July 16, 2025 • 38 mins
Why is giving birth still so dangerous for Black women in America?
Dr. Uché Blackstock—physician, mother, and bestselling author—returns to the podcast to talk with Carol about the Black maternal health crisis. The U.S. maternal mortality rate is significantly higher than in other high-income countries, and within the U.S., the rate is by far the highest for Black women. Black mothers are still three to four times more likely to die from pregnancy-related causes than white mothers. It’s a terrifying reality, but it doesn’t have to be our future.
Dr. Blackstock talks with Carol about how bias and systemic racism in medicine impacts Black maternal health, and what we can do about it. They also talk about real solutions: what doulas and midwives can do, how to choose the right OB-GYN, and the push for national policy changes. Dr. Blackstock’s valuable perspective as both a physician and a Black mother makes this an extraordinarily compelling conversation. Whether you're parenting now or thinking ahead to building a family, this episode offers the insight and guidance we all need to hear.
Follow Ground Control Parenting:
📱 Instagram, TikTok & Facebook: @GroundControlParenting
💼 LinkedIn: Carol Sutton Lewis
🌐 Website: GroundControlParenting.com
Dr. Uché Blackstock—physician, mother, and bestselling author—returns to the podcast to talk with Carol about the Black maternal health crisis. The U.S. maternal mortality rate is significantly higher than in other high-income countries, and within the U.S., the rate is by far the highest for Black women. Black mothers are still three to four times more likely to die from pregnancy-related causes than white mothers. It’s a terrifying reality, but it doesn’t have to be our future.
Dr. Blackstock talks with Carol about how bias and systemic racism in medicine impacts Black maternal health, and what we can do about it. They also talk about real solutions: what doulas and midwives can do, how to choose the right OB-GYN, and the push for national policy changes. Dr. Blackstock’s valuable perspective as both a physician and a Black mother makes this an extraordinarily compelling conversation. Whether you're parenting now or thinking ahead to building a family, this episode offers the insight and guidance we all need to hear.
Follow Ground Control Parenting:
📱 Instagram, TikTok & Facebook: @GroundControlParenting
💼 LinkedIn: Carol Sutton Lewis
🌐 Website: GroundControlParenting.com
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
Hello, and welcome to Ground Control Parenting, a blog and
now a podcast creative for parents raising black and brown children.
I'm the creator and your host, Carol Sutton Lewis. In
this podcast series, I talk with some really interesting people
about the job and the joy of parenting. This season,
we're asking experts across many fields about the best ways
to raise our children to be curious, confident, and healthy humans.
(00:28):
And today we are talking about health. Many of us
have heard about the statistics which show the higher mortality
rate that Black people in the United States of all
ages face. Doctor lu J Blackstock, an emergency physician who's
the author of a legacy a Black Physician Reckons with
Racism and Medicine, not only knows these stats intimately, she's
dedicated her career to understanding the roots of these statistics
(00:50):
and improving them. A few weeks ago, doctor Blackstock joined
me on this podcast to talk about what every black
parent should know about healthcare, and today she's back to
help us focus more closely on the black maternal health crisis.
In addition to being a doctor and the author of
a New York Times best selling book, doctor Blackstock is
also the founder and CEO of Advancing Health Equity. She
(01:11):
launched this organization in twenty nineteen to help healthcare institutions
identify and eliminate racial disparities and care. A former associate
professor and diversity leader at New York University School of Medicine,
doctor Blackstock is a powerful voice in the media, writing
for The Washington Post and Scientific American, and serving as
an exclusive medical contributor for MSNBC and NBC News. The
(01:34):
daughter of a Harvard trained doctor, doctor Blackstock and her
twin sister, doctor Onny Blackstock received both their undergraduate and
medical degrees from Harvard University, making them the first black
mother daughter legacies from Harvard Medical School. Doctor Blackstock currently
lives in her hometown of Brooklyn, New York, with her
two sons, who are eight and ten. Welcome back to
Ground Control Parenting, Doctor Blackstock.
Speaker 2 (01:56):
Thank you so much for having me back.
Speaker 1 (01:58):
So happy to have you here. So today I want
to spend some time talking about an issue that's critically
important to so many families, the Black maternal health crisis.
In your book, you shine a light on how racism
and medicine affects Black mothers at every stage, from pregnancy
through postpartum. You bring both your personal and professional lens
to this topic, and I think it's so important for
(02:20):
our listeners to hear what's really going on and what
we can do about it. So let's get started, and
let's start with a big picture. So the terrible statistics
which many have heard, but everyone needs to know that
black women are three to four times more likely to
die from pregnancy related causes than white women in this country.
And you write powerfully about how this is not just
(02:41):
a medical issue but also a deeply rooted systemic one.
So when you think about this, how do you explain
the core reasons behind this crisis to people who don't
yet fully grasp the scope or the urgency.
Speaker 2 (02:53):
You know, it's so interesting.
Speaker 3 (02:54):
I think about the fact that you know, we're in
twenty twenty five and we've seen tremendous advances and innovation,
research and technology and healthcare, and it's still it is
more dangerous today to give birth than twenty years ago.
Plus you know the statistic that you shared. What that
(03:14):
speaks to is the far reaching impact of racism in
our lives. And so it happens at so many different
levels for us. It happens when we interface with the
healthcare system. We know that black mothers are less likely
to be listened to, that their concerns are often minimized
(03:36):
and dismissed. We know that actually a lot of the
complications around pregnancy have been in the postpartum period, and
so we have a system where we don't take care
of people in the postpartum period. So, for example, and
I think most people know that you have maybe one
or two postpartum visits after you give birth. That is
(03:58):
an anomaly income countries. There's someone that actually comes to
your home every day for weeks and checks on you.
Speaker 1 (04:06):
Wow.
Speaker 3 (04:07):
Yeah, So these are policy issues also. So there's what
happens in the healthcare system, there's what happens outside, you know,
once you get home after you give birth, but also
even before you give birth. One thing I talk about
in the book is this phenomenon called weathering, and that
was a term coined by a public health researcher named
(04:27):
Arlene Geronymis. She practices just a research in the University
of Michigan. But weathering is this phenomenon where, because of
the stress of living with everyday racism, it causes a
wear and tear on our bodies that we can't even see.
That makes us more susceptible to chronic diseases, premature aging,
(04:47):
and the complications that come along with giving birth. So
we're seeing these A lot of these factors are what's
happening on a physiological level, what's happening on an interpersonal level,
and systemic level. That's accounting for why in twenty twenty
five we're seeing these horrific statistics.
Speaker 1 (05:07):
It's stunning. There is no positive way look at this
except that we're now paying attention to it people like
you were talking about it. That's the only positive.
Speaker 3 (05:16):
Absolutely, And the thing is we and we do have solutions.
We have solutions for it.
Speaker 1 (05:21):
Oh good, good, Yes, I definitely want to get to
those solutions. Now. You've seen this both as a physician
and as a black woman who gave birth to two babies.
So having gone through it yourself in particularly, what are
some of the ways that the bias shows up in
how black women are treated during pregnancy. You talked about
the weathering, but in terms of how doctors listen in
(05:44):
terms of pain management, I mean even well meaning doctors.
Speaker 3 (05:48):
Oh yes, and this is the thing, like, no one
is saying that physicians are out to get their patients,
you know, are out to mistreat them. You know. Unfortunately,
we live in a society where there is lots of
anti black messaging around us that is.
Speaker 1 (06:05):
More sourced than yes.
Speaker 3 (06:07):
That's absorbed by people, and it's whether you go into
medicine or not. And we know that that actually influences
how people care for patients and make decisions. So there
was even a study from the University of Virginia in
twenty sixteen where they interviewed medical students and residents and
they asked them about two cases, two mock cases, white
patient and black patient. Everything was the same, but they
(06:29):
asked them to rate the patient's pain, to give the
patient pain medication, and also whether or not they believed
in these false myths about pain, that black patient's skin
was thicker, that we were less sensitive to pain. And
what we saw was there was actually a difference in
the pain medication that was given to the black patient,
that there was a lower pain score given, and that
(06:51):
over fifty percent of these residents and medical students believed
in these false myths that the authors came up with
about pain. And so what we see is that it
actually manifesting in clinical practice where black mothers are coming
in saying, you know, this doesn't feel right. I'm having pain.
