Episode 11 (Season 1 Finale)- Black Maternal Mortality with Dr BCW

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Episode Transcript

(00:00):
Most people think dying duringchildbirth is a thing of the
past.
But that depends.
Of course things are better thanthey used to be.
We have more knowledge, bettertraining, and better equipment.
All of which make childbirthmuch safer.
However, Serena Williams, one ofthe greatest tennis players of

(00:21):
all times, and black sportsicon, almost died giving birth
in 2017.
So with all of theseadvancements, Why do black women
die in childbirth over threetimes more than white women?
Often it's argued that theproblem is a lack of access to
quality care, which isabsolutely a big part of the

(00:45):
problem.
But if Serena Williams, who canaccess the best healthcare on
the planet, almost felt victim,it's more than access.
Despite her access and celebritystatus, She encountered a
situation that many black womenface.
She knew something was wrong.
She told her healthcare team,and she was dismissed.

(01:07):
If she hadn't kept insisting,she would have died in
childbirth because of theinvisibility that unconscious
bias creates.
So, what is unconscious bias?
It's the social stereotypesabout certain groups of people
that we form on our own, withoutrealizing it.
These are the gut reactions wehave to how people look, talk,

(01:31):
and behave.
Unconscious bias in and ofitself is not a bad thing.
In fact, It's something we allhave.
However, when unconscious biassystematically creates a
damaging outcome for one groupof people, it's something we
need to look at more closely.

(01:53):
The risk black women face in ourhealthcare system is a
complicated topic, and there aremany interacting factors.
So today, I want to bring tolight how race based medical
practices and unconscious biastogether impact Black lives.
Welcome to Pulse Check,Wisconsin.

(02:39):
Good morning, good evening, goodafternoon, whatever it may be
for you.
This is Chris Ford again fromPulseCheck Wisconsin, and I want
to thank you guys for not onlyjoining us for this episode, but
also for supporting us allthroughout this first season.
Believe it or not, this is ourseason finale we are at episode

(02:59):
11, and for this episode we havea very special guest, a doctor
who not only is knownnationally, but also
internationally.
But she also advocates forwomen's health, for improvement
in social determinants ofhealth.
A lot of great things, speaks tothese things at a national

(03:22):
level.
TED Talks, she's had two ofthem.
Dr.
Bayo Curry Wensho.
In lieu of doing a case, I askedDr.
BCW, as we call her, to sharewith us some of her own personal
journey, not only in medicine,but also with an encounter that

(03:44):
she had while she was deliveringone of her children.
And in that, kind of, Wraps upsome of what we're talking about
here, especially in the state ofWisconsin, where we see maternal
mortality and infant mortalityrates be the highest in the
country.
I also had her speak to some ofthe community supports that are

(04:08):
had in.
the national stance as well asthings that are available for
folks here in the city ofWisconsin.
So a lot of great informationthat was gleaned from this and
we will go ahead and start ourinterview with Dr.
BCW.

Bayo (04:57):
So first, thank you so much for just having me here,
Dr.
Chris.
I'm excited to be here.
So I'm Dr.
BCW or Dr.
Bayo Curry Winchell, vwhich isQuite a mouthful.
So I go by Dr.
BCW, um, and, um, it reallyreflects who I am, which is, um,
a mixture of things, the blendof things.
And I'm a family medicine,urgent care physician, and also

(05:19):
subspecialized in sexual assaultand response.
So I'm a medical director for acouple of hospital systems and
the founder behind, um, beyondclinical walls, which is a way
to provide health literacy and adigestible.
Engaging and informative format.
And we're doing that across thenation and just helping people.

(05:39):
So, but also I always like toshare, I'm a practicing
physician as well.
Um, so there's lots of thingsthat are a part of me all rooted
in helping people.

Chris (05:50):
Yeah.
And I feel like that's thebiggest message too, you know,
on top of all those things.
Kind of that bedside, you know,person to person approach of
medicine in general is justinvaluable that that that gift
that we're able to share withpeople and also that opportunity
we're able to have just to helppeople one on one.
It's just that words can'tdescribe that.

Bayo (06:10):
I agree.
You know, when I be, when Idecided to become a physician,
my thought was I have beenprivileged to have all of this
amazing information.
What can I do to share it beyondmyself?
And so as I started practicingand I thought of all the
advocacy work that I had alwaysbeen doing, why not make it even
broader?

(06:30):
Because that's the whole point.
We want to help people.
And so it's It's just beenfantastic to not only practice
medicine, but really elevateequity in that and a variety of
topics, whether it's generaltopics or maternal health, which
you know is so close to myheart.

Chris (06:48):
Absolutely.
And we'll, we'll get more intothat too.
Because I'm really interested inhaving you share that with our
community because I think it isgoing to be, it's going to touch
so many, so many lives Butbefore we do that, can you
explain kind of your journeyinto medicine?
We've been doing this serieswhere we have been talking to
different physicians in thearea, just talking about their
journey for folks that areinterested.
And specifically what inspiresyou to go into your field to

(07:10):
become a family medicine doctor?

Bayo (07:13):
Well, um, I always like to start with the reason why I get
to do what I do.
And that all comes from myfather, William Curry.
So 99 year old world war twoKorean and Vietnam war veteran,
Chris, and I grew up going todifferent events and rallies
and.
Advocating for just a widevariety of things.
And I remember holding up signsand not knowing what I was

(07:36):
really doing there, but knew Iwas doing something to help
someone.
And that is the reason why Idecided with medicine to go
beyond, with, seeing patients inevery way that I can to help
people.
And so my journey was really nontraditional.
So I knew I wanted to helppeople, but I wasn't sure at
like kind of what route would bebest.

(07:58):
And so my major was actuallypsychology.
I worked in the autismbehavioral analysis program, and
I found myself wanting to knowmore about just the inner
workings of the body and Whatelse could I do?
So, uh, I saw that there was aphysician assistant program and
my parents were both militaryand I grew up actually seeing
physician assistants.

