April 24, 2020 • 39 mins
Yesterday, on “Next Question with Katie Couric,” we heard the devastating story of how one mother, Kira Johnson, became a part of a shameful statistic:that between 700 and 900 American women die each year from pregnancy and childbirth-related causes. We learned that structural issues like racism as well as an increase in medical interventions during labor, have led to more women dying from pregnancy and childbirth today than they did 30 years ago. Today, in Part 2, Katie tackles her next question: What is being done to better protect American mothers, and particularly women of color? Katie talks to Olympic runner Allyson Felix who, in 2018, became one of the 50,000 women who nearly die from pregnancy-related complications. “Being a professional athlete,” Allyson says, “I just thought that will never happen to me.” Katie also hears from public health leaders like Dr. Debra Bingham and politicians like New Jersey’s First Lady Tammy Murphy who are actively trying to turn high maternal mortality rates around. Today, given the additional challenges posed by the coronavirus pandemic and the existing racial health disparities COVID-19 has only exacerbated, this kind of work is more urgent and relevant than ever.
Guests and resources for this episode include:
- Olympic runner Allyson Felix helps March of Dimes advocate for the health and safety of moms and babies.
- New Jersey First Lady Tammy Murphy launched in 2019 Nurture NJ, a statewide awareness campaign committed to reducing maternal mortality and morbidity.
- New moms can stay on top of symptoms with the Post-Birth Warning Signs factsheet from the The Institute for Perinatal Quality Improvement
- To help families like the Johnsons, visit 4Kira4Moms.com
For more information, sign up for Katie Couric’s newsletter Wake-Up Call at KatieCouric.com.
Correction (4-27-20):
The podcast incorrectly attributes the "Save Your Life" POST BIRTH warning signs handout to the Institute for Perinatal Quality Improvement. It was developed under the leadership of Debra Bingham, DrPH, RN, FAAN when she worked at the Association of Women's Health Obstetrics and Neonatal Nurses.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hi everyone, I'm Katie Couric, and welcome to Next Question Today,
part two of our look at America's maternal mortality crisis.
If you haven't listened to Part one, I highly recommend
you start there. In it, we heard the devastating story
of how one mother, Kira Johnson, became a part of
(00:22):
a shameful statistic that between seven hundred and nine hundred
American women die every year from pregnancy and childbirth related causes,
and six of those deaths, including Kira's, could have been prevented.
Here's Kira's husband, Charles Johnson. What happened to Kira was
(00:42):
not just a medical tragedy with a medical catastrophe. Everything
that could have went wrong, in fact did so. Not
only did that doctor failed Kira, but the hospital, in
their policies and procedures, failed her. We learned that structural
issues like racism and sexism, as well as an increase
in medical interventions during labor, have led to more women
(01:05):
dying from pregnancy and childbirth today than they did thirty
years ago, a fact that makes the US the only
country in the developed world to see its maternal mortality
rate go up today. In Part two, we tackle my
next question, what is being done to better protect American
(01:25):
mothers from becoming a part of that horrifying statistic. She
was told it was a fluke, And here I was
looking at these data points and saying she wasn't a fluke.
She was actually part of a really important trend that
has not been covered in the US. For investigative reporter
Nina Martin, this question is a personal one. In two
thousand and fifteen, when she and her team at Pro
(01:48):
Publica began reporting their Lost Mother's Project, an investigation into
maternal mortality, they found an alarming statistic that, in addition
to the deaths, there are fifty thousand women who nearly
die every year from pregnancy and childbirth related issues. And
we're not talking about like they have gestational diabetes and
(02:11):
then they cut back on you know whatever, um, the
the amount of sugar, the ice cream that they ate
in pregnancy and then everything is okay. We're talking about
women who, you know, go to the hospital and go
into cardiac arrest. We're talking about women who nearly bleed out.
We're talking about women who have life threatening um infections
that keep them hospitalized for weeks. And UM, that was
(02:34):
really super interesting to me both because of the size
um again, which really was not what people were talking
about in the parenting magazine world that I had spent
some time in. But it also really connected with me
on a personal level because my sister had um given birth.
