May 2, 2025 • 45 mins
Dr. Venice Haynes shares her groundbreaking work on the 100 Weeks Project, which aims to transform maternal healthcare from preconception through the postpartum year by addressing systemic barriers and creating culturally congruent solutions. She reveals how the project's comprehensive journey maps and state-by-state analysis expose critical gaps in care while highlighting opportunities for employers, policymakers, and communities to better support birthing people.
• Black women are almost three times more likely to die from maternity-related causes than white women
• The 100 Weeks framework covers preconception (4 weeks), pregnancy (40 weeks), and extended postpartum (56 weeks)
• Journey maps compare clinical recommendations with actual experiences and highlight ideal care scenarios
• State analysis shows Southern states generally provide poorer postpartum support, tracking with areas that haven't expanded Medicaid
• Cultural congruency in healthcare providers is key to building trust and improving outcomes
• Ideal postpartum care includes more frequent check-ups, home visits, lactation support, and mental health resources
• Employers play a crucial role through parental leave policies and comprehensive health benefits
• Community-based solutions like home visits and non-traditional appointment hours can improve access
• Building trust takes time
• Advocates should contact legislators, donate to community organizations, and create safe spaces for support
- The Journey Map – Maternal health polices often focus solely on birth, overlooking the challenges that Black mothers face before and after pregnancy.
- The State of Postpartum Care – Interactive maps from USofCare show that postpartum outcomes remain worst in the South, home to the largest share of Black Americans.
- Bright Spots in Maternal Health – USofCare identified promising programs and practices improving maternal health outcomes by engaging with Black women and other women of color.
- Listening to Women of Color – Through in-depth conversations, USofCare uncovered key challenges that Black women face.
- Birthing Bias – Through listening work, USofCare identified that Black women frequently experience racial bias and dismissive treatment.
- 100 Weeks of Care Issue Brief – A comprehensive look at the full Black maternity health journey, identifying gaps and inequalities across pregnancy, birth, and postpartum care.
Visit our website, here: https://birthlearning.com/
Follow us on Facebook at Birth Learning
Follow us on Instagram at @birthlearning
Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:52):
Welcome to the Ordinary Doula Podcast.
I am your host, angie Rozier,and we have a pretty incredible
guest with us here today.
We have Dr Venice Haynes.
She lives near Atlanta, georgia, and has some pretty awesome
work she's been focused on.
I'm going to let her do alittle more introduction of that
, but what I love about a lot ofher work is it been focused on.
I'm going to let her do alittle more introduction of that
.
But what I love about a lot ofher work is it's focused on the
postpartum period.
A lot of times that's aneglected in women's health.
That's a neglected period oftime and it's a pretty long
(01:14):
period of time as well.
So we're going to kind of divein today to her work, what it's
doing, how it can help people.
So, dr Venice Haynes, will yougive us a little background
about yourself and let's diveinto the work you've been doing?
Speaker 3 (01:26):
Yes, angie, thank you so much for having me.
It is a pleasure.
I love having theseconversations and I'm really
excited to talk about two reallycool products we've just
released within the last monthand a half or so.
So, as you mentioned, my nameis Dr Venice Haynes.
I've been born and raised in theAtlanta area.
I've left and come back forschool a couple of times, but
(01:47):
I've always been really, reallypassionate about women's health
throughout my public healthcareer.
I bring all about 17 years ofpublic health experience to bear
at United States of Care, whichis a nonpartisan, nonprofit
organization that centers peoplefirst and building policy at
(02:08):
the state and federal level, andso my role is to listen to
people all across the countryaround their pain points and
wants and needs and desires forthe health care system, and I
feed that data up to our stateand federal policy teams to
create better policies thatultimately lead to better
outcomes.
And so I've been really excitedto bring my past experience in
(02:30):
public health and women's healthinto the ecosphere of US care
and, I'll say, in the process ofdoing a lot of listening on a
number of topics in the healthcare space, the maternal health
crisis has come up numeroustimes, so much so that we could
not ignore that it was acritical area that we need to be
addressing in our work, in ourwork streams, and so we've done
(02:54):
a lot of listening since 2003 inthis space with women across
the country, but specificallywomen of color, and we started
with Black women because theyare the most affected by this.
For those that don, and westarted with Black women because
they are the most affected bythis For those that don't know
the stats Black women are almostthree times and in some
instances, wherever you are inthe country, higher than three
(03:15):
times likely to die frommaternity-related causes than
any other woman, and so westarted with a group of women
that were most impacted by itand really wanted to understand
more.
There's a lot of stories that wemay have heard about near-miss
events or unfortunate eventswhere women have actually died,
(03:38):
but in those instances, thoseare extreme instances.
There's a lot of other painpoints that happen with women
that are still here, and so weuncovered that and what I will
talk a lot about.
The framework for our projectis called 100 Weeks, and so we
realized that capturing storiesjust within the 40 week
(04:00):
pregnancy period was not enough.
There was a lot happening inthe preconception period and we
wanted to make sure that we werecategorizing and understanding
the pain points duringpreconception all the way to one
year plus postpartum.
And so you put together fourweeks plus 40 weeks plus 56
(04:22):
weeks.
I think we counted.
I might have my numbers wrong,but somehow that that gets to
100.
It gets to 100 weeks, right.
So that became the framework andthe backdrop for which we talk
to women and ask them theirexperiences across that
continuum, and so what we didwith that information was create
a journey map that chroniclednot only the experiences women
(04:45):
had, but we wanted to add layersthat incorporated what the
clinical recommendations wereright to understand what's
supposed to happen at each phase.
Then we layered on theexperiences of stories that they
told us and that demonstrateswhat's actually happening in
that in each of those phases wewanted to know what her ideal
(05:08):
experience was, so that we arenot only we're not trying to
maintain the status quo, we'reactually trying to highlight the
ideal experience, to call up abetter standard of care in each
phase, and we also one of myfavorite parts is capturing
bright spots, and that isorganizations, community-based
(05:31):
tech companies, corporateemployers for where they are
actually getting in and solvingsome of the problems in the
maternal landscape that areplaguing women across the
country.
So that those are a few of thecritical layers that we have
throughout the journey map,which is really awesome.
I will link that to in yourshow notes if people want to
(05:55):
check it out.
Yes, please do.
Yeah.
Yeah, it's really dynamic andit by no means is exhaustive,
but I think when your viewerscan go in and look at that, what
we've been hearing is peoplecan resonate with some parts of
you know of any any of that.
And one of the things that Ilike to highlight about that and
again when we were startingwith Black women is there's an
(06:19):
element of how they are cominginto their pregnancy experience
based on past injustices andpast experiences from the
healthcare system at large,right.
Speaker 2 (06:29):
So they're having.
There's oftentimes a mistrustright Like a huge mistrust of
the medical system.
Speaker 3 (06:37):
And the reason why is because so much stereotyping
has already happenedCriminalization of pain,
ignoring pain and I'm not eventalking about in maternal health
, it's just trying to get basichealth care needs met and
dismissed.
And so they're coming in withthis stress and mistrust and
(06:59):
wondering and questioning,questioning, and we capture
these emotions and thoughts inthe journey map as well, because
it's an important backdrop toconsider how they're entering
into their decision to becomepregnant or, if it's an
unintended pregnancy, how theycontinue to navigate through the
next year or so.
Speaker 2 (07:18):
And so I can.
I can imagine with and I'veseen this in my own work when
there's clinical recommendations, some of our folks aren't going
to want to, but they're notinterested, sometimes, right,
because of a lot of thosebarriers.
Sometimes it's transportationaccess, the way you're made to
feel getting care.
So, regardless ofrecommendations, some people are
(07:39):
like no thanks, why would Iwant to take any part in that?
Speaker 3 (07:42):
Well, that's exactly right.
And you also have to considerone of the things I love about
what doing the public health andqualitative work is the
ethnographic piece.
You have to look at thetotality of how people are
coming to a thing, in thisinstance we.
The recommendations might be tohave you know what is it?
Three to four prenatal visits.
You have to take off work and,some instances, people.
(08:06):
If you don't go to work, youdon't get paid that day.
If you're in a maternity desertand you have to travel some
distance, that's a cost in time,it's a cost in transportation,
it's a cost in parking, it's acost once you get there.
Speaker 2 (08:21):
And likely you're going to sit in the waiting room
for upwards of half an hour anhour two hours yeah.
Speaker 3 (08:27):
Heaven forbid, you've got other kids like.
There's a lot of other dynamicsat play, and so think about the
decision making process of, youknow, a woman or birthing
person that has to weigh.
Okay, is this visit reallyworth the sacrifice that I'm
going to have to make just toget there, and I have to do this
multiple times?
Right, are we reallyconsidering that?
So the social needs aspect ofit is critical to consider and I
(08:51):
will also note I believeyesterday ACOG released a new
set of recommendations toincorporate social needs in the
prenatal I've been hearing a bitabout that and all the midwives
in my life are like ding, ding,ding, like yep, that's the
midwifery model of care, that'swhat we do?
Yes, exactly.
(09:12):
So more of that, but more ofthat across the continuum.
