-Deep breath. Hold it.
Good. Looks good.
Push.
-[ Groans ]
Push. Doing all right. Push.
-Georgia ranks number one in the country for maternal death.
-Push through it. -We're almost there.
-I can't! I can't!
-If you look at our census records
from the last century... -[ Groans ]
-...most women died during labor or immediately afterwards.
Having a baby is serious business.
-Oh, my gosh!
[ Baby cries ]
-Excellent job.
-Most women in Georgia,
they have to travel for obstetrical access.
-No labor and delivery unit.
No doctors who can deliver babies.
-Okay, you can start the ticket. What's happening?
-We have a patient on the floor
who's fetal heart tones are down.
They're not coming back up.
-The U.S. is one of only three countries in the world
where the rate of maternal deaths is rising.
At least 60% of pregnancy related deaths are preventable.
-People are feeling the pressure of either doing the work
or the guilt of turning people away.
That's a tough call.
Eventually the system's going to fall apart.
♪♪
-Let's take a look at our baby.
-It's a boy!
-See? Right there. -Oh, my God!
-My name is Dr. Donna Adams-Pickett.
I'm an obstetrician-gynecologist who practices in
Augusta, Georgia.
I would describe Augusta as a mid-town.
It's not Atlanta, but it's not a small little hamlet either.
On an average day, I'll see 35 to 40 patients a day.
When I talk to my friends in other areas that are
more OB-dense, most of them see roughly 25 patients a day,
but the situation demands it.
When we look at the statistics in Georgia,
it's roughly 93 counties that do not have hospitals
that have obstetrical care.
So most women in Georgia,
they have to travel for obstetrical access.
The consequences can be fatal.
How are you? Okay. So I want to send you over for an induction.
Some pretty impressive swelling here, though.
-It's honestly been worse in the beginning of the week.
These are compression socks I'm wearing.
-So what we're concerned about is something
called preeclampsia.
Are you familiar with that?
-Yeah, it's like high blood pressure,
and it can cause seizures.
-Mm-hmm. That's when it becomes eclampsia.
The big thing is that it's time for us to have a baby.
-Yeah. -It would be best for a patient
to be able to have access to a labor and delivery unit
within 30 minutes of their home.
In Augusta, we are the main source for patients as far away
as two hours in either direction.
-Alright. [ Sighs ]
-Remember handing me that one six weeks ago?
-Yeah. Can you believe it's been six weeks?
My name is Dr. Jeffrey Harris.
I am a practicing OBGYN doctor in Jesup, Georgia.
I think the challenge is in a rural community
because there is such a high percentage of Medicaid,
is you don't get paid as much, but at some point,
a hospital CEO goes, "That's it, we're done,
we're losing money, and it's not worth it
for what it does for the community."
The county north of us stopped delivering babies.
Up to the west of us, there's one OB.
That's not sustainable.
To the east, there's one doctor, and he's on his way out.
It's hard to get people who want to do this lifestyle.
Probably right now the patient that's traveling the furthest
is from a little town called Hazlehurst.
They used to be able to receive care
at the hospital in Baxley, which was only about
20 minutes away from their house.
But now they're having to drive all the way here
because there is no care in between.
-I feel like I'm always in the car, I'm always driving.
It's about 55 miles from my house to Dr. Harris' office.
Longer each time I drive it.
[ Laughs ]
-Tell me about the baby's movements.
-Um, he's usually really active,
especially when I'm trying to sleep.
-Slow down a lot. -Yeah.
-We'll put you on the monitor here in just a little bit,
make sure everything looks good.
The good side, the blood pressure's good.
-Yay!
-And that probably means you'll have the baby before then.
-I hope so.
-Okay, you are...
...almost three centimeters.
[ Chuckles ]
That that I'm touching right there...
-Uh-huh. -...that's the baby's head
through the vagina. -Holy crud.
-Yeah, you're pretty close.
-Healthcare should be available to everybody.
What if I don't have a car, you know?
What if I wasn't able to drive an hour and 15 minutes?
Because I have to take off work every day I to come here.
I don't feel like people think it's that big of a deal.
Well, to those who don't experience it,
you know, that's not something people think about.
I think it's a big deal.
-Many of us live in the construct that women
have been having babies from the beginning of time,
there's no need to see doctors.
