Black Maternal Health and Cultural Biases: Interview with Octavia Cannon, DO

Black Maternal Health and Cultural Biases: Interview with Octavia Cannon, DO

April 2023

In honor of Black Maternal Health Week, we spoke with Dr. Octavia Cannon who served as the first Black President of ACOOG. She discusses her work supporting Black Maternal Health and shares her thoughts for more informed patient care to address the health disparities facing minority patient populations. 

Dr. Octavia Cannon is a Board-Certified physician and provider at Alliance Obstetrics & Gynecology in East Lansing, Michigan. She is an Honors graduate and active Alumnus of Johnson C. Smith University (Charlotte, NC). Dr. Cannon earned her medical degree at Nova Southeastern University College of Osteopathic Medicine (Miami, FL). She continues her personal mission of public service & health education via numerous leadership roles on local & national levels. She was the 2018 National President of the American College of Osteopathic Obstetricians & Gynecologists and is the first African American president of the organization. Dr. Cannon is a 2023 member of the Board of Directors of the American Medical Women’s Association.

SHWI: You’ve served as the first African American President of the American College of Osteopathic OBGYNs (ACOOG), and, as a panelist for a Women’s Symposium on Black Maternal Health. Please share more about your time serving at that organization and event.

Interview with Octavia Cannon, DO

I started serving in ACOOG when I was a 4th year resident. I was elected Resident Representative of the Residency Evaluation Committee. When that term ended, I continued to be recruited to serve on various committees. My commitment and work ethic proved that I was interested in staying active in ACOOG. I was then nominated to complete the term of a member of the Board of Trustees and was re-elected twice. I was then nominated to become President-Elect. It was a complete surprise. I was just enjoying serving and had no idea that I was being considered. 

Once it became evident that I would become National President, I began to think about the impact that I could make as the first person of color in this office. My main platform was attacking teen pregnancy and sexually transmitted infection rates. I spoke locally and nationally in 2018-19 on those subjects. I also committed to Diversity, Equity and Inclusion in our organization; which I’d informally been doing since I became a member of the ACOOG. It was a personal quest. I wanted everyone to feel welcomed and valued in our organization.  When Dr. Tom Dardarian became ACOOG President after my tenure, he started the DEI Task Force and asked me to Chair it. It is now a formal committee in our Constitution and Bylaws. I am very proud of that milestone.

I think that one of the important aspects of serving in a leadership position like National President is the opportunities that you have is to represent your organization and yourself on local, state and national levels. I was living in Charlotte, North Carolina in 2020 when I was asked to serve on a panel by NC Congresswoman Alma Adams. It was a Women’s Symposium on Black Maternal Health. It took place during Black Maternal Health Week and featured appearances from then US Senator/now Vice-President Kamala Harris, US Senator Cory Booker and Black Maternal Heath Caucus Co-Chair Representative Lauren Underwood. It was an open forum to discuss this preventable health crisis and served as a precursor to the Black Maternal Health Momnibus Act of 2021 legislature. My willingness to serve has allowed me to interact with many movers and shakers who sit in positions to make significant changes in women’s healthcare. I feel honored to have had the opportunity to work alongside them.

SHWI: This month’s topic is focused on Black Maternal Health, a week-long campaign during National Minority Health Month to advance health equity on behalf of racial and ethnic minorities. Studies show that black women are more than three times as likely to die from pregnancy-related complications as white women. What do you think are the main reasons for these kinds of health disparities? What are some ways that healthcare providers can eliminate or minimize these health disparities, particularly to improve health outcomes for their obstetric and postpartum patients?

I think that ALL people, particularly health care providers, would benefit from training on health care disparities and cultural bias. The same beliefs/fears/prejudices that I saw as a medical student/resident persist even as an Attending Physician. It is certainly discouraging, but I refuse to be defeated. I think that I often didn’t speak up in my younger years because I was afraid. However, my career path has empowered me to be an advocate for the underserved and voiceless. There are several factors that contribute to the disparities, including: minimal access to appropriate health care; financial disparities; lack of recognition of high-risk pregnancy situations due to disregard of the patient; lack of respect for patients' needs (social, emotional, medical); racism in general, fear/apprehension to self-advocate and my personal favorite - the horrific myth that Black women do not feel pain (!).  

It seems that the maternal mortality rate is dropping everywhere except the US. Black women are 3 to 4 times more likely to die from pregnancy-related complications. That rate is closely followed by other women of color (LatinX, Native American, Asian American and Pacific Islander). Many of the deaths are preventable. While it would be easy to blame it solely on socioeconomic backgrounds, I have seen these same problems happen to middle and upper class women of color; including patients who are healthcare providers! The patient’s personal appearance was considered before her medical condition. One well-known case involved 23-time Grand Slam Tennis Champion, Serena Williams who suffered from a pulmonary embolus (blood clot in her lung) after giving birth in 2017. Her nurse called her “crazy”. Luckily, that bias did not result in her death. Sadly, there are innumerable instances where death was the subsequent result. 