(08:18):
So I applied and got in and I,it was actually in Ohio and then
did rotations and startedworking in occupational urgent
care and family medicine.
But there was this calling whereI was like, I really want to do
more.
I really want to learn more.
I want to connect those things.
dots in a way that provides moredepth and I want to be able to

(08:39):
provide more, you know, justoverall care.
And so I took a leap of faithand I had one individual in
particular, Dr.
Fairmont, who just believed inme.
And I said, I want to go to medschool.
And often we hear Chris, wherepeople have come up to us or you
hear stories of people saying,They want to go to med school
and people are like, no, no, no,you shouldn't do that.
Are you sure?

(09:00):
But this man did not do that.
He said, of course, of courseyou can do this and helped me
along the way.
And imagine if we had morepeople who just leaned into
immediately when someone said,This is my dream.
This is what I'd like to do.
What you could accomplish whenwe talk about building pipelines
of representation and all ofthose spaces.

(09:22):
So he said, yes, he helped me.
So I was working as a PA as Iwent through to get all of the
extra classes I needed to do.
Uh, left my job when I gotaccepted, uh, went to medical
school, then did my residencyback in Nevada and, helping
people ever since.
So a very non traditionaljourney.
But my heart is just filled withgratitude for just the journey I

(09:47):
was able to take.
And again, all credit goes to myfather, um, who just recently
passed away.
And, He is the reason why I getto do what I get to do.
Um, he was the first start, thefirst person to really believe
in me.
And, that's, that's why I dowhat I do.

(10:09):
It's, it's a love it's, thiswasn't just something I started
doing.
I've been doing it my wholelife.
And, um, just.
Thinking about what can I donow?
What can I do to hopefully helpsomeone in a way?
That meets their needs from anindividual standpoint.

Chris (10:25):
And what a tremendous journey.
And thank you so much forsharing that.
And God bless your father forcreating such an amazing person
and an amazing physician.
Because, you know, like yousaid, it, it, it, there are so
many barriers in the way,especially for minorities,
especially for women in general,in terms of going into
healthcare, especially to becomephysicians, uh, at that level.

(10:47):
And it it's amazing what justone mentor will do.
Right.
I can't tell you much, much likeyour journey, how many people on
the way said, you know, that'stoo hard.
You should consider this, youknow, and for a lot of folks, it
unfortunately is that finalbarrier that prevents them from.
Taking that next step andproviding more physicians in the
community where we already havea Staggering shortage at this

(11:10):
point in time and so, um, youknow kudos to you for for going
on Thank you to your dad to yourmentors for helping to push you
And and for you for knowing thatthat wasn't the route for you to
go you you felt like it wasn'tright uh, you know when you're
at your Suspected finaldestination of pa

Bayo (11:27):
Yeah.
It just felt in my heart.
I was like, I, I want to learnmore, even though I was doing, I
loved being able to provide careand I, Received a great
foundation of information and,and being able to help patients.
But I just knew, especially whenI was going on rotations, even
as a PA student, I was like,there's something amiss here.
And when I share that story,some.

(11:49):
People often wonder like, Oh,did you apply to med school and
not get in?
I did.
And I just, I love thefoundation of PAs where that
connection and spending time, atleast that was what was often
socialized.
And, um, so that was thecalling.
But then I thought I can do thisas a doctor.
It's part of my personalityanyway.
Like any patient who sees me,they know I'm going to give you

(12:10):
my all.
And so.
So, um, I was able to truly givethem my all by going to medical
school and, and immersing myselfin full education and helping
people.

Chris (12:21):
Yeah, and more like you talked about.
So that that personalexperience, one thing that we're
going to get into today is is athing that you're you're a
staunch advocate for, and anational expert at this point in
time.
And that's more.
So maternal health, um, how wasyour experience as a medical
professional?
Both in the professional realmas a PA and then, going on to
get your MD, how has thatexperience shaped your

(12:43):
understanding of maternalhealth?

Bayo (12:46):
It has just really provided a new perspective.
So as I mentioned before, ofcourse, advocating, I've been in
this work of health equity for along time.
And I remember as I was goingthrough PA school and through
medical school, things that wereJust not right.
And I would think to myself, whyare we looking at people based

(13:08):
on the color of their skin?
And more importantly, when I saythat, I mean, why are we
treating people based on thecolor of their skin?
Why do we have certainalgorithms, different things?
Based on that, and then reallyunderstanding, you know, race is
a social construct.
But why are we saying you getthis medication because of the
color of your skin versus theindividual pieces?

(13:31):
And as I went through PA schooland med school, I just, again,
continued to kind of formalizethese thoughts and thought, what
can I do?
And a lot of people don't know,even before social media, you
know, really started, I wasalready advocating for these
things and just trying to, um,put the word out.
And you mentioned with all theintersectionalities that.

(13:52):
Everyone carries, but as a blackwoman in medicine, it is very
difficult sometimes to just evenbe able to be seen, be heard,
and then even when you havethose two pieces to be able to
put it forward.
And so the evolution of seeingthe things that I knew weren't
right.
And continuing to push to make achange has just been really

(14:17):
enlightening.
And also.
The challenges that I continueto face and have faced in the
past fuel me to get stronger andjust think of different,
different ways to reach people.
And then one more example iswe're so politicized.
There's so many different thingsthat really trigger people.
And so I thought with all thelearnings that I've seen, all

(14:39):
the challenges that I faced, ifI can find a way to share
information in a disarming wayand make it digestible.
That is one way to move theneedle when we talk about
disparities and inequities, andthat's why I created the series
that I did, and that's why I dothe work that I do.

(15:00):
I just reshape the informationyou and I know, but I put it in
a way that people can take inand feel like they're not being
talked to, but they're a Part ofthe conversation and that way,
then they can make the decisionthemselves.
And so through all of that, it'sjust been amazing.
And, you know, those challenges,which I know we'll get into have

(15:20):
also, um, ignited me even moreto see what I can do.

Chris (15:26):
Yeah.
And you bring up a couple ofgood points there too,
especially, you know, in thepopulations that are affected
the most by health disparity,um, and healthcare
complications, you know, in theAfrican American community.
There's a lot of mistrust thatfeeds into some of those
disparities and as you've spokento very eloquently in some of
your TED talks and some of yourinterviews, There's a lot of

(15:47):
historical context to that too.
Right.
And having someone, you know,like, like yourself in that
position to be able to breakdown those barriers and to be
able to give it in a palatableway that folks understand folks
don't feel like they're beingtalked that folks don't feel
like they're being experimentedon as, you know, you commonly
hear, um, you know, when you'redoing bedside medicine, those

(16:08):
things are going to be the wayforward that we help break down
those walls of those healthcaredisparities and break down all
those barriers that are inplace.

