and universities, as well as small, local groups, many with a particular focus on the needs of communities of color. The money was used to train doulas, midwives, nurses, and community health workers to offer prenatal and postpartum telehealth services. It funded the purchase of remote monitoring equipment such as scales, blood pressure monitors, smart phones, and tablets. In addition, grants paid for laptops, WIFI equipment, and Internet access.
“People think oftentimes of just rural communities as having access barriers to Internet connections, but we know in a lot of lower income communities, that’s still a huge barrier, because those bills are really expensive, or people just can’t afford to have a computer or
access to those things,” Hernandez says.
Some MTAP grants allowed patients to access the Internet at central community locations so they could talk with maternity care providers. Others funded drive-up blood pressure monitoring sites and drive-up checkup locations for pregnant women. In all, the year-long MTAP project directed maternal health funding to 91 organizations across the nation.
Multi-Faceted Approach A close look at the Center for Maternal Health Equity uncovers a multitude of initiatives underway simultaneously. It undertakes lab research, fertility projects, and efforts to increase access to doulas. It currently is testing a remote blood-pressure monitoring plan to determine if it can improve outcomes related to preeclampsia. A nutritional project conducted with the Georgia Dept. of Public Health — Dads Involved in Nutrition Education — engages fathers in efforts to increase breastfeeding rates and improve maternal health by reducing nutrition disparities.
The center is taking pre-conception counseling into local communities in Georgia and South Carolina. Maternal health education takes place in community-based settings, instead of clinics, “meeting women and their partners where they are and addressing a lot of those underlying health conditions before a woman gets pregnant,” Hernandez explains. One outreach initiative in progress is the redesign of educational materials distributed to pregnant and postpartum women.
“We see ourselves as an information resource hub,” Hernandez explains. “A lot of the information that exists, to a certain degree, is not culturally centered or relevant to the
unique needs of black women and other women of color. It doesn’t really reflect communities of color.”
The center is creating a library of online, print and video communications designed to resonate with women of color, through both images and language.
“A lot of this is done through our research with Maternal Near Misses and other projects to (find out) what’s an easier way to (reach) Black women to talk about preeclampsia or gestational diabetes,” Hernandez says. “We know that culturally people refer to that as ‘the sugar.’ Do we talk about it in that context? Do we take music and make information in a way that’s uniquely positioned to be more relatable to women?” initiatives targeting at-risk populations, MSM’s center also works on improving the training that perinatal providers receive. The idea is to mitigate some of the intangible forces at play.
“You have the structural determinants of health that contribute to these issues, like structural racism, implicit bias, policies that disenfranchise communities,” Hernandez says. “We know it’s so much bigger than what the facts say.”
She points to evidence that Black women with higher levels of education still have worse maternal health outcomes than white women who dropped out of high school.
“There’s something about toxic stress,” she says. “There’s something about these structural and social determinants that do contribute to leading causes of death for women.”
Many of the women participating in the center’s Maternal Near Misses project reported feeling that their health concerns were ignored by doctors and other medical professionals. In response, the center is developing curricula on implicit and explicit bias for training current and future perinatal care providers, including midwives and community health workers.
“We are a medical school, so we are focused on the training of future leaders,” Hernandez notes. “We are developing different programs, such as the Respectful Maternity Care Simulation Model.” The center created patient scenarios touching on common pregnancy concerns and including patients from a wide variety of racial, socio-economic, and family backgrounds. Pre- and post-tests identify changes in provider knowledge and patient experience, and the center’s staff conduct observations to evaluate the impact on patient/provider interactions. In addition, evaluations performed both by providers and
$1.725 MILLION AMERIGROUP FOUNDATION GRANT
The grant will help fund MSM’s Narrowing the Maternal Health Inequity Gap through Training program. The initiative will reach more than 127,000 pregnant and parenting Black women and their families. Through the Perinatal Professional Training Program, doulas and lactation consultants will be trained to support more than 8,500 pregnant Black women in Georgia. The rural residency program will serve 14,450 Black women over the course of the project, aimed at reducing maternal morbidity and mortality rates.