(07:11):
They're being sent home and then coming back because there
was some underlying reason that wasn't worked up or wasn't investigated.
Speaker 1 (07:22):
Still, it's just incredible. I'm still back on the medical
students believing that skin thickness made a difference with pain.
So sticking with the maternity process, you talked about your
two experiences with giving birth, one without a doula and
one with a doula, and the concept of adula, while
it's been around forever, is something that is coming more
(07:45):
and more back into practice and this may be one
of the solutions you were talking about in terms of
how to help black women in the maternality cycle. Can
you talk about how you experienced each birth and what
led you to a doula and what the difference.
Speaker 3 (07:58):
Was, and you know, I think, you know, you know,
part of this I talk about in the book and
where I you know, I'm vulnerable in the book where
I share that there are things even though I'm a physician,
that I didn't know about. You know, when I got
pregnant the first time, I never had even heard of
a doula, nor had I no, you know, but that's
also you know, I was trained in sort of western
(08:20):
bio medical model, right, so I didn't know about dula's,
I didn't know about midwives. All I knew is that
I knew that I was going to give birth in
a hospital by an OBG. I n right, because that's
what all my colleagues did, and that's what I thought
was the standard. And then for my first delivery, it
was it was traumatic. I had prolonged labor, prolonged pushing,
(08:42):
and I ended up having to have a fourceps delivery
where they actually used four SEPs to pull the baby out,
and then I had to have some other procedures that
were very painful during that, and I said, oh my goodness,
is this If this is how it is, I never
want to do this again. And then after that, after
my delivery and then healed and we talked about having
(09:04):
a second child, I started looking into like, how can
I make this experience different? And that's how you know,
I found out about you know, doulas, and they essentially
are emotional support for someone giving birth and also they're
there even before you give birth. They visit you while
you're pregnant. They're there in the delivery room with you,
(09:27):
and they also provide postpartum support. So my duel actually
came after I gave birth to help me with my
second child, to cook meals for me to make sure
that I was okay. And I feel like this sounds
like it shouldn't be rocket science, but it makes sense
right that you have someone that is providing you with support,
and we actually see that there's a decrease in pre
(09:49):
term complications and improved maternal outcomes by using doulas.
Speaker 1 (09:55):
So this makes so much sense. And for many people
I'm sure listening think, oh, well, that's what my mom
did or what my mother in law did or what
my auntie did, and that's fair and that's correct. But
how great is it to have someone who's actually trained
in baby care? And this sounds like one of the
solutions in terms of in other countries where people come
(10:15):
and visit you after you have the baby. I mean,
I've talked with a lot of young people who are
really who are either wanting to become pregnant, or they're
pregnant now or just have babies, and they're very focused
on this fourth trimester. This the postpartum because you know,
back in the day, the dark ages, when I had children,
certainly the concept of postpartum depression existed, but it wasn't
(10:35):
a thing that people talked about much, and it wasn't
something you sought care for. But thankfully now people are
focused on it as a something that can happen and
that there are things to do. But it strikes me
that a doulah could help recognize symptoms flag things, not
only through the pregnancy but afterwards.
Speaker 2 (10:56):
Oh oh absolutely.
Speaker 3 (10:58):
And what we've seen is that you know, a lot
of health insurances don't cover doulas, or Medicaid was not
covering in some states. Now Medicaid does cover doula. There's
a push for that, right And then, so initially having
a doula was something that if you had disposable income
you could have, right, and that really should it shouldn't
(11:19):
be that way. It should be that anyone who needs
one because they're improved outcomes, So why not everyone should
be able to have a doula.
Speaker 1 (11:27):
So, for those of us who aren't as familiar with
all the terminology midwife versus doula, like, what does the
difference you have both. Do you have one or the other?
Speaker 3 (11:36):
That's such a great question. And so a midwife is
a trained health professional who actually cares for the person
that's going to give birth during the sort of the
whole continuum of care, even sometimes even before they get
pregnant to the postpartum period. But they also are involved
(11:57):
in the delivery.
Speaker 1 (11:58):
They deliver the baby, so the midwife can do it
without another medical professional present.
Speaker 3 (12:05):
So for low risk deliveries, yes, midwife usually can deliver
actually at a person's home or in a birthing center.
Usually that usually the midwife will have a relationship with
an obgyn in case there are complications happening, and they
may have admitting privileges to a hospital. And what's interesting
(12:26):
is that, you know, for a very long time in
this country, midwives were the ones that delivered babies. And
I write about in Legacy that was actually in the
nineteen twenties that there was this public health campaign that
tried to make using midwives seem unsanitary and unhygienic, and
that was by actually the physician groups, and so unfortunately
(12:47):
it led to a decrease in the number of midwives
in this country. Like I mean, exponentially, and what we've
actually seen in that is that in other high income
countries that have midwife centered caretually are better outcomes. So
I think for us, for Black communities, I think it's
really important that we just know what all our choices are.
(13:09):
That there is that you can have a duela, that
if you are the appropriate patient, you can actually have
a midwife, or if you have more health issues you
may need to have an obg I N. And that
there are also options for where you can have your baby.
You can have your baby at home, in a birthing
center or a hospital. And so I love that idea
of making sure that we know what our options are.
Speaker 1 (13:31):
And that we know and we talk to our doctors
about them. A friend who just recently had a baby
and has been talking with me about all of this.
She's been a great focus group of one where I
talk about all these issues with her, was saying that
she was very aware, thank Goodness, of the opportunity to
have a duela and midwife, and when she started talking
them with her doctor, she learned that the many things
(13:54):
that she was concerned about, she had a birth plan
that she thought that her doctor would not go along.
With but her doctor was will to go along with
her birth plan in terms of music in the room,
and you know the very specific way in which you
wanted to give birth. And so it's good to know
that you should be smart about all these things, but
be willing and able and not be shy about having
these conversations with your doctor because to your point that
(14:17):
many doctors are very well meaning, they're not. I mean
it's not that they are actively anti any of this,
particularly doctors now, but the way that the world works now,
you have to be a little bit more proactive. Is
is that a thing?
Speaker 3 (14:29):
I absolutely agree, and I think we had talked about
interviewing a pediatrician before you give birth. I think that
it's important to interview your obgi ns or your midwives
to see is this someone who is going to listen
to what I need.
Speaker 1 (14:46):
We'll be right back after these messages, welcome back to
the show. I really love that because people didn't always
think of doctors as people that you would interview. It
wasn't until I sought a pediatrician for my kids that
I wanted to to really interview them, in part because
it wasn't for me. I was advocating on behalf of
another person. But the concept of talking to your doctor
(15:09):
to see if you have a good relationship with them,
I mean, that's a fairly simple thing that we should
feel emboldened to do because that sets the stage for
the kind of relationship you're going to have with I mean.
The flip side of that, though, is the medical refreshion
now is very different in that it is from what
I understand, it has its own share of great stresses.
(15:32):
Now case loads are great, is there are all sorts
of issues with respect to the kind of things that
you have to prescribe that people can't afford it. It's
a more stressful career. So how do you think that
those two things work together? I mean, do you think
is it harder now for doctors to be as compassionate
(15:54):
as we would like them to be.
Speaker 3 (15:56):
That's such a great question, and I think that yes,
there is. There are those pressures just because of the
model of our healthcare system is a for profit system.
There is pressure on physicians to see a certain number
of patients and a certain amount of time. Efficiency is
(16:17):
very important. But at the same time, I've noticed that,
you know, patient feedback is also really important. You know,
if you've ever seen a doctor, sometimes you'll get an
email from the hospital asking you what your experience was.
Hospitals take that very very seriously. So I think that,
you know, there's really a balance that physicians have to
(16:38):
strike now where it's like you are, you have pressure
to see a lot of patients, but then also you
are expected to deliver quality care to your patients. So
there's that tension.
Speaker 1 (16:51):
Yeah, yeah, no, I imagine it would be, but it
doesn't excuse from the patient's perspective. Now they need to
find the physician that they feel.
Speaker 2 (17:00):
Oh absolutely absolutely.
Speaker 1 (17:01):
Speaking of tensions, so we talked about midwives and dulahs.
So you have a midwife who's medically trained, are there
potentially any tensions between your obiguyn and your midwife if
they're both together in the room when there's a delivery.