Bayo (16:16):
It's so true.
And it's interesting because weknow those stories exist.
And I often bring forward thefact that I got to hear it
firsthand because my fatherbeing 99 years old, that's what
the age he was when he passedaway.
I heard his mistrust.
I saw the mistrust.
I also saw how he was treated inthe healthcare system, even as a

(16:40):
veteran.
And so, I use that to think ofhow can I lean into positivity
because there's so manydifferent things that are a
problem in our healthcaresystem.
But if I can find a way tocreate a positive lens and help
people.
That is a win win when you'retrying to kind of climb this

(17:02):
hill.

Chris (17:04):
And one thing you brought up there too is that lived
experience, right?
And one thing that you spoke toas well in the past was kind of
your own journey in that, right?
Specifically with in terms ofmaternal health and maternal
health complications.
Um, can you share your personalexperiences with childbirth
complications and whatchallenges did you face even
after that?

Bayo (17:25):
So, uh, we all know, we've heard the statistic of Black
women dying at the highest rateduring childbirth or shortly
thereafter.
And it's really interestingbecause, of course, I've always
known this statistic, and I'vebeen advocating for maternal
health and health equity allthroughout.
Um, But to have a personal livedexperience of it a whole nother

(17:49):
story.
And to your point, that livedexperience.
And I decided to share whathappened to me because when we
hear about inequities anddisparities, you often hear it's
an access issue.
We need to have more access.
That's going to be the changefactor, or we need to have more
insurance options.
That will be the change.

(18:09):
And that's a part of it.
But the piece that isn't.
Talked about is the bias inhealthcare, the racism in
healthcare.
And when I say bias, often it'snot of malice.
It's just a part of us.
And by sharing what happened tome, I'm able to tell all of the
elements that I faced.
It's not a one directionalpiece.

(18:31):
And I think that's the part thatI really want to highlight when
we talk about this crises.
So I had just delivered mysecond child.
I.
Come out of the O.
R.
And I knew.
I didn't feel the same as I didafter my first delivery.
I was having a hard timespeaking.

(18:52):
And if you know me, even throughdifferent things, I smile.
I'm a positive person, but Ijust felt this extreme fatigue
and inability to reallyArticulate and, and concentrate.
So I shared that with my nurseand I said, something's wrong.
Can you call my doctor?
And she said to me, you lookfine, Byo everything looks okay.

(19:14):
This is normal.
And so I sat with that and thenit started to get even worse.
And I said to her, I don't evenknow the time that lapsed, but I
said, it's getting worse.
I am not feeling well,something's something's wrong
and I'll never forget.
All right.
She's like, your vital signslook fine.
You look good.

(19:35):
This is how you're supposed tofeel.
And so I'm sitting in that andit's getting worse.
And I'm asking my husband, Isaid, can you just call my OB?
And luckily physician tophysician, of course I have his
number in my phone.
Phone and he called him andsaid, can you come over and see
bio?
Something's wrong.

(19:56):
And he came over and he knewthat I wasn't myself.
And I say knew in the fact thathe took in that I, he, he just
knew that something was wrong.
So they took me back to the OR.
I was bleeding internally.
I'd retained products.
I was transfused five units ofblood.
I was hospitalized for twoweeks.

(20:19):
So I almost died and.
I share this story even thoughit's painful in hopes that I can
save another woman's life byknowing that I had the most
access in the world as aphysician, as a medical
director, and that did not helpme.

(20:41):
So we have to think about howthis goes beyond access.
It goes within bias.
And I think, you know, with thenurse, it's not that she was
necessarily trying to hurt me byany means, but in her mind, Her
assessment was based on what shefelt like look like in pain,
what she felt like that imageryof someone who needs help.

(21:04):
And that's the part we have toinvest in because if we don't,
we're going to miss the mark onwhy this crisis keeps happening
because we hear about, Oh, webuilt these amazing centers or
we have all of these wonderfulprofessionals to help advocate.
This is still happening.
So it's many elements that wehave to, that we have to invest

(21:28):
in.
And I am sorry.
I still, it still takes me backevery time I share this story,
but it's worth it because I justwant to help people.

Chris (21:36):
Absolutely.
And thank you so much for beingso brave to share that.
And I'm sorry to conjure upthose, those feelings down

Bayo (21:43):
hear.

Chris (21:43):
but like you said, that's going to help someone.
And, and I feel like what youspoke to most was even in the
best of circumstances, you know,like you said, you were a
medical director, you were amedical professional.
you knew the OB, how many peopleare going to have that ability
to contact and how many peopleare going to have that, you
know, so to speak that internalpull to say, Hey, something is

(22:05):
not right.
And they're sent home or, youknow, they, they wait in the
hospital until things go wrong.
Um, and so, you know, I thinkthe biggest thing that I've,
I've learned from hearing youspeak and from watching some of
your interviews and things likethat, if something doesn't feel
right, Definitely speak up.
You are an advocate.
You are worthy.
You, you know, you, you knowyour body, right?

(22:28):
And I can't tell you how manytimes like that has been life
saving for a lot of patients andhad similar experiences like
yourself.

Bayo (22:35):
And it's interesting that you say that.
So with all the work that I'vebeen doing with equity and, and
raising awareness, my advocacypiece from that experience has
gone threefold.
And because when we think about.
There'll always be sexism,racism, all of these things that
are fractured in our healthcaresystem.

(22:56):
But what I try to do through allof the mediums that I'm sharing
health information, I tell youabout it, but in a way that's
digestible, I raise awareness,but I also help you know how to
advocate for yourself in thatmoment, because that is how
you're going to move thatneedle.
And so if I can create content,which I'm able to do, that helps

(23:18):
you say, Oh, this is.
About this topic.
Now I know what questions toask.
I know what I should be gettingand what I'm not getting.
That is powerful.
And that is health care.
And I think that's the part thatI am just hopeful that more
people look at because that'show we're going to really get
there.
Produce change.