Shaping Provider Training While researching underlying causes of maternal health inequity and creating outreach
by patients help determine if the simulations are moving the needle on doctor/patient interactions. The center is evaluating the model right now at Grady Memorial Hospital.
“We’re hoping it can be something that can be nationally implemented.” Hernandez says. “The scenarios are pretty unique. We’re trying to be very inclusive and think about the intersections that our populations experience. Everything is not heteronormative. Everything is not black and white. Everything is done with intent and it’s based on evidence-informed and evidence-based research.”
Patient Advocates: Medicaid Extension It’s difficult to overstate the role insurance coverage plays in determining maternal health, particularly in regard to postpartum conditions. Many women who qualify for Medicaid coverage during pregnancy lose that health insurance 60 days after giving birth, placing them at risk of having postpartum problems go undiagnosed and untreated. Among recommendations for improving maternal health made in the 2020 March of Dimes report is the extension of Medicaid coverage to 12 months postpartum.
Such coverage is critical to improving maternal outcomes for minority women, especially when they have complicating medical conditions, says MSM’s Dr. Geary.
“There are diagnoses we make during pregnancy that don’t end when the pregnancy ends,” he explains. “These patients need to get continued care well beyond their six-weeks postpartum visit. Just because the pregnancy is done, they still have those medical conditions. Diabetics may be able to attain good glucose control during pregnancy but then postpartum, if the same amount of effort is not spent to control blood sugars, they’re going to have disease progression. They’re going to have heart disease, they’re going to have renal disease, they’re going to have the other things that accompany chronic diseases. We know that with hypertension and pre-eclampsia, there are implications for the cardiovascular system, so those patients really need to follow up with cardiologists. The reality is, they have to have some source of payment to be seen.”
In Georgia, the Center for Maternal Health Equity played an instrumental role as part of a committee on maternal morbidity and mortality that worked to get 2020 legislation passed extending Medicaid coverage to six months postpartum. The committee continues working toward the legislative goal of 12 months postpartum Medicaid coverage.
Power Partnerships The Center for Maternal Health Equity builds momentum for its projects by partnering with national and local institutions working toward the same goals. Partners such as Black Mamas Matter Alliance, Reaching Our Sisters Everywhere, HealthConnect One, Healthy Mothers Healthy Babies, and Healthy Start Initiative all focus on improving maternal and child health. The center also partners with academic institutions and is part of an HBCU maternal health alliance. In addition, it works with corporate health initiatives, secures grants from a wide variety of funders and is deeply connected to researchers, clinicians, policy experts, and community leaders.
“A big aspect of the center is that we have tremendous partnerships with leading organizations across the country,” Hernandez says. “With collective impact, we can address these issues, and the center has been the connector of everyone working together.”
One local partner is an Atlanta organization that adapted its original focus of delivering food to elderly people. In a one-year pilot project, Open Hand Atlanta is testing whether it can contribute to better maternal health outcomes by delivering meals to women who either have gestational diabetes or are at risk of developing it. In addition to providing meals, the project connects pregnant women with a dietitian.
For Open Hand Atlanta and a number of local organizations, the Center for Maternal Health Equity conducts process evaluation, collecting project data and evaluating outcomes to learn whether the innovative efforts are successful and can be repeated elsewhere. In this case, the center measures outcomes, asking questions such as: Did the dietitian increase participants’ health knowledge? Did participants change their behavior? Did the program increase participants’ physical activity? With evidence to document project success, local groups can more successfully secure grant funding to continue or even expand their initiatives.
“We know a lot of the solutions lie in the community,” Hernandez says. “Sometimes organizations have good ideas but they don’t know how to demonstrate that the program worked. What I love about Open Hand is that they took something they already do really well and are adapting it to fit the needs of birthing populations. That was really innovative. We were so excited to partner with them to be able to help them with their evaluation.”