Speaker 3 (17:17):
So what actually would happen is that if you have
a midwife and you've chosen a midwife to help you
give birth, then that only the only time the obigu
i n would be involved is if there are complications
and the midwife would reach out to the obigun and
say we need you. So typically there there isn't that
(17:39):
tension Okay, well that's good. And I also think that
obgyns are now also more accustomed to having patients who
have dulas also, so I think the presence of doulah's
in the delivery room is something that Obijuans are have
gotten much more accustomed to it.
Speaker 1 (18:00):
I should say then that as you are interviewing your doctor,
if you're starting out with an obgu i n yes,
that's a question to ask as to how comfortable they
are with other people in.
Speaker 2 (18:11):
The room exactly.
Speaker 3 (18:12):
And even I would say even for my doulas, I
interviewed five doulas. I interviewed doulas to make sure that
you know, again, just like my o tui n, that
was someone that I felt a connection with, that we
got along, who I felt like would be able to
advocate for me and really hear and appreciate what I
had to say.
Speaker 1 (18:33):
Oh, that's so interesting. So you know, I always had
to say to ask this question because when you talk
about medical care, it shouldn't be incumbent upon the patient
to make sure they get the proper care. You're entrusting
yourself to a professional. But based on the many things
you write about in your book, we know that it's important,
particularly for Black women to go in armed as best
(18:55):
they can be to protect themselves. So and this even
start before pregnancy. I mean, given what we know about
the strange statistics and the horrible statistics about maternal mortality
and maternal issues, how informed should we be about all
the things that could go wrong? I mean, pregnancy is
(19:16):
scary enough. Certainly, you don't want to freak yourself out
with all the bad things that could happen and then
be totally stressed that the doctor you're talking to is
not going to catch them. But by the on the
other hand, it's good to be wise. It's good to
know about what could go wrong. I mean, how do
you suggest that women Black women who are going into
this process think about this?
Speaker 3 (19:34):
Yeah, that's such an important question, you know. I think
from at the very very minimum, you talk to your
friends about.
Speaker 2 (19:44):
Who did they who did they use?
Speaker 3 (19:46):
Right?
Speaker 2 (19:46):
Who who was who.
Speaker 3 (19:47):
Was their midwife or doulah or b G y N. Honestly,
that's how I found my op g I N. You know,
I asked my colleagues, who did you use? What was
your experience like with them? So again, use your village
and then the other piece of it. There are a
lot of really wonderful resources out there. There's one I
want to give a shout out to.
Speaker 2 (20:08):
It's called the.
Speaker 3 (20:08):
Earth app irt app Okay, and it was started by
Kimberly Seals Hollurs, a black woman, And essentially it's like
a Yelp directory for maternal health providers and birthing hospitals.
People go on there and they actually rate like the
midwives or the doctors that they use, or the birthing
(20:30):
hospital experiences. So I feel like we, like black women,
are trying to find the solutions to making sure that
we are fully informed. But again, like I mentioned even
with my Obi Joiane that I chose one of the
reasons why I chose that practice is because they actually
had a low c section rate. So I asked about
(20:51):
their c section rate. I asked about how many deliveries
did they have. I looked at, you know, the pictures
on the wall to make sure that there were there
was diversity in terms of the patients that they cared for.
So all of that is incredibly important. I also think,
I said, it's important to understand like what environment do
(21:11):
you want to have your child and do you want
to have it have your childhood home, a birthing center,
or a hospital, So knowing what all those possibilities are
and what they look like. But I think also what's
important is that also we are more likely to have
chronic diseases, and so really working with your primary care
physician to make sure that your health is optimized even
(21:33):
before you're thinking about having a child.
Speaker 1 (21:36):
That is a very good point, really good point, because
taken by itself, the statistics is alarming. But when you
think about you talked about weathering, when you think about
how so many of us go into pregnancy with these various,
various chronic illnesses, it's going to suggest the current statistic
because we're not as healthy as we should be. I'm
(21:59):
not putting it on us. It's not because we're not trying.
But we need to be just as focused on being
as healthy. So, you know, the kind of good health
practice that we might want to put off because we're
too busy. We need to back up us even before
we start thinking about having kids, that we want to
have the healthiest vessel possible to bring these babies into
the world. You know, On the one hand, I keep
(22:20):
talking about stunning the statistic is that in this unit,
these United States, the wealthiest country, that we have these issues,
but I am heartened to hear that there are some
things that we could do, I mean things that we could.
Speaker 2 (22:31):
Do absolutely, absolutely better.
Speaker 3 (22:33):
And there's the Momnibus Act that is actually unfortunately it's
installed in Congress, but it is a multi bill act
to addruss maternal mortality. But what I love about it
is that it really looks at all different factors. It
looks at what can we do to increase the diversity
(22:54):
of maternal health providers, how can we use telehealth right
to get in touch with people who may not have
access to care, What can we do about what we
called the social determinants of health around education, employment, access
to healthy food. So really looking at all of these
different tiers in terms of how can we make you know,
(23:17):
black mamas more healthy and that experience more joyful because really,
you know, having a baby is really it should be
a wonderful experience. It shouldn't be a scary experience.
Speaker 1 (23:29):
Right, right, right, right, No, absolutely absolutely, It is really
important that we mentioned that it's a joyful thing. Yea,
it is truly a joyful thing. Moments are not as pleasant, yeah,
some of them uncomfortable moments, But ultimately it saddens me
to hear as as you said earlier that based upon
(23:50):
the experience you had giving birth the first time, it
made you think twice about having a second child and
just and then fortunately you learn there was a way
to do it better. But it is so important that
this news, this information gets out, and so I want
to get back to the solutions. Now, what gives you
hope that we can move the needle on this. You
talked about the Act in Congress, and we've talked a
(24:12):
little about dulaism midwives. Is there anything else that gives
us hope that this stat won't stay as horrible as
it is?
Speaker 3 (24:18):
Yeah, you know, I think that what we're seeing is
and it's actually the work that I do with my
firm Advancing Health Equity. We're seeing a lot of local
and state health departments make maternal health like a pillar
or priority for them, and so one thing that a
lot of them are doing is they're looking at it
through a quality improvement perspective and looking at hospitals and
(24:44):
saying we are going to grade you on how well
you do in terms of your maternal health outcomes. Great,
and we are going to make sure that data is transparent.
You know, we will incentivize you to make sure that
you have I proved outcomes. And so I do think
that even though the statistics are very sound, very dismal,
(25:08):
that this issue has become a priority, so hospitals, health systems,
community groups. So even there are I've seen a push
towards building more birthing centers in maternity deserts, so you know,
making sure. In the book, I actually talk about in Minneapolis,
(25:28):
there is a black midwife who founded the Roots Birthing Center,
and Minneapolis has some of the worst racial health inequities,
and she founded this birthing center with the express mission
of providing holistic, respectful, and dignified care to black mamas
and other mamas of color. And they've actually seen this
(25:49):
model has improved maternal and fetal outcomes. So there is
a lot of hope. We actually can look very close
around us, like even hyperlocally and locally see all of
like the really wonderful bright spots that are happening and
efforts that we can help support and amplify.
Speaker 1 (26:08):
That's so great. And again not to to continue to
put the burden on the patient, but it's really important
to be as smart as you possibly can be about
this stuff. I mean, it's it's if we know if
the stats are what the stats are, it's really important
to go in as eyes wide open and not with fear,
but with the power of knowledge.
Speaker 3 (26:30):
Yes, I think that is so important that we that
we focus on the knowledge, advocating for ourselves, making sure
that we have other people they're advocating for us, whether
it's family members, loved ones, or a doula.
Speaker 1 (26:43):
No. Absolutely, yeah, throughout the process, right, it's really important.
I mean, to that end, I often ask doctors this,
but isn't it a good idea even if you're not
in the in pregnancy or but but to have someone
with you if you're in any kind of a other
than a illness visit, but if there's an issue that
you're focusing on, you should have someone with you so
(27:04):
that they can focus for you.
Speaker 2 (27:07):
Absolutely.
Speaker 3 (27:07):
There's actually a viral TikTok video last year with a
white male physician who said, Hey, can someone tell me
why whenever I walk into an exam room with a
black patient, they always have someone on FaceTime And you
should have seen the comments. The comments were because they
(27:29):
want to make sure that there's someone there that is observing,
to advocate for them, to make sure they're being listened to,
you know. And so I'm not saying that you should videotape.