I've I've three sisters, three yeah, and um the oldest
(02:57):
of five. Nina Martin's sister Meal had given birth to
a boy named Aiden in Texas in two thousand. She
and her husband both had good jobs. She was a paralegal,
he was a lawyer, and they had access to good
health care. She was very healthy, had a really good pregnancy,
(03:17):
and she nearly died after in her postpartum period she
had to very severe infections, one of which was they've
caught and fixed in the hospital, and the second one
which nearly killed her. And I remember going and trying
to help out at the time and how freaked out
everybody was, and then it was kind of over. People
said to her, you know, oh, well, you know this
(03:39):
never happened to anybody. We have no idea that we've
never seen anything like this before. And and also, um,
don't worry, you're a little head about it, because you're
fine now and your baby's fine, and go home and
live your life and be happy that everything's okay. And
so her experience was completely erased. Being a professional athlete,
(04:02):
I just thought that will never happen to me. Olympic
runner Alison Felix became one of the fifty thousand women
who nearly died from pregnancy related complications in two thousand eighteen.
During her pregnancy, she was diagnosed with severe preclampsia, a
condition characterized by high blood pressure that puts mothers at
(04:24):
risk for stroke, among other things. The only cure for
severe cases like Allison's is to get the baby out.
So it just thirty two weeks she had to deliver
her daughter, Cameron, via emergency c section. It happened so
fast she didn't even realize how much danger she was
in during and after the birth. My family was definitely
(04:48):
very concerned, and I think that they were even more
concerned than I was, because obviously all of my attention
was on Cameron, and I was consumed with how she
was doing and all of that. Um But I was
still having issues with my blood pressure and we were
still trying to get that to be at a manageable level,
and so I was still in the hospital for several days.
(05:10):
After both Cameron and I were together, UM and uh
for several weeks. I was still trying to regulate my
own blood pressure. Today, both Alison and Cameron are happy
and healthy, but the six time Olympic gold medalists is
determined to not let her experience be erased. In May
of two thousand nineteen, she testified at a House Ways
(05:32):
and Means committee hearing about racial disparities in the maternal
mortality crisis. First, let me welcome this Alison Felix, United
States Track and Field star, nine time Olympic medalists, going
through this experience, UM, and just feeling so scared as
I went through it all. That was really the turning
(05:52):
point from me and talking to girl friends and UM,
just feeling like my friends are not even educated, you know,
on this topic. It really pushed me to share my story.
I'm a person who is, you know, more private, and
so it was definitely something that was out of my
comfort zone. My name is Alison Felix, and I am
(06:12):
Cameron's mom, and I would like to share the story
of the two most terrifying days of my life. What's
scary about Allison's story is that she didn't realize anything
was wrong until everything went very wrong. I had a
really great pregnancy. I was I knew I wanted to
come back to compete, so I was training. I was
(06:33):
pretty much training four or five days a week. I
was on the track, um, in the gym, in the pool,
so you know, really intentional with the idea that you know,
I was going to resume right back onto the track.
And at thirty two weeks, I went into the doctor
and I was just going for my routine checkup and
so went in and immediately when I came in, I
(06:54):
found out that I was spelling protein. And from there,
my doctor sent me straight to the hospital or further monitoring,
and um, it was not going well what they were seeing,
and so I was admitted right away and I spent
that night in the hospital. And that's when things really
started to go downhill. You know, I was diagnosed with
(07:15):
a severe case of pre clampsia, and um my blood
pressure was through the roof, and you know, the baby
was not doing well, and things happened just so quickly,
and I was trying to wrap my head around what
was happening and trying to understand what was happening, and UM,
from there after that evening the next day, it continued
(07:37):
to get worse, and UM, we realized that it was
an emergency situation and that the only way out of
it was to have an emergency c section and to deliver.
So it was terrifying, you know, it was so far
from what my birth plan was and UM, just trying
to understand, you know, what was really going on camera.