With so many projects underway and so many innovative ideas to support, the center’s partnerships are touching the lives of pregnant women of color all across the nation, Hernandez points out. “The small investment that the state made into Morehouse School of Medicine has quadrupled in terms of initiatives and funding and things that we’re able to do with the seed funding from the state.” M
DISPELLING THE MYTH OF ABSENT BLACK FATHERS
By David Hefner, EdD
At the turn of 21st century, the absence of Black fathers dominated the news and became another ominous stereotype in American life. The rise of drugs and gun violence in Black communities in the 1980s and 1990s fueled the proliferation of Black males in prison amid policies such as three-strikes-you’re-out. The absence of Black fathers — so called “dead beat Dads” — had become the presumptive norm rather than the exception and, when true, had profound consequences for the children left behind.
Josh Levs’ book, All In, suggests that 2.5 million of 4.2 million black fathers — nearly 60 percent — live with their children. They may not be a married partner to the mother, but they are very involved with their children. Today, however, things have taken a significant turn as Black fathers were found to be the most involved among all fathers, according to a study by the Centers for Disease Control and Prevention. And Latrice Rollins, PhD, a behavioral scientist at Morehouse School of Medicine, is dedicating her career to studying the engagement of Black fathers in the lives of their children, families, and the African American community.
Rollins recently received funding through a collaborative grant that provides $1.8 million per year over the next five years to establish the National African American Child and Family Research Center, which will study ways to better serve African American families and children in programs such as Temporary Assistance for Needy Families (TANF), Head Start, and childcare assistance. Black fathers are a central aspect of her research. Such research is vitally needed to inform policy, funding, and services needed to address issues and opportunities to strengthen African American communities, families, and children.
“We really want to be transformative,” Rollins says of the impact of the collaborative grant. “Fathers are not the whole thing, but it’s critical that fathers are engaged at this stage. So they are a part of these programs.”
Latrice Rollins, PhD, assistant professor, Community Health and Preventive Medicine, Morehouse School of Medicine
Research suggests that children significantly benefit when fathers engage in their lives. They graduate from high school at a higher rate, have better social skills, closer family ties, and fewer risky and delinquent behaviors. They also tend to be healthier. Conversely, when fathers are absent, children can have a myriad of negative behavioral outcomes at all levels of development, according to research reported by the National Responsible Fatherhood Clearinghouse under a study supported by the U.S. Department of Health and Human Services.
In the Community In the African American community, the issue of fatherhood is both significant and sensitive as studies find that roughly two-thirds of Black children live in single-parent households, the majority of which are headed by mothers. Such statistics have been linked to many challenges facing Black children, thereby making Rollins’ research of Black fatherhood particularly important. Moreover, the legacy of American slavery, the pernicious history of lynching, killing, and mass incarceration of Black males provide the context that makes her research particularly compelling.
“It’s historic,” says Rollins, a Spelman College graduate who received her doctoral degree in social work from the University of Georgia. “Not only the myth, but the whole issue of mass incarceration that removed fathers. There is this perception that African American fathers do not want to be in their children’s lives. It’s a terrible myth that people just run with, even our people. And it’s hard to shake. It’s very frustrating when a father is met with cynical views or resistance to providing resources because folks just assume that they are not deserving of resources. They feel that fathers do not deserve as much attention as mothers or children.”
Rollins has seen this play out in real time. After earning her doctorate, she worked for the Georgia Office of Child Support Services and then for a state fatherhood program, where she observed the challenges that made it difficult for fathers to receive needed resources to be involved in their children’s lives. Fathers, she said, were defined solely by their ability or inability to pay child support.
“Fathers had to pay child support or go to jail, and there were no programs to refer them to,” she recalls. “During that time, there were wanted ads with fathers’ pictures on them in the child support office. But that idea of the criminal nature of fathers, even if they are not paying their child support, not even considering that they may have job issues or education issues. It portrayed them as criminals.”
For the last two years, Rollins and her team in MSM’s prevention research center have held numerous events, workshops, and panel discussions on Black fatherhood and the critical role fathers play in sustaining communities, families, and children. Her efforts have led to her recent induction into the National Partnership for Community Leadership’s Spirit of Fatherhood Hall of Fame. She is also the first person to receive two awards in one, the Vicki Turetsky Woman in Fatherhood and the Ronald B. Mincy Research Scholar Award.
“We really have to keep telling this story,” Rollins says. “We really have to show the reality. When fathers need resources and services, they should be available to them just as they are for moms. And we know when we have strong families, we have strong communities.”