Chris (23:39):
Yeah, absolutely.
And, you know, I'm going to plugeverything, uh, beyond clinical
walls to this episode, because,you know, the information that
you're giving and especiallythat lived experience is, is
paramount and, you know, I feelas though making it palatable
for so many folks that are goingthrough similar, avenues is, is,
is the way forward.

Bayo (23:59):
It is.
And people are often surprised,you know, they want to know
like, cause what you see ononline can be different from
behind the scenes.
And so I'll share with you, Imentioned I'm a practicing
doctor, but I write all my owncontent.
Of course, my husband is anengineer for a company, but he
does.
The videos at like 1 AM, likethis is a small, but mighty

(24:21):
team, all rooted in what can wedo to help people?
And the part, the reason why wehave it that way is there's a
level of authenticity to what weare putting out there.
There's not this overlay ofextra pieces.
It's a physician, a black womanwho is sharing information and
hopes to fold, help that healthliteracy, but build that

(24:45):
representation.
Because if a black or brown girlcan see someone that looks like
me, because you don't see myface, someone who looks like me
on always on national TV or allthese other platforms.
Then maybe you're going to thinkI can do this.
Or you're someone who's facingan illness.
I see someone that looks like meand she can help me in a very

(25:06):
digestible manner and isapproachable and is actually
seeing patients.
That's a win win in so manydifferent ways.
And that's why I do what I do.

Chris (25:16):
Absolutely.
Absolutely.
One thing that I wanted to touchon here was, you know, we see a
ton of factors that you spoke toin the beginning.
You know, it's not just accessto, you know, physical health
care.
You have the ability to go toclinic.
It's not just access toinsurance things of that nature.
What are some of the mostsignificant factors that you see
contributing to the high ratesof maternal mortality,

(25:39):
specifically amongst black womenin the United States?

Bayo (25:43):
I would say, you know, when we think of bias, um,
whether it's due to yourthoughts of what pain should
look like, what your thoughts ofsomeone.
What someone should get as faras care.
Those are really importantpieces that are adding to this
crisis, because when you look atsome of the studies that have

(26:04):
shown it spans across all socialeconomics.
So this is really a, an issue ofcourse, racism and bias, but
that those two pieces, I thinkwe're missing the boat.
I do think of course, dualismmidwives are helpful and they're
a part of it, But if that biasstill exists, and this is

(26:25):
something I often say, if thatclinician isn't listening to the
patient, what's going to changefor them to listen to that
doula, that midwife and soforth.
If we haven't invested in thebias piece or the imagery piece
of what you think should begoing forward, for someone to

(26:45):
get help during their pregnancy,or when they're coming to you
saying, I have this certainconcern.
Those are the parts.
And then literacy, healthliteracy, the more you're
informed, the more you canreally say, you know, I don't
feel right in my pregnancy.
And this is the reason why.
And I know These things could bedue to preeclampsia, other

(27:08):
factors, or a big piece that Ioften I've done multiple videos
on this, we forget that duringpregnancy, if you've had any
complications, it actuallyincreases your risk for heart
disease down the road.
So if you are facing, you facean issue and maybe your doctor,
not because of malice or illintent and so forth, just didn't

(27:30):
share that with you that, Hey,you should get your heart
checked out.
One month, three months, sixmonths, or just keep an eye.
If you have any of these issues,that could be a sign of heart
failure.
Imagine by sharing that withthat patient, how informed that
they can be with their health.
So there's many elements to thiscrises and the parts that we're

(27:52):
missing is really embracing allof those areas and highlighting
our voices.
Those of us who are seeingpatients, those of us, you and I
that are advocating, we are.
Practicing physicians, we arepeople who are seeing the
underserved and I, I actually amvery careful with that word.
Historically excludedpopulations that deserve to know

(28:17):
more information about theirhealth.

Chris (28:20):
yeah.
And no more information in a waythat is palatable to, like you
said, breaking that down, youknow, just speaking at people as
we've seen historically doesn'twork.
Right?
Like, if you're, if you'respeaking, you know, medical at
people, no one knows what you'retalking about in these
situations.
So, breaking it down in a waythat is acceptable, breaking it
down in a way that's palatableis, is, is important.

(28:41):
It's going to be the only waythat folks are going to know
those complication risks, andthey're going to return, you
know, before things get too bad.

Bayo (28:48):
And a good example of that is when I was approached to do
the Ted, the TEDx talk, Ithought we often hear this,
this, this statistic, um, butpeople don't really have someone
that they can connect to.
And I think stories are sopowerful.
And I thought to myself, if Ican share my story, even though
it's painful, it will allowsomeone to think that way.

(29:10):
Deeper about that statistic thatthey see.
Think of like their approach,all of the things that they
associate with it.
And then I knew I needed to makesure that I delivered the
speech, in a very disarmingmanner, because if you come at.
Come at it attacking or saying,well, this and this is
happening.
And this is why without invitingpeople in to share the

(29:33):
information and tell your story,you're going to miss the boat
and you're not going to makeprogress.
And that's why I did it.
And, um, I, I get messages everyday of black and brown women
saying, thank you so much forsharing your story.
I feel empowered.

(29:53):
During my pregnancy or I feelempowered now after and that's
what it's about.

Chris (29:59):
Absolutely.
We talked about, um, some thingsthat medical providers can help
to, can do to help support blackmothers during before and after
childbirth.
Do you think there's anyinterventions that we can do
specifically at the medicaltraining level to help address
those implicit biases and ensurebetter outcomes for black women?

Bayo (30:19):
Yes First I start with diversity, of course, and we
know that in representation Butwhen I mentioned stories,
there's a reason why if yourclass is diverse imagine the
color all of the the things thatyou're going to have and added
to your education from thefriendships, the acquaintances,

(30:40):
all the people that you meetwill shape how you deliver your
health care for future patients.
And so I think that part is avery important piece.
And then when it comes to bias,being able to Really have
situations where people canshare.
These are the bias that I haveand not feel like they're,

(31:01):
they're bad people.
And there's a part of my talkthat I talk about.
We all have unconscious bias andit doesn't mean it's a bad
thing.
It's something that we all have.
And I highlight it's somethingthe way how people look, talk
and behave.
And I use those examples becauseI think when you do that,
everybody can reflect on that.
It doesn't mean that they were.
You know, coming from a badplace.