(08:00):
Just three pounds seven ounces when she was born and
was taken to the Nick you right away, where she
would stay for a month. But in addition to worrying
about her PREMI day in and day out, Allison also
had to heal from her own trauma. It was honestly
very difficult. UM, all of my energy and all of
(08:20):
my focus was really trying to be in the Nick
seven and I was so concerned with everything that was
happening with Cameron that UM, I felt very low on
that list. UM. If it wasn't for my support system,
I don't know, you know what if I would have
taken so much care for myself. But my family really
stepped up and UM, you know, made sure that I was,
(08:44):
you know, going to doctor's appointments, making sure that I
was taking my medication UM because I was still dealing
with the blood pressure even well after I was released
from the hospital. So having um other people helped me
was um enormous Because as I was spending you know,
night and day in the nick, you you could see
how someone without means, without a support system, without good
(09:08):
doctors or attentive doctors, could really fall through the cracks,
can't you so easily? I mean, and I didn't deal
with any postpartum depression, but I just kept thinking, Wow,
if that had kicked in as well, UM, how could
this have been manageable. It's just so much that it
can feel overwhelming, and so my heart goes out to
(09:29):
those two women who have to, you know, deal with
these extra things on top of having a newborn in
so many changes within your body. One of the biggest
reasons Alison has turned to advocacy is she wants to
get the message out her story can be anyone's story. Frankly,
it's something she wished she had known leading up. I
(09:54):
think that I was not UM prepared enough. You know,
I wasn't told what to look out for. I wasn't
told that I was at risk UM, and so That's
something that I wish had gone differently. You know. I
think had I known beforehand what to look out for, um,
just that I was at risk, then I could have
(10:15):
wrapped my head more around, you know, a possible stay
in the Nike You and what that means and kind
of all of these things. But it was it was
terrifying to have to go through this ordeal and straight
into you know, I was still dealing with the symptoms
UM and the after effects of what I had been through,
and straight into now my daughters in the nick You
and what does life there look like? And I'm trying
(10:38):
to manage all of that as well. And when you
say you were at risk, what made you at risk
for this? Just being a black woman? That made me
at risk? And that is something that I didn't understand before.
You know, I had heard. But I know, I'm a
professional athlete, you know, I trained for a living, I'm healthy,
I know how to eat right. I exercised throughout my ignancy,
(11:00):
and I was um wanting to have this beautiful natural birth,
and so I just didn't think it would be me,
you know, And that is just such a misconception that um,
that I want to bring awareness to that women of
color are at risk. According to the Agency for Healthcare Research,
(11:22):
black women are at least fifty more likely to experience
preclampsia than white women. The effects are also more severe
and present earlier than in other races. Did your doctor
ever even mentioned the term preclampsia? I don't recall, you know,
having that conversation, and so that's pretty scary looking back,
(11:45):
you know, I would have loved to know, you know,
these are the symptoms. These are things that you really
should pay attention to UM and just be on the
lookout for. Well, tell us what those are, because I
feel like people listening can learn from your experience. So
what are some of the symptoms swelling? Swelling is definitely
(12:07):
one of the big ones. But I think what makes
it also scary is that sometimes you don't have any symptoms,
and so I really feel like I fell into that category.
I mean, the swelling was one thing, but other than that,
I felt really good, and so that is really scary.
But UM headaches can be a symptom along you know,
the swelling. UM also rapid weight gain, UM, vomiting. So
(12:31):
there are some things to be on the lookout for,
but really more than anything consistent, your consistent healthcare. Because
once you go in to have your appointment and you
see that you're spelling protein, that is an indicator, um,
right there, that something is not right. Spelling protein means
protein in your urine, so there's successive amounts of it
(12:52):
and your urine. It's interesting, do they understand why Black
women are at higher risk other than just the sheer
no bursts of women who experienced preclampsia. Yes, I mean,
I'm far from an expert on this, but from my understanding,
that is what we need more research to be done,
um and to be able to understand because some of
(13:12):
the contributing factors that we know about, you know, not
having as high of healthcare, we're seeing this happen in
really privileged black women. Beyonce reveals for the first time
the harrowing emergency she had while pregnant with twins in
two thousand seventeen. Beyonce also suffered preclampsia during her pregnancy
(13:33):
and had to deliver her twins via emergency C section.
Tenn's great Serena Williams with baby Alexis Olympia shares her
harrowing ordeal for Serena Williams, it was something else Entirely
after giving birth via emergency C section, Serena had to
beg staff to take her pain and her understanding of
(13:54):
her own body seriously. She nearly died first of a
blood clot and then a hemorrhage. If Serena Williams struggles
to be heard, it's clear this isn't just a matter
of access to good care. I think a big factor
in it, as well as having to advocate for your
own for yourself UM. For some reason, either the tolerance
(14:17):
of pain or black women's pain in general is not believed,
and that is something that has to change. Do you
think racism played a role in your your experience looking back,
I it's really hard to pinpoint, but I think that
there might have been some of that implicit uh bye
(14:38):
is going on in my UM doctor's appointments previously. Really
why you know, do you think that that the doctor
whoever your doctor was, was educating, say, a white patient.
