Dr. Rachel Bervell, MD knew she wanted to be a doctor at 12 years old, when her grandmother (who raised her for most of her childhood) passed away as the result of healthcare inequities. For Dr. Tamandra Morgan, MD, it was her master’s degree in genetic counseling that encouraged her to pursue medicine — she loved the idea of forming a therapeutic relationship with a patient for more than one aspect of their care.
The desire to become doctors put both Dr. Bervell and Dr. Morgan in the same place at the same time at University of Illinois for medical school. The two quickly went from study buddies to close friends. In the spring of 2019, while preparing to enter residency in obstetrics and gynecology programs, they launched the Instagram account “The Black OBGYN Project” so they could keep up with a community of Black reproductive health physicians spread out across the country starting their own residency training.
Now, a year and a half later, over 12.1K people follow Dr. Bervell and Dr. Morgan’s posts — which range from spotlights on Black OB-GYNs to educational resources on racial inequity in reproductive healthcare. These two (very busy) residents were kind enough to squeeze in some time with us to talk about their Instagram account, racial disparities in healthcare, and advocating for yourself when dealing with doctors.
Keep reading for the highlights from our conversations with Dr. Bervell and Dr. Morgan.
On starting the Instagram account
- The Black OBGYN Project first began as a way to keep in touch with other Black doctors. “The residency interview season is such an interesting and unique period in the medical school process. You're sending out applications to all these programs and, before COVID, you're flying across the country learning about different programs, getting to know them, they're getting to know you. You're in these situations where you're maybe the only Black person at that interview date or maybe the only Black woman,” says Dr. Rachel Bervell, MD. Dr. Tamandra Morgan, MD continues, “So, we ended up forming a group chat with other Black applicants of our year, and [it grew] from just people meeting me along the way and word of mouth. Toward the end of interviews, there were at least 100 of us. After everyone matched and found out where they were going into residency, we realized that having a way to follow along on our intern-year journey would be nice. Instagram came up [as an idea] for a kind of visual journal of our experiences through residency.”
- The murders of George Floyd, Ahmaud Arbery, and Breonna Taylor sparked a social justice movement both online and IRL, and the Black OBGYN Project’s community grew as more people sought out information about racial disparities in healthcare and beyond. Dr. Bervell describes it like this: “Fast forward a year: George Floyd’s murder happened, and Ahmaud Arbery and Breonna Taylor. There were all these cases that happened at the same time — things that have been happening for years. Shout out to my med school: Back in 2014, when Laquan McDonald was murdered, we did a blackout. We were very active as medical students. So none of this was new for me and Tamandra. But what was interesting is that for a lot of the community with whom we were engaging with, it was the first time that they were really made aware of how horrible these occurrences actually are and can be. We were just doing the same things we were always doing — posting about maternal health disparities, reminding you that Black lives matter.
- The duo behind the Instagram account is using their platform to continue educating. As Dr. Bervell describes it, “Overnight, we went from 200 to 1,000 followers. We were looking at the demographics of people following our page, and a lot of them are people who are not BIPOC. Fast forward again, come July, now we have 5,000. And we're like, ‘Well, we're gonna use this platform to keep doing what we've always wanted to do... while making sure that in the process, we remember that we're learners, too.’”
On under-discussed racial disparities in medicine
- There was a lightbulb moment for Dr. Bervell when she learned about epigenetics for the first time. Here’s how it happened: “I studied neuroscience in college, and I remember my professors saying that, unfortunately, there has been a higher rate of schizophrenia in Irish communities. And a lot of researchers believe that's related to the Irish famine, which happened in the 1840-50s, where the continued stress on women was passed down epigenetically to their children — and, unfortunately, a lot of male and female adults. I remember in that moment thinking, ‘Oh, gosh. Why aren’t we talking about this and slavery?’ My parents are immigrants, so that may not necessarily be my history, but that is my history. I'm Black. Everyone might not identify with the epigenetic consequences of it, but the impact of racism and socioeconomic stress is something we should talk about when we talk about health issues.”