So another cool feature thatcame out of that body of work,
too, was a state-by-stateanalysis of where we are as a
country in postpartum care whenit relates to mental health,
(09:34):
postpartum mental health, accessto much needed information via
perinatal health workers, andthat means can women get the
answers to their questions aboutlactation, around breastfeeding
supports, around things thatare happening with their body,
and are they able to access thatinformation through OBGYNs,
(09:56):
midwives, community healthworkers, doulas how can we make
those resources more availableto them more readily?
Coverage for said services,whether regardless if they're on
Medicaid or their employerinsurance or some other
mechanism.
And support for loss and latestage pregnancy loss, and we
(10:22):
heard a lot of that in ourlistening how they really just
didn't feel supported by thesystem and in some instances by
their employers, to be able totake the time that they need for
bereavement.
They're still in theirpostpartum body, even though
they did not bring home baby.
But the most heartbreakingpiece of that is they were not
afforded the same benefits inpostpartum as if they had
(10:44):
brought a baby home, and sothere's a lot One blow on top of
another Exactly, and so there'sa lot of work to do in that
space, and so that was one ofthe biggest highlights that we
wanted to bring in that state bystate analysis.
It's not talked enough about,and that's a support for women
that experience loss.
So two really cool items,resources that I encourage your
(11:08):
viewers to check out for thosethat are really into the
advocacy space.
Call on your local leaders todo better about that.
One of the biggest findings wesaw a lot in that, but people
that live in the South reallyhave it a lot harder than other
(11:28):
parts of the country.
Granted, all states need to dobetter in this space.
The South in particular has,and it tracks with some of the
morbidity and mortality ratesthat we are seeing.
It tracks with the states thathave not expanded Medicaid.
It tracks with the states thathave the biggest maternity
(11:49):
deserts.
It tracks with the highestlevel of postpartum depression
right.
So there's some work, some workwe've got to do in the South.
Speaker 2 (11:59):
Absolutely.
I lived and worked in the Southfor several years, and what a
difference.
As I came from the West, insome regards I felt like I went
back in time.
I'm like, oh wow, we're doingthis or we're not doing that.
My eyes were opened, incredibly, too.
There were some things thatwere better, honestly, but most
things were not so veryinteresting.
(12:19):
All right, so tell us a littlebit about this 100-week project.
In a perfect scenario, if wehave a pregnant person, what
does that look like?
Speaker 3 (12:30):
to do is and the two products I just outlined is
really kind of like a landscapeanalysis right that you can get
(12:53):
into, latch on to hopefully youresonate with various parts of
it and it's really kind ofinformative in nature for you to
kind of see where things are.
Like I said, it's by no meansexhaustive, but in an area where
we are losing access to dataregularly based on this new
(13:15):
administration and adeprioritization of women and
women's health Very difficult totrack.
Speaker 2 (13:23):
Yeah.
Speaker 3 (13:24):
Yep, it was already a call to action to do better
around data collection and inthe process of that we are.
We've lost PRAMS, which is ahuge, huge, publicly available
data set that gives us access tothe things that we need to know
about.
Because my mantra is you can'tfix what you can't what you
don't measure Right.
You need to be aware of it, allabout it.
(13:45):
How are you supposed to fix thething?
Yet in the background, women aresuffering all across the
country with very common thingsright.
So there's a ton of resourcesthat we have on this 100 week
site that we encourage folks toengage with, whether it be from
the policy side of things, thestate of Medicaid, what
(14:07):
employers can do better smallbusinesses, large corporations,
employers have a huge role,because, while 40% of births
happen on Medicaid, which is alot there's a fight we'll have
there, but there's a lot thatemployers can do, especially in
the postpartum space, to createbetter postpartum experiences.
(14:27):
We heard a lot about the stressthat women go through having to
return to work too early.
There's employers that aredoing some great things right.
In some countries people gethalf a year off.
We're doing good in thiscountry if we get three months
off, but the reality is some getsix weeks right.
Speaker 2 (14:45):
Dr.
I just yesterday worked with anurse.
She was a nurse at a children'shospital.
She got eight weeks Dr.
Speaker 3 (14:51):
Yeah, it's not enough .
So I think it was great thatMedicaid expanded their coverage
to 12 months.
We can still do more Havinglike parental leave not just
maternally but parental leave,because part of the work that I
probably don't talk enough aboutis we talk to partners of women
(15:12):
too in this and they haveconcerns, they have challenges
with partners, you know, withtheir mental health.
Heaven forbid there was a lossthere.
You know, men process thingsdifferently.
They process things differently.
So paternity leave is alsocritical.
Speaker 2 (15:29):
I've been surprised in the work like how many men
suffer from postpartumdepression of some kind.
Yeah, Don't talk about that atall.
Speaker 3 (15:39):
So that was an element.
We've got some you knowinformation on our site on on on
on some of that too, and sothere's so many different areas
to plug in on this site.
I think it depends on, like,what you're good at, what I
always tell people, what canpeople do or where do we start
with.
Everybody doesn't have to workon everything, but if you're a
(16:01):
person to you know, engage inyour local, with your local
officials, and require someaccountability for them to pass
policies that better support andfavor women throughout their
pregnancy journey, butparticularly in the postpartum
period, advocate for that.
Talk to your employers aboutplans that and support systems
(16:22):
that they have in place or, youknow, put some pressure on them
to say, hey, what do you have inplace or can you put something
in place to better support us?
We've got some information toshow that the attention is
better, the retention is better,the investment in the company
is better, so it's a betterbenefit when employers invest in
(16:43):
women in their postpartum.
Speaker 2 (16:44):
You get some loyalty back from that investment.
Speaker 3 (16:47):
Yep.
Find that community of peoplethat you feel safe with.
It doesn't do a lot of momshaming and you can actually
open up and share and comparenotes so that you don't have to
go it alone.
One of the biggest things weheard from our listening was the
community that the women hadjust to talk and hear that they
were not by themselves and notfeeling like they had to go it
(17:09):
alone and feel isolated in theirjourney.
So there's a lot of differentareas and ways that people can
plug in and tackle this.
I'm a firm believer that we canfix this problem in this
country.
But let's be honest, thecurrent state of affairs is a
reflection of how we value womenin this country.
Right Got to do better.
Speaker 2 (17:33):
We have to hold the powers of being accountable,
absolutely okay, um, so tell mea little bit about what a an
ideal.
Somebody gets pregnant, has ababy um, there's pretty standard
pieces of care in place forthat, whether people have access
to them or take advantage ofthem or not.
Afterwards we have oftentimes asix-week visit.
(17:55):
So many things can happen insix weeks.
Right, that we've missed, andthen we have a lot of time after
that.
Tell us a little bit about whatan ideal scenario for
postpartum care looks like.
Feels like who are the playersthere, what expertises are
coming in, and how and where arethey being accessed?
Speaker 3 (18:14):
Yes, that's a lot it is.
So one thing I am reminded of iseverybody doesn't need the same
things at the same time.
There are some things that arepretty standard.
That one-time, six-weekcheck-in is absolutely not
enough, right?
(18:35):
I would argue as many prenatalvisits need to happen as
postnatal you know postpartumvisits, right, but they need to
be accessible.
If you're asking for a woman orbirthing person to come back to
work at six weeks and then theyhave to make all these prenatal
appointments you have a newbaby, you might have other, you
know children at home you've gotto it still becomes a
(18:58):
logistical thing.
How can you do that?
Can we figure out likedifferent combinations of care
plans where you've got yourpostpartum visit?
It's like a one-stop shop.
You might have childcare sothat you can focus on that visit
.
You might have a lactationconsultant come in.
You might have access to dualservices.
You've got time to get yourquestions answered.
(19:20):
We need to make it easier, butwe need to make it affordable
too, right?
I think one of the most idealthings is you don't have to do
the extra work to find theresources that are needed if you
have questions that need to beanswered.
You've got a community healthworker.
You've got a doula, you can,you know, get your midwife on
the phone.
You can get your ob-gyn on thephone if you need to, but it's
(19:44):
sounding like everything is sosaturated, so swamped and
everybody is, like you know,head spinning trying to stay
afloat.
How can we even that out?
Well, we can cover more of theseservices through private
insurance, through Medicaid,right, let's start there,
because a number of times, yes,women want these things if they
(20:05):
are aware of them.
So there's an educationcomponent on what lactation
consultants are, what doulas doand the benefits of them.
But then they have to becovered and made readily
available so they don't have todo the extra work and they
actually leverage those.
And I think you know this, thehealth outcomes when you have a
doula present are significantlybetter than when you don't.
(20:27):
Right, so that, I think, wouldbe ideal.
And having that proper timeafter baby, having that support
from your employer to be able totake the time that you need to
heal Heaven forbid, you had acesarean section, right?
Women are having so many more.
Speaker 2 (20:43):
Yep, what do you know ?
A current percentage ofcesarean rates for black women,
you would ask me that I have?
I have a couple like ideas froma couple states, but I don't
know.
Speaker 3 (20:55):
I think it.
Yeah, I think it varies bystate.
I'm not sure what the aggregateacross the US, I just know it's
higher, for it is.
Yep, yep, absolutely startlinglyhigher usually yes, something
about 39% sticks out.
Y'all don't quote me on that,but it's.
It's up there.
We know it's too high, yeah, upthere.
And so there's a lot ofimplications that come with that
, right.