More about this, I think when when I look back,
I guess it definitely wasn't outright, that was not my
(14:59):
situation at all. But the fact that I that this
wasn't a conversation that I wasn't discussed, especially as you said,
since you were at greater risk. Yes, I feel like
every woman of color you know immediately that you should
be sat down and explained that you know, this is
something you're at risk for. Do you think had you
(15:19):
not had the resources that you have, had you not
been an Olympic athlete, had you not been able to
get the best medical care possible, that there's a chance
that you might not be here. I think it's a
possibility for sure. And that is what really is scary
to me. And that's what really wanted me to open
(15:41):
up and to share my experience in my story, because
I felt like, you know, I had the best of
the best, you know, and I still ended up in
a situation that was really scary and that we weren't
sure about. And if I'm experiencing this, someone who might
not have the best of health care, or might not
have even been heard to the level that I was,
(16:02):
might not have made it. When we come back how
some states are managing to turn their maternal mortality rates around.
(16:23):
In Part one, we met Deborah Bingham, a registered nurse
with a doctorate in public health who spent her career
focusing on improving the health of moms and babies. In
two thousand and six, as the founding executive director of
California's first Maternal Quality Care Collaborative, Deborah learned that California's
maternal mortality rate had actually been going up. We then
(16:46):
sought permission to talk about this in small groups. As
we went around organizing the California Maternal Quality Care Collaborative,
I would hear gaps in the room from the clinicians
in that space, so that would be physicians, registered nurses,
and midwives who were running hospitals leading uh and also
(17:08):
public health leaders literally gasping at this was brandon news.
Nobody had expected this. We did not think that it
would be on our watch that we would see this rise.
Deborah and her committee of experts reviewed three years of
maternal deaths that occurred in the state, and one of
the things they found was that death by hemorrhage could
(17:31):
often be prevented. We found that there was quite a
bit of denial and delay had led to these deaths,
meaning that women were not um the severity of the
hemorrhage was not recognized early enough. They We're not getting
blood early enough, which is life saving. Obviously and um
(17:53):
and so a lot of our efforts became around how
to eliminate this denial and delay, how to better recognize hemorrhages,
how to better prepare. What Debora ultimately did was to
help create a standardized action plan to help tackle potentially
fatal complications like hemorrhage. Debora refers to these plans as
(18:16):
quality improvement toolkits or safety bundles. They can be implemented
in hospitals in different ways, but they typically include a
checklist of the four rs or steps to improve readiness, recognition, response,
and reporting so that women receive life saving medications and
treatments in time. In addition to the hemorrhage safety Bundle,
(18:39):
there's also one for preclampsia and reduction of C sections.
And I think my years of being in a frontline
position in the hospitals and actually running hospitals and knowing
how busy you are in those in those roles, helped
me put together a model that would be very practical,
(18:59):
uh and also just kind of cut through a lot
of cripheral information and what would it take to actually
really save lives and what did people really need to do?
Safety bundles also include preparation protocols like running simulation drills
and huddling with staff and family as the mother is
being admitted to the hospital to assess possible risks she
(19:21):
may have. California is one of the only states that
has seen a rise in maternal mortality and also a
decrease in fact um. Their data shows that in a
five year period UH that there was about a fifty
decrease in pregnant in maternal mortality, and that was unbelievably
(19:46):
unexpected that we would see that decrease so quickly. Back
in two thousand and six, California's maternal mortality rate was
just shy of seventeen deaths per one thousand live births. Today,
that number, according to an investigation by USA Today, has
dropped to four deaths in one hundred thousand. That's the
(20:09):
lowest maternal mortality rate in the country, and now other
states are trying to follow suit. New Jersey has one
of the highest national rates, at thirty six point two
deaths per one hundred thousand live births. Deborah Bingham has
joined a team in New Jersey to turn that around.
The initiative, launched in two thousand nineteen is called Nurture
(20:31):
New Jersey. New Jersey is the medicine cabinet of America
and has some of the finest hospital systems in the
United States. First Lady Tammy Murphy is the driving force
behind this new initiative. So my naive assumption was that
this all centered around access to prenatal care. And you know,
(20:55):
it became immediately clear after going on a listening to
her all around the state and speaking with all stakeholders,
whether they be the hospital systems, foundations, nurses, dulas, midwives,
any stakeholders who were out there, that the problem was
much more complicated than I had assumed. Um, the problem
(21:19):
is truly if you're going to look at this, it's
systemic racism and implicit bias, and it brings in all
the social determinants of health. And so our goal is
to uh not only reduce maternal mortality by over five years,
but it's also to eliminate racial disparities and birth outcomes.
