March 4, 2025 • 36 mins
In the U.S., pregnancy-related illness and mortality are more likely to affect black women than white or hispanic women. This maternal health crisis, rooted in bias and inequality, is explored by Dr. Jen Ashton and her expert guests in episode 2 of The Visibility Gap.
Guest Charity Watkins shares her personal story of diagnosis and discovery of a multi-generational maternal health condition.
Next, health experts Dr. Margaret Rutherford and Dr. Deirdre Cooper Owens suggest actionable solutions companies can use to mitigate these health challenges.
All Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group. © 2025 Cigna Healthcare
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Episode Transcript
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SPEAKER_01 (00:00):
Welcome to The Visibility Gap.
I'm Dr.
Jen Ashton.
Today we're diving into acritical and urgent
conversation, maternalmortality.
Did you know that Black women inthe United States are two and a
half to three times more likelyto die from pregnancy-related
(00:20):
causes?
than white women and three timesmore likely to die than Hispanic
women.
These statistics, reported bythe Commonwealth Fund,
underscore a devastatingreality.
According to the CDC,disparities in maternal
mortality are driven by acombination of complex factors,
including differences in healthcare quality, chronic health
(00:42):
conditions, structural racism,and implicit bias.
These barriersdisproportionately impact Black
women.
This is what the visibility gapis all about, shining a light on
inequities that demand urgentattention.
In this episode, we'll unpackthe systemic issues fueling
these disparities, explore howimplicit biases and healthcare
(01:06):
barriers perpetuate the issue,and discuss actionable steps to
close this deadly gap.
It's a tough but essentialconversation about lives at risk
and Thank you so much for comingto share your story about your
(01:40):
pregnancy and your experience.
First, I want to say
SPEAKER_04 (01:43):
thank you so much for addressing this very
important topic.
So before I became pregnant, Iwas a doctoral student working
on my PhD in social work.
I was active.
I exercised pretty regularly.
I was healthy.
I had no health concerns.
(02:04):
The most And we should just
SPEAKER_01 (02:16):
mention for people who aren't familiar, to get a
Ph.D.
in social work takes how manyyears?
Oh, it depends.
SPEAKER_04 (02:24):
So I would say five to seven years, potentially.
SPEAKER_01 (02:28):
It's longer in many times and many cases to get a
PhD than to get an MD.
So that is really impressive.
But just again, to summarize,higher education.
Yes.
You had a job.
You had health care.
You were motivated.
You were informed.
Yes.
all of this going into yourpregnancy.
SPEAKER_04 (02:48):
Yes, and also at that point had been married for
two years before I found out Iwas pregnant.
And my husband was amicrobiologist and had his PhD.
And so we were two, a family oftwo with PhDs.
And, you know, that's a rareoccasion and what I thought
(03:09):
would be something that would bea positive factor for me.
SPEAKER_01 (03:14):
And you were how old when you...
I was
SPEAKER_04 (03:16):
30 when I had my daughter.
SPEAKER_01 (03:19):
Okay, 30 and healthy when you delivered.
Yes.
Then when did things change?
When did your experience withpregnancy kind of take a turn?
SPEAKER_04 (03:27):
No major concerns until...
It was time to deliver.
And my daughter, who the joy ofmy life, was very, very
comfortable.
She did not want to leave.
She actually arrived 10 daysafter her due date.
And it was an eviction notice.
(03:48):
I would have to say.
She had to be evicted.
And I had to go through,unfortunately, an unplanned
cesarean delivery.
I had spent about two to threedays in the hospital trying to
do natural birth, and it justwasn't progressing.
And so they told me that inorder to avoid any
(04:09):
complications, that we wouldhave to do a cesarean.
SPEAKER_01 (04:12):
So as you probably know, No, now, or hopefully this
was explained to you at thetime, from 41 to 42 weeks of
gestation, of pregnancy, therisks to the fetus and to the
mom really sharply increase,which is why usually...
antenatal testing of the fetusand the mom really picks up if a
(04:38):
woman goes significantly afterher due date.
So were you having additionalultrasounds and blood tests and
blood pressure checks, anythinglike that?
Not that I can
SPEAKER_04 (04:48):
remember.
No, I don't remember anyadditional tests.
It was actually not determineduntil I had been admitted for
her to be delivered that I wastold that I need a cesarean
delivery.
So it was There was noconversation about me needing it
before, maybe two hours beforeit actually happened.
SPEAKER_01 (05:08):
So you were asked to come to the hospital for an
induction.
Yes.
And...
What transpired between when youchecked into the hospital to the
C-section?
SPEAKER_04 (05:18):
I mean, we went through almost every single
intervention possible to inducebefore getting to the point of
doing a cesarean.
SPEAKER_01 (05:27):
So they said you're not dilating, she's not
descending.
It's a failed induction, whichis the OB term.
So we're going to recommenddelivery by a C-section.
And then what was it like whenyou first held her in your arms?
SPEAKER_04 (05:44):
Oh, so my husband and I would tell the story to
her about the sound that cameout of him because he was
actually the first one to seeher versus me.
And so here I was, this baby.
Right.
Right.
(06:08):
Like this noise just came out ofhim just innately.
And then I just remember cryingbecause, you know, we had went
through so much to have her.
We weren't sure how we weregoing to get through this
pregnancy as two young adultsstarting our lives together.
But we were just overjoyed.
(06:28):
She was going to be the firstgrandchild on his side of the
family and first greatgrandchild.
And so she was the start of anew generation.
To see her little face when Ifirst delivered her was just the
best gift ever.
SPEAKER_01 (06:44):
Incredible.
I just got chills.
And then what happened in termsof your postpartum course?
Because that was for you...
where things really started tochange?
SPEAKER_04 (06:56):
Yeah, before I even left the hospital, things began
to change.
So I remember at least, I thinkmaybe 24 hours after my
cesareans, and I actually wantto say it's a surgery.
It's a major surgery.
Major surgery through some majormuscles.
Laparotomy, incision.
Exactly.
(07:17):
I was encouraged to walk aroundmy hospital room.
And so I did that.
I was one who was going toListen to what the doctors
recommended and follow throughon those terms.
And so I began walking around myhospital room and there was one
moment when I was sitting in thechair for a period of time
talking to family members whowere visiting and I got up and I
(07:40):
literally still now to this dayhear the sound of blood hitting
that tile floor.
just blood just rushed out of meas soon as I stood up.
And here was my husband who wasscared to see something like
that happen.
And then my sister-in-law wasthere holding my daughter.
SPEAKER_01 (07:58):
And this was the First day after?
Yes.