Your provider should always ask for permission. Right in some
states that's illegal, but you know, I do think that
is really important to bring a loved one or significant
(27:52):
other with you because either you you know, you're not
feeling your best and you need someone to speak on
your behalf, or you just need to want to be
there for moral support.
Speaker 1 (28:00):
Absolutely, and if you're dealing with something that's difficult, you're
going to hear one set of things and the person
that's there is going to hear absolutely what we said.
So no, it's really that's really really important. So before
we close on this, I want to widen this a
little and talk about black women's health generally, not just
maternal health. So you write in your book about a
(28:23):
really horrific medical experience that you have when you were
a medical school student. So can you talk about how
that experience led you to better understand treatment in equities
in the healthcare system for women and especially for.
Speaker 3 (28:34):
Black mess I think often we have experiences, you know,
I feel like I've lived on both sides, you know,
as a physician and a patient. But we have these
experiences as patients where we're like, we feel like you're
being gas lit. You're like, did that just happen, right,
or something's happening to me. I'm not feeling like myself,
but I feel like I'm not being listened to. And
(28:54):
so this experience that I had as a first year
medical student where I developed very bad abdominal pain and
was having other horrible symptoms, and actually I went to
our medical school's teaching hospital. I ended up going three
times over the course of a week, and during some
of those visits, I was questioned about how much pain
(29:15):
I seemed to be in. I was told I didn't
seem to be in that much pain. I was questioned
repeatedly about my sexual history in a way that you know,
there are some appropriate questions to ask someone of child
bearing age who's having abdominal pain, but I was asked
in a way that that sounded it was like very
accusatory and was sort of fulfilling these stereotypes of you know,
(29:38):
black women being promiscuous, right, And so because I was
not listened to, I ended up on my third visit
going to the hospital having shaking, meaning that I had
bacteria in my blood. Turned out that I had an appendicitis,
and by that time my appendix had ruptured and I
(29:58):
actually had to have an open appendectomy, which is where
they actually have to cut your abdomen open to take
out the appendix as opposed to using laparoscopic or the
little cameras, because I had so much pus in my abdomen.
Speaker 2 (30:12):
And after that I ended up developing an infection.
Speaker 3 (30:15):
I missed about a month of medical school, and interestingly,
I ended up being what they called an eminem morbidity
and mortality case for the teaching Hospitals surgery department, and
it was like, what can.
Speaker 2 (30:27):
We learn from this case?
Speaker 1 (30:29):
Wow, that's a horrible story. Is there a small silver lining?
Speaker 3 (30:35):
So silver lining is that I remember at the time
I was a medical student. So I did not feel
even as a medical student, did not feel comfortable speaking
up and saying hey, I'm still having a lot of pain.
Even my twin sister one who was in medical school
with me the time, said to me, I think you
have appendicitis. That was the first visit, But even we
(30:55):
didn't feel comfortable enough speaking up, so I can imagine
what someone without any medical background. But in retrospect, at
the time, I didn't realize I was being like that,
I was being treated that way because maybe because I
was a young black woman. But as I as I
got older and I was practicing, I reflected on that
and I said, wow, Wow, I was just not listened to.
(31:16):
And I think that forever changed me as a physician
in terms of just like the simple action just listen
to your patients, listen to them, like just just ground
yourself and listen to what they're they're telling you.
Speaker 1 (31:31):
That that is really really important. And reading that in
your book reminded me or gave me a new perspective
on a similar incidents that I had as an adult
many years ago. Now. I was traveling home from a
vacation with one of my children and got really sick
right before it was getting on the plane and sharp pains.
(31:51):
And had it been on the side of the body
of the appendix is, I would have not gotten on
the plane because I would have thought it was appendicidis,
not knowing what that feels like. But I just thought,
this is a weird internal pain. But it was on
the other side, it wasn't. So I knew it wasn't.
That I got off the plane went directly to the
hospital because it was that painful, and my doctorship met
me there and the hospital was ready to send me
(32:13):
home because they said it was some kind of infection.
It was simple infection and here's mantibiotics and you can
go home now. And my doctor, who happened to be
a female doctor, who looked at me and I was
in terrible pain, and she said, there's no way that
she's leaving this hospital. You have to admit her. And
but for her advocating on my behalf. She happened to
be a black woman doctor. But for her advocating for
(32:35):
my faff, I would have gone home. Long story short,
I had developed sepsis, and had I gone home, it
could have been a horrible, horrible ending. I mean literally
an hour or so after that, everything's kind of crashed
and they were able to fix me pretty quickly. But
if I'd crashed it home, it was my in and build.
My not being in a medical center would have definitely
(32:55):
impacted the outcome. And when I was reading that part
of the book, I was like, you know, I can't
actually attribute any kind of abject racist or gendered focus.
I mean, I don't think they were looking at me
and saying, oh.
Speaker 2 (33:07):
This right.
Speaker 1 (33:09):
But to your point about how it's kind of indoctrinated,
it's part of the system. In that instance, I tell
that story to say that my advocate, that doctor, she
could well have saved my life. And caring professionals who
advocate for you are so important to have as you
go through any kind of a medical experience. And your
sister called it the first visit.
Speaker 2 (33:31):
As a medical student.
Speaker 1 (33:32):
As a medical student. Unfortunately, it didn't save you the
sort of the trauma of the incidents, but it must
have felt at least so much better to have someone
there with you. And now both of you, doctors in
the world would trust her instincts immediately and make sure
that didn't happen to someone else. Well, okay, final question
(33:53):
for you after Blackstock if you could change the way
that the medical education trains doctors to care for black women.
I mean, you kind of alluded to it before with
a listening, but what are the top things that you'd
want to change?
Speaker 3 (34:06):
Yeah, you know, I think what's really important and what
I didn't get when I was in medical school, is
really talking explicitly about how pain is undertreated in black
patients and especially in black women, Like where does that
come from? And talk about the history. It's deeply deeply
rooted in the history of slavery and in terms of
(34:29):
how enslaved people were used in medical experiments. Also in
terms of how we teach about race in medical school.
There are some aspects of it where it suggested that
there's something biologically different between black people and other people, right,
and so I think we need to really explicitly address
those myths, where they came from, how they are perpetuated. Actually,
(34:52):
one thing that I'm working on now is I'm working
on a curriculum for medical schools about how pain is
undertreated in black patients and especially black women. And part
of that is educating the students about the history, but
also then having them reflect on how that may impact
their clinical decision making and how that shows up in
(35:13):
the clinical setting.
Speaker 1 (35:15):
Oh, that's really important, and I guess related to that,
I mean, of course, you want to debunk the myths
that people are different by virtue of their race, but
there are some chronic illnesses that black people have, just
like there are some that do wish people have people
from Mediterranean just set their doctors in training need to
understand that there are illnesses that you need to have
(35:36):
in the back of your mind and you need to
be able to focus on if you have a patient
that is from any of the lands.
Speaker 3 (35:42):
Absolutely, so I think, you know, we need to be
really clear about the difference between what is due to racism,
right and it's impact on the body. What's a result
of geographical ancestry. So, like sickle cell disease right right, right,
which you talk about it impacts actually people from Mediterranean,
some Saharan aff for South America. But in the US,
(36:03):
because most people who have sickle cell disease are black,
it's been racialized as a black disease.
Speaker 1 (36:07):
Interesting. Interesting, Yeah, actually I'm guilty of that. I didn't
realize that sickle cell you know, it's known as sort
of the African American disease.
Speaker 3 (36:15):
But that's only because most of the people who have
sickle cell disease in this country are black.
Speaker 1 (36:20):
So we want our doctors to have in their medical
vocabulary the illnesses that affect different people based on their
geographic origins, right, But we don't want them to make
presumptions based upon their conscious or subconscious biases that come
from exactly inadequate training. Well, I'm very glad, doctor Blackstock,
(36:41):
that your work now is to help change this. I mean,
you are going to make the difference, and we very
much appreciate it.
Speaker 2 (36:46):
I'm huntered and humbled to do so well.
Speaker 1 (36:49):
We are grateful. And this brings us to the end
of our second conversation with doctor Blackstock. Thank you so much.
