Four years ago, Stacey D. Stewart became the first Black President and CEO of March of Dimes. A fierce advocate for maternal and infant health, specifically around the Black maternal mortality crisis, Stewart has steered the organization in a new direction while staying true to its original mission. Under her leadership, March of Dimes is advocating for state and federal legislation that would better protect mothers and babies. I spoke to Stewart about why she took on this role and how she hopes to continue transforming the organization.
Amy Shoenthal: What drew you to take on this role at the March of Dimes?
Stacey D. Stewart: I had always known about March of Dimes and did one of their walks when I was 12 years old. I was so proud to have walked 20 miles. At that time, the more you walked, the more money you could raise. I was determined to finish the 20 mile route so that I could raise the most money possible.
The organization has such a great legacy and I was really drawn to the challenge of trying to revamp and revitalize it. I wanted to help make it new again. That’s what we’ve tried to do over the last four years. I’m a mother myself, so I definitely appreciate the mission.
Shoenthal: What were some turning points on your career journey before now?
Stewart: When I was 28 years old, I was one of the most senior members in the Atlanta office at Fannie Mae, which creates housing opportunities for families across the country. While I took the position after working several years in a demanding, high-pressure job on Wall Street, I felt awkward and uncomfortable in meetings with my peers and higher ups. My supervisor noticed and pulled me aside. He told me he hired me for my skills and expertise and encouraged me to speak up in meetings and share my ideas. The conversation became a real turning point in my career and gave me the confidence I needed to feel part of the team.
I often share this experience with others who ask me about my career progression which has included serving as President and CEO of three major national global organizations, most recently at March of Dimes, where I’m the first African-American leader in the organization’s history. I think great leaders inspire others to be the best they can be, and young women especially benefit from knowing their manager values their input and opinions and encourages them to share it.
Shoenthal: What are some of your goals at March of Dimes?
Stewart: When I came here, we were really focused on premature birth. The reality is, this affects many women in this country, whether they’re Black or Hispanic or white, in rural areas or urban areas. The premature birth rate in this country is significantly worse than a lot of other highly industrialized nations.
Based on the data, it didn’t make sense that we would only focus on what’s happening with a woman during pregnancy when we know that so much of a woman’s health and the pregnant woman’s health really determines the health of the baby. The two are very much connected. So we retooled our strategy to focus on healthier babies. We needed to have a much more holistic approach.
We couldn’t ignore the fact that we have huge disparities in a country where a Black woman is 2% more likely to have a baby born prematurely, that Black women die at a rate of three to four times that of white women in this country, that Black babies are still more likely twice as likely to die for the first birthday. The Black maternal mortality rates and the infant mortality rate seems to be the worst of any other group in the country.
If you want results, you have to focus on where the problems are the worst. The March of Dimes actually has a very, very interesting history in health equity, dating back to the polio epidemic. They created a rehab center for Black people who were affected by polio. Black scientists there were involved in the research for the clinical trials. It was very intentional to include Black people in the clinical trial to make sure that the vaccine would be effective for all communities, not just white communities.
Once the vaccine was made available, there was a very intentional effort to address vaccine hesitancy. They had Black kids featured on the posters with celebrities Sammy Davis Jr. to ensure that the polio vaccine was as available to every single community. So in some ways, health equity isn’t something that’s new to us.
Whether the CEO is Black or Brown or white doesn’t matter, the person in this job has to take a responsible approach to addressing health equity. Otherwise, we’re being a little disingenuous about our stance on solving the health crisis that we see in this country right now.
Shoenthal: Was March of Dimes always focused on Black Maternal Health or did that start under your tenure?
Stewart: A few years ago, we launched our own emphasis on this crisis. Research shows that Black women do not feel heard, listened to, or responded to by medical professionals in the ways that would really meet their needs. As a result, some of them become really ill, which unfortunately leads to death. Women experience this before, during and after pregnancy.
The research shows that even Black women who are higher income with all the education, access to care, still die at five times the rate of that of their white counterparts. So when you strip away the issues of education, income, and access to care, what else do you have left other than a woman’s skin color?