And it was not, just to clarify,it was not coming from your
incision.
No.
It was vaginal.
Right, right.
SPEAKER_04 (08:08):
And so my husband went to go find a doctor, and I
laid in bed just to prepare forwhat, I don't know what was
going to happen.
And so as my sister-in-law washolding my one-day-old, daughter
and looking out the window justto try to give me some privacy.
My husband was holding my hand.
(08:28):
A doctor came in, didn't reallyprovide much explanation of what
was going on other than I hadclots.
And he physically, manuallyremoved the clots while I was in
my hospital bed with nomedication, no pain relief or
anything, just manually removed.
(08:49):
Reached up into your uterus.
Twice.
Twice.
Twice.
And the pain was extraordinary.
The pain was something I wouldnever want to wish on anyone.
And I remember the scream that Ilet out.
And my dad, who was waiting inthe waiting area outside,
(09:10):
actually heard me scream.
And that was his introduction tohis granddaughter, was hearing
me scream.
And It was just like he came–the doctor came in, and then he
was gone.
SPEAKER_01 (09:24):
Was a nurse in the room with you?
No.
No.
Okay.
So that sounds incrediblytraumatic.
It was.
What happened after
SPEAKER_04 (09:35):
that?
Well– Continued my stay in thehospital for, I think, two
additional days.
I was discharged and we wenthome with my daughter.
And overall, I was feeling okay.
I, of course, had to preparemyself for recovery from a major
(09:56):
surgery while also preparingmyself for entering motherhood.
SPEAKER_01 (10:00):
And how much did the experience you had just in the
hospital affect your feelingspersonally?
about pregnancy, possibly futurepregnancies, and particularly in
the experiences that you sharewith your friends and family.
SPEAKER_04 (10:17):
Oh, I did not want to think about going back to the
hospital for any reason, whetherit was having a child or not.
I wanted to avoid the hospitalafter that because it was a
scary place for me.
Yes, I was able to walk out ofthe hospital, which I would have
to admit that many pregnantpeople are not able to do.
But I had the experience ofhearing that sound that has
(10:42):
stuck with me for over eightyears now.
I still have the experience ofhaving someone manually respond.
And how
SPEAKER_01 (10:56):
much was it affected by communication or lack thereof
in the way it made you feel?
Oh,
SPEAKER_04 (11:04):
I felt dehumanized.
I felt as if I wasn't...
Dehumanized.
Dehumanized.
I didn't feel like I was reallythere.
It almost felt like I waswatching from above what was
happening because...
How I was handled didn't feellike a human being who had
feelings, who had the capacityto experience pain, who had any
(11:27):
need for explanation of what wasgoing on and what kind of care I
would need afterwards.
Before or after?
Nope.
I wasn't even told
SPEAKER_01 (11:36):
what my aftercare would look like.
So feelings of loneliness,isolation.
Yes, yes.
Yes, very much.
Right.
SPEAKER_04 (12:02):
See, that is a part of the experience of being a
person, a Black person,specifically for me in America,
is that you are left with thequestions of whether this had
something to do with my race ornot.
I don't know because I don'tknow what the counter story
would be.
(12:22):
I do wonder if I was a whitewoman, for instance, maybe they
would have taken the time toexplain to me what was going on.
Maybe I would have been providedmore care and compassion through
that experience.
Maybe my family would have evenbeen communicated with about
what was going on with me.
But those are all questions I amstuck with.
(12:44):
And another piece of the burdenof being a person who
experiences racism.
SPEAKER_01 (12:51):
Had you ever had any experience that made you
question whether your race was arole before, even
professionally, academically?
Oh, yes.
SPEAKER_04 (13:03):
Definitely.
Definitely.
I am an outspoken young Blackwoman in a field that is
dedicated to justice.
I definitely have had...
those experiences myself withinmy educational experience
outside of that.
And I was aware of what racialbias looked like.
I was also aware of whatinstitutional and structural
(13:25):
racism were.
And I also had an idea of how tocombat them and also advocate
for myself.
I just didn't think that I wasgoing to need to do that while
also giving birth to my first
SPEAKER_01 (13:38):
child.
Right.
Have you ever had a healthcareexperience Thank you.
SPEAKER_04 (13:44):
I have.
I have.
I would say that my relationshipwith my cardiologist has been
very positive.
She actually was thecardiologist who helped me in
the hospital and provided mewith care.
And I had that opportunity tochoose my provider moving
forward after I was diagnosed.
And I said, I want her.
I want Dr.
Chang.
And she has been amazing.
(14:06):
She communicates with me.
She takes the time to explain tome what my diagnosis is, what
kind of symptoms I should orshouldn't be experiencing.
She explains what medicationsI'm taking and what they do.
She asks me questions about mylife.
She cares about my child.
She asks about how she's doingin school.
And she is just absolutelyamazing.
(14:29):
I take pictures with her just tosignify, hey, we're now eight
years into this, and I'm doing alot better because of the care
that you have provided me andthe tools that you have offered
me as a patient who is engaged.
And
SPEAKER_01 (14:45):
how's your health today?
A
SPEAKER_04 (14:47):
lot better.
Definitely a lot better.
So when I was initiallydiagnosed, my heart function was
around 5 to 10 percent.
And I was very close to notsurviving.
And now I'm able to have what myheart rate, what my heart rate
is now.
Heart function is around 45 to50 percent, which is just on the
lower end of normal.
(15:08):
I'm able to exercise four tofive times a week.
I do cardio and strengthtraining.
I feel good.
I'm able to keep up with mydaughter, which is one of the
most important indicators for meof my health.
And I feel good about life.
I feel optimistic and I feelthat I have the capacity to help
others from either notexperiencing what I did or to
(15:31):
have even better outcomes thanme.
SPEAKER_01 (15:33):
That's incredible.
What would you say to someonewho's going through pregnancy or
postpartum feeling invisible orthat they're not getting the
support or attention that theyneed, whether it's from their
health care system, their workenvironment, their family
(15:54):
circle.
What's your advice?
SPEAKER_04 (15:56):
Oh, stand in your purpose and recognize that you
are here and you have thecapacity to change how people
view you, whether they have achoice, like whether they want
to or not.
I learned to speak up for myselfno matter how much I felt that I
was on the lower end of knowingwhat to do.
(16:17):
I am not an MD.
Was that hard?
It was.
It was.
It was something I had topractice over and over again.
And sometimes you make mistakes.
You might trip up with whatyou're saying.
You may not ask the questionthat you really had in mind at
the moment that you have theopportunity to ask it, but you
still...
You still say, hey, I am notsure what that means.
