California Surgeon General speaks at UCLA on her approach to improving maternal health across the state

The UCLA Center for Reproductive Science, Health and Education (CRSHE) established its biannual Distinguished Speaker Series to share information with the public and spark conversations around reproductive science and health. Held each fall and spring, the event series brings influential leaders to UCLA to share their expert insights.

On October 20, UCLA students, scientists, educators, physicians, leaders, and local community members filled the auditorium at the California NanoSystems Institute to hear from the latest CRSHE Distinguished Speaker, California Surgeon General Diana Ramos.

Life Sciences Dean Tracy Johnson introduced Ramos (UCLA alum, MPH ’04) as “a visionary public health leader,” lauding her for championing equitable initiatives and policies to improve reproductive and maternal health, mental wellness, and outcomes of adverse childhood experiences (ACEs).

Having worked as an obstetrician-gynecologist for over thirty years, and more recently as surgeon general, Ramos lives by the belief that “losing one mom is one mom too many.”

The surgeon general began her presentation with an introduction to “adverse childhood experiences”, ACEs. These are significant stressors experienced in childhood–like abuse, neglect, violence, and divorce. ACEs have been associated with higher risks of developing long-term health issues later in life.

Ramos said high ACE scores in women were associated with cardiovascular disease, gestational hypertension, preterm birth, and postpartum depression. Significantly, cardiovascular disease is the leading cause of maternal mortality in California.

The California Surgeon General’s Office established its Strong Start and Beyond initiative with the aim of reducing maternal mortality across the state. Ramos said 80% of maternal deaths can be prevented, and her office’s strategies focus on prevention.

In collaboration with researchers and community organizers, the surgeon general’s office developed PreMA (Preconception Medical Assessment) targeting women of childbearing age. PreMA is essentially a brief questionnaire that identifies specific chronic diseases and other known pregnancy risk factors. Ideally, screening results will launch the process of treatment well-before pregnancy is established. By implementing PreMA, we could reduce a great number of maternal deaths and improve women’s health more generally, since it’s been estimated that one in three women of childbearing age have a chronic health condition. 

 ”(With) recognition of the importance of ACEs, of PreMA, in our health encounters in the community–imagine the healing, the prevention that we can start…We can connect families to support where it’s needed, before conception,” Ramos said. “This is not just healthcare – this is prevention – and it’s more powerful.”

Key to the surgeon general’s plan is spreading awareness and action around prevention. She called on UCLA students to help promote participation in PreMA, and encouraged future healthcare providers to consider a compassionate “whole person” approach to learn relevant history from their patients that could inform better, holistic care.

“You will meet patients whose bodies tell the stories that their voices may not, that chronic stress really wore out their bodies,” Ramos said. “You may be the first person to ask, ‘How are you really feeling?’ And remember to listen. We need to learn to listen.”

 In addition to professions in healthcare, research, public health, and policy–Ramos encouraged students to consider the wide range of professions needed to improve maternal health outcomes. Ramos said the state is expanding community-based health support–doulas, peer health navigators, and behavioral health teams. In addition, she highlighted the need for people with computer programming skills who can advance technologies. Wherever their talents and passions lay, she urged students to use them to contribute to solutions for better health outcomes.

Reflecting on the surgeon general’s message, fourth-year molecular, cell, and developmental biology major Grace Brewer said, “As an aspiring physician, Dr. Ramos’ emphasis on creating safety and belonging in healthcare deeply resonated with me. I also realized that it’s not just policymakers and healthcare providers who improve maternal health outcomes, it takes everyone’s participation. We all have the ability and the responsibility to make a difference.”

Following her presentation, the surgeon general sat down with CRSHE director Amander Clark who moderated a Q&A that covered a range of maternal health topics in California–including current causes of maternal mortality, how technology might improve maternal health, and the state’s efforts to address paternal mental health. Ramos then answered questions from the audience, revealing a wide range of helpful resources made available through different state health departments and initiatives.

Listening, guiding, and encouraging future leaders in health care

As the event came to a close, the surgeon general offered to stay and answer any remaining questions from the audience. Several students cued up to speak with her, and Ramos took time to listen and thoughtfully respond to each student, one-by-one. 

“Dr. Ramos made an effort to make each student feel seen, meeting them where they were at. As she provided answers and information, she seemed to be empowering students, helping them problem solve, offering guidance and inspiration,” said CRSHE associate director Stephanie Kiesow-Edoh. “To see a leader of her status come in with this level of dedication to connecting with individual students, this seemed really special to me.”

****