Editors’ Note

Dr. Dawnette Lewis is the director for Northwell’s Center for Maternal Health, where she guides the system’s mission to reduce maternal morbidity and mortality rates, specifically among Black women. She is also Director of Maternal-Fetal Medicine and Associate Director of Patient Quality and Safety at North Shore University Hospital; Physician Lead for New York State Birth Equity Improvement Project; and Associate Professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. Born in St. Elizabeth, Jamaica, and raised in the Bronx, Dr. Lewis earned a BA degree in biology and Africana studies at Cornell University, a master of public health degree at New York University, and an MD at the Medical College of Ohio.

Will you discuss your role and areas of focus?

As a Northwell leader, I have the privilege of occupying key roles, each with distinct areas of responsibility that collectively aim to improve maternal and fetal health outcomes. Additionally, I can positively impact medical education and patient safety. Here are my current roles and how they align with the goals and mission of the Center for Maternal Health and Northwell.

• Director, Center for Maternal Health:

In this role the focus is on leading initiatives to improve maternal health outcomes, reduce health disparities, especially in underserved communities, and create comprehensive maternal care models. This involves both clinical and strategic leadership in developing programs and policies to address the diverse needs of mothers in our communities. Additionally, the collaboration of multidisciplinary teams, community outreach, and innovative care delivery approaches are key aspects of this program.

• Director, Maternal-Fetal Medicine, North Shore University Hospital:

The Maternal-Fetal Medicine Department at North Shore University Hospital has a stellar reputation for excellence, and its members have managed the care of numerous high-risk pregnancies and patients. As the current head, one of my roles includes managing a team of MFM specialists, setting clinical standards, and ensuring high-quality care for patients facing obstetrical complications. Additionally, I strive to foster clinical research, favor new medical practices and evidence-based medicine, as well as focus on the integration of cutting-edge technology into patient care. I also provide direct patient care of high-risk patients and provide specialized care for complex maternal and fetal patients.

• Associate Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell:

I am very proud of the strong academic endeavors of our medical school and the incredible number of amazing medical students that have gone on to successfully complete their residency and establish thriving practices. In my academic role, I focus on teaching medical students and residents, mentoring young physicians and contributing to the academic mission through research and curriculum development. As an Associate Professor, I focus on delivering lectures, leading research studies related to maternal and fetal health with goals to publish findings in medical journals and advance knowledge in the field.

• Associate Director, Patient and Quality Safety, North Shore University Hospital:

North Shore University Hospital has a robust, multidisciplinary team of healthcare professionals and leaders that make up the Patient Quality and Safety Committee. As the Associate Director, my role centers on ensuring high standards of patient safety and quality care across the hospital are met, with an emphasis on identifying and mitigating risk. Some of my responsibilities include implementing quality improvement initiatives, analyzing patient outcomes, and promoting evidence-based practices. This role requires close collaboration with hospital administration and clinical teams to enhance patient experience and safety.

These descriptions are but an abridged version of my current roles. I’d like to mention how these combined roles require extensive collaboration, strategic leadership, and a commitment to patient-centered care. My primary goal is to have a direct positive impact on patient outcomes and foster long-term improvements in maternal and fetal healthcare with an emphasis on decreasing gaps in care for vulnerable and underserved populations.

What are the keys to driving impact in improving Black maternal health and reducing disparities?

Improving Black maternal health and reducing disparities requires a comprehensive and intentional approach that addresses both healthcare practices and social determinants of health. As the Director of the Center, there are certain key drivers I believe impact this critical area:

• Culturally Competent Care: Ensuring that healthcare providers are trained in cultural sensitivity and implicit bias is essential. This involves developing awareness of and respect for the unique experiences of Black women, leading to a more compassionate and understanding approach that builds trust and improves patient-provider communication and outcomes.

• Community-Centered Approaches: Partnering with local organizations and leaders to better understand and address community-specific needs can enhance access to care. Engaging communities in designing maternal health initiatives can ensure that they’re relevant, sustainable, and well-received.

• Increasing Access to Quality Prenatal and Postpartum Care: Expanding access to comprehensive maternal care, particularly in underserved areas, can reduce risks and improve outcomes. Tools we have used involve telehealth services, mobile health units, and other innovative solutions to reach more women.

• Data Collection and Accountability: Tracking maternal health outcomes by race and ethnicity and language allows for a better understanding of disparities and reveals gaps. Health systems can use this data to monitor the effectiveness of interventions and ensure accountability.

• Addressing Social Determinants of Health: Recognizing and addressing the broader social factors that impact health – such as housing, nutrition, and financial stability – can have a powerful effect on maternal outcomes. Integrating social support services into maternal care can alleviate some of the pressures that contribute to health disparities.

• Advocacy and Policy Change: Supporting policy initiatives that address Black maternal health disparities, such as Medicaid expansion, enhanced maternal leave, and financial support for maternal health programs, can have a long-lasting, essential impact.

• Empowering Black Mothers: Educating and empowering Black women to advocate for their own health and providing them with resources to navigate the healthcare system can help reduce risks and improve their maternal experiences and outcomes. Community health workers or doulas can be invaluable for providing personalized support. Really, another impactful tool Black mothers can use is a support person (friend, family member) who can also advocate for them when they are unable to do so, especially during critical situations.

Together, these strategies can create a healthcare environment that not only improves Black maternal health outcomes, but also moves towards equity and justice in maternal healthcare.