(16:42):
Can you ask me or can youexplain that to me a little bit
more detail?
Sometimes it takes humility inorder to do that.
Other times it takes thehumility of others to provide
you with the space to do that.
I just think that when itbecomes a question of life or
death, that we have an onus todo all we can to ensure we get
(17:05):
the care that we need.
SPEAKER_01 (17:07):
I mean, I just want to emphasize, you have a PhD.
Yes.
Yes.
So for you to feel trepidation,uneasiness, self-conscious,
whatever, any of those things inasking more questions or
advocating for yourself is trulythe epitome of how anyone can
(17:32):
can have those feelings.
It is not a reflection on howsmart you are, how many initials
are after your name.
It can happen to anyone.
Thank you so much for sharingyour story.
I know that you quite literallycould have saved lives by
relating your experience as awoman in pregnancy and as a mom
(17:56):
and as a doctor of social work.
So I really appreciate that.
I'm very grateful to have hadthis chance to talk to you, Dr.
Charity Watkins.
Thank you.
(18:19):
Thank you so much.
(18:49):
She is a professor of history atthe University of Connecticut.
Dr.
Cooper-Owen's groundbreakingwork has shed light on the
intersections of slavery, race,and reproductive medicine,
offering crucial insights intohow history shapes our
present-day healthcare systems.
Welcome to you both.
I am so happy to be having thisconversation with you.
(19:09):
What was your reaction tohearing Dr.
Watkins' story?
Yeah, I was
SPEAKER_02 (19:16):
not shocked.
Unfortunately, I've been doingreproductive justice work since
2010.
And it's not shocking, but it'sstill jarring because it's so
traumatic.
And to see her, you know, thisaccomplished, beautiful young
woman and know that that is apart of her birth story.
You know, it was unsettling andsad.
(19:39):
You know, resiliency, I alwayssay, is born out of people's
trauma.
And so although she's resilientand is raising this beautiful
eight-year-old daughter, butthere was something still so sad
about that experience that ithad to happen, you know, in this
nation.
SPEAKER_01 (19:56):
You know, sadly, her story is not unique.
Dr.
Cooper-Owens, you know this databetter than anyone.
Black women, as you know, have athreefold increased risk of
dying from during or afterpregnancy compared to white
women.
Asian American women have thelowest risk.
(20:17):
Hispanic women are at about atwo and a half time increased
mortality risk.
It is a complicated, complexproblem.
What do you think the biggestcontributing factors are?
SPEAKER_02 (20:29):
When you look at Black women, unlike any of the
other groups that you named, andI'd also probably include Native
or Indigenous women and birthingpeople, what you find is The
markers of success thattypically act as protectors,
whether one is partnered ormarried, whether one is educated
or economic standing, if you'remiddle class, all of those
(20:52):
markers of kind ofrespectability that also
protects the patient or theexpectant mother.
They don't matter when it comesto Black women.
So the CDC discovered a fewyears ago that the person who is
most at risk in this country forpregnancy complications or even,
you know, dying after givingbirth, Black women who hold
(21:14):
PhDs.
SPEAKER_01 (21:15):
Do you think it would be different if patients
were matched to their healthcareprovider based on race?
SPEAKER_02 (21:23):
The stats say yes.
because the infant mortality,maternal mortality and morbidity
rates are decreased by over 50%.
Rachel Hardiman did a study ofalmost 2 million hospital
records in Florida from 1992 to2015.
She's at the University ofMinnesota School of Public
Health.
And she found that when therewere practitioners and
(21:46):
specialists who wereAfrican-American, those stats
were decreased by over 50%.
But we live in a nation wherethat shouldn't have to happen,
right?
That the laws should protect usall.
And so in no way do I want to bethe person to say, let's go back
to, you know, Jim Crowsegregationist era medical
(22:06):
practices.
SPEAKER_01 (22:07):
Well, in medicine, I say, you know, I'm a board
certified OBGYN.
To be a compassionateoncologist, you don't have to
have had cancer yourself.
So you're right.
We shouldn't have to...
take those kind of things intoaccount.
But it is interesting when youlook at the data and you look at
(22:28):
outcomes.
I think that's, you know,there's subjective, there's
objective, and then there'soutcomes.
I don't have to tell either ofyou the pathetic world ranking
that the United States holds interms of maternal mortality.
Eighty percent of the deathsduring and after pregnancy are
(22:49):
considered to be largelypreventable.
So we can make an impact onthis, possibly even in this
conversation, by increasingawareness.
I want to talk about, becauseit's the name of the podcast,
visibility.
You are a pregnant person, maybea pregnant woman of color.
(23:11):
How do you, what would youradvice be, Margaret, in terms of
just navigating that period oftime in a stressful, demanding
environment, whether that'sworkplace, work outside the
home, within the home,domestically, socially,
(23:31):
financially, you name it, in away that can help that person
feel more seen, more confident,more empowered.
SPEAKER_00 (23:42):
I think this is advice that I hand out to a lot
of people who are going todoctors, is that I know I go to
a doctor and I forget half ofwhat I had thought about that I
needed to say.
And I think mentally andemotionally, it's often very,
very triggering to go to adoctor's office.
I mean, it may be that themedical profession, the more
(24:06):
assertive you are, that it istaken as an affront and as a
challenge.
SPEAKER_02 (24:12):
Yeah.
I often tell people when I'mgiving talks or just consulting
with folks to ask for a patientnavigator or doula.
You know, and so oftentimespeople are like, what do they
do?
I'm like, they advocate.
Like, that's the most importantbecause a lot of people feel
really intimidated because it'salready an unequal situation,
(24:32):
right?
So you're like, doctor, nurse,and then they're like, hey,
Rebecca.
Hey, Shaniqua.
You know, so there's alreadythat kind of imbalance.
And so to be able to havesomeone who can advocate for
you, but also when you're atyour most fragile state, right?
I mean, you want to concentrateThank you so much.
(25:15):
that can help you data track,that people can go to, you know,
there's an Earth app, all ofthose kinds of things.
SPEAKER_01 (25:21):
I want to ask both of you about something that got
my attention.
The World Health Organization,actually, to address the
maternal mortality crisis, andwe may be doing among the worst
in the world, but sadly, a lotof countries are not doing well.
They recommend four healthcontacts, doesn't have to be an
(25:43):
in-person visit, but a healthcontact, they call it, in the
first six weeks of thepostpartum period.
Oh, I think that's a great idea.
Forty percent of American womenskip their one postpartum visit,
which is why in the UnitedStates there's this big push for
the so-called fourth trimester,which I loved that term.
