How medical student Azva Alvi’s personal and professional experience led to research on Native American prenatal care and a deep desire to promote cultural competence.
Azva Alvi is a student at Ross University School of Medicine.
I was with her once when the doctor came in and immediately asked me, “does your mom speak English?,” without even acknowledging her, the patient, first. She’s obviously an immigrant, but if you do that in a manner that might not be so comforting, with a patient who’s already scared, it hinders communication. Providers need to break stereotypes and look past their own biases to treat women.
Before I started at Ross University School of Medicine, I was doing my master’s in medical humanities at the University of Rochester. We had to complete a capstone thesis project, and it could be anything that we wanted—ideally a lifelong project that we would want to pursue as part of our medical career.
Racial Disparities in Maternal Healthcare
When I started my research project, I was looking at disparities in maternal healthcare, specifically why the maternal mortality rate was so high for different groups, specifically for women of color.
I was an EMT for two years in downtown Binghamton, New York. I remember going on a call for a patient who was pregnant and didn’t even know. I later found out that she was four months along. She was African American and had received no pre-natal care at that point.
Understudied: Native American Maternal Care
I was able to contact Native American women who spoke about their experiences receiving prenatal care. When I spoke to them, I realized that it does not only stem from whether or not they’re going to the doctor, but also the quality of care that they’re receiving and whether they’re being heard.
One of the key components of the Native American community is family and having that support system. Mothers are taken care of emotionally, mentally, and physically and they have their own customs and rituals of how they celebrate the mom. Everyone comes and prays for her. So, when there are complications in childbirth and they must transport mothers from facilities that aren’t equipped to help them, it’s hard to stay together. Trying to navigate their healthcare alone is an additional challenge.
They strongly believe that the natural birthing process is sacred and that there’s a transformation of the woman. There’s a lot of spirituality connected to that process. So, when they go to hospitals, they would be disappointed that physicians don’t have a thorough conversation about their birth plan and instead want to do a C-section to get the process over with.
Education, Empathy, and Cultural Competence
Education, I believe, is important for providers when it comes to treating their patients. It really comes down to the provider being willing to educate themselves through reading, traveling, reflecting on their own biases, asking open-ended questions, and interacting with communities.
Simply acknowledging someone’s pain, even if you’re not able to change their circumstances, comes down to the human aspect of medical practice. And that’s just something that all medical students and all providers should be training since day one.
Cultural competence is something that’s tangible, not just a phrase that we throw around.
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