(31:21):
It's just these things that popin our mind, but it's what you
do with that.
So once you can acknowledge it,then the work starts to be able
to reshape it or think aboutwhere did that come from?
And that allows you to buildthat.
That kind of pipeline to share,Oh, this was not what I thought
it was, and this is why Ithought, and then share that

(31:44):
amongst others.
So I think that's a powerfulpiece that we need to bring in
and have those stories, havepatient stories, have people
come in and highlight what hashappened during their pregnancy,
because if you can have thatconnection, it brings it into a
different perspective.

Chris (32:01):
Yeah.
And, and I feel like a lot ofmedical schools are starting to
go in that direction.
We just recently had on, um, oneof my good friends, Dr.
Nimmer, who spoke to, uh, theprogram that she's running
through the children's hospital,which is a D and I initiative.
And it's more so geared towardsopening up those doors, taking
those objective measures andsaying, these are my implicit

(32:22):
biases that are going intopatient care that are going into
my day to day activity.
Like you said, there's nothingthat.
We're looking to penalize anyonefor it's nothing that we're
looking to, wag our fingers atand say, you know, you're wrong
for thinking this way, but moreso taking the next step and
saying, how can I make thesechanges in my thought process to
prove to prevent, you know,premature closing in a patient

(32:44):
diagnosis to kind of shun, youknow, that, that, that vital
sign abnormality and say, Oh,everything's fine.
It'll, it'll be okay.
Right?
To open yourself up to be thatadvocate for your patient
sitting in front of you.

Bayo (32:56):
Yes.
And then also, um, you know, Ihave students that still rotate
with me, medical students andresidents.
And when they present, I willask them, so tell me why you
said what you said.
Tell me why you said the paindoesn't look that bad.
And I, And I do it in a verydeliberate and an open way that

(33:18):
allows them to think about,well, why did I say it like

Chris (33:21):
Yeah.
Mm

Bayo (33:22):
And then the unconscious bias comes into play and they're
able to see it.
So, I think if more medicalinstitutions, of course, that
training, all those things thatwe talked about, but pair them
up with preceptors that canallow this delivery of D.

(33:43):
E.
I.
in a way that they can justlearn from it and see.
See it.
I think that's going to besomething that could really help
change, because we can all readbooks, we can all do certain
things, but if you can havesomeone that can bring them in
and understand it, that'samazing.
And I, I get to do that throughstudents and to see that like

(34:06):
light click and they do it forme.
So it's bidirectional.
They're like Dr.
BCW.
Well why did you say that?
I'm like.
Oh gosh, I did say that.
And you know, and, and, and thispart, you'll, you'll resonate.
We all, those of us who arestill teaching, why do we do it?
Because the student keeps us onour toes.
They keep us fresh, right?
But they can also keep you freshas well on your bias.

(34:28):
So I think that would be anamazing thing if we could do
more of that.
And that's why I'm like, I'lltake as many students as I can,
because I love that.

Chris (34:37):
we're all learning from each other and medicine in
general is a lifetime learningprocess, right?
It's one of those vocations thatyou have to always keep, you
know, the doors open, alwayshave to be learning and even
from an own personal standpoint,right?
Like, you need to check yourselfand say, like, where, where am I
at as a person right now?
Where am I at in my emotionalintelligence?

(34:57):
Right?
And so those are things thatstudents and are going to be
invaluable with.
Providing as you know, we'regetting more and more
generations of physicians thatare going to be coming out.

Bayo (35:07):
I agree.
I actually use that often in my,in my speeches.
I'm like, you got to check it,check yourself, start with you
first.
And, um, you know, cause I givetalks to amazing organizations
and often organizations that arelike amazing FQHCs and, you
know, their heart is in theright place, but they're often
surprised when I'm able tohighlight some of the bias that

(35:29):
they do have.
And again, it's.
It's not you.
It's just something thathappens.
But once you can recognize it,and I help you recognize it,
it's fantastic.

Chris (35:39):
One of the things that we talk about is kind of that
advocacy and that empowermentarm that, that you're so, um,
uh, powerful at doing for yourpatients.
What, how important, just ingeneral, as we talked about a
little bit before is selfadvocacy and ensuring better
health outcomes.
And let's say, you know, youhave, a pregnant patient that
comes to you.

(36:00):
What are some, of the techniquesthat you will, will sort of
teach them to advocate forthemselves down the road?

Bayo (36:08):
So first, um, the first thing I tell all my patients,
pregnant and non pregnant, don'tdoubt yourself.
Do not doubt yourself.
What you feel, what you areconcerned about should be
honored.
Should be trusted by you first,because when you start with
that, that helps you thenadvocate because if you have

(36:32):
that self doubt, all of thethings that I can teach you
won't be able to really flourishwithout you believing in it.
yourself.
So that's the part I start with.
And then really highlightingdifferent topics, different
things that are a part ofdifferent diagnoses, whether
it's preeclampsia, whether, butin a digestible way.

(36:53):
And I, Put the puzzle togetherin a way of symptoms.
And this is related to this, andthis is why, and this is why
this could be a problem, but Ido that in a very condensed
manner and a way that lets themknow why they should be
concerned.
And if they see someone whodoesn't acknowledge, cause I get
this question often, well, I sawsomebody and they weren't

(37:16):
hearing me, Dr.
BCW.
They weren't listening to me.
What should I do?
And so one of the ideas that Ihave, which often people are
like shocked when I say this, Isay, ask, tell that clinician
that you don't feel like you'rebeing heard because having grace
is so powerful because a goodexample is we've all had a

(37:38):
friend where we thought we werehelping and then they tell us.
Why didn't you help me?
And I'm like, I thought I was,and there was just a misstep and
that can happen even in thoseclinical encounters.
So if you feel comfortabletelling them, saying, I don't
feel like you're hearing mebecause they may be in a space
thinking they are hearing you.

(37:59):
So those are some of theexamples and I have other ones
as well that I use to empowerpatients to be able to ask.
Advocate for themselves.
And, um, you know, I get to doit in person online.
Every medium that I can do, I'mgoing to tap into it just to try
to help people because we alltake in information differently.

Chris (38:19):
Yeah, no, absolutely.
And you never know, you know,what medium will be the key to
get to that, you know, thatthought process to get those
gears turning as well.
It's different for everyone,like you said.
And, you know, maybe it's aTikTok video.
Maybe it's a short, right?
You never know what it is.