(26:05):
It's the period of time after awoman actually gives birth where
traditionally and historically,I would love to hear your
viewpoint on this, the wholehealthcare system unplugs from
that woman.
It's like you've done your job,you've incubated a new human,
now a all of our attention willfocus on that baby.
(26:25):
And you just go back to, youknow, the way things were before
you were pregnant.
Except nothing's the way it wasbefore.
That's right.
And so that fourth trimester isan opportune time for
information, for encounters withany kind of healthcare nurse,
practitioner, midwife,obstetrician, family medicine
(26:46):
physician.
What's your advice for thewoman?
Because it has to start with us.
Right.
We can't rely.
We're in critical condition.
We can't wait for someone to fixthis for us, even though I know
we're trying.
What's your advice, both of you,to the woman to say, okay, I
know about the fourth trimesternow.
(27:09):
How do I be a better new mom andperson in that fourth trimester
for myself?
UNKNOWN (27:17):
Wow.
SPEAKER_02 (27:18):
So I think the personal is political.
I grew up in a very small townin a poor county in South
Carolina that did not have amaternity ward since 1990.
And that's when I graduated highschool.
And so what I would say forpeople who live in that
situation, there's no publictransportation system, those
kinds of things.
Make sure you have a network ofsupport.
(27:38):
Because doulas and midwives justdon't exist in those places.
That's right.
You can't just jump on the busor the subway.
So you want to make sure thatyour friends and family are
there to support you.
You
SPEAKER_00 (27:47):
know, the problem is that we still don't understand
postpartum depression and howprevalent it is.
Right.
It is the shame and theconfusion and the just— utter, I
mean, they're disgusted withthemselves that they don't feel
(28:08):
this bond that they're supposedto feel.
Or the stigma associated withit.
It's so lonely.
It's often a secret that theyfeel that way.
And so I really think thattrying to spread the word about
just how common some, I mean,it's on a spectrum just like
everything else.
SPEAKER_01 (28:26):
You know, obviously now, as you said, it's a
spectrum.
Perinatal mood disorders is nowthe term because it's been
recognized that it's not justdepression but also postpartum
anxiety and a lot of women whoexperience that after delivery
in the postpartum period alsohad antenatal during their
(28:50):
pregnancy mood disorders thatoftentimes went unrecognized
underdiagnosed undertreated orundermanaged which of course is
another huge problem but thebiggest myth that I have heard
in my 20 years as an OBGYN,which absolutely drives me right
(29:10):
up the wall, is when people sayto a woman who clearly has a
mood disorder surroundingpregnancy, you're just tired.
You know what?
I don't know.
The woman will say, do you thinkI could have postpartum
depression?
And a lot of times the answeris, you know, I feel like you're
(29:31):
just tired.
It takes a while to become amom.
And I cannot emphasize thisenough, and you know this as a
mental health professional, youknow this as a historian,
particularly in reproductivemedicine, it can be
life-threatening.
This is not fluff.
This isn't, you know, somethingthat's just going to
(29:52):
miraculously improve if a womantakes a nap.
And there are economicconsequences to this, right?
I mean, put into words what youthink the actual financial toll,
because we've talked aboutsocietal toll, cultural, racial
and ethnic, economic andfinancial toll of this maternal
(30:15):
mortality issue is significant.
SPEAKER_02 (30:19):
It's hugely significant.
I mean, so this is, it's socomplicated.
It's so nuanced.
The amount of money that isbeing poured into the
reproductive medicine field isjust astronomical.
And then you think about thenegative medical outcomes.
(30:39):
And so I'm like, something hasto give here, right?
The number of C-sections thatare often scheduled, you know,
and not for the benefit of theperson giving birth.
And yet, as you said, the UnitedStates remains the most
dangerous place for women, youknow, and particularly women of
color to give birth.
SPEAKER_01 (30:58):
The United States, as you know, is the only country
that does not federally mandatepaid births.
Really?
Yes.
Wow.
Federally mandated.
There are some states that havestarted to do it, but as a
country, we are the onlycountry.
That's right.
Let that sink in.
(31:20):
And Dr.
Cooper-Owens, how important doyou think the male voice is in
solving this problem?
You
SPEAKER_02 (31:27):
know, I think it is important.
I don't think we need to besiloed off.
But what I do think is importantis to have a male voice that is
willing to listen and notnecessarily be amplified in the
ways that it has been amplifiedin the past.
And so to also be willing towork in concert with...
(31:51):
women and communities.
You know, there's something thatdoulas that I've worked with,
you know, they talk about fullspectrum doula care.
And so that's at the moment thatsomeone finds out they're
pregnant to that kind of postcare that you referenced before.
And so to know that as a maninvolved in this field, that it
(32:12):
has to be collaborative, thatthe large complaint that I've
heard from women across theboard is that people just don't
listen to our voices.
And so, you know, to be able tobe a part of a project like the
Visibility Cab, it really isabout erasing the invisible,
right?
And bringing to the forepointsomething that is visible.
(32:34):
And so one of the wonderfulthings that social media has
done is you can now find a lotabout maternal care.
You can find a lot aboutreproductive rights reproductive
justice, and you can learn fromvetted sources.
And so I think that is alsoimportant.
But I just think men need tolisten to what their patients
(32:58):
are telling them.
And to also...
Be empathetic to imagineyourself in the place of someone
who is, as you said, frightened.
This might be the firstpregnancy or the first
successful pregnancy and whatthat means after someone has
experienced such loss.
And so I just think listening,being empathetic, being willing
(33:22):
to collaborate is are important.
SPEAKER_01 (33:25):
I'm going to ask you both a question that I like to
ask our experts at the end.
I would like you to imagine thatyou are single-handedly in
charge, responsible for fixingthis whole situation.
And to start with the actualwoman who may be listening to
you, what would your number onepiece of advice be?
SPEAKER_02 (33:51):
Ooh, I would have...
Birthing centers, centersplural, in every state, in every
territory that works in concertwith OBGYNs, lactation
specialists, pediatricians,midwives, doulas.
I mean, they would all be incommunity for the successful
(34:14):
care program.
Let's
SPEAKER_00 (34:17):
do it.
And I'll make an addition tothat model.
SPEAKER_01 (34:45):
Communication can be improved on everyone, 360
degrees, from the healthcareprofessional to the patient, to
the patient support system, tothe hospital staff, to the
workplace.
Communication, education,awareness, starting from a place
of no stigma, let's add a lot ofresources that have been shown
(35:11):
to be effective and effective.
Right.
Absolutely.
(35:33):
Absolutely.
Such an important, we couldliterally talk about this for
hours, but I think that yourtips, your insights, your
perspective, your expertise hasbeen incredibly helpful.