(21:43):
Tammy Murphy says, despite the new challenges posed by the
coronavirus pandemic, the work of Nurture New Jersey continues, and
considering the fact that racial health disparities have only been
exacerbated by the spread of COVID nineteen. She says this
work is more relevant and necessary than ever. There's good
(22:04):
news for pregnant women and mothers all over the country.
At the end of two thousand eighteen, Congress passed groundbreaking
legislation called the Preventing Maternal Deaths Act. The law addresses
one of the fundamental problems at the heart of the crisis,
the severe lack of reliable data about what actually kills
American mothers. That was a very important piece of legislation
(22:28):
that Congress passed. Again, Nina Martin, the set aside a
lot of money for states to create maternal mortality review committees,
to standardize them UM, to make them much more robust,
much more helpful, um much more efficient than they have
been in the past. That's really incredibly important. A lot
(22:50):
of states when we started this process didn't even have
maternal mortality committees, and now almost all of them do.
The ones that did have them have UM improved to them,
and so that's a that's a huge change. We're learning
so much from that process. Some states are also trying
to tackle the issue of insurance Medicaid finances. Nearly half
(23:13):
of all births in the United States, Yet new mothers
on Medicaid are only guaranteed care for two months after
they deliver. What states are trying to do is to
change the rules that allow women to continue to have
Medicaid for the full year along with their babies postpartum.
And so that means, you know, a lot of support
(23:36):
for mental health, for substance use disorders, for cardiac problems,
all the things that we know are killing women in
that first year. What we know from the from the
data is that most maternal deaths don't happen during pregnancy.
They don't happen in the hospital. They happen um when
(23:57):
women go home, they go They happen in the postpartum period. Um,
they happen, you know, sometimes it's a week, sometimes it's
two weeks, Sometimes it's a month, Sometimes it's up to
a year. So it's incredibly important for women to understand
that and for doctors and nurses and midwives and everybody
(24:18):
to understand how risky the postpartum period is, and also
to give women the information that they need to be
able to recognize concerning symptoms. According to the c d C,
thirty six percent of pregnancy related deaths occur up to
(24:40):
one week after giving birth, and then another thirty happen
up to a year postpartum, and it's impossible to predict
which women will suffer such fatal complications, which is why
Deppa being Him says it's important that all women are
educated on symptoms. Her organization, the Institute for Perinatal Quality Improvement,
(25:02):
is helping hospitals do just that. We actually made one
hand out called Savior Life hand Out, which it outlines
all of those post birth warning signs. So that's to
help empower women to know when to seek care. Warning warning.
My name is Stephanie. I'm going to be your discharged
that I needs to meet you. Congratulation. N y U
(25:25):
Land Gone in New York City is just one hospital
that has put Deborah Savior Life hand out to use
as part of its postpartum discharge education. But sometimes it's
hard for overwhelmed new moms to absorb critical information about
life threatening health issues. So n YU now sends families
home with a Savior Life Magnet, which reminds moms so
(25:47):
the symptoms they need to be aware of. I have
this really helpful acronym here, it's post birth. So p
IS stands for a painting your chest, OH stands for
obstructive breathing or shortness of us. S stands for seizures,
and T stands for thoughts of harming yourself or your
baby the birth part. I really encourage all women that
(26:10):
if they just aren't feeling like things are right, to
not give up asking for someone to intervene, someone to
look closer, who not just ignore their symptoms. A lot
of women are very good at ignoring their symptoms. For
most women, the first time they see a doctor is
six weeks after giving birth, which is why the postpartum
(26:32):
period can be so dangerous. But there's a way to
fill this alarming gap in healthcare. According to Monica Malcolmore,
the reproductive health Injustice researcher we heard in part one,
she says insurance can make room for other systems of
support like midwifery. For example, they see people three days postpartum,
they see them seven days postpartum, they see them ten
(26:55):
days postpart there's a more frequent visitation postpartum and also
do us. Doulas are lay professionals in community that provide spiritual, informational,
and physical support to pregnant people across the pregnancy. In
my mind, they are an essential member of the healthcare team,
(27:15):
and we need to integrate team based care because those
are individuals who can move with pregnant people through time,
as opposed to managing the time of birth, which is
a lot of what we do clinically. There are another
pair of eyes to sort of help us keep pregnant
people safe and alive, and we need to own that
at some point and figure out how to finance that.