Bayo (38:35):
That's exactly why I do all of the different mediums.
And I, I love it.
I'm like, okay, this one couldreach this.
And as clinicians, we are taughtto really meet the needs of our
patient and be malleable to ourpatient.
So I'm just doing that online orin person and being able to
connect with people, throughoutthe world.

(38:56):
and It brings my heart so muchjoy.
And, uh, we don't often hearthat people are excited to go to
work.
When I told you I was runninglate, I will share with
everybody because I was seeingpatients today, but I love it.
Yes.
But I get excited, you know, tosee patients and, um, yeah, it,

(39:17):
it brings my heart joy.

Chris (39:19):
Absolutely.
One of the things that we talkabout often here on the show is
our policy and some systemicchanges that need to happen in
order to better promote publichealth.
What policy changes, if any, doyou feel are necessary to
improve maternal health outcomesfor black women?

Bayo (39:39):
Invite black women from all professionals to the table.
That is a big piece ofunderstanding stories, different
things that people haveexperienced, things that we
know, especially those of us onthe front line that no haven't
worked.
And we can share why.
The other thing is inviting allspecialties.

(40:01):
I'm a family medicine doctor,but I've been trained.
In OB GYN, I've been trained inpregnancy.
I've been trained inpreventative, all of those
areas.
And I think often it's thoughtthat it has to be one specialty,
but family medicine doctors.
We see anything and everythingthat comes through our door and
we are the anchor.

(40:22):
And I think when you think ofthis crisis, having more family
medicine doctors, talk about thethings that they're seeing and
also more patients, but alsopatients and physicians that can
share that story.
And that's why another piece ofsharing my story here, I am.
I flip, I fit both sides of thecoin where I can.

(40:43):
Tell you as a doctor, the thingsthat are supposed to do, and
then I can tell you, or that weare supposed to do, but then I
can tell you what happened to me

Chris (40:51):
Right.

Bayo (40:52):
as a patient.
And I think if having more ofthose stories available, when
you're creating policies, thinkof how much more rich and in
depth they will be.
If you invite those people tothe table.

Chris (41:10):
Yeah, yeah, we often talk about, you know, some of the
attacks that we're having now oninitiatives at a national level.
Um, and we also talk about howhaving that diversity of
perspectives at the table.
Will create an environment wherewe're going to avoid some of the
pitfalls that we commonly see.
Right because if you haveeverybody at the table, thinking

(41:31):
the same way.
Right.
We're going to fall into thesame traps that we did before,
and we're not going to moveforward.

Bayo (41:37):
Right.
And when we think of all the,the, the data points that we
know from the past, when we talkabout knowing our history,
that's because it wasn'tdiverse.
That's because there was thisone thought from one perspective
of how things can be.
So if you don't really allow theopportunity to diversify the

(41:59):
policymakers that you have inplace.
You're going to just create thesame thing and the same thing
that we continue to have andcontinue to say, this is an
access issue only.

Chris (42:11):
Absolutely.
We talked about, some of our,our, our mutual interests and
some of our mutual, uh, programsthat we work with.
One being vote ER that we had onearlier in the season.
Are there any existing programsor initiatives that you can
think of that are makingpositive impacts at putting
people in those seats, uh, inorder to have that diversity of
ideas, and what can be learnedfrom programs like those?

(42:34):
Yeah.

Bayo (42:37):
March for Moms, I think they're fantastic.
I've partnered with them in manyways where they really highlight
stories, patient stories.
They highlight, um, doulas,midwives.
All of the pieces that need tobe a part of this crises, um,
are amazing.
Another real change maker thatI'm really grateful brought me

(42:59):
in because when we talk aboutthis problem, like you
mentioned, we have to havesomeone sometimes because the,
the room is filled with some,with people who don't look like
us.
So if someone who doesn't looklike us can invite us into the
conversation.
That is a way to really, youknow, kind of shake things up

(43:20):
and be able to produce change.
And so Liz Powell with thewomen's health med pack, which
is, nonpartisan or bipartisanmovement for women's health.
And she reached out and she'slike, Dr.
BCW, I want you to speak to thisroom and share.
And a lot of them werelegislators, policymakers, just

(43:40):
everyone and share your story.
And I can tell you, Chris, justfrom that moment, it was
amazing.
All of the people who came upand were like, I didn't think
about it like that.
You changed my perspective.
And so the work that her and herteam are doing for the women's
health pack has been fantastic.
March for moms as well.

(44:02):
Um, those are just a few of thenames, that are just doing.
And one more, I have to putStacey Houston.
Um, from six degrees, it's afantastic nonprofit.
And when we talk about peoplebeing open to cold calls, I
reached out to her and I said,you know, Kevin Bacon has this
amazing podcast.

(44:22):
I would love to bring forwardmaternal health.
And she said, yes.
And, uh, was like, let's dothis.
And.
It's amazing because that openedthe door.
She had just had her child andshe's a black woman.
And she was like, let's bringthis to the forefront.
And here you have a platformthat's doing great things and

(44:44):
isn't traditionally in thematernal health space or health
space, but accepted it and said,let's do this.
And we did a, you know, apodcast with that.
And we have some other thingsthat we're going to be doing as
well.
So those are just some of the,some of the things, but invite
people that you wouldn'tnormally invite.
To the table, because you seethe same people often at big

(45:06):
conferences or different things.
Imagine if you just kind ofdisrupted it a little bit and
invited someone non traditionalto that space, that would be
really powerful and helpingpeople reshape policies.

Chris (45:20):
Yeah.
And any, any policymaking.
It's been my experience thatbeing uncomfortable is a good
thing.
If that's okay.
Right.
If you have that diversity ofthought and diversity of ideas
and diversity representation ofdifferent communities of
interest.
Whatever it, it's going to getyou to a point where you find
out how some of the ideas thatyou're having, how that could

(45:44):
fault over across the scenesright across the board.
So, like, you're saying, youknow, having that community,
having that support, havingeveryone there at the table to
have a seat and to makeinferences on what can be done
and why certain things can'twork is the way to go.