So thank you both so much forspending some time.
(35:56):
Thank you.
And thank you to our listeners.
We really hope this episode ofThe Visibility Gap has helped
you and your loved ones feelseen and empowered.
If you found it valuable, pleasedon't forget to share it, like
it, and subscribe to stayconnected with us.
Welcome to The Visibility Gap.
I'm Dr.
Jen Ashton.
Today we're diving into acritical and urgent
conversation, maternalmortality.
Did you know that Black women inthe United States are two and a
half to three times more likelyto die from pregnancy-related
(00:20):
causes?
than white women and three timesmore likely to die than Hispanic
women.
These statistics, reported bythe Commonwealth Fund,
underscore a devastatingreality.
According to the CDC,disparities in maternal
mortality are driven by acombination of complex factors,
including differences in healthcare quality, chronic health
(00:42):
conditions, structural racism,and implicit bias.
These barriersdisproportionately impact Black
women.
This is what the visibility gapis all about, shining a light on
inequities that demand urgentattention.
In this episode, we'll unpackthe systemic issues fueling
these disparities, explore howimplicit biases and healthcare
(01:06):
barriers perpetuate the issue,and discuss actionable steps to
close this deadly gap.
It's a tough but essentialconversation about lives at risk
and Thank you so much for comingto share your story about your
(01:40):
pregnancy and your experience.
First, I want to say
SPEAKER_04 (01:43):
thank you so much for addressing this very
important topic.
So before I became pregnant, Iwas a doctoral student working
on my PhD in social work.
I was active.
I exercised pretty regularly.
I was healthy.
I had no health concerns.
(02:04):
The most And we should just
SPEAKER_01 (02:16):
mention for people who aren't familiar, to get a
Ph.D.
in social work takes how manyyears?
Oh, it depends.
SPEAKER_04 (02:24):
So I would say five to seven years, potentially.
SPEAKER_01 (02:28):
It's longer in many times and many cases to get a
PhD than to get an MD.
So that is really impressive.
But just again, to summarize,higher education.
Yes.
You had a job.
You had health care.
You were motivated.
You were informed.
Yes.
all of this going into yourpregnancy.
SPEAKER_04 (02:48):
Yes, and also at that point had been married for
two years before I found out Iwas pregnant.
And my husband was amicrobiologist and had his PhD.
And so we were two, a family oftwo with PhDs.
And, you know, that's a rareoccasion and what I thought
(03:09):
would be something that would bea positive factor for me.
SPEAKER_01 (03:14):
And you were how old when you...
I was
SPEAKER_04 (03:16):
30 when I had my daughter.
SPEAKER_01 (03:19):
Okay, 30 and healthy when you delivered.
Yes.
Then when did things change?
When did your experience withpregnancy kind of take a turn?
SPEAKER_04 (03:27):
No major concerns until...
It was time to deliver.
And my daughter, who the joy ofmy life, was very, very
comfortable.
She did not want to leave.
She actually arrived 10 daysafter her due date.
And it was an eviction notice.
(03:48):
I would have to say.
She had to be evicted.
And I had to go through,unfortunately, an unplanned
cesarean delivery.
I had spent about two to threedays in the hospital trying to
do natural birth, and it justwasn't progressing.
And so they told me that inorder to avoid any
(04:09):
complications, that we wouldhave to do a cesarean.
SPEAKER_01 (04:12):
So as you probably know, No, now, or hopefully this
was explained to you at thetime, from 41 to 42 weeks of
gestation, of pregnancy, therisks to the fetus and to the
mom really sharply increase,which is why usually...
antenatal testing of the fetusand the mom really picks up if a
(04:38):
woman goes significantly afterher due date.
So were you having additionalultrasounds and blood tests and
blood pressure checks, anythinglike that?
Not that I can
SPEAKER_04 (04:48):
remember.
No, I don't remember anyadditional tests.
It was actually not determineduntil I had been admitted for
her to be delivered that I wastold that I need a cesarean
delivery.
So it was There was noconversation about me needing it
before, maybe two hours beforeit actually happened.
SPEAKER_01 (05:08):
So you were asked to come to the hospital for an
induction.
Yes.
And...
What transpired between when youchecked into the hospital to the
C-section?
SPEAKER_04 (05:18):
I mean, we went through almost every single
intervention possible to inducebefore getting to the point of
doing a cesarean.
SPEAKER_01 (05:27):
So they said you're not dilating, she's not
descending.
It's a failed induction, whichis the OB term.
So we're going to recommenddelivery by a C-section.
And then what was it like whenyou first held her in your arms?
SPEAKER_04 (05:44):
Oh, so my husband and I would tell the story to
her about the sound that cameout of him because he was
actually the first one to seeher versus me.
And so here I was, this baby.
Right.
Right.
(06:08):
Like this noise just came out ofhim just innately.
And then I just remember cryingbecause, you know, we had went
through so much to have her.
We weren't sure how we weregoing to get through this
pregnancy as two young adultsstarting our lives together.
But we were just overjoyed.
(06:28):
She was going to be the firstgrandchild on his side of the
family and first greatgrandchild.
And so she was the start of anew generation.
To see her little face when Ifirst delivered her was just the
best gift ever.
SPEAKER_01 (06:44):
Incredible.
I just got chills.
And then what happened in termsof your postpartum course?
Because that was for you...
where things really started tochange?
SPEAKER_04 (06:56):
Yeah, before I even left the hospital, things began
to change.
So I remember at least, I thinkmaybe 24 hours after my
cesareans, and I actually wantto say it's a surgery.
It's a major surgery.
Major surgery through some majormuscles.
Laparotomy, incision.
Exactly.
(07:17):
I was encouraged to walk aroundmy hospital room.
And so I did that.
I was one who was going toListen to what the doctors
recommended and follow throughon those terms.
And so I began walking around myhospital room and there was one
moment when I was sitting in thechair for a period of time
talking to family members whowere visiting and I got up and I
(07:40):
literally still now to this dayhear the sound of blood hitting
that tile floor.
just blood just rushed out of meas soon as I stood up.
And here was my husband who wasscared to see something like
that happen.
And then my sister-in-law wasthere holding my daughter.
SPEAKER_01 (07:58):
And this was the First day after?
Yes.
And it was not, just to clarify,it was not coming from your
incision.
No.
It was vaginal.
Right, right.
SPEAKER_04 (08:08):
And so my husband went to go find a doctor, and I
laid in bed just to prepare forwhat, I don't know what was
going to happen.
And so as my sister-in-law washolding my one-day-old, daughter
and looking out the window justto try to give me some privacy.
