Sunday Spotlight: Sascha James-Conterelli, Midwife, Researcher, Academic
If you are the parent of a child born in New York State over the past twenty years, or if you hope to one day bring a child into the world, you may owe a thank you to your neighbor Sascha James-Conterelli. For the past two decades, James-Conterelli has dedicated herself to advancing midwifery, the practice of assisting women in childbirth, and advocating for policies and processes that provide better outcomes for women and child-bearing families.
James-Conterelli began practicing midwifery in 2002, working first as a clinician in Rockland County, New York. There, she cared for patients of various racial, ethnic and socio-economic groups. She quickly learned that a patient’s quality of care was often impacted by factors outside of their control, such as race, geographic location or level of education.
“The care that I have to provide goes way beyond direct clinical care. It’s more about meeting folks where they are and trying to empower them to be more able to navigate their own care,” James-Conterelli said. Midwifery care has been shown to have positive outcomes for mothers and infants, and especially for people of color.
After three years as a staff midwife, James-Conterelli set her sights on healthcare administration, with the hopes that she could play a bigger role in affecting change in the maternal healthcare system. Since then, her professional rise has been nothing short of impressive.
James-Conterelli has served on seemingly every board involved in maternal healthcare in New York State, leading working groups and task forces charged with addressing maternal mortality and racial disparities. She helped redesign the CDC’s maternal mortality review form, used to make projections about care in the United States. In 2018, she co-chaired Gov. Andrew Cuomo’s task force for maternal mortality and racial disparities, giving recommendations and actionable steps to address the crisis in the United States. Most recently, she served as a member of Gov. Cuomo’s COVID-19 Maternity Task Force.
A year ago, the CDC issued a staggering report showing the dire state of America’s maternal mortality rate. In 2018, the U.S. maternal mortality rate was 17.4 maternal deaths per 100,000 live births, a rate that placed the U.S. last among similarly wealthy countries. For Black women in the U.S., the rate was twice that. James-Conterelli is committed to doing everything she can to help change that.
“Since 2010, The United States is the only westernized country that has managed to increase our maternal mortality rate instead of decreasing it. We are also the only country that spends the amount of money we do on maternity care. We spend billions, but we have the most moms and babies dying in the world,” James-Conterelli said, adding that these alarming figures trickle down to the state level. “It’s pushed us to think about what we’re doing, and how we could better ourselves.”
Along with her colleagues, James-Conterelli had to take a hard look at how their own practices and implicit biases may have been perpetuating the system. In listening sessions across the state, they were surprised to learn that as a healthcare group, they were continuing to marginalize the marginalized.
“Here I am as a Black female provider. I have children, I provide care. I think I’m doing good. But I’m told that I’m perpetuating the cycle. We were sure that all of us in our greatest intent to do no harm, were not perpetuating that. We need to learn to stop.”
For James-Conterelli and her healthcare colleagues, a group already committed to equity of care, the realization that they were still not getting it right was painful, but not shocking. James-Conterelli pointed to iconic women of color such as Serena Williams and Beyoncé, who, despite having plenty of money and the best access to care, still faced life-threatening complications in childbirth.
In the case of Serena Williams, James-Conterelli said, “she still had to tell her healthcare providers, something is happening to me and you need to pay attention to what I’m saying.” The ‘what’ and the ‘how’ of solving for systemic racism and implicit bias in the perinatal field are the challenges that James-Conterelli and her colleagues are focused on in their work.
What’s needed, she said, is a multi-pronged approach that takes steps to break the cycle and that engages communities at every level of society. As Vice President of the Pequenakonck Elementary School PTO in North Salem, James-Conterelli can have some impact within her own community. Her and her husband Charles’ twin boys, Chase and Caleb, are fourth graders at the school.
“If I’m truly dedicated to making things better for folks, I need to be an active member of my community,” James-Conterelli said. In her role on the PTO, she’s focused on embracing differences. Her work on both a national and state-wide level taught her that everyone has something valuable to bring to the table.
“I’m a little bit outspoken. But for me fundamentally, it’s about respectful communication, respecting each other as human beings and embracing the fact that we’re all different.” James-Conterelli hopes to pass that view on to the next generation.
“I hope for our children that they’re able to see folks not by their differences but for their commonality. I know that’s very idealistic, but the reality is, that’s really all I want.”