Dr. Karen A. Scott is a board-certified obstetrician-gynecologist and a Fellow of the American College of Obstetricians and Gynecologists (FACOG), with nearly two decades of hands-on experience in gynecology, surgery, and birth care. While the letters after her name — MD, MPH, FACOG — reflect her extensive qualifications, they don’t begin to tell the full story of who she is or the arc of her career.

Truly, these markers of expertise are just one small piece of a larger and deeply meaningful mosaic of her life and impact. When I asked her to introduce herself, she didn’t start with her credentials. Instead, she began: “My name is Dr. Karen Antoinette Scott. My pronouns are she/her/hers. I identify as a queer, Black, Midwesternized Southern Black woman born and raised in Nashville, Tennessee, as well as a midwiferized, recovering OB-GYN.”

A Foundation of Resilience and resistance Amid Systemic Barriers 

Dr. Karen A. Scott’s groundbreaking work in maternal care is deeply rooted in her lived experiences — many untold until now. 

Born and raised in East Nashville, a neighborhood she described as “one step above the projects,” she witnessed and experienced firsthand the layered impact of systemic oppression.

“My childhood and young adulthood represent ways in which I navigated poverty, gender-based violence, and misogynoir in my home and community,” she said. “I didn’t know we were poor,” she reflected. “I just knew that the women in my community were resourceful, resilient, and deeply invested in their families and neighborhoods, even while navigating systems designed to marginalize them. [And] I was always curious about how Black and Brown women in my neighborhood made decisions about their bodies, their roles as parents and partners, and how they showed up for themselves.” 

These early observations planted the seeds for her future work. “I saw how women made decisions about their bodies and their lives — decisions shaped by their circumstances but also by their agency,” she said. “That tension between navigating barriers and asserting autonomy has always stayed with me.”

Inspired by the strength of the women around her, Dr. Scott pursued a career in medicine. “Naively, I thought being a physician would give me the authority to be heard,” she shared.

Challenging Systems from the inside

As Dr. Scott moved through her training and into clinical practice, she encountered new barriers embedded in obstetrics and gynecology that prioritized efficiency over empathy and outcomes over experiences.

“As an OB-GYN, I was supposed to help people bring life into the world, but the model of care I was part of felt more like managing pathology than supporting potential,” she explained. “Patients weren’t treated as partners in care — they were treated as problems to solve. And that didn’t sit right with me.”

Her rare patient-centered approach made a significant impact on her patients — and made her stand out. At one time, the high volume of patients in her care made her one of the highest producers of revenue for the hospital where she worked. "Within my first two years of practice, which is big. I was the only Black woman on staff at this hospital," she explained. Yet, instead of being celebrated, her success was met with resentment and resistance. “From pet to threat — That's really been my experience as a Black woman in this work,” she candidly shared.  

She went on to explain how at that time, she was not only serving a vast population of Black women, but white women as well. "A lot of white women in the role of wives or daughters as office managers for their white husband’s or father’s practice — they would call me whispering, saying, ‘Hey, I’m going to send X, Y, and Z to you. Because whatever you did to help this woman in this neighborhood, she's telling everybody, and everybody wants to knwo, who is this Dr. Scott?’ So I had a booming gyn practice of white women who were really drawn to my person-focused care.”

Rather than embracing her ability to provide compassionate, effective care, Dr. Scott faced pushback rooted in racism and misogynoir. “The owner of that practice basically came up to me and said, ‘I just don't want you to be here anymore.’”

“The system wasn’t designed to celebrate Black women thriving within it — it was designed to contain us,” she said. These experiences underscored what she had long understood: the harm Black women and people experience in perinatal care (both receiving and providing it) isn’t incidental — it’s structural.

Reconciling the OBGYN Identity + Restoring Her Humanity

Because Dr. Scott brought a unique perspective shaped by her background as a Black feminist, humanist, and social scientist from as early on as residency, her awareness of how deeply her values clashed with the standard practices and philosophies of the field continuously grew throughout her career — and with it, so did her discontent.

