“A friend who runs an organization for Black parental support told me that a local family lost a new mother to a postpartum preeclampsia stroke. It’s daily. We tend to hear about the deaths, but there are so many ‘almost, could haves’ that we don’t hear about, too. My fellow Black OB-Gyn colleagues and I always say the same thing: ‘Not on my watch’ – meaning, we’re going to do everything in our power to help each and every last one of our patients.”
As the United States’ birthing person population reels from the Dobbs decision of 2022, Dr. Kasandra White noticed the exacerbation of already-clear issues of health equity and access for Black women. As many states rushed to enact powerfully invasive anti-abortion laws, the precarious systems of abortion-supportive states have been strained under increased need. “Now,” she said, “we’re hearing more and more about mortality and morbidity. It comes down to a failure to rescue. We have to have the resources in place to assure that all staff are well-equipped to provide proper medical interventions that are necessary in situations that require us to respond quickly.”
From a young age, Dr. White was aware that education, outreach, and exposure could alter the course of Black women’s reproductive lives. She reflected on her close friend, who became a mother of three children while they were in high school, and wondered how she, herself, was spared from a similar outcome. Dr. White was born in Oakland, California, and raised with love by her mother, aunts, grandmother, and grandfather, who impressed upon her that “there’s no such word as ‘can’t’.”
After her mother became pregnant when the future Dr. White was a teen, she made sure to take her daughter with her to prenatal appointments, and into the delivery room. “She wanted me to understand what it meant to be a teen mom. How hard it was on the body. The time constraints. How there was so much responsibility.” These experiences prompted Dr. White to better understand how it was that she didn’t become a young mother, and the type of educational and social gaps that prevented young women from both fully understanding their bodies and not reaching their full potential.
“My mom was very proactive, and I think that, between her and volunteering at a hospital, my energy was taken away from other things that may have been happening in my community.” Dr. White said with a smile. After attending the University of California at Berkeley, she eventually attended medical school at the Michigan State University’s College of Human Medicine. A former investment banker, Dr. White entered medicine with a strong sense of how money affects all facets of life, including medical care. “There truly is a business of medicine, but it’s also how we sustain access: with all of the intricacies of a business, but the business decisions we make affect patient outcomes.”
Race always plays a role in care – whether it’s the race of the patient, or of the provider. Earlier in her career, Dr. White felt discouraged by working in predominantly white care spaces, and even considered leaving medicine after a succession of difficult experiences. She realized though, that she needed to better position herself to make decisions, and to guide early-career OB-Gyns, particularly non-white OB-Gyns. After entering the role of Chief of Obstetrics and Medical Director of Family Birthing Center in Oakland, Dr. White was able to offer the professional development and mentorship that fulfilled her. She also had access to maternal morbidity data that allowed her a constant and holistic view of the missing pieces within and without her practice.
For Dr. White, part of the position’s value was also the opportunity to model what ideal patient care looks like: a focus on transparency and valuing each and every patient. “I wanted to ensure quality care for our patients, and to make sure that this translated to the rest of the team. We all need to value our patients the way we would value our own loved ones, including challenging the system. Not chastising, but holding accountability for myself, for others, and digging into policy, procedures and workflows.” She noted. As in any medical setting, publicly-funded programs can present unique challenges to vulnerable populations of color. “We work with mostly Medi-Cal patients, so resources can be scarce, but there’s opportunity to balance the standard of care and individualized care. Sometimes just investing in listening and focusing on each patient is how we create change within our hospital system.”
An award-winning gynecological surgeon recognized for her strides in minimally invasive procedures, Dr. White centers care and compassion as patients who trust her with their sensitive organs and with their futures. Though everyone recognizes the role of OB-Gyns in pregnancy and childbirth, their importance is substantiated at every stage of life for people with uteruses. For any patient, she encourages asking questions, inviting loved ones to appointments, and to request that everything, including denial of tests and treatments, be recorded in their charts. “There shouldn’t be that type of pressure on patients to advocate for themselves,” Dr. White says. “We [providers] are the healthcare system, and we should be taking those steps.”
Dr. White wonders how physician’s unions might affect the healthcare field, though whether or not these organizations become reality, the OB-Gyns that she mentors are taught that much of their job is and will be patient advocacy. “They’ll work with community organizations, legislators, public health officials – there are just so many ways to make an impact that could change the care landscape. Even as a Medical Director of the Family Birthing Center, I was out and about, meeting people and trying to create opportunities to change healthcare.”
Dr. White’s joy and motivation to push forward is her day-to-day, which she might describe as ‘crazy’. “It’s insane. We’re understaffed. We might not be able to take lunch breaks. But we gon’ figure it out, and we do it by sharing stories and experiences. I feel honored, privileged, and humbled to care for my community.”
Alexandria Hicks is a writer of prose, healthcare, and advertising. Born and raised in Nashville, Tennessee, she’s lived in Los Angeles, California and Houston, Texas. She currently calls New York City home.