And so just having the supportto be able to heal, like I said,
(21:19):
the support after pregnancyloss, a number of miscarriages
go, not talked about, not talkedabout, right, more discussion
and support around the loss of achild, and you know all of the
(21:40):
elements that happen in thepostpartum period around that
are critical.
So who to tap into on those?
Again, the same ones calling onour legislatures to do better
and have a priority one, youknow, having the infrastructure
for it.
What can employers do?
What can our communities do?
How can we make resources morereadily available?
I'm reminded of a program inrural South Carolina and I'm
(22:05):
partial because I went to schoolthere but really got to know
family solutions and there'sother organizations that have
this home visits model, right,but they follow the woman all
the way through their pregnancyup to two years after they've
had their baby.
They've got trained communityhealth workers, trained doulas.
They make house calls, theybring supplies, they bring
diapers, they bring car seats,like whatever it is that they
(22:29):
need and they use communitybusinesses and resources to pull
that together and to be able togo out and deliver those
services.
They have not lost a mother yet.
Speaker 2 (22:41):
Wow, so that's very much a team effort in that
community.
Speaker 3 (22:43):
It completely is, and that's what I mean.
Like everybody doesn't needeverything at the same time, but
make it available for when theydo.
Better to have it and not needit than to need it and not have
it.
The challenge, though, is thatthey are heavily reliant on
federal funds.
If you're tracking the news, weknow where that's standing now,
(23:06):
and it's not just you know thatorganization.
It's happening all across thecountry when federal dollars are
at threat.
Speaker 2 (23:13):
We already at a dire you know Right, we're just
barely making it as it is.
Speaker 3 (23:17):
Take the federal funding out of it, we're really
going to have to go back tograssroots Right.
And so another something folkscan do donate to these community
organizations that are tryingto meet the needs of women in
their communities in real time,so kind of a call to step up
right for anyone and everyonewhere you stand to be able to
(23:38):
step up.
Speaker 2 (23:40):
Okay, speak to me a little bit about.
I am a firm believer in homevisits, especially postpartum.
I hate, you know, requiring orrequesting someone to pack up
their baby and make thetransportation.
But I know also how can weaddress because some people,
like, are not comfortable.
That's also not a comfortablesetting.
(24:01):
Sometimes Somebody's cominginto my home.
They're taking notes, they'rewatching me, they're what are
they doing here?
So how do we address that?
Like with community healthworkers, postpartum doulas,
lactation how can we addressthat to make it more comfortable
for for home visits to occur?
Speaker 3 (24:17):
Yeah, that's a tough one and we did hear that.
We heard that exchange like, ohwell, I don't want somebody
coming to my house and thatagain goes back to I know for
black women it goes back tomistrust.
Somebody coming to my house andthat again goes back to I know
for Black women it goes back tomistrust.
Distrust absolutely Also lookingfor any excuse to go report
back something that they saw andthey're going to take their
children away.
That's the fear, and so, as aresult of that, they're not open
(24:43):
to getting the resources thatare available to them to help.
And so is there and I don'thave the perfect solution to
this, but this is where I thinkbirthing centers and community
centers, like community, isgoing to be the key player in
this.
So, okay, you don't want a homevisit?
(25:05):
Well, where do you feelcomfortable going?
Right, let's ask and find outwhere do you feel like, where
can are you able to do on aregular, consistent basis?
Do you have someone you canleave your child with to be able
(25:31):
to come to get these resourcesfor an hour?
Okay, we'll be right up thestreet over here from such and
such time and such time, and westart hours because people have
to work.
Speaker 2 (25:42):
Have jobs, it needs to be sometimes evening
appointments.
Yeah Right.
Speaker 3 (25:45):
Everything can't happen between eight and five
when everybody works betweeneight and five, right?
So, thinking outside the box,well, you know, we'll be here
from you know six to nine andthen again from six to nine pm,
so that you can get what youneed, just not thinking in the
traditional you know way.
Um, could be one way, but mybiggest thing is to ask people
(26:08):
what they can do and meet themwhere they are.
And that might look differentfor different communities and so
programs need to be flexible.
Speaker 2 (26:16):
Right like I love what you said.
Think outside the box.
Are you familiar with usazivillage in kansas city, missouri
?
I am not.
Speaker 3 (26:27):
You just look about Mamatona Village in DC.
Speaker 2 (26:30):
Okay, yeah, look, look up Usazi Village in Kansas
City.
It's.
It's been started, I think itwas at 2013 or 2008.
And I've done extensive workwith them over a few years.
An amazing model of care, whichnow is a clinic um, with
culturally congruent providersof all kinds and they can go
(26:51):
there for um.
There's child care, there'schildbirth classes, they have a
doula program, um.
So, yeah, check that out.
That's a model that might beworth looking at because it
sounds like it can meet in thatcommunity, within that community
can meet, and took years tobuild right, like it took a lot
of brick upon brick, theyfiguring things out and building
things there.
Speaker 3 (27:11):
So I think too.
One thing I've definitely heardis to your point, it takes time
and it takes resources, but themore one-stop shop
opportunities that there are, Ithink one model from like breast
cancer screening is mobileunits.
Yes, access, access in astation place.
You come to that at a certainamount of time.
(27:33):
Go to the people yes, it takesresources, yep.
Speaker 2 (27:38):
Absolutely Wow.
So I can see within, as I mybrain is just going like within
this model, taking time within aclient experience.
Right, if we're looking at 100weeks and I have a question for
you about that in just a momentbut during the over the course
of a pregnancy, building trustwithin a system so that by the
(27:59):
time we are postpartum, you mayfeel comfortable with this
community health worker or thisdoula that you've come to know,
you've learned from them, you'veshared with them, they've
shared with you.
Then you're like okay, yeah,I'm cool with you doing a home
visit, go ahead and come on tomy house.
So, taking time to build atrust, that is critical.
Speaker 3 (28:17):
And cultural congruency is also key.
Heard it throughout when youhave someone that you can relate
to and can understand and youfeel like you are not being
judged.
Speaker 2 (28:30):
Yes.
Speaker 3 (28:31):
That is critical across the continuum, right.
Adherence to visits andscreenings and clinical
recommendations are much morelikely.
But I always say we talk abouthaving more, you know,
culturally congruent doctorsthat can meet women where they
are.
That requires another systemicadjustment for how we are
(28:55):
training those culturallycongruent providers, right.
So there's, there's resistancethere.
Again, the backdrop of how weare operating in life right now
looks very different.
So it's not like you can justturn out a bunch of black OBGYNs
in a month, right.
You can't turn out blackmidwives, you cannot turn out
(29:16):
doulas just by snapping yourfingers and you have to pay
people for their time, right.
So we have to kind of reimagineand take down some of the
barriers to making that happen.
Again, that goes back to howmuch do you prioritize the
health and well-being of womenin this country and their
(29:38):
families to be able to reverseand change and think creatively
about how these things are, howpeople are trained, how they are
paid and the models of care.
Speaker 2 (29:49):
Yeah, so some of the solutions we set into action
today may come to fruition fiveyears, 10 years, 15 years down
the road, especially seekingproviders right Absolutely.
Speaker 3 (30:00):
Which is why we say when you go to our 100 website,
we say better postpartum care by2030.
That's five years from now.
We've got five years to figureit out.
How can we put a, how can wemake our mark in doing better by
women in a postpartum period by2030?
The next five years.
Speaker 2 (30:18):
So I have a question about the hundred years.
Sorry, hundred weeks, hundredyears feels like it, sometimes
hundred weeks.
So in my experience and someresearch I've done, it feels
difficult to get people engagingprenatally preconception.
Like people like, how do youget folks, any people, to listen
(30:38):
?
It's like, hey, you're thinkingof getting pregnant.
Here's some information, here'ssome.
Why don't you think about thesethings for both partners, right
?
How do you capture folks there?
A lot of times, like we'refurther downstream, sometimes
way too far downstream, before,um, like intention starts taking
over, like oh yeah, we need tolook into this.
(30:59):
So how, how, what have youfound?
Are some ways to engage people?
Preconception?
That's hard, it is hard.
Speaker 3 (31:06):
People are coming.
They're they're coming inpreconception from a couple of
ways the pregnancy is intended,or they have had a wealth of
fertility issues.
Okay, um, right, that can be anup and down crazy experience in
and of itself.
If you've been trying, activelytrying to conceive, if you've
(31:27):
had a loss previously, right,there's some trepidation and
fear for entering into it again.
Then there's the I'm not sureif I want to be pregnant right
now.
Can we consider that intendedor unintended?
I'm a little iffy.
And then there's like, a lot ofsocial dynamics happening in
(31:49):
the background.
There's cultural dynamicshappening in the background.
There's partner relationshipdynamics happening in the
background.
There's and if the pregnancy isunintended that's even more so
there's a level of denial thatis happening Right, right,
stories um, a woman that didn'tgo see a doctor till she was six
(32:10):
months, you know, pregnant,which happens.
So we have to call things out,like, like, what's happening.
Yes, this is what's supposed tohappen, this is the
recommendation, but the realityof what people are thinking and
feeling.
And there's the affordabilityof health care, right, large for
(32:31):
everybody.
It's the number one pain pointof people across the country.
