Hear Me Now: The importance of racial concordance in health care

February 27, 2024

Providence Health Team

[5 MIN READ]

This story comes from the Providence Institute for Human Caring featuring Violet Larry, clinical nurse supervisor and program manager at Healthy Birth Initiative, and Drechelle McCray, her daughter.
Larry and McCray discuss their experiences with McCray’s two pregnancies, including the benefits of the Healthy Birth Initiative for McCray’s second pregnancy.
We provide a brief recap of the story and topics Larry and McCray discussed together.

Representation matters. Perhaps nowhere is that representation more life-altering than in health care.

Violet Larry, clinical nurse supervisor for Providence, works to improve care for underserved patients every day. She is a program manager at Healthy Birth Initiative, which strives to lower infant mortality, low birth weight, preterm birth, and maternal mortality and morbidity for pregnant Black women.

That experience took a turn when Larry’s daughter, Drechelle McCray, experienced a medical emergency while pregnant with her first child.

Larry and McCray spoke on the Hear Me Now storytelling and listening program about their experiences with racial concordance (when providers and patients share the same race or cultural identity) in health care, especially for pregnant Black women.

An unexpected hospital visit

McCray was not part of the Healthy Birth Initiative during her first pregnancy because, for the most part, things were going smoothly. That changed when McCray went to the dentist when she was 34 weeks pregnant with her son.

“My blood pressure was extremely high,” says McCray. The dentist would not see her and advised her to call her health care provider.

Things only escalated from there. After being admitted to the hospital, McCray found out she had developed HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, which was causing her high blood pressure that wouldn’t come down.

As McCray grew more nervous about the quickly evolving situation, she took comfort that some of the nurses knew who she was through her role as a teacher. “But at the same time,” she says, “it was still nerve-wracking because I was still a Black face in a White space.”

McCray had an emergency cesarean (C-section) at 35 weeks and gave birth to a 4-pound, 10-ounce baby boy. When the nurses brought her son back into the room, McCray began hemorrhaging.

“We almost lost her because of the severe amount of blood she was losing,” says Larry. A nurse herself, Larry knew how quickly things had changed and was aware of the shift of the nursing staff who came to care for her daughter.

As McCray recovered, Larry noted, she didn’t get to have the euphoria of being a new mom, given all the challenges of managing a preterm baby, caring for herself and even helping Larry, who had surgery to remove a tumor shortly after her grandson was born.

Changing course

McCray’s baby boy is now eight years old and thriving. But, she says, it’s still scary to be a Black woman in labor. “It’s always in the back of my head – what kind of care am I going to get or what kinds of comments am I going to receive?” McCray noted that, particularly when it comes to pain management, providers don’t always believe Black women when they say they’re in pain and often don’t get adequate treatment.

"I never thought that with all the support she has, she would face this challenging moment,” added Larry.

Many women are already extremely nervous during their first pregnancy given all the changes happening to their bodies, but for Black women, it can be even more frustrating going into a space where no one looks like them, says McCray.

When McCray became pregnant again, she chose to be part of the Healthy Birth Initiative – a move that helped ease much of the burden and stress McCray felt during that first pregnancy. “I called my mom and I said, ‘I had no idea that having a Black nurse – someone who looks like me – would make such a difference.’”

The assigned nurse stays with the family from pregnancy until the child is two and checks on how things are going emotionally, mentally, financially and even elsewhere in the community. McCray credits the program with helping things go much smoother with her second child, a healthy baby girl.

“We stepped out of our comfort zone to let someone else in,” says Larry.

Being seen

Healthy Birth Initiative even helped McCray find an African American pediatrician for her two young children. Having a Black doctor, says McCray, helps them know that there’s someone who looks like them and who cares about their health.

“He asked what is their hair care routine,” says McCray. “That showed me that he saw us.” The family’s new pediatrician also addresses concerns around diversity and representation in the children’s classrooms, but one heartwarming moment came when McCray’s son shared, “Mom, my doctor looks like me!”

“We’re hopeful and know that change is happening, but change takes a long time,” says Larry. “We’re hoping that we as a society can get there so we can eliminate these poor birth outcomes.”

Programs like Healthy Birth Initiative mean pregnant Black women can be seen and understood by providers who know them.

“You don’t have to explain,” says McCray. “You can just be.”

Learn more about Healthy Birth Initiative and its work to address the needs of pregnant Black and African American women.

To listen to more Hear Me Now stories or the Hear Me Now Podcast go to HearMeNowStories.org

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