Bayo (46:01):
Yes, that's the starting point.
If you can go from there,imagine versus just resharing
all the things that we alreadyknow.
But if you can really disrupt bysharing those stories, those
things that are not workingwell, but providing solutions.
And I think that's the biggestthing because we hear people
raising awareness.
But for me, I want to helpsomebody at the bedside who

(46:25):
needs.
Tangible ways to say, this ishow I need to stand up for
myself.
This is what I need to knowabout this diagnosis in a very
bite sized manner.
That's my jam.
That is my, in all areas ofhealth.
Like that's what I love to do.
Um, it feeds my soul.

Chris (46:44):
Yeah.
One thing that we spoke to isthe power of having a community
and the power of having asupport system.
In a lot of cases, as I'm sureyou see as well in your
practice, there are a lot ofmothers who are kind of walking
this journey of maternity bythemselves.
What are some things that yousee that communities can do to

(47:06):
better support black mothersthroughout their pregnancy and
especially during theirpostpartum periods?
Because a lot of folks don'tunderstand, you know, that
postpartum period, you needequally, if not more support
than you did during thepregnancy itself.

Bayo (47:21):
I would say investing the same investment that you have
from the beginning, have it tothe end and increase it because
there's this thought of mom andbaby, but we also need to look
at often.
It's heavily baby focused, butwe need to make sure mom is.
A part of it as well.

(47:41):
And so when we think of the manycheckups that we have for to
check on the baby, we need tohave those same checkups for the
mom moving forward as well.
And that should tap into yourmental, your physical health,
your social health, All of thosepieces are what we need.
And when we look at those whoare, um, pregnant and, and may

(48:03):
not have a partner or have acircumstance because they do not
want to partner, which we needto honor as well, thinking
about.
The bias that you associate withwhy they don't have a partner or
what social economics they mayhave pulling back from that and
finding ways to think about howcan I help this person as an

(48:27):
individual, how can I help themthrough their health?
That part, I think, is whathealthcare systems need to look
at when we talk aboutunwrapping, uncoupling, that is
a way to really make that personfirst and foremost be seen, be
heard through their individualsituation, because all things

(48:49):
aren't what they seem, and ifyou approach it in that manner,
You will miss the boat and nothelp that person as well as you
could have.

Chris (48:58):
Absolutely.
One of the big things that weare dealing with here in the
state of Wisconsin, um, is oneof the pieces that we talked
about, you know, it's noteverything, but it is one of the
pieces and that's access tohealth care postpartum.
One of the things that we'reseeing is the failure of
expansion of Medicaid here.
We call it BadgerCare in thestate of Wisconsin for
postpartum women at this pointin time.

(49:19):
That coverage is only extendedto 60 days postpartum as
compared to the other, you know,states.
We are, you know, a couple ofthe states here in the, in the,
in the, in the union that don'thave that expansion to 12
months.
And so, you know, initiativeslike that are gonna be important
to cover women.
It needs, like you said, notonly, uh, from a physical

(49:40):
standpoint, but from a mentalhealth standpoint.
There are a lot of things thatare going on from a social
standpoint as well to helppromote.
Not only the health of thatbaby, but also to focus it on
the mother too, because as wesaw before, as you spoke to in
your own testimony, even in thebest of circumstances, things
can go wrong and they happenoften.
And if that happens, you know,if you don't have access to

(50:00):
care, if you don't have accessto insurance, a lot of times
folks will come to the urgentcare centers or they'll go to
the emergency department.
And unfortunately it's too lateat that time sometimes.
Right.
And so we want to make sure thatwe're, Putting our money where
our mouth is in thoseinitiatives and making sure that
we are continuing to reach outto people who are legislators
who are, you know, not asmedically versed, but sitting at

(50:20):
that table and making thosedecisions.

Bayo (50:23):
It's so true.
Um, you know, I work in anurgent care as well, multiple
jobs.
And I see women who come inpostpartum and have these
ailments and things that havebeen going on.
And the, one of the things thatI often hear is I thought this
was supposed to be, I thoughtthis was normal.
I thought this is what I'msupposed to, or I just thought

(50:43):
it's not that bad.
And they have this.
Self talk of like damperingtheir own symptoms.
And that leads to a longer, uh,delay and actually being seen.
And again, those complicationsthen are just festering and it.
Could have been dealt withsooner, but then there's this,

(51:05):
you know, concern.
I didn't want, I often hear, Ididn't want to waste anybody's
time.
And I say, it's your time.
You're not wasting anyone'stime.
This is your health.
And those are the pieces that wehave to, um, really look at if
we want to make a change.
And then also think about whatdo, what is the term access?

(51:27):
And again, I like to kind ofunroof things.
So when we talk aboutpolicymakers, you know, of
course people having access, butwhat is your definition of
access?
Is it a building?
Who is in the building?
Whoever's in the building?
Are they trained in DEI?
Are they trained in biastraining?
So there's so many pieces thatwe have to uncover to really

(51:53):
know what access is and todeliver it in the right way.

Chris (51:57):
Let's look towards the future.
Looking ahead, what are yourhopes for the future of maternal
health care for black womenspecifically?

Bayo (52:05):
First, my hope is that that statistic isn't a
statistic.
That's what I hope for.
I hope for that black women canreally have a pregnancy like
other people have where it's notthis thought when I get
pregnant, truly could I die?

(52:30):
Will I have a bad outcome?
Will I be able to find a doctorthat will listen to me?
My hope is I'm pregnant.
And I get to just have myjourney like others and really
being able to remove thosepieces that are a part of that
black woman's pregnancy journeyand that those stressors add to

(52:53):
increased heart rate.
They add to mental stressors,all the things that we know can
add to your overall health.
And that's my hope because if wecan tap into those things,
imagine how much healthier momand baby can be if we focus on
those pieces.
And that's my hope that when youget pregnant as a black and

(53:15):
brown woman, that you're,you're, you get to relish in
those pieces because thehealthcare system has been able
to take care of those parts thatwe are not able to do.
Get at this point.

Chris (53:30):
Absolutely.
We talked about a coupleprojects that you're currently
involved with initiatives tohelp address these issues.
Is there anything else that youwould like to share with our
listeners about black maternalmortality or your personal
journey?
Anything that you want to leaveour listeners with?
Absolutely.