And so now you're like, oh, Ican't afford health care for
myself, and now there's thishuman that I'm going to have to
consider and think about.
Can Can I really afford my lifeand theirs?
This world is crazy.
(32:52):
This healthcare system is crazy.
How am I going to navigate this?
I don't know where to start,and so this is my social
behavioral scientist piecekicking in.
When people have too manythings to try to solve for they
shrink back Right, they're goingto shut down something,
something and really like we canpretend we would.
Speaker 2 (33:10):
It would be great if pregnancy was everyone's main
priority for all pregnant people, but it's not right.
They're like I am.
I say like there's so manyother layers, first right,
relationship issues and workissues, and and sometimes the
pregnancy is very much put onthe back burner for sometimes a
long time.
So there's other other issueswe need to kind of look at in
(33:30):
creating that safe space of care.
That's right and it's outside.
Speaker 3 (33:33):
It's often out I'm not going to say often.
Outside there's a lot ofdynamics as it relates to the
healthcare system.
But then outside, in the socialenvironment, women are having
babies later in life.
They're focusing on theircareers.
They're thinking about well,how is this going to hamper my
career, or is it like what kindof support am I going to have?
I'm up for this promotion, butnow I'm pregnant.
(33:56):
How are they going?
How are my peers going to viewme Like, there's okay, now I
need to keep it quiet.
Speaker 2 (34:00):
I'm not excited about this, I'm not.
Yeah.
Speaker 3 (34:03):
I don't even know if I want kids.
We have to really think aboutwhat is in the psyche of people,
versus assuming that they aregoing to do something because
you say they are supposed toRight.
Speaker 2 (34:15):
Absolutely Interesting.
Okay, all right, I know we'recoming a little close on time,
so, if you can share, I have acouple of questions, if that's
all right, for takeaways fromyour work.
What are, like, the top three?
You talked about affordability,maybe that's one of them.
What are the top three painpoints, the top three things
(34:36):
people are needing, wanting,aching for whatever that might
be, and there's, as you heard,stories.
What are the top three umthings to address that need
addressing?
Yeah, it's a hard question.
I'm so sorry, but you havegreat answers.
Speaker 3 (34:56):
Great discussion, cover more stuff, affordability.
Affordability Because if theyhave to pay for out of pocket,
you're already bringing a newlife into this world.
The likelihood of a woman orpregnant person spending that
money on themselves and theirhealth and well-being compared
(35:17):
to their new baby in theirfamily is less likely.
So the more we can cover oneither Medicaid or employer
sponsored insurance and the like, the better.
Right, we definitely have tomeet people where they are.
We talked about culturallycongruent providers.
That's critical to buildingtrust.
When trust is built, you getmore engagement and you get
(35:41):
better outcomes.
That is absolutely, absolutelykey.
There's some great examples outthere, but we have to meet
people where we are and wealluded to all of this in our
conversation.
But there is a return oninvestment when you invest in
(36:03):
your people, absolutely and justthe health and well-being of
your workplace and society atlarge workplace and society at
large.
So employers I think we willmove the needle a lot if we get
employers to reimagine theirbenefit plans to be able to
incorporate and make moreprovisions for women and men in
(36:24):
the workplace paternity care andnew support around family.
Speaker 2 (36:34):
I work with a small healthcare plan company and it's
interesting, like it's how muchof what they want and what I
want, like as a doula, iscongruent.
It's the same they as we metwith them and they're and
they're working with differentproducts, like there's so many
health plan products availableout there.
They're looking at a certaindoula program that they're
(36:55):
incorporating as a benefit,which is amazing.
But they had this year we arewhat are we?
In April They've had four NICUbabies, right, and and, and it's
a smaller, it's a smallerhealth plan, but they're like
those are killing us, those NICUbabies millions of dollars.
And so this health care plan,like how can we prevent this?
(37:16):
What can we do?
So they have a lot of the sameobjectives that I do as a doula.
And then we have the hospitalsystem, the medical care system
in the middle, which is sointeresting because we have a
lot of these the insurers, thepolicy providers and holders,
and the doulas, the lactationconsultants, have so many of the
same objectives, which ispretty fascinating to me.
(37:37):
So, I think, also workingtogether with them and, yes,
employers I love that piece ofemployers and a lot of times
that's going to be againawareness, education, helping
employers be aware of what isavailable and why the ROI, the
return on investment, is goingto be huge.
I mean, I mean it's all aboutmoney for them.
Honestly, it's so much aboutmoney as it comes down to why
(37:57):
they're doing what they're doingand when they understand big
picture, like, oh, for X amountof dollars, which is so much
less than a NICU stay, let'saddress lactation or pregnancy
care or that support during Okay, very fascinating.
Speaker 3 (38:13):
All of these resources can be found.
We have some extensive work onwhat employers can do on our
site, so go to our website.
Speaker 2 (38:20):
Okay, okay, and that will be in our show notes.
That link is in our show notes,all right, I think.
One more question that I havefor you, if that's okay, you got
on time.
Yeah, okay, solutions what aresome top?
We've also touched on this, butlet's tie it up and like what
are some good solutions?
And you're talking in ouraudience here.
(38:41):
We have a lot of pregnantpeople right, or people who
support them, but I think everysingle person has the ability,
an obligation, responsibility totweak the system in some small
way.
We can't come in and make major, sweeping changes very quickly,
but we can do the under theunder, just tweak the underbelly
of a system.
So what are some solutions thatpeople can walk away today,
(39:05):
whether they're a pregnantperson, whether they're a doula,
a lactation consultant, becausewe have a pretty broad audience
there.
What can we do?
Speaker 3 (39:14):
Let's start having more conversations about this
one.
I think education and awarenessis critical.
Find your community of people.
I am a believer of power innumbers and so, as I said
earlier in the conversation, ifyou are a person that wears an
advocacy hat, I'm in this space.
(39:36):
I'm on this energy to start tohold our local leaders, our
state leaders, our federalleaders accountable.
Get on the phone, and I'msaying this because we have
heard our senators, ourrepresentatives.
They're tracking the phonecalls and the conversations and
what we're calling them about.
Burn up those phone lines.
(39:57):
What are you doing to protectwomen in this country?
What are you doing to protectour families?
What are you doing to havethings in place such that we are
not dying at such alarmingrates?
Lactation consultants, doulas,midwives, um lactation
(40:19):
consultants, doulas, midwives.
Education is key.
Um, I understand, but was alsosaddened by the number of women
that did not know the differencebetween what a midwife, a
midwife and a doula does.
It's crazy, yeah, a lot.
And or, if they did, they havethis notion of what they're do
what they do and it's not reallyfor me and not really
understanding the benefits ofhaving those supports outside of
(40:41):
your OBGYN.
Let's face it the workforce istapped.
The clinician workforce istapped.
They're spread really thin.
Absolutely.
I feel like a lot of questionsthat women and birthing people
have.
They want to hear from theirOBGYN.
Let's also be realistic.
They can't be on the phone witheverybody answering all their
(41:01):
questions.
They're not accessible andthey're not Right.
And so how can we get find theother community health workers
in your area?
Are there doulas that peoplecan recommend?
Are there local level peoplethat you can engage with?
Are there, and I'm so much morework to put on doulas and
community health workers, butcan there be some more synergy
(41:25):
in the education andavailability and awareness of
who is there and, like I said,building your community?
I had a conversation the otherday about like the online groups
and in and connecting, andwhile that is great, because
there's a lot of women thatdon't want to reach out for help
(41:46):
and feeling like they're goingit alone, this is where the
awareness and education is key.
But let's let's be be oursister's keeper in terms of
creating safe spaces for womento ask questions and not feel
shamed because they're askingthose questions or seeking help
or, you know, wanting to knowmore about a thing.
(42:08):
There's a lot of that happening, but we have to kind of band
together in this fight onmaternal health because at the
rate we're going, we are notgetting a lot of help and
support.
But if we band together anddemand more and better, we can
actually move the needle on this, but it's going to take a lot
of different layers, a lot ofdifferent actions getting on the
(42:30):
phone with our state, local andfederal leaders banding
together in communitiesawareness and education between
midwives and doulas, communityhealth workers around what's
available, lactation consultants, and making sure that when we
are calling those senators,making sure that we get those
services covered.
Speaker 2 (42:49):
Yeah, awesome, awesome, awesome, okay, yeah,
awesome, awesome, awesome.
Okay, you've prompted so manymore conversations, but I love
what we've talked about today,so tell us the website people
can go to.
Speaker 3 (43:03):
We'll link it in our show notes as well.
Again, it's 100, the number,100 weeks, dot, united states of
care, dot, org.
And when you go there you findeverything.
You find the journey map, youfind the state of postpartum
care um, you find our vision forpostpartum care and there's a
(43:26):
number of resources, includingthe ones that I highlighted
about employer supports, umpolicy landscapes and the like.
And so get into it.
We'd love your feedback, we'dlove your ideas.
I'm always constantly learningand listening to other
conversations in this space andit's going to take all of our
ideas Absolutely.
Speaker 2 (43:47):
It's a big problem, so it's going to take a lot of
solutions.
Perfect, I love the work you'redoing.
It just yeah, it's resonates somuch and it's so needed.
It's so needed across the boardand I I'm excited to go look at
that state map.
That's going to be prettyfascinating.