I mean, this has been as informative and really important
as I knew it would be. And I'm sure that
parents listening, particularly the women out there who are listening,
really appreciate hearing your experience. I want tomind everyone the
(37:10):
doctor Blackstocks New York Times. The best selling book Legacy,
A Black Physician Reckons with Racism in Medicine is available
at bookstores and online everywhere, so be sure to pick
up a copy. And I will just say it is
a really wonderful combination of really important medical information and
wonderful memoir. I mean it really, it's so delightful to read,
(37:30):
so it's worth it to everyone. Please pick up a copy.
Thank you again, It's been such a pleasure.
Speaker 2 (37:35):
Thank you, Carol.
Speaker 1 (37:37):
I hope everyone listening enjoyed this conversation that you'll come
back for more. Please subscribe, rate and review where you
find your podcasts, and tell your friends. For more parenting
info and advice, please check out the Ground Control Parenting
website at www. Groundcontrolparenting dot com. You can also find
us on Facebook and Instagram at ground Control Parenting and
on LinkedIn under Carol Sutton Lewis. Until take care and
(38:01):
thanks for listening.
Hello, and welcome to Ground Control Parenting, a blog and
now a podcast creative for parents raising black and brown children.
I'm the creator and your host, Carol Sutton Lewis. In
this podcast series, I talk with some really interesting people
about the job and the joy of parenting. This season,
we're asking experts across many fields about the best ways
to raise our children to be curious, confident, and healthy humans.
(00:28):
And today we are talking about health. Many of us
have heard about the statistics which show the higher mortality
rate that Black people in the United States of all
ages face. Doctor lu J Blackstock, an emergency physician who's
the author of a legacy a Black Physician Reckons with
Racism and Medicine, not only knows these stats intimately, she's
dedicated her career to understanding the roots of these statistics
(00:50):
and improving them. A few weeks ago, doctor Blackstock joined
me on this podcast to talk about what every black
parent should know about healthcare, and today she's back to
help us focus more closely on the black maternal health crisis.
In addition to being a doctor and the author of
a New York Times best selling book, doctor Blackstock is
also the founder and CEO of Advancing Health Equity. She
(01:11):
launched this organization in twenty nineteen to help healthcare institutions
identify and eliminate racial disparities and care. A former associate
professor and diversity leader at New York University School of Medicine,
doctor Blackstock is a powerful voice in the media, writing
for The Washington Post and Scientific American, and serving as
an exclusive medical contributor for MSNBC and NBC News. The
(01:34):
daughter of a Harvard trained doctor, doctor Blackstock and her
twin sister, doctor Onny Blackstock received both their undergraduate and
medical degrees from Harvard University, making them the first black
mother daughter legacies from Harvard Medical School. Doctor Blackstock currently
lives in her hometown of Brooklyn, New York, with her
two sons, who are eight and ten. Welcome back to
Ground Control Parenting, Doctor Blackstock.
Speaker 2 (01:56):
Thank you so much for having me back.
Speaker 1 (01:58):
So happy to have you here. So today I want
to spend some time talking about an issue that's critically
important to so many families, the Black maternal health crisis.
In your book, you shine a light on how racism
and medicine affects Black mothers at every stage, from pregnancy
through postpartum. You bring both your personal and professional lens
to this topic, and I think it's so important for
(02:20):
our listeners to hear what's really going on and what
we can do about it. So let's get started, and
let's start with a big picture. So the terrible statistics
which many have heard, but everyone needs to know that
black women are three to four times more likely to
die from pregnancy related causes than white women in this country.
And you write powerfully about how this is not just
(02:41):
a medical issue but also a deeply rooted systemic one.
So when you think about this, how do you explain
the core reasons behind this crisis to people who don't
yet fully grasp the scope or the urgency.
Speaker 2 (02:53):
You know, it's so interesting.
Speaker 3 (02:54):
I think about the fact that you know, we're in
twenty twenty five and we've seen tremendous advances and innovation,
research and technology and healthcare, and it's still it is
more dangerous today to give birth than twenty years ago.
Plus you know the statistic that you shared. What that
(03:14):
speaks to is the far reaching impact of racism in
our lives. And so it happens at so many different
levels for us. It happens when we interface with the
healthcare system. We know that black mothers are less likely
to be listened to, that their concerns are often minimized
(03:36):
and dismissed. We know that actually a lot of the
complications around pregnancy have been in the postpartum period, and
so we have a system where we don't take care
of people in the postpartum period. So, for example, and
I think most people know that you have maybe one
or two postpartum visits after you give birth. That is
(03:58):
an anomaly income countries. There's someone that actually comes to
your home every day for weeks and checks on you.
Speaker 1 (04:06):
Wow.
Speaker 3 (04:07):
Yeah, So these are policy issues also. So there's what
happens in the healthcare system, there's what happens outside, you know,
once you get home after you give birth, but also
even before you give birth. One thing I talk about
in the book is this phenomenon called weathering, and that
was a term coined by a public health researcher named
(04:27):
Arlene Geronymis. She practices just a research in the University
of Michigan. But weathering is this phenomenon where, because of
the stress of living with everyday racism, it causes a
wear and tear on our bodies that we can't even see.
That makes us more susceptible to chronic diseases, premature aging,
(04:47):
and the complications that come along with giving birth. So
we're seeing these A lot of these factors are what's
happening on a physiological level, what's happening on an interpersonal level,
and systemic level. That's accounting for why in twenty twenty
five we're seeing these horrific statistics.
Speaker 1 (05:07):
It's stunning. There is no positive way look at this
except that we're now paying attention to it people like
you were talking about it. That's the only positive.
Speaker 3 (05:16):
Absolutely, And the thing is we and we do have solutions.
We have solutions for it.
Speaker 1 (05:21):
Oh good, good, Yes, I definitely want to get to
those solutions. Now. You've seen this both as a physician
and as a black woman who gave birth to two babies.
So having gone through it yourself in particularly, what are
some of the ways that the bias shows up in
how black women are treated during pregnancy. You talked about
the weathering, but in terms of how doctors listen in
(05:44):
terms of pain management, I mean even well meaning doctors.
Speaker 3 (05:48):
Oh yes, and this is the thing, like, no one
is saying that physicians are out to get their patients,
you know, are out to mistreat them. You know. Unfortunately,
we live in a society where there is lots of
anti black messaging around us that is.
Speaker 1 (06:05):
More sourced than yes.
Speaker 3 (06:07):
That's absorbed by people, and it's whether you go into
medicine or not. And we know that that actually influences
how people care for patients and make decisions. So there
was even a study from the University of Virginia in
twenty sixteen where they interviewed medical students and residents and
they asked them about two cases, two mock cases, white
patient and black patient. Everything was the same, but they
(06:29):
asked them to rate the patient's pain, to give the
patient pain medication, and also whether or not they believed
in these false myths about pain, that black patient's skin
was thicker, that we were less sensitive to pain. And
what we saw was there was actually a difference in
the pain medication that was given to the black patient,
that there was a lower pain score given, and that
(06:51):
over fifty percent of these residents and medical students believed
in these false myths that the authors came up with
about pain. And so what we see is that it
actually manifesting in clinical practice where black mothers are coming
in saying, you know, this doesn't feel right. I'm having pain.
(07:11):
They're being sent home and then coming back because there
was some underlying reason that wasn't worked up or wasn't investigated.
Speaker 1 (07:22):
Still, it's just incredible. I'm still back on the medical
students believing that skin thickness made a difference with pain.
So sticking with the maternity process, you talked about your
two experiences with giving birth, one without a doula and
one with a doula, and the concept of adula, while
it's been around forever, is something that is coming more
(07:45):
and more back into practice and this may be one
of the solutions you were talking about in terms of
how to help black women in the maternality cycle. Can
you talk about how you experienced each birth and what
led you to a doula and what the difference.
