Below you will find the note I sent to Wendy Davis’ organization, Deeds Not Words.  It is my first move toward engaging with activist groups to assist with Citizen Science.


To Wendy Davis at Deeds Not Words

I attended the Circle of Health event at the Texas Theater last night and was struck by the fact that the women on the panel were voicing the need for “evidence-based” care. As a nurse and researcher, searching for evidence is at the forefront of what I do. However, I realize that researchers’ own implicit bias and ignorance of the needs of women, especially those women of color, affect and the research they do to produce much of the “evidence” surrounding maternal mortality.

One case in point is the focus of the Texas Task Force on Maternal Morbidity and Mortality on the measurement of maternal mortality. The political act of measuring maternal mortality has taken center stage and even found its way into mainstream Obstetric medicine. The new “enhanced” method of measuring mortality only in the first 42 days following pregnancy and only deaths “related to pregnancy”, significantly narrowed the view of the problem, making maternal mortality a problem that can be solved by improving hospital care rather than improving the systemic bias and social injustices which so heavily influence the risk of a mother’s death. For example, the Task Force has issued no recommendations for addressing maternal mortality caused by assault even though homicide is one of the leading causes of death of women who are pregnant or have been pregnant within one year of their death.

As Marsha Jones pointed out, the researchers and clinicians serving on the task force are talking among themselves rather than with the people affected. Professionals learn primarily from their peers and see the problem through professional lenses. Doctors and nurses view the problem as a technical one which can be solved by adhering to treatment “bundles”. Economists and policy makers view the problem as one of scarce or maldistributed resources. Certainly, those views of the problem can lead to needed action but until the voices of women and their families are heard, critical knowledge of the full scope of challenges women of color face every day will remain hidden from the view of those who can ease those challenges and reduce the risk they will lead to death.

My colleagues and I at TWU have been studying infant mortality and maternal mortality for more than 20 years. Our research team is made up of nurses who have expertise in public health, midwifery, ob/gyn nursing and intimate partner violence. After 20 years we have learned a great deal about the scope of infant mortality and maternal mortality and the factors related to them. What we have not learned, however, is how to remove the systemic biases that create and sustain factors contributing to these preventable events.

I believe that President Obama’s idea of Citizen Science is the key to finding the missing evidence needed to solve problems of infant mortality and maternal mortality. Paraphrasing his words, “Science should be about all people, for all people, and by all people.” In that spirit I would like to offer whatever research skills our team can provide to groups such as those we heard on last night’s panel. Women of color are noticeably absent from the Task Force on Maternal Morbidity and Mortality and from the academic settings in which much research is carried out. Likewise, researchers are noticeably absent from activist organizations which have the will and energy to put evidence into practice. I am reaching out to Deeds Not Words to address at least one half of this deficit.

Please contact me if you see a need our team could meet.

Patti Hamilton, RN, PhD
Emeritus Professor
College of Nursing
Texas Woman’s University
940 759 2055

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I am professor, emeritus, of nursing at Texas Woman's University, Denton, Texas

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