There's a call to action rightthere.
Speaker 3 (44:04):
You've got right.
Speaker 2 (44:05):
Yep, and I would imagine the South is struggling,
like that's what I noticedliving there and working there
was it was different.
So, okay, dr Venice, oh, we'reso glad that you could be with
us today, appreciate yourexpertise and your dedication to
this work.
It's so vitally important.
We appreciate that so much.
Thank you, thank you, thank you.
(44:28):
So we're going to wrap it uptoday for the ordinary dealer
podcast.
Thank you so much for beingwith us today and, as I always
end every episode, thisresonated a lot today like go
out and make a human connection,whether that's online, in
person, eye contact, a touch ofa hand.
Please make a human connectionto someone else.
It'll help your day and helptheirs as well.
Thanks for being with us andwe'll see you next time.
Speaker 1 (45:06):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth you.
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helping thousands of
people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:52):
Welcome to the Ordinary Doula Podcast.
I am your host, angie Rozier,and we have a pretty incredible
guest with us here today.
We have Dr Venice Haynes.
She lives near Atlanta, georgia, and has some pretty awesome
work she's been focused on.
I'm going to let her do alittle more introduction of that
, but what I love about a lot ofher work is it been focused on.
I'm going to let her do alittle more introduction of that
.
But what I love about a lot ofher work is it's focused on the
postpartum period.
A lot of times that's aneglected in women's health.
That's a neglected period oftime and it's a pretty long
(01:14):
period of time as well.
So we're going to kind of divein today to her work, what it's
doing, how it can help people.
So, dr Venice Haynes, will yougive us a little background
about yourself and let's diveinto the work you've been doing?
Speaker 3 (01:26):
Yes, angie, thank you so much for having me.
It is a pleasure.
I love having theseconversations and I'm really
excited to talk about two reallycool products we've just
released within the last monthand a half or so.
So, as you mentioned, my nameis Dr Venice Haynes.
I've been born and raised in theAtlanta area.
I've left and come back forschool a couple of times, but
(01:47):
I've always been really, reallypassionate about women's health
throughout my public healthcareer.
I bring all about 17 years ofpublic health experience to bear
at United States of Care, whichis a nonpartisan, nonprofit
organization that centers peoplefirst and building policy at
(02:08):
the state and federal level, andso my role is to listen to
people all across the countryaround their pain points and
wants and needs and desires forthe health care system, and I
feed that data up to our stateand federal policy teams to
create better policies thatultimately lead to better
outcomes.
And so I've been really excitedto bring my past experience in
(02:30):
public health and women's healthinto the ecosphere of US care
and, I'll say, in the process ofdoing a lot of listening on a
number of topics in the healthcare space, the maternal health
crisis has come up numeroustimes, so much so that we could
not ignore that it was acritical area that we need to be
addressing in our work, in ourwork streams, and so we've done
(02:54):
a lot of listening since 2003 inthis space with women across
the country, but specificallywomen of color, and we started
with Black women because theyare the most affected by this.
For those that don, and westarted with Black women because
they are the most affected bythis For those that don't know
the stats Black women are almostthree times and in some
instances, wherever you are inthe country, higher than three
(03:15):
times likely to die frommaternity-related causes than
any other woman, and so westarted with a group of women
that were most impacted by itand really wanted to understand
more.
There's a lot of stories that wemay have heard about near-miss
events or unfortunate eventswhere women have actually died,
(03:38):
but in those instances, thoseare extreme instances.
There's a lot of other painpoints that happen with women
that are still here, and so weuncovered that and what I will
talk a lot about.
The framework for our projectis called 100 Weeks, and so we
realized that capturing storiesjust within the 40 week
(04:00):
pregnancy period was not enough.
There was a lot happening inthe preconception period and we
wanted to make sure that we werecategorizing and understanding
the pain points duringpreconception all the way to one
year plus postpartum.
And so you put together fourweeks plus 40 weeks plus 56
(04:22):
weeks.
I think we counted.
I might have my numbers wrong,but somehow that that gets to
100.
It gets to 100 weeks, right.
So that became the framework andthe backdrop for which we talk
to women and ask them theirexperiences across that
continuum, and so what we didwith that information was create
a journey map that chroniclednot only the experiences women
(04:45):
had, but we wanted to add layersthat incorporated what the
clinical recommendations wereright to understand what's
supposed to happen at each phase.
Then we layered on theexperiences of stories that they
told us and that demonstrateswhat's actually happening in
that in each of those phases wewanted to know what her ideal
(05:08):
experience was, so that we arenot only we're not trying to
maintain the status quo, we'reactually trying to highlight the
ideal experience, to call up abetter standard of care in each
phase, and we also one of myfavorite parts is capturing
bright spots, and that isorganizations, community-based
(05:31):
tech companies, corporateemployers for where they are
actually getting in and solvingsome of the problems in the
maternal landscape that areplaguing women across the
country.
So that those are a few of thecritical layers that we have
throughout the journey map,which is really awesome.
I will link that to in yourshow notes if people want to
(05:55):
check it out.
Yes, please do.
Yeah.
Yeah, it's really dynamic andit by no means is exhaustive,
but I think when your viewerscan go in and look at that, what
we've been hearing is peoplecan resonate with some parts of
you know of any any of that.
And one of the things that Ilike to highlight about that and
again when we were startingwith Black women is there's an
(06:19):
element of how they are cominginto their pregnancy experience
based on past injustices andpast experiences from the
healthcare system at large,right.
Speaker 2 (06:29):
So they're having.
There's oftentimes a mistrustright Like a huge mistrust of
the medical system.
Speaker 3 (06:37):
And the reason why is because so much stereotyping
has already happenedCriminalization of pain,
ignoring pain and I'm not eventalking about in maternal health
, it's just trying to get basichealth care needs met and
dismissed.
And so they're coming in withthis stress and mistrust and
(06:59):
wondering and questioning,questioning, and we capture
these emotions and thoughts inthe journey map as well, because
it's an important backdrop toconsider how they're entering
into their decision to becomepregnant or, if it's an
unintended pregnancy, how theycontinue to navigate through the
next year or so.
Speaker 2 (07:18):
And so I can.
I can imagine with and I'veseen this in my own work when
there's clinical recommendations, some of our folks aren't going
to want to, but they're notinterested, sometimes, right,
because of a lot of thosebarriers.
Sometimes it's transportationaccess, the way you're made to
feel getting care.
So, regardless ofrecommendations, some people are
(07:39):
like no thanks, why would Iwant to take any part in that?
Speaker 3 (07:42):
Well, that's exactly right.
And you also have to considerone of the things I love about
what doing the public health andqualitative work is the
ethnographic piece.
You have to look at thetotality of how people are
coming to a thing, in thisinstance we.
The recommendations might be tohave you know what is it?
Three to four prenatal visits.
You have to take off work and,some instances, people.
(08:06):
If you don't go to work, youdon't get paid that day.
If you're in a maternity desertand you have to travel some
distance, that's a cost in time,it's a cost in transportation,
it's a cost in parking, it's acost once you get there.
Speaker 2 (08:21):
And likely you're going to sit in the waiting room
for upwards of half an hour anhour two hours yeah.
Speaker 3 (08:27):
Heaven forbid, you've got other kids like.
There's a lot of other dynamicsat play, and so think about the
decision making process of, youknow, a woman or birthing
person that has to weigh.
Okay, is this visit reallyworth the sacrifice that I'm
going to have to make just toget there, and I have to do this
multiple times?
Right, are we reallyconsidering that?
So the social needs aspect ofit is critical to consider and I
(08:51):
will also note I believeyesterday ACOG released a new
set of recommendations toincorporate social needs in the
prenatal I've been hearing a bitabout that and all the midwives
in my life are like ding, ding,ding, like yep, that's the
midwifery model of care, that'swhat we do?
Yes, exactly.
(09:12):
So more of that, but more ofthat across the continuum.
So another cool feature thatcame out of that body of work,
too, was a state-by-stateanalysis of where we are as a
country in postpartum care whenit relates to mental health,
(09:34):
postpartum mental health, accessto much needed information via
perinatal health workers, andthat means can women get the
answers to their questions aboutlactation, around breastfeeding
supports, around things thatare happening with their body,
and are they able to access thatinformation through OBGYNs,
(09:56):
midwives, community healthworkers, doulas how can we make
those resources more availableto them more readily?
Coverage for said services,whether regardless if they're on
Medicaid or their employerinsurance or some other
mechanism.
And support for loss and latestage pregnancy loss, and we
(10:22):
heard a lot of that in ourlistening how they really just
didn't feel supported by thesystem and in some instances by
their employers, to be able totake the time that they need for
bereavement.
They're still in theirpostpartum body, even though
they did not bring home baby.
But the most heartbreakingpiece of that is they were not
afforded the same benefits inpostpartum as if they had
(10:44):
brought a baby home, and sothere's a lot One blow on top of
another Exactly, and so there'sa lot of work to do in that
space, and so that was one ofthe biggest highlights that we
wanted to bring in that state bystate analysis.
It's not talked enough about,and that's a support for women
that experience loss.
So two really cool items,resources that I encourage your
(11:08):
viewers to check out for thosethat are really into the
advocacy space.
Call on your local leaders todo better about that.