- The field of obstetrics and gynecology has a deeply racist history — and we’re only just starting to really unpack what that means. Dr. Morgan explains: “We did a series on our page about the racist history of obstetrics and gynecology. Just recently, our governing body, the American College of Obstetrics and Gynecology, released a statement acknowledging our past. But prior to that, throughout medical school, and a lot of times in residency training, the names that we used to refer to — like the Sims device and things like that — were based on people who in actuality were not great people. We don't always acknowledge that. I think now there's been more of a reckoning and coming to terms with our history.”
- Racism is still a risk factor today — and the risk is climbing for Black people with ovaries. Here’s one example, as explained by Dr. Morgan: “We use a calculator to help patients decide their risk of having a successful vaginal delivery after having a C-section. It's called the VBAC (vaginal birth after C-section) calculator, but one of the big flaws in that calculator is the fact that it takes into consideration the patient's race. So, if you're Black or Hispanic, your risk of having a VBAC is automatically less. The problem with the calculator is that it’s inherently racist. Race is not the contributing factor — it's racism. Why are Black and Hispanic women less likely to have a successful birth? There's been a move toward not using that calculator or replacing the predictor variables with measures other than race. This has been a great time to see the evolution of thinking on a lot of the things that we just accepted as fact and didn't really question. So that's been nice to see — how communities and organizations are making amends for their often racist pasts.”
On advocating for yourself with your doctor
- Don’t be afraid to ask questions. “And, if necessary, get a second opinion,” says Dr. Bervell. “You want to make sure that you feel like you're being heard.” Dr. Morgan adds, "It's always reaffirming when patients tell you how glad they are that someone has finally listened to them; they feel valued and they feel like they're being heard.” She continues, “That's not always the expectation for some of our patients, when our patients are used to being in clinical scenarios where they don't feel heard ... or they don't feel like their concerns are being taken seriously.”
- Vet your providers for how they’re thinking about and addressing disparities in reproductive care: “If you know that the person you're working with acknowledges that they exist, that's helpful context to have,” says Dr. Morgan. It’s a good way to start a conversation about getting the care you deserve.
- Ask for a different doctor if you don’t feel supported: “Find someone who's both an advocate and ally for you, as well as a physician who's there to treat you,” Dr. Morgan explains. “If you feel like the relationship isn't there, don’t be afraid to ask around for another provider.” Find the right match for you.
- Tell your doctor what you’re excited about, too: “We can give the impression that medicine seems a little bit dark and heavy,” Dr. Bervell says. “But there's a lot of times you go to the doctor when there's really good news.” Also talking about the good stuff can make you feel more connected to your doctor — make it feel more like a conversation.
Dr. Bervell and Dr. Morgan recommend the following list of things to read and listen to as you build your knowledge about Black history, reproductive health, and racial inequities in reproductive healthcare.
- “The Immortal Life of Henrietta Lacks,” by Rebecca Skloot
- “Killing the Black Body: Race, Reproduction, and the Meaning of Liberty,” by Dorothy Roberts
- “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present,” by Harriet A. Washington
- “Medical Bondage: Race, Gender, and the Origins of American Gynecology,” by Deirdre Cooper Owens
- Intersectionality Matters!
- The V Word Pod
- The Nocturnists
- Sisters in Loss
- Sawbones: A Medical Tour of Misguided Medicine
Recent research and articles:
- Protecting Your Birth: A Guide for Black Mothers
- Maternal Deaths Are Preventable: 10 Things Every Black Woman Should Do to Have a Safe Pregnancy
- Black newborns more likely to die when looked after by White doctors
- Advancing Maternal Health as a Human Right
P.S. Follow @The Black OBGYN Project for ongoing education around healthcare inequities for Black people with ovaries.