Allyson Felix, Advocate and Olympic Athlete, on the Keys to Codesigning Better Maternal Health Care

Allyson Felix, the most decorated American track-and-field Olympian of all time, never imagined she would one day speak out against pregnancy discrimination. But then, during contract negotiations, her longtime sponsor, Nike, threatened her with a 70 percent pay cut after giving birth to her daughter, Camryn, in 2018. Despite the risk to her primary source of income, she went public with her story in a New York Times opinion piece.

Allyson Felix never expected to become a maternal health advocate. But after a life-threatening bout of pre-eclampsia, Felix learned more about the heightened risks Black women face before, during, and after childbirth in the US. According to the Centers for Disease Control and Prevention (CDC), “Black women are three times more likely to die from a pregnancy-related cause than White women.”

Aware of the platform her status as a celebrated athlete gives her, Felix said during a recent interview with the Institute for Healthcare (IHI), “I’m grateful to be in the position to do my best as an advocate.” Felix will be a keynote speaker at the 2023 IHI Forum.

Perhaps Felix should not have been surprised that her life would eventually turn to advocacy. Growing up in Los Angeles, California, her pastor father and elementary school mother inspired her. “My parents were people who served their community,” Felix recalled. She traced her “passion and love for helping other people” to them.

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Driven by this passion and love, and the many stories she has heard from women and their families about their experiences, Felix shared what she sees as the keys to codesigning a safer and more respectful maternal health care system:

• Believe patients’ pain. Felix expressed empathy for care providers who face multiple pressures, including time constraints that can make it difficult to develop effective communication and trust with patients and families. “Everyone's trying to do the best that they can,” she acknowledged. But, she added, “So many of my friends have had some sort of difficulty with feeling like their concerns were dismissed by their health care provider.” Sometimes patients or family members “just know something’s wrong,” she explained, and “it’s important for patients to have the confidence that their health care provider is going to take them seriously.”
• Be willing to have difficult conversations. Felix noted that having candid discussions about systemic racism and unconscious bias in health care can be difficult. There is room, however, to have “thoughtful conversations [between clinicians and patients] about how we are all trying, and we all want the same outcomes. But how can we be better?”
• Focus on reasons for hope. Felix admitted that working to improve maternal health can feel overwhelming at times, but “seeing the collaboration and contributions from so many people” makes her “excited for the future.” She added, “so many [maternal] deaths and complications are preventable, and that should make us all feel hopeful because that means we can turn this around.”

When asked how she would know that we have achieved a safer, more equitable maternal health system in the US, Felix said, “There won’t be so much fear for women of color that have children.” Pointing out that her history of preeclampsia has increased her likelihood of being diagnosed with it again, she admitted, “it's scary for me to think about having another child.” Improving care would instill “more confidence in the health care system,” Felix said, and that “does something for the culture to not feel so terrified about doing something as natural as bringing a child into this world.” She added, “I’m so hopeful that when we start to do a better job, more mothers will be here to raise their children.”