She described carrying profound guilt for years: “I carried guilt, from 2002 to literally maybe last week, for becoming not only part of the problem but, at times, a driver of the problem,” she said. The problem was specifically her role in perpetuating what she called the “manufactured maternal health crisis,” which often focused more on diagnosing problems and managing risks than on understanding and supporting the full experiences and needs of birthing people. 

“The beauty of being an OB-GYN was that it gave me proximity to Black women and girls so I could hear their stories. But the only way I felt I could serve them without retaliation in that role was by reproducing harm. Being an OB-GYN made me complicit. I did not know that becoming an OB-GYN would come at the expense of the erosion of my own humanity and my genius,” she reflected.

Reconciling her role as an OB-GYN with her personal values required profound introspection. She shared how she recently embarked on an emotional journey with the support of her therapist to “lay to rest” the OB-GYN identity she felt she had outgrown. “I had a conversation with myself, my inner child, and the OB-GYN in me. I thanked her for getting us to where we are — financially stable and with the knowledge we’ve gained — but I also told her it was time to rest,” she shared. “That work came at a cost, and I didn’t know the price until it was paid.”

This deeply intimate and meaningful process allowed Dr. Scott to redefine her work in a way that aligned with her values and her superpowers. “I’ve always believed in acknowledging, affirming, and amplifying the power, promise, and potential of Black women,” she explained.

This was the beginning of her shift away from direct care and practice, and toward reclaiming and creating systems of care that uphold dignity, humanity, and equity.

The Respite of Midwifery

One bridge from within in her obstetric career to her future work was her relationship with midwifery. She saw how the midwifery model prioritized connection, respect, and the autonomy of birthing people — values she found so often absent in traditional obstetrics.

“I’ve always admired midwives and the way they center birthing people in their care,” she said. “Midwifery challenges the rigid, hierarchical dynamics that dominate obstetrics. It’s about respecting the process of birth and the person giving birth, rather than controlling or managing it.”

Dr. Scott credits midwifery with teaching her to truly listen and trust birthing people. “Midwives taught me how to create space —space to hear stories, to see the whole person, and to honor their decisions,” she shared. “That kind of care requires humility and a willingness to challenge the power dynamics that are so entrenched in medicine.”

The Birth of the SACKRED Framework

The SACKRED framework is a transformative model for maternal care. Based on interviews with 36 Black mothers and birthing people in Oakland and Los Angeles, the framework redefined quality care by prioritizing what made people feel safe, respected, and whole.

Each letter represents an aspect of care they defined: Safety, Autonomy, Communication, Kinship, Racism, Empathy, and Dignity.

Dr. Scott explained: “Traditional metrics of success in obstetrics — like low C-section rates or healthy Apgar scores — don’t tell the whole story. For example, one mother told me her birth was ‘perfect’ on paper, but she didn’t feel whole afterward. That disconnect is what SACKRED seeks to address. It’s about making sure people leave their births feeling whole, honored, affirmed, valued, and safe — not just alive.”

A World Without Obstetric Racism

Today, Dr. Scott’s work focuses on structural and systemic change, activating the power of parents to navigate a flawed and fractured healthcare system with confidence. Groundbreaking initiatives like the PREM-OB Scale®, diagnosing and dismantling Obstetric Racism, and the Obstetric Patient Safety Summit (OPPS), and more have earned her national and global recognition.

She envisions a world where obstetric racism and violence are considered “never events” — harms so egregious that they are unacceptable under any circumstances.

“Black women have always been the architects of our own survival,” she said. “My work is about amplifying that truth and ensuring that care systems reflect and respect our humanity.”

For parents, Dr. Scott’s message is clear: Your experiences matter, your voice matters, and your safety is non-negotiable. Through her work, she paves the way for a future where perinatal care fully honors every birthing person.

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