My husband was holding my hand.
(08:28):
A doctor came in, didn't reallyprovide much explanation of what
was going on other than I hadclots.
And he physically, manuallyremoved the clots while I was in
my hospital bed with nomedication, no pain relief or
anything, just manually removed.
(08:49):
Reached up into your uterus.
Twice.
Twice.
Twice.
And the pain was extraordinary.
The pain was something I wouldnever want to wish on anyone.
And I remember the scream that Ilet out.
And my dad, who was waiting inthe waiting area outside,
(09:10):
actually heard me scream.
And that was his introduction tohis granddaughter, was hearing
me scream.
And It was just like he came–the doctor came in, and then he
was gone.
SPEAKER_01 (09:24):
Was a nurse in the room with you?
No.
No.
Okay.
So that sounds incrediblytraumatic.
It was.
What happened after
SPEAKER_04 (09:35):
that?
Well– Continued my stay in thehospital for, I think, two
additional days.
I was discharged and we wenthome with my daughter.
And overall, I was feeling okay.
I, of course, had to preparemyself for recovery from a major
(09:56):
surgery while also preparingmyself for entering motherhood.
SPEAKER_01 (10:00):
And how much did the experience you had just in the
hospital affect your feelingspersonally?
about pregnancy, possibly futurepregnancies, and particularly in
the experiences that you sharewith your friends and family.
SPEAKER_04 (10:17):
Oh, I did not want to think about going back to the
hospital for any reason, whetherit was having a child or not.
I wanted to avoid the hospitalafter that because it was a
scary place for me.
Yes, I was able to walk out ofthe hospital, which I would have
to admit that many pregnantpeople are not able to do.
But I had the experience ofhearing that sound that has
(10:42):
stuck with me for over eightyears now.
I still have the experience ofhaving someone manually respond.
And how
SPEAKER_01 (10:56):
much was it affected by communication or lack thereof
in the way it made you feel?
Oh,
SPEAKER_04 (11:04):
I felt dehumanized.
I felt as if I wasn't...
Dehumanized.
Dehumanized.
I didn't feel like I was reallythere.
It almost felt like I waswatching from above what was
happening because...
How I was handled didn't feellike a human being who had
feelings, who had the capacityto experience pain, who had any
(11:27):
need for explanation of what wasgoing on and what kind of care I
would need afterwards.
Before or after?
Nope.
I wasn't even told
SPEAKER_01 (11:36):
what my aftercare would look like.
So feelings of loneliness,isolation.
Yes, yes.
Yes, very much.
Right.
SPEAKER_04 (12:02):
See, that is a part of the experience of being a
person, a Black person,specifically for me in America,
is that you are left with thequestions of whether this had
something to do with my race ornot.
I don't know because I don'tknow what the counter story
would be.
(12:22):
I do wonder if I was a whitewoman, for instance, maybe they
would have taken the time toexplain to me what was going on.
Maybe I would have been providedmore care and compassion through
that experience.
Maybe my family would have evenbeen communicated with about
what was going on with me.
But those are all questions I amstuck with.
(12:44):
And another piece of the burdenof being a person who
experiences racism.
SPEAKER_01 (12:51):
Had you ever had any experience that made you
question whether your race was arole before, even
professionally, academically?
Oh, yes.
SPEAKER_04 (13:03):
Definitely.
Definitely.
I am an outspoken young Blackwoman in a field that is
dedicated to justice.
I definitely have had...
those experiences myself withinmy educational experience
outside of that.
And I was aware of what racialbias looked like.
I was also aware of whatinstitutional and structural
(13:25):
racism were.
And I also had an idea of how tocombat them and also advocate
for myself.
I just didn't think that I wasgoing to need to do that while
also giving birth to my first
SPEAKER_01 (13:38):
child.
Right.
Have you ever had a healthcareexperience Thank you.
SPEAKER_04 (13:44):
I have.
I have.
I would say that my relationshipwith my cardiologist has been
very positive.
She actually was thecardiologist who helped me in
the hospital and provided mewith care.
And I had that opportunity tochoose my provider moving
forward after I was diagnosed.
And I said, I want her.
I want Dr.
Chang.
And she has been amazing.
(14:06):
She communicates with me.
She takes the time to explain tome what my diagnosis is, what
kind of symptoms I should orshouldn't be experiencing.
She explains what medicationsI'm taking and what they do.
She asks me questions about mylife.
She cares about my child.
She asks about how she's doingin school.
And she is just absolutelyamazing.
(14:29):
I take pictures with her just tosignify, hey, we're now eight
years into this, and I'm doing alot better because of the care
that you have provided me andthe tools that you have offered
me as a patient who is engaged.
And
SPEAKER_01 (14:45):
how's your health today?
A
SPEAKER_04 (14:47):
lot better.
Definitely a lot better.
So when I was initiallydiagnosed, my heart function was
around 5 to 10 percent.
And I was very close to notsurviving.
And now I'm able to have what myheart rate, what my heart rate
is now.
Heart function is around 45 to50 percent, which is just on the
lower end of normal.
(15:08):
I'm able to exercise four tofive times a week.
I do cardio and strengthtraining.
I feel good.
I'm able to keep up with mydaughter, which is one of the
most important indicators for meof my health.
And I feel good about life.
I feel optimistic and I feelthat I have the capacity to help
others from either notexperiencing what I did or to
(15:31):
have even better outcomes thanme.
SPEAKER_01 (15:33):
That's incredible.
What would you say to someonewho's going through pregnancy or
postpartum feeling invisible orthat they're not getting the
support or attention that theyneed, whether it's from their
health care system, their workenvironment, their family
(15:54):
circle.
What's your advice?
SPEAKER_04 (15:56):
Oh, stand in your purpose and recognize that you
are here and you have thecapacity to change how people
view you, whether they have achoice, like whether they want
to or not.
I learned to speak up for myselfno matter how much I felt that I
was on the lower end of knowingwhat to do.
(16:17):
I am not an MD.
Was that hard?
It was.
It was.
It was something I had topractice over and over again.
And sometimes you make mistakes.
You might trip up with whatyou're saying.
You may not ask the questionthat you really had in mind at
the moment that you have theopportunity to ask it, but you
still...
You still say, hey, I am notsure what that means.
(16:42):
Can you ask me or can youexplain that to me a little bit
more detail?
Sometimes it takes humility inorder to do that.
Other times it takes thehumility of others to provide
you with the space to do that.
I just think that when itbecomes a question of life or
death, that we have an onus todo all we can to ensure we get
(17:05):
the care that we need.
SPEAKER_01 (17:07):
I mean, I just want to emphasize, you have a PhD.