PEOPLE OFTEN FEAR WHAT THEY DO NOT UNDERSTAND. Therefore, it would be helpful for health care providers and ALL HUMAN BEINGS to be exposed to the cultural melting pot called the world. Ask your patient questions when you want to understand more about them. Ask your questions with empathy and respect. Listen to your patients and your colleagues. Don’t disregard them because they don’t seem to care or listen to your advice. There may be a reason for their attitude or behavior. Do they understand? Are they afraid? Are they angry? I am sure that some health care providers avoid the “deep dive” into a patient’s life because they don’t have the time (nor interest) in going down the “rabbit hole”. That becomes a greater concern when your hospital system requires you to see a certain number of patient in a limited time period. The best way to avoid it is to learn how to ask the most relevant and appropriate questions in an efficient manner. It is a work in progress.

SHWI: As an obstetrics and gynecology DO, one of your sub-specialties is vaginitis. Can you share more about your approach to diagnosis and treatment of vaginal dysbiosis?

One of the principles of osteopathic medicine is that the body structure and function are interrelated. Therefore, many times the patient’s issues involve simple vaginal hygiene modifications. But there may also be other factors like depression, anxiety, PTSD, history of sexual/emotional/physical abuse, life stressors, dietary habits, medications and physical/mental disabilities. It is important to take a thorough history and physical before examining the patient. I often see patients who have literally struggled for years with vaginitis and I can often diagnose and treat them after one encounter. I often look for “outliers” that may get missed by doing a general bacterial swab. Other times, there may be more than one culprit involved in the infection Vaginitis is such an expansive topic. There are many ways to approach it and successfully treat it.

My method starts with simply asking the patient relevant questions and listening to their answers, like: Do you wear panties to bed at night? Females/people with female anatomy should NOT wear underwear or tight undergarments to bed starting at age 12-unless they are on their menstrual cycle. Skin is the largest organ on the human body and it needs oxygen! Wearing the clothing close to the skin under blankets, etcetera simply causes more sweating and warmth. Yeast and bacteria love warm, dark, moist environment. Your vagina becomes a petri dish (remember those from science lab?) for bothersome itchy problems! I find it baffling when I meet women who say that they’ve never been advised about prophylactic feminine hygiene by their healthcare providers. Once they follow my suggestions, they report rapid improvement! I think that some people are embarrassed to complain about itchiness or discharge, so they try to treat it with over the counter medications or they do get treated but get re-infected. Other questions include: “what do use to wash your body?” “do you wear tight jeans/leggings/thong underwear regularly?” “Does your partner complain of jock itch-that’s equivalent of a yeast infection in a female”. The patient and her partner could be passing the infections back and forth.

SHWI: What are you most passionate about as a doctor and gynecologist, and what makes your career rewarding?

I am most passionate about women’s health in general. I don’t actually make a concerted effort to teach or make a difference; it just naturally happens because I can only be my authentic self. I try to get to know my patients and meet them where they are most comfortable. I ask them questions and listen to their answers. I speak Spanish (well, really it’s Spanglish), so my effort to try to make patients comfortable makes them feel that I can be trusted and I truly care about their health. I embrace the diverse cultures and family dynamics and I ask questions. Many times, the patient’s issues are often entangled in their life stressors. I want to help the patients take good care of themselves and share their knowledge with other people. I absolutely love delivering babies! It’s so beautiful watching that little head spin around in mom’s vagina just as it comes out. It’s a blessing to be the first hands who touch that new life. In my case, I believe that it is a God-given gift. I do not take it for granted.

I really feel that it’s important to start teaching our young people EARLY. Start with personal hygiene and self-esteem. My brother is an elementary school principal in Detroit and I try to go to his school every year to talk to the 6-8th graders about menstrual cycles, their bodies, personal hygiene and self-esteem. I buy products and give them gift bags with products to get my point across. I take those 75-100 bags of products and show them that they are important. I ask their teachers to give them index cards to submit anonymous questions before I come to the school and I answer them during the session. My brother gets permission slips from their parents/guardians and I discuss things that they want to know.  I get so much joy from speaking to small and large groups of people about relevant medical issues: vaginitis, self-care, menopause, fibroids, overall health-any topics that will help them live their best lives! I would love to continue have those conversations in public forums as my career continues. The feeling that I get when people approach me and tell me how I have changed their lives or helped them with/through a situation is unspeakable joy!


Additional Resources and Ways to Support Black Maternal Health Week

BMHW 2023 National Call - YouTube

Black Mamas Matter Alliance - Press Release

Black Maternal Health Week Social Media Kit (BMMA)

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