Providing culturally competent healthcare for mothers and families Rosie Avila, MD

Before Rosie Avila, MD completed her residency at Adventist Heath White Memorial and joined our obstetrics and gynecology faculty… before she interned at Mercy Hospital and Medical Center in Chicago… before she taught middle school for two years with Teach for America in Boston… before she completed graduate school at Tufts University… before she completed undergraduate studies at Yale… before she graduated from Franklin High School in Highland Park… she was simply a daughter tagging along with her mother to her doctor appointments. Rosie went because no one at the doctor’s office spoke Spanish.Mother with newborn baby

“I was very little going to doctor appointments with my mom and having to be the translator for her because no one else in the office would speak any Spanish,” Dr. Avila says. “All my interactions since I was very little definitely guided me to want to do something in healthcare. And then, as I got older, I definitely wanted to be a doctor. And then it was, I wanted to be a women’s health doctor.”

Today, Dr. Avila practices obstetrics and gynecology. That includes prenatal care, labor and delivery, a little primary care and performing surgery on patients on patients when needed.

Dr. Avila moved to the United States with her family from Mexico when she was two. Her mother often had health issues, so from an early age, Dr. Avila was exposed to the American healthcare system. And because her family didn’t have health insurance, she saw firsthand how challenging it can be for immigrants to navigate the complex insurance system. However, one thing that struck her was the importance of practicing culturally competent healthcare.

The struggle for Latina women to receive culturally competent care when seeking help for pregnancy and other reproductive healthcare is indisputable. As a result, a great deal of mistrust may form between Latina women and their medical providers, resulting in inadequate use of preventative health services and sometimes even longer-term health problems. Furthermore, without a basic understanding of the cultural context inherent in Latina patient populations — including language, religion and traditional healthcare practices — clinicians can miss essential details necessary to provide proper care to the patient.

“They’re very grateful to have a native Spanish speaker and someone who understands where they’re coming from and understands all the little cultural old wives tales to treat certain things,” Dr. Avila says when asked about culturally competent care at Adventist Health White Memorial. “I have to acknowledge cultural beliefs and not make my patients feel dumb. So we try to find ways to incorporate their beliefs and their alternative medicines with Western medicine. I grew up with these things too, so I understand them and hear them.”

Some common treatments she hears from patients are garlic in the ear for ear infections or banana peels on the feet to bring down a fever. Throughout her career, she has witnessed firsthand the unique challenges and barriers that Latina women in under-resourced communities face when it comes to accessing quality healthcare. These challenges are often compounded by a lack of healthcare insurance system literacy.

One patient facing such a problem was “Ana,” who came to Dr. Avila for prenatal care. She desperately wanted a baby. But she had already suffered more than five miscarriages. She’d gone to doctors and clinics for help, and her medical records were spread across many different places. So Dr. Avila had to really take the time to gather as much information as she could from Ana. By staying persistent and asking the right questions, she was able to track down Ana’s records. She realized what Ana needed to have her baby was a cerclage. A cerclage is essentially a procedure to strengthen the cervix to help it hold a pregnancy in the uterus so that a mother can carry her unborn baby to full term. So the cerclage treatment was performed, and Ana finally had her baby.

At Adventist Health White Memorial, we are taking proactive steps towards improving care by hiring personnel proficient in Spanish and familiar with Latino cultural norms. By ensuring a better understanding of perceptions around women’s health in the local communities, we can engage more effectively with our patients and create trusted partnerships.

Furthermore, we offer specialized programs such as classes on nutrition and breastfeeding. We conduct regular outreach efforts to teach mothers how to access resources such as WIC. And we create custom childbirth plans to make it easier for everyone in the community to access quality reproductive health services.

Adventist Health White Memorial strategies are bearing fruit. By offering culturally competent care specific to the needs of the community we serve, we have seen an increase in overall visits and improved patient outcomes among these populations. This suggests that when cultures are embraced, true success becomes possible.

“I see myself being here for a really long time,” Dr. Avila says when asked about her long-term career goals. “I hope to become this well-known doctor who cares about her patients in the community. I want them to say, ‘I’m going to go see Dr. Avila because I know she’ll take care of me, she speaks Spanish and she’s Mexican.'”

Please visit our website to learn more about Adventist Health White Memorial’s maternity care and level III Neonatal Intensive Care Unit (NICU).

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