Yes.
Yes.
So for you to feel trepidation,uneasiness, self-conscious,
whatever, any of those things inasking more questions or
advocating for yourself is trulythe epitome of how anyone can
(17:32):
can have those feelings.
It is not a reflection on howsmart you are, how many initials
are after your name.
It can happen to anyone.
Thank you so much for sharingyour story.
I know that you quite literallycould have saved lives by
relating your experience as awoman in pregnancy and as a mom
(17:56):
and as a doctor of social work.
So I really appreciate that.
I'm very grateful to have hadthis chance to talk to you, Dr.
Charity Watkins.
Thank you.
(18:19):
Thank you so much.
(18:49):
She is a professor of history atthe University of Connecticut.
Dr.
Cooper-Owen's groundbreakingwork has shed light on the
intersections of slavery, race,and reproductive medicine,
offering crucial insights intohow history shapes our
present-day healthcare systems.
Welcome to you both.
I am so happy to be having thisconversation with you.
(19:09):
What was your reaction tohearing Dr.
Watkins' story?
Yeah, I was
SPEAKER_02 (19:16):
not shocked.
Unfortunately, I've been doingreproductive justice work since
2010.
And it's not shocking, but it'sstill jarring because it's so
traumatic.
And to see her, you know, thisaccomplished, beautiful young
woman and know that that is apart of her birth story.
You know, it was unsettling andsad.
(19:39):
You know, resiliency, I alwayssay, is born out of people's
trauma.
And so although she's resilientand is raising this beautiful
eight-year-old daughter, butthere was something still so sad
about that experience that ithad to happen, you know, in this
nation.
SPEAKER_01 (19:56):
You know, sadly, her story is not unique.
Dr.
Cooper-Owens, you know this databetter than anyone.
Black women, as you know, have athreefold increased risk of
dying from during or afterpregnancy compared to white
women.
Asian American women have thelowest risk.
(20:17):
Hispanic women are at about atwo and a half time increased
mortality risk.
It is a complicated, complexproblem.
What do you think the biggestcontributing factors are?
SPEAKER_02 (20:29):
When you look at Black women, unlike any of the
other groups that you named, andI'd also probably include Native
or Indigenous women and birthingpeople, what you find is The
markers of success thattypically act as protectors,
whether one is partnered ormarried, whether one is educated
or economic standing, if you'remiddle class, all of those
(20:52):
markers of kind ofrespectability that also
protects the patient or theexpectant mother.
They don't matter when it comesto Black women.
So the CDC discovered a fewyears ago that the person who is
most at risk in this country forpregnancy complications or even,
you know, dying after givingbirth, Black women who hold
(21:14):
PhDs.
SPEAKER_01 (21:15):
Do you think it would be different if patients
were matched to their healthcareprovider based on race?
SPEAKER_02 (21:23):
The stats say yes.
because the infant mortality,maternal mortality and morbidity
rates are decreased by over 50%.
Rachel Hardiman did a study ofalmost 2 million hospital
records in Florida from 1992 to2015.
She's at the University ofMinnesota School of Public
Health.
And she found that when therewere practitioners and
(21:46):
specialists who wereAfrican-American, those stats
were decreased by over 50%.
But we live in a nation wherethat shouldn't have to happen,
right?
That the laws should protect usall.
And so in no way do I want to bethe person to say, let's go back
to, you know, Jim Crowsegregationist era medical
(22:06):
practices.
SPEAKER_01 (22:07):
Well, in medicine, I say, you know, I'm a board
certified OBGYN.
To be a compassionateoncologist, you don't have to
have had cancer yourself.
So you're right.
We shouldn't have to...
take those kind of things intoaccount.
But it is interesting when youlook at the data and you look at
(22:28):
outcomes.
I think that's, you know,there's subjective, there's
objective, and then there'soutcomes.
I don't have to tell either ofyou the pathetic world ranking
that the United States holds interms of maternal mortality.
Eighty percent of the deathsduring and after pregnancy are
(22:49):
considered to be largelypreventable.
So we can make an impact onthis, possibly even in this
conversation, by increasingawareness.
I want to talk about, becauseit's the name of the podcast,
visibility.
You are a pregnant person, maybea pregnant woman of color.
(23:11):
How do you, what would youradvice be, Margaret, in terms of
just navigating that period oftime in a stressful, demanding
environment, whether that'sworkplace, work outside the
home, within the home,domestically, socially,
(23:31):
financially, you name it, in away that can help that person
feel more seen, more confident,more empowered.
SPEAKER_00 (23:42):
I think this is advice that I hand out to a lot
of people who are going todoctors, is that I know I go to
a doctor and I forget half ofwhat I had thought about that I
needed to say.
And I think mentally andemotionally, it's often very,
very triggering to go to adoctor's office.
I mean, it may be that themedical profession, the more
(24:06):
assertive you are, that it istaken as an affront and as a
challenge.
SPEAKER_02 (24:12):
Yeah.
I often tell people when I'mgiving talks or just consulting
with folks to ask for a patientnavigator or doula.
You know, and so oftentimespeople are like, what do they
do?
I'm like, they advocate.
Like, that's the most importantbecause a lot of people feel
really intimidated because it'salready an unequal situation,
(24:32):
right?
So you're like, doctor, nurse,and then they're like, hey,
Rebecca.
Hey, Shaniqua.
You know, so there's alreadythat kind of imbalance.
And so to be able to havesomeone who can advocate for
you, but also when you're atyour most fragile state, right?
I mean, you want to concentrateThank you so much.
(25:15):
that can help you data track,that people can go to, you know,
there's an Earth app, all ofthose kinds of things.
SPEAKER_01 (25:21):
I want to ask both of you about something that got
my attention.
The World Health Organization,actually, to address the
maternal mortality crisis, andwe may be doing among the worst
in the world, but sadly, a lotof countries are not doing well.
They recommend four healthcontacts, doesn't have to be an
(25:43):
in-person visit, but a healthcontact, they call it, in the
first six weeks of thepostpartum period.
Oh, I think that's a great idea.
Forty percent of American womenskip their one postpartum visit,
which is why in the UnitedStates there's this big push for
the so-called fourth trimester,which I loved that term.
(26:05):
It's the period of time after awoman actually gives birth where
traditionally and historically,I would love to hear your
viewpoint on this, the wholehealthcare system unplugs from
that woman.
It's like you've done your job,you've incubated a new human,
now a all of our attention willfocus on that baby.
(26:25):
And you just go back to, youknow, the way things were before
you were pregnant.
Except nothing's the way it wasbefore.
That's right.
