CLEVELAND — Walking through University Hospitals’ downtown Labor & Delivery wing, Celina Cunanan greets staff members with hugs and enthusiastic “How are you's?” It’s been two years since she delivered her last baby, one of many during her time as a midwife.
“I think it was always just this love of being fascinated by birth and fascinated with that joy and that miracle that happens that, ‘gosh, it's so cool that women can grow humans,’” she said. “I always kind of joke around that it's my family business. I went into the family business.”
Cunanan described how midwives take into account “the whole person,” not only addressing the mother’s physical wellbeing, but also their mental, spiritual, and emotional wellbeing.
“Throughout the pregnancy we tend to spend a lot more time with education and talking about support,” she said. “We do a lot with social support. We talk a lot about the dynamics of the family. We talk a lot about who's going to help you there. We really focus a lot, too, on the adjustment to motherhood.”
It’s something that was immediately felt by Stephanie Purdom, a former patient of Cunanan’s. Purdom’s now 2-year-old daughter, Iris, was the last baby Cunanan delivered.
“Celina is someone who really authentically cares for people, whether it's an individual in her life or a community that she's a part of, and I think I felt that that day, and I feel it every time I see her in the neighborhood and she wants to hold Iris and is asking about how we are,” Purdom said. “I felt cared for in all ways that I could talk about, not just the baby's health, but also about how I was doing.”
Raised by an obstetrician father and obstetrics nurse mother, healthcare was in Cunanan’s blood from a young age, along with perseverance and a strong work ethic. Values her parents, Filipino immigrants, instilled in her growing up.
“It was never really lost on me how hard they worked to try and make a better life for us here,” she said. “They always instilled in us the importance of education and working hard.”
Cunanan applied those lessons to her career, becoming UH’s first division director for nurse midwifery in 2007, then taking over as system chief for nurse midwifery in 2017. 21 years after she joined UH as a midwife, she was appointed Chief Diversity, Equity & Belonging Officer.
“It was a really good lesson for me to never put limitations on what my own mindset was, not to put that ceiling on myself,” she said. “That really, I could do anything that I wanted to do if I just really kind of believed in it and worked towards it. So it's been quite a journey.”
Cunanan said all of her past roles and experiences have helped prepare her for her current role, in which she oversees the hospital system’s strategies to promote a culture of equity within both the organization and communities it serves. She’s particularly passionate about infant and maternal health.
“There's room for everyone and we need everyone in healthcare,” she said. “We have our high risk physicians, our high risk specialists, maternal fetal medicine specialists. We have our general OBGYNs, obstetrician gynecologists. We have certified nurse midwives and then our nurses and then nurse practitioners as well, or PAs. There is room for everyone. Building an environment which supports all women really means having a real collaborative, collegial group of providers that are focused on the same thing and in working together.”
According to data shared by the Cleveland Department of Public Health, in 2021, Cleveland’s infant mortality rate was 10.5, higher than the county’s rate of 7.5, and higher than the 2020 rates for both the state (6.5) and country (5.4).
Additionally, the data shows a 2.28 Black to white infant death inequity ratio. The infant mortality rate for babies with non-Hispanic Black mothers was 14.4, compared to non-Hispanic white mothers at 6.3, according to the data.
“To hear that Cleveland has some of the worst outcomes, or has outcomes for infant mortality that are rivaling developing countries, was shocking,” Cunanan said. “Because here I was going to work every day doing my very best to provide great care to patients. To realize that that had very little impact on the health outcomes of babies and women in our community was disheartening.”
That’s when Cunanan began asking questions – such as why this was happening to women in the community. She became involved in First Year Cleveland, still serving as a board member today. In 2020, Celina continued to grapple with those questions as the wife of a Black man raising biracial boys.
“What is the impact that I can have on this organization and then on the communities that we service?” she asked. “If I can affect the outcomes and influence 32,000 caregivers as the second largest employer in this region, what does that ripple effect for the communities that we're so privileged to serve and how do we make them feel like they belong?”
Those questions are ones she takes with her daily in her role. Cunanan’s passion and experience in the field are seen by her colleague Dr. Daniel Simon, president of Academic and External Affairs, and Chief Scientific Officer for UH.
“She's a clinician, so she's been on the front line of this mother-baby disparity for a long time, and she has one of the largest midwife programs in the country,” he said. “I think she brings a cultural sensitivity of the importance of supporting individuals and going to them in their own neighborhood and reaching them at their own cultural needs.”
As part of her role at Chief Diversity, Equity & Belonging Officer, Cunanan oversees a number of initiatives, including the Food for Life Markets, which help address food insecurity and healthy food access, along with the Health Scholars Program, which exposes students to careers in healthcare.
The impact of access and outreach, something Cunanan understands firsthand.
“We know what a huge influence that can have on kids on just thinking, ‘oh, I can do that. I see somebody that looks like me and I want to do that,’” she said. “It's the same opportunity I got so many years ago as working at 15 in my dad's office and seeing and thinking that that's normal. I can do that. I had access to those opportunities, which helped to shape my career to where I am now. And I just want everyone else to have those opportunities to access that as well.”