If you look at our census records from the last century,
most women died during labor or immediately afterwards.
For the 700 people who died last year,
nearly 50,000 almost died.
So when you're dealing with a state like Georgia
where there's not ready access to hospitals,
ready access to doctors, then we have a number of women
whose medical conditions before, during, and after pregnancy
can be so severe that they're, if not deadly, nearly deadly.
-Sweetie, you don't have an appointment today.
Tell me what's going on.
Do you feel like you want to harm yourself?
Sweetie, I really --
Dominique? Dominique?
Get her phone number.
I'm gonna get her because she just hung up on me.
Angel, get me Dominique's address.
I need police for a wellness check.
So I am a physician. This is a patient. Um...
She called in and said that she was very, very depressed
and said that she just didn't feel like going forward
with the pregnancy.
I asked her to come in now, and then she hung up on me.
Okay, thank you. Okay.
All right.
We're in a crisis.
If I don't see these patients, somebody has to see them.
Until we're able to bring more healthcare providers
to Georgia, I have to be prepared for the work.
-This is Miss Carter.
Miss Carter had a C-section this morning
because her baby wanted to misbehave
and have a really bad fetal heart tracing.
But fortunately, everything turned out very well.
Knock, knock. How do you feel?
-Like crap. -[ Chuckles ]
You want to show the little one off?
-Yeah.
-What did you name her? -Riley.
-All right, Miss Riley.
Say hi for the camera.
See, this is why we do all this.
Huh? Take care of you and your mama.
We're gonna make sure there's still people
to take care of you.
The problem is Medicaid only lasts about eight weeks
after the delivery because after that,
they lose medical benefits.
Affordable care, not affordable for most of these people.
So they'll become uninsured. Some people drop off.
Don't see him ever again.
-The labor and delivery units,
they began closing in roughly 2015.
And at that time, I was doing 10 to 15 deliveries a month.
Since then, I've done consistently 25 to 30
deliveries a month.
OBs are in the top five of those physicians who are sued,
and that scares a lot of residents
from pursuing this career.
It's very important to me to be there for these women.
What few people know is that my paternal grandmother died
in labor.
My dad was 12 years old when his mom died,
and the baby died on a little tobacco farm
in Greenville, North Carolina.
Trying not to get choked up talking about it.
"Oh, that was a pretty baby."
I could see him talking about it.
And it was one of the few times in my life
that I ever saw my dad cry.
And I knew then that I wanted to go into OB.
I wanted to take care mamas. I wanted to take care of babies.
Unfortunately, in 2020, women are still dying.
And with labor and delivery units being so far apart,
they might as well be on that little tobacco farm
in Greenville, North Carolina, in 1943
because the access to care is almost just as bad.
Not only are we dealing with a maternal mortality crisis,
but more severely we're dealing
with a Black maternal mortality crisis.
African-American women are three to four times
more likely to die in labor or immediately after delivery.
It's not just uneducated, poor Black women.
Educated Black women are three times more likely to be affected
by maternal mortality than other ethnicities.
And that's when it is very important that we address
that there is implicit bias.
Until we recognize that there is a problem in how we interact
with women of color, we won't fix it.
-In Burke County, there are no practicing
board certified OBGYNs.
There are none.
So if you have a baby, you have to go to Augusta.
That's going to take at least 45 minutes.
We definitely are a prime example
of what should not happen.
The fact that here I am with two degrees,
you know, a wonderful career,
you know, going to my prenatal appointment.
And yet I was still almost that statistic.
And that's crazy in 2020 that I get sub-par care
or I get ignored because I don't look like the way you --
your normal or the people that you're close to.
And that's so sad.
It's heartbreaking.
And it's almost like because you're a Black woman,
you're tough, you can't be hurting that bad.
It's almost like we're not human.
So I had my son. He's 8 now.
I had issues.
We called an answering service. It wasn't Dr. Pickett.
And when he called back, he was like,
"You're having pains because you're in your third trimester."
It was kind of like, "Okay, it's going to be fine.
If you have more problems, just call me back."
And come to find out my liver had shut down,
my kidneys were shot, like, everything was failing.
So the second time, was it my son,
went in for a routine C-section.
You know, everything was going perfect.
Then something happened.
Dr. Pickett, it's amazing, when my heart stopped,
for whatever reason, actually was right there.