(27:36):
The other crucial element here to keep mothers safe after
giving birth is making sure they don't have to rush
back to work. I like to remind people that we
actually have no paid family leave in the United States.
If people can have the time that they need knowing
that they're not going to lose their job or that
they don't have to go back to work too soon,
then we could go a really long way in reducing
(27:57):
maternal death in the postpartum period rate. When Alison Felix
decided in two thousand eighteen that she wanted to be
a professional athlete and a mother, she was in the
midst of contract negotiations with her long time sponsor Nike.
This time around, she wanted to ensure that she was
protected during and after pregnancy. The way athletic contracts are
(28:23):
structured as a lot of it is performance based, and
so you need to perform to a certain level or
you will have a reduction in your salary. Obviously, when
you have a baby, you need a bit of time
to get back to talk performance um and at at
the time when I was negotiating, they were unwilling to
grant that time. UM and other athletes had experience also
(28:45):
when they became pregnant that their contracts were actually paused,
meaning that they were not receiving any pay um at all,
and their likeness was still being used. They were still
required to make appearances, they were still training with the
intention of coming back. It's an issue that I had
seen repeatedly throughout my career UM and the culture was
(29:07):
really silent surrounding it, you know, it was just something
that women would go through, and I got to the
point where I felt like I had to speak on it.
I had to share my experience because things I felt
like things would not change if I didn't. Alison asked
Nike to guarantee in her contract that she wouldn't be
(29:28):
punished if she didn't perform at her best in the
months before and after childbirth, Nike declined. In May of
two thousand nineteen, Allison broke ties with Nike and wrote
a powerful op ed in The New York Times detailing
her experience. By the end of the month, Nike announced
it would end financial penalties for pregnant athletes. By July,
(29:53):
Allison signed with Athleta, an athletic wear company owned by
Gap that wanted Allison explicitly for her outspoken advocacy. Are
you proud of yourself for speaking up? I know that
you have talked about your upbringing. You were raised in
a very Christian family. UM, probably taught to be respectful,
(30:15):
to respect authority, to not be a troublemaker, etcetera, etcetera.
So did it kind of go against your brain Allison,
to say, Hey, this isn't right, I'm speaking out. It
was completely against when against the grain. It was, UM,
so far out of my comfort zone. UM. Not only
you know, am I more of a private person, but
(30:35):
everything you just mentioned was completely true for me, and
so it just felt very scary. But after I did
speak out, the encouragement from so many people, UM really
reassured me. And more than anything, it was my daughter.
You know, she was the one who helped me find
my voice, and it really when I thought about her
life and her growing up and the things that I
(30:57):
didn't want her to have to you know, fight for UM.
That definitely just gave me the booth that I needed.
When we return messages of empowerment for today's pregnant moms
and their families. That's right after this. A lot of
(31:23):
what we face right now with the coronavirus pandemic is scary,
but it makes some maternal health crisis and the inequities
around giving birth in this country more urgent than ever.
It's important to share the stories we've heard so that
we can honor those who have been affected and possibly
save others from the same fate. So here are some
(31:44):
of the lessons from those who have experienced the unimaginable. First,
Alison Felix, no matter who you are, educate yourself. You know,
be fully prepared, have a birth plan, um, but don't
be married to it. For me, that was a big issue.
So just understand that issues may arise and um, you know,
(32:06):
be willing to um go with the flow. But but
educate yourself and be prepared and listen to your body. Right.
I mean, I think you even probably discounted the swelling
you experienced. Had you known you were at high risk,
I think you would have said, oh, I need to
call my doctor right away about this. Right, definitely, definitely, Um,
I would have gone right and immediately had I known
(32:28):
what to look for, and like you said, listen to
your body and if anything doesn't feel right, make sure
you're hurt, and don't stop. Be persistent. I wish that
I had understood walking into the hospital that day, that
this was even a potential outcome from my wife. Again,
Charles Johnson, this never even crossed our minds. We had
(32:51):
no clue, and we consider ourselves progressive informed people that
women were dying, you know, almost twice a day from
childbirth in this country. I wish that I had known.