Over 20% of Black women say they’ve experienced actual outright racism in their interactions with their healthcare provider. That’s why two years ago, we started an implicit bias training program where we really looked at the history of maternal and infant care. We try to help healthcare providers see their own implicit biases as they’re providing care for a range of different patients.
In the past 18 to 24 months, we’ve reached about 15,000 healthcare providers with implicit bias training. We’ve been recognized by the American Hospital Association for this. It’s not just the doctors and nurses, we’ve been focusing on receptionists and anybody that has any potential interaction with any patient.
We’re also doing advocacy work. We fully support The Black Maternal Health Momnibus Act of 2021, legislation that is critical to filling the gaps in existing policies to improve health outcomes for Black moms who are dying at three to four times the rate of their White counterparts.
Shoenthal: Tell me more about that. What does the Momnibus Act specifically propose that will help with this issue?
Stewart: We’re really fortunate that in Congress right now, we’ve got leaders who are taking the bull by the horns and have decided that the issue of Black maternal health, and maternal health overall is quite unacceptable where we are right now. That’s driving Congress to create change at a policy level, which is really important because when we talk about equity, a big part of what we’re talking about is the fact that we have under-resourced and underfunded systems. We have too many millions of women that are uninsured, or millions of women that live in what we call maternity care deserts, which are counties that basically have no obstetric care. That’s what the Momnibus Act is attempting to address.
We fully support the entire group of legislative actions. There are actually about a dozen bills that are included in it. For example, one of the bills that just passed in Congress under Lauren Underwood’s leadership is the bill addressing the maternal mortality of our military moms. It’s intended to take a very comprehensive approach to maternal health, especially addressing needs of Black pregnant women and babies, trying to tackle these long standing health disparities.
Shoenthal: What obstacles have you faced during your tenure?
Stewart: When I came to March of Dimes, it was obvious as an outsider looking in that the organization had lost its ground. In my first 45 days, it was pretty clear that we needed to cut at least $30 million out of our spending and I only had about 30 to 45 days to do that. Immediately, I examined where our inefficiencies were and figured out how we could do things differently and more quickly so March of Dimes could do more streamlined, effective work without making big programmatic or staff cuts.
I also realized early on that people’s understanding of the March of Dimes and its relevance in the world had become unclear and people no longer knew what our work was all about. The organization was doing really great work, but it wasn’t being communicated it in a way that newer audiences understood. We were no longer focused on polio, which we helped to eradicate, but on the health of all moms and babies. That message had to get through.
Based on reports that we released last year, there is still so much work to be done in the maternal and infant health space. Our country is still in a crisis and in some cases we are trending in the wrong direction. Yet, each day I am constantly inspired by the dedication and ingenuity of my team. I have at least one moment each day that makes me hopeful for the future.
Shoenthal: What are you most hopeful for right now?
Stewart: I’m very encouraged by how there is a growing recognition that we must deal with the maternal and infant health crisis facing our nation. States have recognized that women who receive Medicaid services are often only covered for up to 60 days after giving birth. This isn’t enough to address a woman’s care, which could include many health concerns she may have due to giving birth, and caring for a newborn. I’m excited by efforts at the state level to extend coverage.
On the federal level, I’m also encouraged that Congress is about to take a very positive step by including an option for states to extend Medicaid coverage to 12 months postpartum in the American Rescue Plan Act of 2021. That option will streamline state efforts to achieve this policy, but it’s not enough. Bolder action is needed at a time when the pandemic is disproportionately impacting Black, Latino and Native Americans, and the maternal mortality rate of Black women is abysmal. We must work to permanently extend Medicaid for a year after birth in all states. This full policy change can truly have a lasting impact in addressing our nation’s maternal and infant health crisis.
Shoenthal: What’s the best advice you’ve heard?
Stewart: Find your voice, be authentic, and never stop advocating for the less fortunate. This is advice that was taught to me early on in my life by my parents as they are a living example of this. Both my father and mother refused to shy away from a challenge if they truly believed it would help create better opportunities for others. This taught me no matter what you do there is always space to push, always a way to increase access and ensure equity.