One of the biggest findings wesaw a lot in that, but people
that live in the South reallyhave it a lot harder than other
(11:28):
parts of the country.
Granted, all states need to dobetter in this space.
The South in particular has,and it tracks with some of the
morbidity and mortality ratesthat we are seeing.
It tracks with the states thathave not expanded Medicaid.
It tracks with the states thathave the biggest maternity
(11:49):
deserts.
It tracks with the highestlevel of postpartum depression
right.
So there's some work, some workwe've got to do in the South.
Speaker 2 (11:59):
Absolutely.
I lived and worked in the Southfor several years, and what a
difference.
As I came from the West, insome regards I felt like I went
back in time.
I'm like, oh wow, we're doingthis or we're not doing that.
My eyes were opened, incredibly, too.
There were some things thatwere better, honestly, but most
things were not so veryinteresting.
(12:19):
All right, so tell us a littlebit about this 100-week project.
In a perfect scenario, if wehave a pregnant person, what
does that look like?
Speaker 3 (12:30):
to do is and the two products I just outlined is
really kind of like a landscapeanalysis right that you can get
(12:53):
into, latch on to hopefully youresonate with various parts of
it and it's really kind ofinformative in nature for you to
kind of see where things are.
Like I said, it's by no meansexhaustive, but in an area where
we are losing access to dataregularly based on this new
(13:15):
administration and adeprioritization of women and
women's health Very difficult totrack.
Speaker 2 (13:23):
Yeah.
Speaker 3 (13:24):
Yep, it was already a call to action to do better
around data collection and inthe process of that we are.
We've lost PRAMS, which is ahuge, huge, publicly available
data set that gives us access tothe things that we need to know
about.
Because my mantra is you can'tfix what you can't what you
don't measure Right.
You need to be aware of it, allabout it.
(13:45):
How are you supposed to fix thething?
Yet in the background, women aresuffering all across the
country with very common thingsright.
So there's a ton of resourcesthat we have on this 100 week
site that we encourage folks toengage with, whether it be from
the policy side of things, thestate of Medicaid, what
(14:07):
employers can do better smallbusinesses, large corporations,
employers have a huge role,because, while 40% of births
happen on Medicaid, which is alot there's a fight we'll have
there, but there's a lot thatemployers can do, especially in
the postpartum space, to createbetter postpartum experiences.
(14:27):
We heard a lot about the stressthat women go through having to
return to work too early.
There's employers that aredoing some great things right.
In some countries people gethalf a year off.
We're doing good in thiscountry if we get three months
off, but the reality is some getsix weeks right.
Speaker 2 (14:45):
Dr.
I just yesterday worked with anurse.
She was a nurse at a children'shospital.
She got eight weeks Dr.
Speaker 3 (14:51):
Yeah, it's not enough .
So I think it was great thatMedicaid expanded their coverage
to 12 months.
We can still do more Havinglike parental leave not just
maternally but parental leave,because part of the work that I
probably don't talk enough aboutis we talk to partners of women
(15:12):
too in this and they haveconcerns, they have challenges
with partners, you know, withtheir mental health.
Heaven forbid there was a lossthere.
You know, men process thingsdifferently.
They process things differently.
So paternity leave is alsocritical.
Speaker 2 (15:29):
I've been surprised in the work like how many men
suffer from postpartumdepression of some kind.
Yeah, Don't talk about that atall.
Speaker 3 (15:39):
So that was an element.
We've got some you knowinformation on our site on on on
on some of that too, and sothere's so many different areas
to plug in on this site.
I think it depends on, like,what you're good at, what I
always tell people, what canpeople do or where do we start
with.
Everybody doesn't have to workon everything, but if you're a
(16:01):
person to you know, engage inyour local, with your local
officials, and require someaccountability for them to pass
policies that better support andfavor women throughout their
pregnancy journey, butparticularly in the postpartum
period, advocate for that.
Talk to your employers aboutplans that and support systems
(16:22):
that they have in place or, youknow, put some pressure on them
to say, hey, what do you have inplace or can you put something
in place to better support us?
We've got some information toshow that the attention is
better, the retention is better,the investment in the company
is better, so it's a betterbenefit when employers invest in
(16:43):
women in their postpartum.
Speaker 2 (16:44):
You get some loyalty back from that investment.
Speaker 3 (16:47):
Yep.
Find that community of peoplethat you feel safe with.
It doesn't do a lot of momshaming and you can actually
open up and share and comparenotes so that you don't have to
go it alone.
One of the biggest things weheard from our listening was the
community that the women hadjust to talk and hear that they
were not by themselves and notfeeling like they had to go it
(17:09):
alone and feel isolated in theirjourney.
So there's a lot of differentareas and ways that people can
plug in and tackle this.
I'm a firm believer that we canfix this problem in this
country.
But let's be honest, thecurrent state of affairs is a
reflection of how we value womenin this country.
Right Got to do better.
Speaker 2 (17:33):
We have to hold the powers of being accountable,
absolutely okay, um, so tell mea little bit about what a an
ideal.
Somebody gets pregnant, has ababy um, there's pretty standard
pieces of care in place forthat, whether people have access
to them or take advantage ofthem or not.
Afterwards we have oftentimes asix-week visit.
(17:55):
So many things can happen insix weeks.
Right, that we've missed, andthen we have a lot of time after
that.
Tell us a little bit about whatan ideal scenario for
postpartum care looks like.
Feels like who are the playersthere, what expertises are
coming in, and how and where arethey being accessed?
Speaker 3 (18:14):
Yes, that's a lot it is.
So one thing I am reminded of iseverybody doesn't need the same
things at the same time.
There are some things that arepretty standard.
That one-time, six-weekcheck-in is absolutely not
enough, right?
(18:35):
I would argue as many prenatalvisits need to happen as
postnatal you know postpartumvisits, right, but they need to
be accessible.
If you're asking for a woman orbirthing person to come back to
work at six weeks and then theyhave to make all these prenatal
appointments you have a newbaby, you might have other, you
know children at home you've gotto it still becomes a
(18:58):
logistical thing.
How can you do that?
Can we figure out likedifferent combinations of care
plans where you've got yourpostpartum visit?
It's like a one-stop shop.
You might have childcare sothat you can focus on that visit
.
You might have a lactationconsultant come in.
You might have access to dualservices.
You've got time to get yourquestions answered.
(19:20):
We need to make it easier, butwe need to make it affordable
too, right?
I think one of the most idealthings is you don't have to do
the extra work to find theresources that are needed if you
have questions that need to beanswered.
You've got a community healthworker.
You've got a doula, you can,you know, get your midwife on
the phone.
You can get your ob-gyn on thephone if you need to, but it's
(19:44):
sounding like everything is sosaturated, so swamped and
everybody is, like you know,head spinning trying to stay
afloat.
How can we even that out?
Well, we can cover more of theseservices through private
insurance, through Medicaid,right, let's start there,
because a number of times, yes,women want these things if they
(20:05):
are aware of them.
So there's an educationcomponent on what lactation
consultants are, what doulas doand the benefits of them.
But then they have to becovered and made readily
available so they don't have todo the extra work and they
actually leverage those.
And I think you know this, thehealth outcomes when you have a
doula present are significantlybetter than when you don't.
(20:27):
Right, so that, I think, wouldbe ideal.
And having that proper timeafter baby, having that support
from your employer to be able totake the time that you need to
heal Heaven forbid, you had acesarean section, right?
Women are having so many more.
Speaker 2 (20:43):
Yep, what do you know ?
A current percentage ofcesarean rates for black women,
you would ask me that I have?
I have a couple like ideas froma couple states, but I don't
know.
Speaker 3 (20:55):
I think it.
Yeah, I think it varies bystate.
I'm not sure what the aggregateacross the US, I just know it's
higher, for it is.
Yep, yep, absolutely startlinglyhigher usually yes, something
about 39% sticks out.
Y'all don't quote me on that,but it's.
It's up there.
We know it's too high, yeah, upthere.
And so there's a lot ofimplications that come with that
, right.
And so just having the supportto be able to heal, like I said,
(21:19):
the support after pregnancyloss, a number of miscarriages
go, not talked about, not talkedabout, right, more discussion
and support around the loss of achild, and you know all of the
(21:40):
elements that happen in thepostpartum period around that
are critical.
So who to tap into on those?
Again, the same ones calling onour legislatures to do better
and have a priority one, youknow, having the infrastructure
for it.
What can employers do?
What can our communities do?
How can we make resources morereadily available?
I'm reminded of a program inrural South Carolina and I'm
(22:05):
partial because I went to schoolthere but really got to know
family solutions and there'sother organizations that have
this home visits model, right,but they follow the woman all
the way through their pregnancyup to two years after they've
had their baby.
They've got trained communityhealth workers, trained doulas.
They make house calls, theybring supplies, they bring
diapers, they bring car seats,like whatever it is that they
(22:29):
need and they use communitybusinesses and resources to pull
that together and to be able togo out and deliver those
services.
They have not lost a mother yet.
Speaker 2 (22:41):
Wow, so that's very much a team effort in that
community.
Speaker 3 (22:43):
It completely is, and that's what I mean.
Like everybody doesn't needeverything at the same time, but
make it available for when theydo.
