Dr. Lisa Saul on Fighting the Black Maternal Health Crisis

Even with the ongoing challenges to reproductive rights and the persistent Black maternal health crisis, Dr. Lisa Saul remains a beacon of hope and motivation. As the chief medical officer of women’s health for United Healthcare, she’s deeply committed to fighting for better outcomes for Black mothers, a mission that fuels her work despite the slow pace of change.

Staying Motivated Amidst Challenges

Dr. Saul, a seasoned neonatologist and former maternal-fetal medicine specialist, shared her insights during Black Maternal Health Week. She acknowledged the stark reality: Black women are still more than three times as likely to die from childbirth-related causes compared to their white counterparts. Yet, she finds encouragement in the possibility of reducing preventable harm and the progress being made, however incremental.

Her extensive experience, including leading maternity care initiatives in Minneapolis, now informs her national efforts to shape policy, improve access to care, and ultimately enhance health outcomes for women across the country. She believes that progress is possible and that continued advocacy is crucial.

The Power of Doula Support

One significant cultural shift Dr. Saul highlighted is the growing recognition of the vital role doulas play, particularly for Black women. She noted that many pregnant individuals feel unsupported, often relying solely on partners. Doulas offer crucial support not just during labor and delivery, but throughout the entire pregnancy journey.

“Doulas provide a tremendous amount of support throughout the entire pregnancy journey,” Dr. Saul explained. “They provide another set of eyes and ears, but most importantly, they allow our members to feel seen and heard when they have questions, fears, or insecurities that are part of any pregnancy.”

Addressing Preventable Complications

Reflecting on the 10th Black Maternal Health Week, Dr. Saul identified the most urgent issue: the continued occurrence of preventable complications among Black women. She pointed out that these disparities persist even for those who are insured, educated, and actively engaged with the healthcare system. This suggests the problem extends beyond mere access to care, encompassing the cumulative effects of ‘weathering’—the physiological impact of chronic stress—and unconscious bias.

Progress and Future Needs

Despite the challenges, Dr. Saul acknowledged progress in obstetric care, including improved protocols for hemorrhage, hypertension, and sepsis. The increasing value placed on continuous, nonclinical support like doulas is also a positive step. However, she stressed that lasting change requires addressing the underlying societal conditions that impact health long before pregnancy even begins.

• Black women are over three times more likely to die from childbirth-related causes.
• Preventable complications remain a critical issue.
• Doula support is increasingly recognized as life-saving.
• Addressing cumulative stress (‘weathering’) and bias is essential.
• Maternal health requires a whole-person, lifelong approach.

Dr. Saul emphasized the need to view maternal health through a holistic lens, considering the body’s condition entering pregnancy and the support available afterward. She believes that understanding vulnerabilities tied to mental health, chronic conditions, and cumulative stress is key to truly transforming outcomes for Black women.