Speaker 3 (07:58):
Was, and you know, I think, you know, you know,
part of this I talk about in the book and
where I you know, I'm vulnerable in the book where
I share that there are things even though I'm a physician,
that I didn't know about. You know, when I got
pregnant the first time, I never had even heard of
a doula, nor had I no, you know, but that's
also you know, I was trained in sort of western
(08:20):
bio medical model, right, so I didn't know about dula's,
I didn't know about midwives. All I knew is that
I knew that I was going to give birth in
a hospital by an OBG. I n right, because that's
what all my colleagues did, and that's what I thought
was the standard. And then for my first delivery, it
was it was traumatic. I had prolonged labor, prolonged pushing,
(08:42):
and I ended up having to have a fourceps delivery
where they actually used four SEPs to pull the baby out,
and then I had to have some other procedures that
were very painful during that, and I said, oh my goodness,
is this If this is how it is, I never
want to do this again. And then after that, after
my delivery and then healed and we talked about having
(09:04):
a second child, I started looking into like, how can
I make this experience different? And that's how you know,
I found out about you know, doulas, and they essentially
are emotional support for someone giving birth and also they're
there even before you give birth. They visit you while
you're pregnant. They're there in the delivery room with you,
(09:27):
and they also provide postpartum support. So my duel actually
came after I gave birth to help me with my
second child, to cook meals for me to make sure
that I was okay. And I feel like this sounds
like it shouldn't be rocket science, but it makes sense
right that you have someone that is providing you with support,
and we actually see that there's a decrease in pre
(09:49):
term complications and improved maternal outcomes by using doulas.
Speaker 1 (09:55):
So this makes so much sense. And for many people
I'm sure listening think, oh, well, that's what my mom
did or what my mother in law did or what
my auntie did, and that's fair and that's correct. But
how great is it to have someone who's actually trained
in baby care? And this sounds like one of the
solutions in terms of in other countries where people come
(10:15):
and visit you after you have the baby. I mean,
I've talked with a lot of young people who are
really who are either wanting to become pregnant, or they're
pregnant now or just have babies, and they're very focused
on this fourth trimester. This the postpartum because you know,
back in the day, the dark ages, when I had children,
certainly the concept of postpartum depression existed, but it wasn't
(10:35):
a thing that people talked about much, and it wasn't
something you sought care for. But thankfully now people are
focused on it as a something that can happen and
that there are things to do. But it strikes me
that a doulah could help recognize symptoms flag things, not
only through the pregnancy but afterwards.
Speaker 2 (10:56):
Oh oh absolutely.
Speaker 3 (10:58):
And what we've seen is that you know, a lot
of health insurances don't cover doulas, or Medicaid was not
covering in some states. Now Medicaid does cover doula. There's
a push for that, right And then, so initially having
a doula was something that if you had disposable income
you could have, right, and that really should it shouldn't
(11:19):
be that way. It should be that anyone who needs
one because they're improved outcomes, So why not everyone should
be able to have a doula.
Speaker 1 (11:27):
So, for those of us who aren't as familiar with
all the terminology midwife versus doula, like, what does the
difference you have both. Do you have one or the other?
Speaker 3 (11:36):
That's such a great question. And so a midwife is
a trained health professional who actually cares for the person
that's going to give birth during the sort of the
whole continuum of care, even sometimes even before they get
pregnant to the postpartum period. But they also are involved
(11:57):
in the delivery.
Speaker 1 (11:58):
They deliver the baby, so the midwife can do it
without another medical professional present.
Speaker 3 (12:05):
So for low risk deliveries, yes, midwife usually can deliver
actually at a person's home or in a birthing center.
Usually that usually the midwife will have a relationship with
an obgyn in case there are complications happening, and they
may have admitting privileges to a hospital. And what's interesting
(12:26):
is that, you know, for a very long time in
this country, midwives were the ones that delivered babies. And
I write about in Legacy that was actually in the
nineteen twenties that there was this public health campaign that
tried to make using midwives seem unsanitary and unhygienic, and
that was by actually the physician groups, and so unfortunately
(12:47):
it led to a decrease in the number of midwives
in this country. Like I mean, exponentially, and what we've
actually seen in that is that in other high income
countries that have midwife centered caretually are better outcomes. So
I think for us, for Black communities, I think it's
really important that we just know what all our choices are.
(13:09):
That there is that you can have a duela, that
if you are the appropriate patient, you can actually have
a midwife, or if you have more health issues you
may need to have an obg I N. And that
there are also options for where you can have your baby.
You can have your baby at home, in a birthing
center or a hospital. And so I love that idea
of making sure that we know what our options are.
Speaker 1 (13:31):
And that we know and we talk to our doctors
about them. A friend who just recently had a baby
and has been talking with me about all of this.
She's been a great focus group of one where I
talk about all these issues with her, was saying that
she was very aware, thank Goodness, of the opportunity to
have a duela and midwife, and when she started talking
them with her doctor, she learned that the many things
(13:54):
that she was concerned about, she had a birth plan
that she thought that her doctor would not go along.
With but her doctor was will to go along with
her birth plan in terms of music in the room,
and you know the very specific way in which you
wanted to give birth. And so it's good to know
that you should be smart about all these things, but
be willing and able and not be shy about having
these conversations with your doctor because to your point that
(14:17):
many doctors are very well meaning, they're not. I mean
it's not that they are actively anti any of this,
particularly doctors now, but the way that the world works now,
you have to be a little bit more proactive. Is
is that a thing?
Speaker 3 (14:29):
I absolutely agree, and I think we had talked about
interviewing a pediatrician before you give birth. I think that
it's important to interview your obgi ns or your midwives
to see is this someone who is going to listen
to what I need.
Speaker 1 (14:46):
We'll be right back after these messages, welcome back to
the show. I really love that because people didn't always
think of doctors as people that you would interview. It
wasn't until I sought a pediatrician for my kids that
I wanted to to really interview them, in part because
it wasn't for me. I was advocating on behalf of
another person. But the concept of talking to your doctor
(15:09):
to see if you have a good relationship with them,
I mean, that's a fairly simple thing that we should
feel emboldened to do because that sets the stage for
the kind of relationship you're going to have with I mean.
The flip side of that, though, is the medical refreshion
now is very different in that it is from what
I understand, it has its own share of great stresses.
(15:32):
Now case loads are great, is there are all sorts
of issues with respect to the kind of things that
you have to prescribe that people can't afford it. It's
a more stressful career. So how do you think that
those two things work together? I mean, do you think
is it harder now for doctors to be as compassionate
(15:54):
as we would like them to be.
Speaker 3 (15:56):
That's such a great question, and I think that yes,
there is. There are those pressures just because of the
model of our healthcare system is a for profit system.
There is pressure on physicians to see a certain number
of patients and a certain amount of time. Efficiency is
(16:17):
very important. But at the same time, I've noticed that,
you know, patient feedback is also really important. You know,
if you've ever seen a doctor, sometimes you'll get an
email from the hospital asking you what your experience was.
Hospitals take that very very seriously. So I think that,
you know, there's really a balance that physicians have to
(16:38):
strike now where it's like you are, you have pressure
to see a lot of patients, but then also you
are expected to deliver quality care to your patients. So
there's that tension.
Speaker 1 (16:51):
Yeah, yeah, no, I imagine it would be, but it
doesn't excuse from the patient's perspective. Now they need to
find the physician that they feel.
Speaker 2 (17:00):
Oh absolutely absolutely.
Speaker 1 (17:01):
Speaking of tensions, so we talked about midwives and dulahs.
So you have a midwife who's medically trained, are there
potentially any tensions between your obiguyn and your midwife if
they're both together in the room when there's a delivery.
Speaker 3 (17:17):
So what actually would happen is that if you have
a midwife and you've chosen a midwife to help you
give birth, then that only the only time the obigu
i n would be involved is if there are complications
and the midwife would reach out to the obigun and
say we need you. So typically there there isn't that
(17:39):
tension Okay, well that's good. And I also think that
obgyns are now also more accustomed to having patients who
have dulas also, so I think the presence of doulah's
in the delivery room is something that Obijuans are have
gotten much more accustomed to it.
Speaker 1 (18:00):
I should say then that as you are interviewing your doctor,
if you're starting out with an obgu i n yes,
that's a question to ask as to how comfortable they
are with other people in.
Speaker 2 (18:11):
The room exactly.
Speaker 3 (18:12):
And even I would say even for my doulas, I
interviewed five doulas. I interviewed doulas to make sure that
you know, again, just like my o tui n, that
was someone that I felt a connection with, that we
got along, who I felt like would be able to
advocate for me and really hear and appreciate what I
had to say.
