-My first three birthing experiences
hasn't been too great.
My very, very first child,
I experienced fetal demise a few hours after his birth.
Throughout that whole prenatal care,
I really was in the dark.
-You know the baby now.
You know the movements. You know the pattern.
There's probably a time when baby's less active,
like you say, during the day.
So if that changed, then you need to let us know
because something might be going on.
You're the best monitor, right?
So if she tells you that, I'm not sure,
then you pick up that phone
because we need to be on top of it.
-The US recorded one of the worst rates
of maternal mortality in its history in 2021,
and Black women continue to suffer the most.
-Maternal mortality includes deaths during pregnancy
and up to a year after giving birth.
-As you know, birth is supposed to be a happy, celebratory time.
But for so many factors, it's not,
especially for Black people.
-Since 2018,
the rate of maternal deaths in the United States
has been rising, and for Black women,
the statistics are even more dire.
Black women are now two to three times more likely to die
in pregnancy or childbirth than their white counterparts.
For over two decades, Jennie Joseph
has worked to improve maternal health
for Black mothers through her nonprofit,
Common Sense Childbirth.
She founded the Easy Access Clinic in Central Florida,
which helps even the most vulnerable patients
through a patient centered model she calls the JJ Way.
-There's, as far as I'm concerned,
one reason and one reason only that we have the worst,
highest maternal mortality rate amongst developed nations.
And it's racism.
It's classism, gender discrimination, marginalization.
This is about power.
You've already proven that with all things being equal,
good contractions moving along,
your power, your energy, you can get the baby out.
-It was important for me to seek great prenatal care this round,
because I think I kind of have like PTSD
from the previous births of not being listened, heard.
Obviously I'm a bigger woman, so I have bigger kids,
so I just want to make sure that I'm safe,
my baby is safe, and when I give birth,
I don't want to die. I don't want my baby to die.
-What I want to do for sure, Jaria,
is make sure there's no fear.
Like, let's get the fear off the table.
Right? Let's take it out. You're not on your own.
And you don't have to hold that. Let that go.
-What issues, what structural racism
has done to some of these patients,
they are bringing all of that to the pregnancy.
And so we need to remember
and think about the point of view of our patients.
We need to listen to them.
For example, why is this woman late?
Her appointment was at 1:00, and she showed up at 1:30.
Do we ever take a pause to say,
did she really have to take three busses to get here
for this 10 minute visit, and I'm about to turn her away?
-Joseph has also trained health workers and midwife
and doula principles, in addition to developing
a national network of like minded providers.
-The midwifery model of care, the way that midwives work
inherently opens up opportunities for listening.
Because midwives and midwifery center the birthing person,
and in centering somebody, you always keep them safe.
Why are you scared? What you scared about?
-The labor part? Yeah.
So let's get you into childbirth education class.
-Too often, studies and experts
say the medical establishment mistreats Black patients,
dismissing requests for help, brushing off cries of pain,
and pressuring them into unwanted interventions
such as C-sections.
And for every maternal death,
there are anywhere from 50 to 100 women
who experience severe maternal morbidity,
which is often less scrutinized than deaths.
Regina Davis Moss, the executive director
of the reproductive justice advocacy group
In Our Own Voice, was one of those women.
-I am a classic example of what you need to do
in terms of prenatal care.
However, I still had what was called a near miss.
I had my blood pressure spike, I had high temperature.
My son was in the NICU.
So we see, I'm degreed.
I live in a higher socioeconomic status,
but I still have these outcomes,
which lets you know that education,
financial means, access to care is not the only reason
that we're seeing these problems.
-With nearly 80% of deaths occurring shortly after birth,
OB/GYNs like Tamika Auguste have begun calling on providers
to begin seeing women much sooner
than the standard six week checkup.
-Pregnancy associated deaths from hemorrhage or infection
happen in the immediate postpartum period,
within that first week to a couple of weeks.
Cardiac issues usually happen within those
first four weeks.
So if you as a pregnant woman has a complication of
high blood pressure or diabetes,
it's going to be really important
to be seen much sooner rather than later.
So instead of see you in six weeks,
it's let's see you in one week,
see how you're doing, check your blood pressure,
see if there's anything that you need.
-On a policy level, Illinois Congresswoman Lauren Underwood
is one of the lawmakers leading efforts to pass bills
aimed at addressing every driver of maternal mortality,
morbidity, and disparities in the United States.
-We know that solutions exist.
We just need policy makers to invest in them.
There's 13 bills within the Momnibus
designed to address every clinical
and non-clinical contributing factor
to the maternal health crisis in the United States.
So, as an example, one of our bills
is called the Social Determinants for Moms Act.
It addresses issues like housing and transportation,
nutrition assistance, right?
Things that we know are contributing
to maternal death in this country.
We also have legislation to grow and diversify
what we call the perinatal workforce,
so that we can have more OBs,
more midwives, more nurse midwives,
more doulas, more lactation consultants.
-While the Momnibus has received
bipartisan support in Congress, it has only been introduced.
For maternal health advocates like Joseph,
the cost of waiting on government
and medical systems is too high.
-I'm so happy to be able to welcome you all into this work
and to have you be part of this movement,
because this is a movement.
-In 2020, Joseph broke ground as the first Black person
in the US to privately operate
a nationally accredited midwifery school,
where she is increasing the number of Black midwives.
-We are making sure that midwives students are equipped
and are supported to create sustainable practices
and to be able to offer outpatient services
and to move the integration of midwifery
into mainstream maternal health care.
We're talking about saving lives,
which on the one hand sounds so dramatic, doesn't it?
And then on the other hand, that's our reality.
-Our health care system is broken in the United States.
It's not always driven by the best science.
Sometimes it's driven by the bottom line.
Then we start to dehumanize, and we make these decisions.
And that's the other thing I want to say,
is that we're talking about rates and ratios, right?
But these are real people.
These are mothers. These are daughters.
These are sisters. These are cousins.
These are our best friends.
We have to realize that this is an issue that impacts all of us,
and we have to look at everybody as having value.
-You all have done great work,
and you should be so proud of yourselves.
-While advocates like Joseph acknowledge
that community based models of care
are not the only solution,
they're encouraged by the growing number of Black midwives
and doulas yearning to confront this national crisis head on.
-Every time I'm able to participate
or just observe a class,
a training where so many people come forward
who are almost desperate to get out there,
and to be impactful,
it fills me to a point of there's got to be hope.
This is one of the ways that we're moving forward
and actually moving this needle.