Bayo (53:50):
you know, really think of this is this statistic.
I can't say that word is it'sactual people individualize it.
So when you see numbers, whenyou see data points, think of
me, when you think of maternalhealth.
And when I say that it's apowerful thing for me to say,

(54:11):
because my hope is the storythat I just took the time to
share my birth story.
That that will live with youwhen you hear about this crisis,
and you will see that this isaffecting black and brown women
across the world.
And think about one thing thatyou can do, and that can even
start with checking your ownbiases.

(54:35):
Thinking about, why is thishappening?
And what can I do, even if it'sjust one thing, to make a
difference?
And that's what I hope forChris, that more people can, can
think about that and also investin health literacy, invest in
different ways that yourorganization healthcare system

(54:56):
is delivering that literacy andlook at how currently your
outcomes could be better.
If you just reshaped it, if youtapped into people who could
actually meet those people wherethey are in different mediums.
So that's my hope that peopleremember what I shared and, and

(55:18):
make a difference.
That's all that I asked for.
And I'm grateful, so grateful tobe on the show.

Chris (55:26):
And we are so grateful to have you here, Dr.
BCW.
I want to thank you so much forsharing your story, sharing your
powerful testimony and all ofthe advice that you were able to
give to our listeners.
And, you know, we, we, we hopeto have you on again.
I'm looking forward to seeeverything that you are going to
accomplish and we'll definitelylink all those resources that

(55:48):
you gave to us and, um, youknow, beyond clinical walls,
we're going to shout it from therooftop.
So,

Bayo (55:53):
Thank you.
And the TEDx, I tell everyone toshare it, you know, TED is
nonprofit, but every time if youcan share that story and share
the, the talk, it's a mad, it'samazing what, you know, you can
do to save a life from justthose.
Little 12 minutes.

Chris (56:10):
Yeah, absolutely.
Absolutely.
Well, thank you so much.
Hope you uh, enjoy your yourday.
I hope you get some days offcoming up here.
So

Bayo (56:17):
Oh, I'm going back to work after this.

Chris (56:19):
Oh gosh, okay.
Well Enjoy the work All right,my friend, There was a recent
article.
That was published by Wisconsinpublic radio.
Back in December of 2023, thathighlighted some of the work of
the states, maternal mortalityreview team.

(56:39):
And they studied the 55 maternaldeaths that happened in 2021.
And in that work, they foundthat more than 90% of those
deaths were preventable.
One of the members of the teamhighlighted.
That many deaths in Wisconsinare happening after the child is
born.
When people stop receiving thecare that they need.

(57:00):
From their obstetricians or fromfollow-up care.
As mentioned in the interview.
A lot of this is due to the lackof insurance or the lack to
access of care.
Here in the state of Wisconsin,we have, what's known as
BadgerCare or Medicaid that isprovided to mothers who are

(57:20):
postpartum.
Unfortunately in the state.
That has kept it around 60 days.
So that means that.
A mother will lose the access tohealthcare insurance.
Coverage.
After 60 days postpartum but youcompare this to other states in
the union and we see that.
That is extended to about 12months with Medicaid expansion.

(57:44):
And so that's why on this showand you'll see me doing, uh,
interviews and commercials andpromos that are going to be
coming up.
That highlights the need for usto expand Medicaid here in the
state of Wisconsin.
As we are only in a handful ofstates that have not done.
So.

(58:05):
It's going to be a tremendous.
Benefit for people who don'thave access to care.
And it's going to reducematernal mortality.
It's going to reduce mortalityfor patients that have a number
of elements around the state.
Getting back to maternalmortality.
Oftentimes, it's not only due tothe physical health of the
mother, some types of studentswith mental health.

(58:26):
Sometimes due to addictions aswell.
But all those things again, willbe covered.
If we have better access tocare.
And if we address these racialdisparities, We can reduce.
Pregnancy related deaths.
One thing that this articlementioned was while black people
represent about 10% of thestate's births annually.
They represent about 21%.

(58:48):
Of pregnancy related deaths eachyear.
Now as always.
Especially as we're gettingcloser and closer to national
elections.
There are a lot of sentiments onboth sides of the Al.
That.
Make statements like this.
More provocative and difficultto discuss.
However, as we sit before beinguncomfortable is, okay, we need

(59:09):
to discuss racial disparities inhealthcare.
We need to discuss ways that wecan improve the health outcomes
for folks who historically havebeen affected disproportionately
by racial disparities.
And the way that we do that isto be upfront.
Is to.
Lean into the science and thestatistics that we have

(59:31):
available.
And also have folks at thetable.
Like Dr.
BCW.
Who have experienced.
Racial disparities.
Firsthand.
Again, I'll link this articleto.
This podcast I'll link.
Dr.
BCWS.
Information to this as well toher website.
As well as to her podcast, shealso has a podcast in addition

(59:54):
to all the other amazing thingsthat she's doing.
And we're hoping to have her onagain, just to touch base and
to.
Keep us up to date with.
The things that she's doing andthe things that we can hopefully
in the future, collaborate on.
To help bring you moreinformation and to help.
Less than the divided.
That is created by these racialdisparities in healthcare.

(01:00:16):
As always.
I want to thank you all.
For joining us here today.
Again, this has been an amazingfirst season.
I want to think.
Everyone who has subscribed whenI think everyone who has
provided.
Um, commentary and, theirquestions, these things are
going to be super helpful ingoing forward.
Looking forward to season two,we're going to continue to touch

(01:00:39):
on some of these hard hittinghealthcare topics that affect
your health every day.
And we're going to continue tobring you.
That transparency because as Dr.
BCW talked about.
Our goal.
Is to be advocates for ourcommunity.
We're looking to provide youwith the truth and what.
We see as deficiencies inhealthcare.

(01:01:01):
And to provide that bridge tofolks who may have a hard time
understanding.
Why they're on these medicationsand historically may have some
mistrust in the healthcaresystem with, again, Is
well-rooted and there are goodreasons for it.
So we're hoping to lessen that.
Load for folks.

(01:01:22):
And we're looking to continueto, again, bridge that gap.
So again, too.
All out there.
I want to thank you.
Enjoy the rest of your summer.
We'll see you in a few weeks.
When we start off with seasontwo.
And as always.
Take care of yourselves.
Take care of each other.
And if you need me.

(01:01:44):
Come and see me.