Like, whether it was compressions or shocking me
or whatever, like, she was there.
When I first came to, I didn't even remember
that I had a baby.
Once I was extubated and able to,
like, really hold him, I just feel like everything
just got better.
Them bringing him, and I could see his face,
and I could hold him against me.
I think that was the turning point for me.
To see the staff members, like, emotional,
it kind of let me know, like,
"Oh, yeah, they did everything they could do."
-My nurses are some of the most loving, giving women.
So when Alquita coded, well,
they decided to keep him in the nursery at our hospital,
and they loved on that baby every day.
And the night that I discharged Alquita,
I can count at least three nurses
who just burst into tears,
who were, "I'm not ready, we weren't prepared for this."
They are so eager to see him
that they wanted to throw him a first birthday party.
Look at this.
Oh, my gosh.
Look at this.
You can feel it.
[ Laughing ]
That is the coolest thing. I love that.
-All doctors to the E.R.
-What's going on?
Hey, hey, hey. Start the ticket.
What's happening?
-We have a patient on the floor
whose fatal heart tones are down.
Dr. Adams-Pickett is going back to the O.R.
to open up for another doctor in an emergency situation.
-Okay.
Hey, sir, we're gonna try to get someone in there.
Hi. I'm Dr. Adams-Pickett.
We're gonna have to get your wife
into delivery really quickly because her baby's heart rate
is down and it's not coming up.
♪♪
-Getting close. You're next door out of the race.
This job is the best job in the world.
And some days, it's like being inside the dryer
getting tumbled around.
♪♪
All right, your starting the contractions.
Take a deep breath, hold it.
Push like you got to push.
-[ Groans ]
-Push normally.
Push. Don't breathe. Hold your breath and push.
Again. One more time. -[ Groans ]
-Push. I'm beginning to see baby's head a little bit.
-[ Groans ] -Push.
-5, 6, 7, 8...
-[ Screams ] -Almost there.
It's gonna burn. -[ Gasps ]
-Push through that burn. -Push through that burn.
-Push through it. -Little more.
We're almost -- come on, push.
-Push through that burn. -Come on, you're so close.
Come on. -Give it all you've got,
all you've got right now. -One more big push.
Stop pushing.
Breathe.
-Take a deep breath, okay?
-Baby's head's out.
-Push.
-Almost out. Push, push, push.
-Got to push, get him out.
-[ Grunting ] -Oh, my God!
-[ Gasps ]
-Look down here, Mama.
-[ Gasps ]
-There he is. -[ Panting ]
-That is a boy.
-[ Breathing heavily ] -Excellent job!
Everything with delivering a baby is just so cool.
It's 90% sheer joy and 10% sheer panic.
I have done this 38 years, and I never get tired of it.
It's the best thing in the world.
-Your baby is fine. Your baby is just fine.
-My gosh, he's a chunky monkey.
-She was like 5-12. -Uh-huh.
-I don't know what she was doing in there.
Look at her.
Congratulations. -Now you know, now you know.
-We got into the operating room emergently.
We made a decision at 28, and we had a baby at 29.
[ Laughing ] So, it was...
And she was she was holding on to her umbilical cord
like it was a bungee jump or something like that.
And I think that's why her heart rate went down.
But, so this is the life of an OB, so unpredictable.
And I have to tell baby Liam that he saved this baby's life
because if I weren't here,
I don't know if our little baby would have made it, and...
There he -- look at all the hair!
Oh, my goodness!
[ Laughs ]
[ Speaking indistinctly ]
Hey, sugar!
I'm the first set of hands to ever touch you.
-That's right. -That was me.
Georgia doesn't have the only maternal mortality
in the United States.
Every other state in this country
needs to prioritize mothers and their health.
And until it becomes a priority, it's just going to worsen.
You just saved that baby's life.
Did you know -- Oh!
-When you have a bad outcome when everybody expected
a joyous event, it's obviously traumatic for the family,
but it's traumatic for all the healthcare providers.
If we allow more labor and delivery units to close
and if we don't adequately replace obstetricians
as they retire, there will be more deaths.
-There's no statistic that can quantify what it's like
to tell an 18-month-old that his mother's never coming home.
My wife deserved better.
Women all over this country deserve better.
♪♪
[ Laughter ]