Better to have it and not needit than to need it and not have
it.
The challenge, though, is thatthey are heavily reliant on
federal funds.
If you're tracking the news, weknow where that's standing now,
(23:06):
and it's not just you know thatorganization.
It's happening all across thecountry when federal dollars are
at threat.
Speaker 2 (23:13):
We already at a dire you know Right, we're just
barely making it as it is.
Speaker 3 (23:17):
Take the federal funding out of it, we're really
going to have to go back tograssroots Right.
And so another something folkscan do donate to these community
organizations that are tryingto meet the needs of women in
their communities in real time,so kind of a call to step up
right for anyone and everyonewhere you stand to be able to
(23:38):
step up.
Speaker 2 (23:40):
Okay, speak to me a little bit about.
I am a firm believer in homevisits, especially postpartum.
I hate, you know, requiring orrequesting someone to pack up
their baby and make thetransportation.
But I know also how can weaddress because some people,
like, are not comfortable.
That's also not a comfortablesetting.
(24:01):
Sometimes Somebody's cominginto my home.
They're taking notes, they'rewatching me, they're what are
they doing here?
So how do we address that?
Like with community healthworkers, postpartum doulas,
lactation how can we addressthat to make it more comfortable
for for home visits to occur?
Speaker 3 (24:17):
Yeah, that's a tough one and we did hear that.
We heard that exchange like, ohwell, I don't want somebody
coming to my house and thatagain goes back to I know for
black women it goes back tomistrust.
Somebody coming to my house andthat again goes back to I know
for Black women it goes back tomistrust.
Distrust absolutely Also lookingfor any excuse to go report
back something that they saw andthey're going to take their
children away.
That's the fear, and so, as aresult of that, they're not open
(24:43):
to getting the resources thatare available to them to help.
And so is there and I don'thave the perfect solution to
this, but this is where I thinkbirthing centers and community
centers, like community, isgoing to be the key player in
this.
So, okay, you don't want a homevisit?
(25:05):
Well, where do you feelcomfortable going?
Right, let's ask and find outwhere do you feel like, where
can are you able to do on aregular, consistent basis?
Do you have someone you canleave your child with to be able
(25:31):
to come to get these resourcesfor an hour?
Okay, we'll be right up thestreet over here from such and
such time and such time, and westart hours because people have
to work.
Speaker 2 (25:42):
Have jobs, it needs to be sometimes evening
appointments.
Yeah Right.
Speaker 3 (25:45):
Everything can't happen between eight and five
when everybody works betweeneight and five, right?
So, thinking outside the box,well, you know, we'll be here
from you know six to nine andthen again from six to nine pm,
so that you can get what youneed, just not thinking in the
traditional you know way.
Um, could be one way, but mybiggest thing is to ask people
(26:08):
what they can do and meet themwhere they are.
And that might look differentfor different communities and so
programs need to be flexible.
Speaker 2 (26:16):
Right like I love what you said.
Think outside the box.
Are you familiar with usazivillage in kansas city, missouri
?
I am not.
Speaker 3 (26:27):
You just look about Mamatona Village in DC.
Speaker 2 (26:30):
Okay, yeah, look, look up Usazi Village in Kansas
City.
It's.
It's been started, I think itwas at 2013 or 2008.
And I've done extensive workwith them over a few years.
An amazing model of care, whichnow is a clinic um, with
culturally congruent providersof all kinds and they can go
(26:51):
there for um.
There's child care, there'schildbirth classes, they have a
doula program, um.
So, yeah, check that out.
That's a model that might beworth looking at because it
sounds like it can meet in thatcommunity, within that community
can meet, and took years tobuild right, like it took a lot
of brick upon brick, theyfiguring things out and building
things there.
Speaker 3 (27:11):
So I think too.
One thing I've definitely heardis to your point, it takes time
and it takes resources, but themore one-stop shop
opportunities that there are, Ithink one model from like breast
cancer screening is mobileunits.
Yes, access, access in astation place.
You come to that at a certainamount of time.
(27:33):
Go to the people yes, it takesresources, yep.
Speaker 2 (27:38):
Absolutely Wow.
So I can see within, as I mybrain is just going like within
this model, taking time within aclient experience.
Right, if we're looking at 100weeks and I have a question for
you about that in just a momentbut during the over the course
of a pregnancy, building trustwithin a system so that by the
(27:59):
time we are postpartum, you mayfeel comfortable with this
community health worker or thisdoula that you've come to know,
you've learned from them, you'veshared with them, they've
shared with you.
Then you're like okay, yeah,I'm cool with you doing a home
visit, go ahead and come on tomy house.
So, taking time to build atrust, that is critical.
Speaker 3 (28:17):
And cultural congruency is also key.
Heard it throughout when youhave someone that you can relate
to and can understand and youfeel like you are not being
judged.
Speaker 2 (28:30):
Yes.
Speaker 3 (28:31):
That is critical across the continuum, right.
Adherence to visits andscreenings and clinical
recommendations are much morelikely.
But I always say we talk abouthaving more, you know,
culturally congruent doctorsthat can meet women where they
are.
That requires another systemicadjustment for how we are
(28:55):
training those culturallycongruent providers, right.
So there's, there's resistancethere.
Again, the backdrop of how weare operating in life right now
looks very different.
So it's not like you can justturn out a bunch of black OBGYNs
in a month, right.
You can't turn out blackmidwives, you cannot turn out
(29:16):
doulas just by snapping yourfingers and you have to pay
people for their time, right.
So we have to kind of reimagineand take down some of the
barriers to making that happen.
Again, that goes back to howmuch do you prioritize the
health and well-being of womenin this country and their
(29:38):
families to be able to reverseand change and think creatively
about how these things are, howpeople are trained, how they are
paid and the models of care.
Speaker 2 (29:49):
Yeah, so some of the solutions we set into action
today may come to fruition fiveyears, 10 years, 15 years down
the road, especially seekingproviders right Absolutely.
Speaker 3 (30:00):
Which is why we say when you go to our 100 website,
we say better postpartum care by2030.
That's five years from now.
We've got five years to figureit out.
How can we put a, how can wemake our mark in doing better by
women in a postpartum period by2030?
The next five years.
Speaker 2 (30:18):
So I have a question about the hundred years.
Sorry, hundred weeks, hundredyears feels like it, sometimes
hundred weeks.
So in my experience and someresearch I've done, it feels
difficult to get people engagingprenatally preconception.
Like people like, how do youget folks, any people, to listen
(30:38):
?
It's like, hey, you're thinkingof getting pregnant.
Here's some information, here'ssome.
Why don't you think about thesethings for both partners, right
?
How do you capture folks there?
A lot of times, like we'refurther downstream, sometimes
way too far downstream, before,um, like intention starts taking
over, like oh yeah, we need tolook into this.
(30:59):
So how, how, what have youfound?
Are some ways to engage people?
Preconception?
That's hard, it is hard.
Speaker 3 (31:06):
People are coming.
They're they're coming inpreconception from a couple of
ways the pregnancy is intended,or they have had a wealth of
fertility issues.
Okay, um, right, that can be anup and down crazy experience in
and of itself.
If you've been trying, activelytrying to conceive, if you've
(31:27):
had a loss previously, right,there's some trepidation and
fear for entering into it again.
Then there's the I'm not sureif I want to be pregnant right
now.
Can we consider that intendedor unintended?
I'm a little iffy.
And then there's like, a lot ofsocial dynamics happening in
(31:49):
the background.
There's cultural dynamicshappening in the background.
There's partner relationshipdynamics happening in the
background.
There's and if the pregnancy isunintended that's even more so
there's a level of denial thatis happening Right, right,
stories um, a woman that didn'tgo see a doctor till she was six
(32:10):
months, you know, pregnant,which happens.
So we have to call things out,like, like, what's happening.
Yes, this is what's supposed tohappen, this is the
recommendation, but the realityof what people are thinking and
feeling.
And there's the affordabilityof health care, right, large for
(32:31):
everybody.
It's the number one pain pointof people across the country.
And so now you're like, oh, Ican't afford health care for
myself, and now there's thishuman that I'm going to have to
consider and think about.
Can Can I really afford my lifeand theirs?
This world is crazy.
(32:52):
This healthcare system is crazy.
How am I going to navigate this?
I don't know where to start,and so this is my social
behavioral scientist piecekicking in.
When people have too manythings to try to solve for they
shrink back Right, they're goingto shut down something,
something and really like we canpretend we would.
Speaker 2 (33:10):
It would be great if pregnancy was everyone's main
priority for all pregnant people, but it's not right.
They're like I am.
I say like there's so manyother layers, first right,
relationship issues and workissues, and and sometimes the
pregnancy is very much put onthe back burner for sometimes a
long time.
So there's other other issueswe need to kind of look at in
(33:30):
creating that safe space of care.
That's right and it's outside.
Speaker 3 (33:33):
It's often out I'm not going to say often.
Outside there's a lot ofdynamics as it relates to the
healthcare system.
But then outside, in the socialenvironment, women are having
babies later in life.
They're focusing on theircareers.
They're thinking about well,how is this going to hamper my
career, or is it like what kindof support am I going to have?
I'm up for this promotion, butnow I'm pregnant.
(33:56):
How are they going?