Speaker 1 (18:33):
Oh, that's so interesting. So you know, I always had
to say to ask this question because when you talk
about medical care, it shouldn't be incumbent upon the patient
to make sure they get the proper care. You're entrusting
yourself to a professional. But based on the many things
you write about in your book, we know that it's important,
particularly for Black women to go in armed as best
(18:55):
they can be to protect themselves. So and this even
start before pregnancy. I mean, given what we know about
the strange statistics and the horrible statistics about maternal mortality
and maternal issues, how informed should we be about all
the things that could go wrong? I mean, pregnancy is
(19:16):
scary enough. Certainly, you don't want to freak yourself out
with all the bad things that could happen and then
be totally stressed that the doctor you're talking to is
not going to catch them. But by the on the
other hand, it's good to be wise. It's good to
know about what could go wrong. I mean, how do
you suggest that women Black women who are going into
this process think about this?
Speaker 3 (19:34):
Yeah, that's such an important question, you know. I think
from at the very very minimum, you talk to your
friends about.
Speaker 2 (19:44):
Who did they who did they use?
Speaker 3 (19:46):
Right?
Speaker 2 (19:46):
Who who was who.
Speaker 3 (19:47):
Was their midwife or doulah or b G y N. Honestly,
that's how I found my op g I N. You know,
I asked my colleagues, who did you use? What was
your experience like with them? So again, use your village
and then the other piece of it. There are a
lot of really wonderful resources out there. There's one I
want to give a shout out to.
Speaker 2 (20:08):
It's called the.
Speaker 3 (20:08):
Earth app irt app Okay, and it was started by
Kimberly Seals Hollurs, a black woman, And essentially it's like
a Yelp directory for maternal health providers and birthing hospitals.
People go on there and they actually rate like the
midwives or the doctors that they use, or the birthing
(20:30):
hospital experiences. So I feel like we, like black women,
are trying to find the solutions to making sure that
we are fully informed. But again, like I mentioned even
with my Obi Joiane that I chose one of the
reasons why I chose that practice is because they actually
had a low c section rate. So I asked about
(20:51):
their c section rate. I asked about how many deliveries
did they have. I looked at, you know, the pictures
on the wall to make sure that there were there
was diversity in terms of the patients that they cared for.
So all of that is incredibly important. I also think,
I said, it's important to understand like what environment do
(21:11):
you want to have your child and do you want
to have it have your childhood home, a birthing center,
or a hospital, So knowing what all those possibilities are
and what they look like. But I think also what's
important is that also we are more likely to have
chronic diseases, and so really working with your primary care
physician to make sure that your health is optimized even
(21:33):
before you're thinking about having a child.
Speaker 1 (21:36):
That is a very good point, really good point, because
taken by itself, the statistics is alarming. But when you
think about you talked about weathering, when you think about
how so many of us go into pregnancy with these various,
various chronic illnesses, it's going to suggest the current statistic
because we're not as healthy as we should be. I'm
(21:59):
not putting it on us. It's not because we're not trying.
But we need to be just as focused on being
as healthy. So, you know, the kind of good health
practice that we might want to put off because we're
too busy. We need to back up us even before
we start thinking about having kids, that we want to
have the healthiest vessel possible to bring these babies into
the world. You know, On the one hand, I keep
(22:20):
talking about stunning the statistic is that in this unit,
these United States, the wealthiest country, that we have these issues,
but I am heartened to hear that there are some
things that we could do, I mean things that we could.
Speaker 2 (22:31):
Do absolutely, absolutely better.
Speaker 3 (22:33):
And there's the Momnibus Act that is actually unfortunately it's
installed in Congress, but it is a multi bill act
to addruss maternal mortality. But what I love about it
is that it really looks at all different factors. It
looks at what can we do to increase the diversity
(22:54):
of maternal health providers, how can we use telehealth right
to get in touch with people who may not have
access to care, What can we do about what we
called the social determinants of health around education, employment, access
to healthy food. So really looking at all of these
different tiers in terms of how can we make you know,
(23:17):
black mamas more healthy and that experience more joyful because really,
you know, having a baby is really it should be
a wonderful experience. It shouldn't be a scary experience.
Speaker 1 (23:29):
Right, right, right, right, No, absolutely absolutely, It is really
important that we mentioned that it's a joyful thing. Yea,
it is truly a joyful thing. Moments are not as pleasant, yeah,
some of them uncomfortable moments, But ultimately it saddens me
to hear as as you said earlier that based upon
(23:50):
the experience you had giving birth the first time, it
made you think twice about having a second child and
just and then fortunately you learn there was a way
to do it better. But it is so important that
this news, this information gets out, and so I want
to get back to the solutions. Now, what gives you
hope that we can move the needle on this. You
talked about the Act in Congress, and we've talked a
(24:12):
little about dulaism midwives. Is there anything else that gives
us hope that this stat won't stay as horrible as
it is?
Speaker 3 (24:18):
Yeah, you know, I think that what we're seeing is
and it's actually the work that I do with my
firm Advancing Health Equity. We're seeing a lot of local
and state health departments make maternal health like a pillar
or priority for them, and so one thing that a
lot of them are doing is they're looking at it
through a quality improvement perspective and looking at hospitals and
(24:44):
saying we are going to grade you on how well
you do in terms of your maternal health outcomes. Great,
and we are going to make sure that data is transparent.
You know, we will incentivize you to make sure that
you have I proved outcomes. And so I do think
that even though the statistics are very sound, very dismal,
(25:08):
that this issue has become a priority, so hospitals, health systems,
community groups. So even there are I've seen a push
towards building more birthing centers in maternity deserts, so you know,
making sure. In the book, I actually talk about in Minneapolis,
(25:28):
there is a black midwife who founded the Roots Birthing Center,
and Minneapolis has some of the worst racial health inequities,
and she founded this birthing center with the express mission
of providing holistic, respectful, and dignified care to black mamas
and other mamas of color. And they've actually seen this
(25:49):
model has improved maternal and fetal outcomes. So there is
a lot of hope. We actually can look very close
around us, like even hyperlocally and locally see all of
like the really wonderful bright spots that are happening and
efforts that we can help support and amplify.
Speaker 1 (26:08):
That's so great. And again not to to continue to
put the burden on the patient, but it's really important
to be as smart as you possibly can be about
this stuff. I mean, it's it's if we know if
the stats are what the stats are, it's really important
to go in as eyes wide open and not with fear,
but with the power of knowledge.
Speaker 3 (26:30):
Yes, I think that is so important that we that
we focus on the knowledge, advocating for ourselves, making sure
that we have other people they're advocating for us, whether
it's family members, loved ones, or a doula.
Speaker 1 (26:43):
No. Absolutely, yeah, throughout the process, right, it's really important.
I mean, to that end, I often ask doctors this,
but isn't it a good idea even if you're not
in the in pregnancy or but but to have someone
with you if you're in any kind of a other
than a illness visit, but if there's an issue that
you're focusing on, you should have someone with you so
(27:04):
that they can focus for you.
Speaker 2 (27:07):
Absolutely.
Speaker 3 (27:07):
There's actually a viral TikTok video last year with a
white male physician who said, Hey, can someone tell me
why whenever I walk into an exam room with a
black patient, they always have someone on FaceTime And you
should have seen the comments. The comments were because they
(27:29):
want to make sure that there's someone there that is observing,
to advocate for them, to make sure they're being listened to,
you know. And so I'm not saying that you should videotape.
Your provider should always ask for permission. Right in some
states that's illegal, but you know, I do think that
is really important to bring a loved one or significant
(27:52):
other with you because either you you know, you're not
feeling your best and you need someone to speak on
your behalf, or you just need to want to be
there for moral support.
Speaker 1 (28:00):
Absolutely, and if you're dealing with something that's difficult, you're
going to hear one set of things and the person
that's there is going to hear absolutely what we said.
So no, it's really that's really really important. So before
we close on this, I want to widen this a
little and talk about black women's health generally, not just
maternal health. So you write in your book about a
(28:23):
really horrific medical experience that you have when you were
a medical school student. So can you talk about how
that experience led you to better understand treatment in equities
in the healthcare system for women and especially for.