And so that fourth trimester isan opportune time for
information, for encounters withany kind of healthcare nurse,
practitioner, midwife,obstetrician, family medicine
(26:46):
physician.
What's your advice for thewoman?
Because it has to start with us.
Right.
We can't rely.
We're in critical condition.
We can't wait for someone to fixthis for us, even though I know
we're trying.
What's your advice, both of you,to the woman to say, okay, I
know about the fourth trimesternow.
(27:09):
How do I be a better new mom andperson in that fourth trimester
for myself?
UNKNOWN (27:17):
Wow.
SPEAKER_02 (27:18):
So I think the personal is political.
I grew up in a very small townin a poor county in South
Carolina that did not have amaternity ward since 1990.
And that's when I graduated highschool.
And so what I would say forpeople who live in that
situation, there's no publictransportation system, those
kinds of things.
Make sure you have a network ofsupport.
(27:38):
Because doulas and midwives justdon't exist in those places.
That's right.
You can't just jump on the busor the subway.
So you want to make sure thatyour friends and family are
there to support you.
You
SPEAKER_00 (27:47):
know, the problem is that we still don't understand
postpartum depression and howprevalent it is.
Right.
It is the shame and theconfusion and the just— utter, I
mean, they're disgusted withthemselves that they don't feel
(28:08):
this bond that they're supposedto feel.
Or the stigma associated withit.
It's so lonely.
It's often a secret that theyfeel that way.
And so I really think thattrying to spread the word about
just how common some, I mean,it's on a spectrum just like
everything else.
SPEAKER_01 (28:26):
You know, obviously now, as you said, it's a
spectrum.
Perinatal mood disorders is nowthe term because it's been
recognized that it's not justdepression but also postpartum
anxiety and a lot of women whoexperience that after delivery
in the postpartum period alsohad antenatal during their
(28:50):
pregnancy mood disorders thatoftentimes went unrecognized
underdiagnosed undertreated orundermanaged which of course is
another huge problem but thebiggest myth that I have heard
in my 20 years as an OBGYN,which absolutely drives me right
(29:10):
up the wall, is when people sayto a woman who clearly has a
mood disorder surroundingpregnancy, you're just tired.
You know what?
I don't know.
The woman will say, do you thinkI could have postpartum
depression?
And a lot of times the answeris, you know, I feel like you're
(29:31):
just tired.
It takes a while to become amom.
And I cannot emphasize thisenough, and you know this as a
mental health professional, youknow this as a historian,
particularly in reproductivemedicine, it can be
life-threatening.
This is not fluff.
This isn't, you know, somethingthat's just going to
(29:52):
miraculously improve if a womantakes a nap.
And there are economicconsequences to this, right?
I mean, put into words what youthink the actual financial toll,
because we've talked aboutsocietal toll, cultural, racial
and ethnic, economic andfinancial toll of this maternal
(30:15):
mortality issue is significant.
SPEAKER_02 (30:19):
It's hugely significant.
I mean, so this is, it's socomplicated.
It's so nuanced.
The amount of money that isbeing poured into the
reproductive medicine field isjust astronomical.
And then you think about thenegative medical outcomes.
(30:39):
And so I'm like, something hasto give here, right?
The number of C-sections thatare often scheduled, you know,
and not for the benefit of theperson giving birth.
And yet, as you said, the UnitedStates remains the most
dangerous place for women, youknow, and particularly women of
color to give birth.
SPEAKER_01 (30:58):
The United States, as you know, is the only country
that does not federally mandatepaid births.
Really?
Yes.
Wow.
Federally mandated.
There are some states that havestarted to do it, but as a
country, we are the onlycountry.
That's right.
Let that sink in.
(31:20):
And Dr.
Cooper-Owens, how important doyou think the male voice is in
solving this problem?
You
SPEAKER_02 (31:27):
know, I think it is important.
I don't think we need to besiloed off.
But what I do think is importantis to have a male voice that is
willing to listen and notnecessarily be amplified in the
ways that it has been amplifiedin the past.
And so to also be willing towork in concert with...
(31:51):
women and communities.
You know, there's something thatdoulas that I've worked with,
you know, they talk about fullspectrum doula care.
And so that's at the moment thatsomeone finds out they're
pregnant to that kind of postcare that you referenced before.
And so to know that as a maninvolved in this field, that it
(32:12):
has to be collaborative, thatthe large complaint that I've
heard from women across theboard is that people just don't
listen to our voices.
And so, you know, to be able tobe a part of a project like the
Visibility Cab, it really isabout erasing the invisible,
right?
And bringing to the forepointsomething that is visible.
(32:34):
And so one of the wonderfulthings that social media has
done is you can now find a lotabout maternal care.
You can find a lot aboutreproductive rights reproductive
justice, and you can learn fromvetted sources.
And so I think that is alsoimportant.
But I just think men need tolisten to what their patients
(32:58):
are telling them.
And to also...
Be empathetic to imagineyourself in the place of someone
who is, as you said, frightened.
This might be the firstpregnancy or the first
successful pregnancy and whatthat means after someone has
experienced such loss.
And so I just think listening,being empathetic, being willing
(33:22):
to collaborate is are important.
SPEAKER_01 (33:25):
I'm going to ask you both a question that I like to
ask our experts at the end.
I would like you to imagine thatyou are single-handedly in
charge, responsible for fixingthis whole situation.
And to start with the actualwoman who may be listening to
you, what would your number onepiece of advice be?
SPEAKER_02 (33:51):
Ooh, I would have...
Birthing centers, centersplural, in every state, in every
territory that works in concertwith OBGYNs, lactation
specialists, pediatricians,midwives, doulas.
I mean, they would all be incommunity for the successful
(34:14):
care program.
Let's
SPEAKER_00 (34:17):
do it.
And I'll make an addition tothat model.
SPEAKER_01 (34:45):
Communication can be improved on everyone, 360
degrees, from the healthcareprofessional to the patient, to
the patient support system, tothe hospital staff, to the
workplace.
Communication, education,awareness, starting from a place
of no stigma, let's add a lot ofresources that have been shown
(35:11):
to be effective and effective.
Right.
Absolutely.
(35:33):
Absolutely.
Such an important, we couldliterally talk about this for
hours, but I think that yourtips, your insights, your
perspective, your expertise hasbeen incredibly helpful.
So thank you both so much forspending some time.
(35:56):
Thank you.
And thank you to our listeners.
We really hope this episode ofThe Visibility Gap has helped
you and your loved ones feelseen and empowered.
If you found it valuable, pleasedon't forget to share it, like
it, and subscribe to stayconnected with us.
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