How are my peers going to viewme Like, there's okay, now I
need to keep it quiet.
Speaker 2 (34:00):
I'm not excited about this, I'm not.
Yeah.
Speaker 3 (34:03):
I don't even know if I want kids.
We have to really think aboutwhat is in the psyche of people,
versus assuming that they aregoing to do something because
you say they are supposed toRight.
Speaker 2 (34:15):
Absolutely Interesting.
Okay, all right, I know we'recoming a little close on time,
so, if you can share, I have acouple of questions, if that's
all right, for takeaways fromyour work.
What are, like, the top three?
You talked about affordability,maybe that's one of them.
What are the top three painpoints, the top three things
(34:36):
people are needing, wanting,aching for whatever that might
be, and there's, as you heard,stories.
What are the top three umthings to address that need
addressing?
Yeah, it's a hard question.
I'm so sorry, but you havegreat answers.
Speaker 3 (34:56):
Great discussion, cover more stuff, affordability.
Affordability Because if theyhave to pay for out of pocket,
you're already bringing a newlife into this world.
The likelihood of a woman orpregnant person spending that
money on themselves and theirhealth and well-being compared
(35:17):
to their new baby in theirfamily is less likely.
So the more we can cover oneither Medicaid or employer
sponsored insurance and the like, the better.
Right, we definitely have tomeet people where they are.
We talked about culturallycongruent providers.
That's critical to buildingtrust.
When trust is built, you getmore engagement and you get
(35:41):
better outcomes.
That is absolutely, absolutelykey.
There's some great examples outthere, but we have to meet
people where we are and wealluded to all of this in our
conversation.
But there is a return oninvestment when you invest in
(36:03):
your people, absolutely and justthe health and well-being of
your workplace and society atlarge workplace and society at
large.
So employers I think we willmove the needle a lot if we get
employers to reimagine theirbenefit plans to be able to
incorporate and make moreprovisions for women and men in
(36:24):
the workplace paternity care andnew support around family.
Speaker 2 (36:34):
I work with a small healthcare plan company and it's
interesting, like it's how muchof what they want and what I
want, like as a doula, iscongruent.
It's the same they as we metwith them and they're and
they're working with differentproducts, like there's so many
health plan products availableout there.
They're looking at a certaindoula program that they're
(36:55):
incorporating as a benefit,which is amazing.
But they had this year we arewhat are we?
In April They've had four NICUbabies, right, and and, and it's
a smaller, it's a smallerhealth plan, but they're like
those are killing us, those NICUbabies millions of dollars.
And so this health care plan,like how can we prevent this?
(37:16):
What can we do?
So they have a lot of the sameobjectives that I do as a doula.
And then we have the hospitalsystem, the medical care system
in the middle, which is sointeresting because we have a
lot of these the insurers, thepolicy providers and holders,
and the doulas, the lactationconsultants, have so many of the
same objectives, which ispretty fascinating to me.
(37:37):
So, I think, also workingtogether with them and, yes,
employers I love that piece ofemployers and a lot of times
that's going to be againawareness, education, helping
employers be aware of what isavailable and why the ROI, the
return on investment, is goingto be huge.
I mean, I mean it's all aboutmoney for them.
Honestly, it's so much aboutmoney as it comes down to why
(37:57):
they're doing what they're doingand when they understand big
picture, like, oh, for X amountof dollars, which is so much
less than a NICU stay, let'saddress lactation or pregnancy
care or that support during Okay, very fascinating.
Speaker 3 (38:13):
All of these resources can be found.
We have some extensive work onwhat employers can do on our
site, so go to our website.
Speaker 2 (38:20):
Okay, okay, and that will be in our show notes.
That link is in our show notes,all right, I think.
One more question that I havefor you, if that's okay, you got
on time.
Yeah, okay, solutions what aresome top?
We've also touched on this, butlet's tie it up and like what
are some good solutions?
And you're talking in ouraudience here.
(38:41):
We have a lot of pregnantpeople right, or people who
support them, but I think everysingle person has the ability,
an obligation, responsibility totweak the system in some small
way.
We can't come in and make major, sweeping changes very quickly,
but we can do the under theunder, just tweak the underbelly
of a system.
So what are some solutions thatpeople can walk away today,
(39:05):
whether they're a pregnantperson, whether they're a doula,
a lactation consultant, becausewe have a pretty broad audience
there.
What can we do?
Speaker 3 (39:14):
Let's start having more conversations about this
one.
I think education and awarenessis critical.
Find your community of people.
I am a believer of power innumbers and so, as I said
earlier in the conversation, ifyou are a person that wears an
advocacy hat, I'm in this space.
(39:36):
I'm on this energy to start tohold our local leaders, our
state leaders, our federalleaders accountable.
Get on the phone, and I'msaying this because we have
heard our senators, ourrepresentatives.
They're tracking the phonecalls and the conversations and
what we're calling them about.
Burn up those phone lines.
(39:57):
What are you doing to protectwomen in this country?
What are you doing to protectour families?
What are you doing to havethings in place such that we are
not dying at such alarmingrates?
Lactation consultants, doulas,midwives, um lactation
(40:19):
consultants, doulas, midwives.
Education is key.
Um, I understand, but was alsosaddened by the number of women
that did not know the differencebetween what a midwife, a
midwife and a doula does.
It's crazy, yeah, a lot.
And or, if they did, they havethis notion of what they're do
what they do and it's not reallyfor me and not really
understanding the benefits ofhaving those supports outside of
(40:41):
your OBGYN.
Let's face it the workforce istapped.
The clinician workforce istapped.
They're spread really thin.
Absolutely.
I feel like a lot of questionsthat women and birthing people
have.
They want to hear from theirOBGYN.
Let's also be realistic.
They can't be on the phone witheverybody answering all their
(41:01):
questions.
They're not accessible andthey're not Right.
And so how can we get find theother community health workers
in your area?
Are there doulas that peoplecan recommend?
Are there local level peoplethat you can engage with?
Are there, and I'm so much morework to put on doulas and
community health workers, butcan there be some more synergy
(41:25):
in the education andavailability and awareness of
who is there and, like I said,building your community?
I had a conversation the otherday about like the online groups
and in and connecting, andwhile that is great, because
there's a lot of women thatdon't want to reach out for help
(41:46):
and feeling like they're goingit alone, this is where the
awareness and education is key.
But let's let's be be oursister's keeper in terms of
creating safe spaces for womento ask questions and not feel
shamed because they're askingthose questions or seeking help
or, you know, wanting to knowmore about a thing.
(42:08):
There's a lot of that happening, but we have to kind of band
together in this fight onmaternal health because at the
rate we're going, we are notgetting a lot of help and
support.
But if we band together anddemand more and better, we can
actually move the needle on this, but it's going to take a lot
of different layers, a lot ofdifferent actions getting on the
(42:30):
phone with our state, local andfederal leaders banding
together in communitiesawareness and education between
midwives and doulas, communityhealth workers around what's
available, lactation consultants, and making sure that when we
are calling those senators,making sure that we get those
services covered.
Speaker 2 (42:49):
Yeah, awesome, awesome, awesome, okay, yeah,
awesome, awesome, awesome.
Okay, you've prompted so manymore conversations, but I love
what we've talked about today,so tell us the website people
can go to.
Speaker 3 (43:03):
We'll link it in our show notes as well.
Again, it's 100, the number,100 weeks, dot, united states of
care, dot, org.
And when you go there you findeverything.
You find the journey map, youfind the state of postpartum
care um, you find our vision forpostpartum care and there's a
(43:26):
number of resources, includingthe ones that I highlighted
about employer supports, umpolicy landscapes and the like.
And so get into it.
We'd love your feedback, we'dlove your ideas.
I'm always constantly learningand listening to other
conversations in this space andit's going to take all of our
ideas Absolutely.
Speaker 2 (43:47):
It's a big problem, so it's going to take a lot of
solutions.
Perfect, I love the work you'redoing.
It just yeah, it's resonates somuch and it's so needed.
It's so needed across the boardand I I'm excited to go look at
that state map.
That's going to be prettyfascinating.
There's a call to action rightthere.
Speaker 3 (44:04):
You've got right.
Speaker 2 (44:05):
Yep, and I would imagine the South is struggling,
like that's what I noticedliving there and working there
was it was different.
So, okay, dr Venice, oh, we'reso glad that you could be with
us today, appreciate yourexpertise and your dedication to
this work.
It's so vitally important.
We appreciate that so much.
Thank you, thank you, thank you.
(44:28):
So we're going to wrap it uptoday for the ordinary dealer
podcast.
Thank you so much for beingwith us today and, as I always
end every episode, thisresonated a lot today like go
out and make a human connection,whether that's online, in
person, eye contact, a touch ofa hand.
Please make a human connectionto someone else.
It'll help your day and helptheirs as well.
Thanks for being with us andwe'll see you next time.
Speaker 1 (45:06):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth you.
Popular Podcasts
NFL Daily with Gregg Rosenthal
Gregg Rosenthal and a rotating crew of elite NFL Media co-hosts, including Patrick Claybon, Colleen Wolfe, Steve Wyche, Nick Shook and Jourdan Rodrigue of The Athletic get you caught up daily on all the NFL news and analysis you need to be smarter and funnier than your friends.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com