Reporter Nina Martin says, there's power in that knowledge. I
think it's really important for people to know the worst
(33:14):
case scenario possible, because if you don't, then you will
not trust yourself, your advocates will not continue to push
in the way that they need. To believe what you're
feeling in your own body and and then make somebody
listen to you if possible, or to help get your
(33:37):
the help of your advocates, to make them be listened
and don't give up if possible, because it really could
be the difference between life and death. Tragically, there's only
so much a mother and her family can do. As
we've learned, sometimes all the knowledge and the support in
(33:59):
the world simply isn't enough. That's the heartbreaking thing about
Charles Johnson's story is that he pushed, and Kia pushed
and it wasn't enough. But you know what, if maybe
Kira were still alive and she were giving birth, now
people would listen to her right because they would know
that that this happens. And you know, it's that's the
(34:24):
heartbreak of it, um but it's also what he's been
able to accomplish in what the work that he's done.
In the years since Cura's death, Charles Johnson started a
nonprofit dedicated to maternal mortality advocacy for Cure four Moms.
It's an organization that I found it too honor Cure
(34:44):
as well as the tens of thousands of women that
we have lost due to this maternal mortality crisis, and
so I truly believe that although there's nothing I can
do to bring Cure back the highest honor, that I
can pay her to do everything that I can to
send other mother's home with their precious babies for care
of four moms also helps provide support to families left behind,
(35:08):
providing babies, supplies, child care services, legal support, and even
grief counseling, because Charles and his young boys know all
too well what that's like. As they get older, they're understanding. Uh,
it grows and they ask questions, and I do my best.
(35:31):
I made a decision very early on that I would
do my best to celebrate here and everything that we do.
If you come into our home, there are huge pictures
of her everywhere. Uh. We deal with Mommy's memory head on.
We tell stories. When Prince comes on the radio, we
turn it up the full brast and we say that,
you know, Mommy loved this song. When we go places,
(35:52):
we talked about Mommy took you here. When we watch
Race Car Drive and we talked about how much Mommy
loved to race cars. But it doesn't matter, because it's
still this immense void, and it still doesn't prevent Charles
from waking up in the middle of the night, just crying,
just saying that he wants his mommy. It doesn't prevent
(36:13):
Langston asking the question, well, why can't mommy come to
my school? And so I do my best to explain that, well,
mommy is in heaven and you know she's doing important work.
But there's nothing that can prepare you for what it's like.
When you tell a two year old dad mommy is
in heaven and he says to you, well, Daddy, I
(36:33):
want to go to heaven, all right. That just rips
your heart right out of your chest. And at the
end of the day, if I can prevent one other
father of having the conversation with their children that I
have to have with mine, then it's all worth it.
If you'd like to support families like the Johnson's, you
(36:54):
can visit for Kira for moms dot com. We started
reporting this story long before COVID nineteen infected hundreds of
thousands of people across the country, not to mention millions globally.
It's a public health crisis of historic scale and one
that frankly, this country was not prepared for what the
(37:18):
coronavirus pandemic will mean for the maternal health crisis. We
may not know for a very long time, but the
fact is right now, tens of thousands of women are
giving birth in unprecedented circumstances, sometimes alone and often without
the support networks and in person care they need to
stay healthy before, during, and after birth. Meanwhile, COVID nineteen
(37:44):
is only underscoring already existing racial disparities that put black
and underserved Americans at greater risk. While it's terrifying to
think of the damage this pandemic could do to the
maternal mortality crisis, there are still so many people, healthcare
professionals and advocates who are working tirelessly on behalf of
(38:06):
pregnant women. To that in We've compiled a resource this
section around the maternal mortality crisis, including people, information and
organizations mentioned in these episodes. You can find that in
my morning newsletter wake Up Call, and I'll link to
it on my social media channels. If you'd like to
get Wake Up Call every morning in your inbox, you
(38:27):
can subscribe at Katie Currek dot com to share this
important series or to subscribe to Next Question. Find us
on an Apple podcast, the I Heart radio app, or
wherever you listen until next time and my Next Question.
I'm Katie Couric. Next Question with Katie Kurik is the
(38:50):
production of I Heart Radio and Katie Currek Media. The
executive producers are Katie Kurik, Courtney Litz, and Tyler Klang.