Speaker 3 (28:34):
Black mess I think often we have experiences, you know,
I feel like I've lived on both sides, you know,
as a physician and a patient. But we have these
experiences as patients where we're like, we feel like you're
being gas lit. You're like, did that just happen, right,
or something's happening to me. I'm not feeling like myself,
but I feel like I'm not being listened to. And
(28:54):
so this experience that I had as a first year
medical student where I developed very bad abdominal pain and
was having other horrible symptoms, and actually I went to
our medical school's teaching hospital. I ended up going three
times over the course of a week, and during some
of those visits, I was questioned about how much pain
(29:15):
I seemed to be in. I was told I didn't
seem to be in that much pain. I was questioned
repeatedly about my sexual history in a way that you know,
there are some appropriate questions to ask someone of child
bearing age who's having abdominal pain, but I was asked
in a way that that sounded it was like very
accusatory and was sort of fulfilling these stereotypes of you know,
(29:38):
black women being promiscuous, right, And so because I was
not listened to, I ended up on my third visit
going to the hospital having shaking, meaning that I had
bacteria in my blood. Turned out that I had an appendicitis,
and by that time my appendix had ruptured and I
(29:58):
actually had to have an open appendectomy, which is where
they actually have to cut your abdomen open to take
out the appendix as opposed to using laparoscopic or the
little cameras, because I had so much pus in my abdomen.
Speaker 2 (30:12):
And after that I ended up developing an infection.
Speaker 3 (30:15):
I missed about a month of medical school, and interestingly,
I ended up being what they called an eminem morbidity
and mortality case for the teaching Hospitals surgery department, and
it was like, what can.
Speaker 2 (30:27):
We learn from this case?
Speaker 1 (30:29):
Wow, that's a horrible story. Is there a small silver lining?
Speaker 3 (30:35):
So silver lining is that I remember at the time
I was a medical student. So I did not feel
even as a medical student, did not feel comfortable speaking
up and saying hey, I'm still having a lot of pain.
Even my twin sister one who was in medical school
with me the time, said to me, I think you
have appendicitis. That was the first visit, But even we
(30:55):
didn't feel comfortable enough speaking up, so I can imagine
what someone without any medical background. But in retrospect, at
the time, I didn't realize I was being like that,
I was being treated that way because maybe because I
was a young black woman. But as I as I
got older and I was practicing, I reflected on that
and I said, wow, Wow, I was just not listened to.
(31:16):
And I think that forever changed me as a physician
in terms of just like the simple action just listen
to your patients, listen to them, like just just ground
yourself and listen to what they're they're telling you.
Speaker 1 (31:31):
That that is really really important. And reading that in
your book reminded me or gave me a new perspective
on a similar incidents that I had as an adult
many years ago. Now. I was traveling home from a
vacation with one of my children and got really sick
right before it was getting on the plane and sharp pains.
(31:51):
And had it been on the side of the body
of the appendix is, I would have not gotten on
the plane because I would have thought it was appendicidis,
not knowing what that feels like. But I just thought,
this is a weird internal pain. But it was on
the other side, it wasn't. So I knew it wasn't.
That I got off the plane went directly to the
hospital because it was that painful, and my doctorship met
me there and the hospital was ready to send me
(32:13):
home because they said it was some kind of infection.
It was simple infection and here's mantibiotics and you can
go home now. And my doctor, who happened to be
a female doctor, who looked at me and I was
in terrible pain, and she said, there's no way that
she's leaving this hospital. You have to admit her. And
but for her advocating on my behalf. She happened to
be a black woman doctor. But for her advocating for
(32:35):
my faff, I would have gone home. Long story short,
I had developed sepsis, and had I gone home, it
could have been a horrible, horrible ending. I mean literally
an hour or so after that, everything's kind of crashed
and they were able to fix me pretty quickly. But
if I'd crashed it home, it was my in and build.
My not being in a medical center would have definitely
(32:55):
impacted the outcome. And when I was reading that part
of the book, I was like, you know, I can't
actually attribute any kind of abject racist or gendered focus.
I mean, I don't think they were looking at me
and saying, oh.
Speaker 2 (33:07):
This right.
Speaker 1 (33:09):
But to your point about how it's kind of indoctrinated,
it's part of the system. In that instance, I tell
that story to say that my advocate, that doctor, she
could well have saved my life. And caring professionals who
advocate for you are so important to have as you
go through any kind of a medical experience. And your
sister called it the first visit.
Speaker 2 (33:31):
As a medical student.
Speaker 1 (33:32):
As a medical student. Unfortunately, it didn't save you the
sort of the trauma of the incidents, but it must
have felt at least so much better to have someone
there with you. And now both of you, doctors in
the world would trust her instincts immediately and make sure
that didn't happen to someone else. Well, okay, final question
(33:53):
for you after Blackstock if you could change the way
that the medical education trains doctors to care for black women.
I mean, you kind of alluded to it before with
a listening, but what are the top things that you'd
want to change?
Speaker 3 (34:06):
Yeah, you know, I think what's really important and what
I didn't get when I was in medical school, is
really talking explicitly about how pain is undertreated in black
patients and especially in black women, Like where does that
come from? And talk about the history. It's deeply deeply
rooted in the history of slavery and in terms of
(34:29):
how enslaved people were used in medical experiments. Also in
terms of how we teach about race in medical school.
There are some aspects of it where it suggested that
there's something biologically different between black people and other people, right,
and so I think we need to really explicitly address
those myths, where they came from, how they are perpetuated. Actually,
(34:52):
one thing that I'm working on now is I'm working
on a curriculum for medical schools about how pain is
undertreated in black patients and especially black women. And part
of that is educating the students about the history, but
also then having them reflect on how that may impact
their clinical decision making and how that shows up in
(35:13):
the clinical setting.
Speaker 1 (35:15):
Oh, that's really important, and I guess related to that,
I mean, of course, you want to debunk the myths
that people are different by virtue of their race, but
there are some chronic illnesses that black people have, just
like there are some that do wish people have people
from Mediterranean just set their doctors in training need to
understand that there are illnesses that you need to have
(35:36):
in the back of your mind and you need to
be able to focus on if you have a patient
that is from any of the lands.
Speaker 3 (35:42):
Absolutely, so I think, you know, we need to be
really clear about the difference between what is due to racism,
right and it's impact on the body. What's a result
of geographical ancestry. So, like sickle cell disease right right, right,
which you talk about it impacts actually people from Mediterranean,
some Saharan aff for South America. But in the US,
(36:03):
because most people who have sickle cell disease are black,
it's been racialized as a black disease.
Speaker 1 (36:07):
Interesting. Interesting, Yeah, actually I'm guilty of that. I didn't
realize that sickle cell you know, it's known as sort
of the African American disease.
Speaker 3 (36:15):
But that's only because most of the people who have
sickle cell disease in this country are black.
Speaker 1 (36:20):
So we want our doctors to have in their medical
vocabulary the illnesses that affect different people based on their
geographic origins, right, But we don't want them to make
presumptions based upon their conscious or subconscious biases that come
from exactly inadequate training. Well, I'm very glad, doctor Blackstock,
(36:41):
that your work now is to help change this. I mean,
you are going to make the difference, and we very
much appreciate it.
Speaker 2 (36:46):
I'm huntered and humbled to do so well.
Speaker 1 (36:49):
We are grateful. And this brings us to the end
of our second conversation with doctor Blackstock. Thank you so much.
I mean, this has been as informative and really important
as I knew it would be. And I'm sure that
parents listening, particularly the women out there who are listening,
really appreciate hearing your experience. I want tomind everyone the
(37:10):
doctor Blackstocks New York Times. The best selling book Legacy,
A Black Physician Reckons with Racism in Medicine is available
at bookstores and online everywhere, so be sure to pick
up a copy. And I will just say it is
a really wonderful combination of really important medical information and
wonderful memoir. I mean it really, it's so delightful to read,
(37:30):
so it's worth it to everyone. Please pick up a copy.
Thank you again, It's been such a pleasure.
Speaker 2 (37:35):
Thank you, Carol.
Speaker 1 (37:37):
I hope everyone listening enjoyed this conversation that you'll come
back for more. Please subscribe, rate and review where you
find your podcasts, and tell your friends. For more parenting
info and advice, please check out the Ground Control Parenting
website at www. Groundcontrolparenting dot com. You can also find
us on Facebook and Instagram at ground Control Parenting and
on LinkedIn under Carol Sutton Lewis. Until take care and
(38:01):
thanks for listening.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies!
The Breakfast Club
The World's Most Dangerous Morning Show, The Breakfast Club, With DJ Envy, Jess Hilarious, And Charlamagne Tha God!