The supervising producer is Lauren Hanson. Our show producer is
Bethan Macaluso. The associate producers are Emily Pinto and Derek Clements.
Editing by Derrek Clements, Dylan Fagin and Lowell Berlante, Mixing
(39:11):
by Dylan Fagan. Our researcher is Gabriel Loser. For more
information on today's episode, go to Katie Curik dot com
and follow us on Twitter and Instagram at Katie Currik.
For more podcasts for My Heart Radio, visit the I
Heart Radio app, Apple podcast, or wherever you listen to
(39:32):
your favorite shows,
Hi everyone, I'm Katie Couric, and welcome to Next Question Today,
part two of our look at America's maternal mortality crisis.
If you haven't listened to Part one, I highly recommend
you start there. In it, we heard the devastating story
of how one mother, Kira Johnson, became a part of
(00:22):
a shameful statistic that between seven hundred and nine hundred
American women die every year from pregnancy and childbirth related causes,
and six of those deaths, including Kira's, could have been prevented.
Here's Kira's husband, Charles Johnson. What happened to Kira was
(00:42):
not just a medical tragedy with a medical catastrophe. Everything
that could have went wrong, in fact did so. Not
only did that doctor failed Kira, but the hospital, in
their policies and procedures, failed her. We learned that structural
issues like racism and sexism, as well as an increase
in medical interventions during labor, have led to more women
(01:05):
dying from pregnancy and childbirth today than they did thirty
years ago, a fact that makes the US the only
country in the developed world to see its maternal mortality
rate go up today. In Part two, we tackle my
next question, what is being done to better protect American
(01:25):
mothers from becoming a part of that horrifying statistic. She
was told it was a fluke, And here I was
looking at these data points and saying she wasn't a fluke.
She was actually part of a really important trend that
has not been covered in the US. For investigative reporter
Nina Martin, this question is a personal one. In two
thousand and fifteen, when she and her team at Pro
(01:48):
Publica began reporting their Lost Mother's Project, an investigation into
maternal mortality, they found an alarming statistic that, in addition
to the deaths, there are fifty thousand women who nearly
die every year from pregnancy and childbirth related issues. And
we're not talking about like they have gestational diabetes and
(02:11):
then they cut back on you know whatever, um, the
the amount of sugar, the ice cream that they ate
in pregnancy and then everything is okay. We're talking about
women who, you know, go to the hospital and go
into cardiac arrest. We're talking about women who nearly bleed out.
We're talking about women who have life threatening um infections
that keep them hospitalized for weeks. And UM, that was
(02:34):
really super interesting to me both because of the size
um again, which really was not what people were talking
about in the parenting magazine world that I had spent
some time in. But it also really connected with me
on a personal level because my sister had um given birth.
I've I've three sisters, three yeah, and um the oldest
(02:57):
of five. Nina Martin's sister Meal had given birth to
a boy named Aiden in Texas in two thousand. She
and her husband both had good jobs. She was a paralegal,
he was a lawyer, and they had access to good
health care. She was very healthy, had a really good pregnancy,
(03:17):
and she nearly died after in her postpartum period she
had to very severe infections, one of which was they've
caught and fixed in the hospital, and the second one
which nearly killed her. And I remember going and trying
to help out at the time and how freaked out
everybody was, and then it was kind of over. People
said to her, you know, oh, well, you know this
(03:39):
never happened to anybody. We have no idea that we've
never seen anything like this before. And and also, um,
don't worry, you're a little head about it, because you're
fine now and your baby's fine, and go home and
live your life and be happy that everything's okay. And
so her experience was completely erased. Being a professional athlete,
(04:02):
I just thought that will never happen to me. Olympic
runner Alison Felix became one of the fifty thousand women
who nearly died from pregnancy related complications in two thousand eighteen.
During her pregnancy, she was diagnosed with severe preclampsia, a
condition characterized by high blood pressure that puts mothers at
(04:24):
risk for stroke, among other things. The only cure for
severe cases like Allison's is to get the baby out.
So it just thirty two weeks she had to deliver
her daughter, Cameron, via emergency c section. It happened so
fast she didn't even realize how much danger she was
in during and after the birth. My family was definitely
(04:48):
very concerned, and I think that they were even more
concerned than I was, because obviously all of my attention
was on Cameron, and I was consumed with how she
was doing and all of that. Um But I was
still having issues with my blood pressure and we were
still trying to get that to be at a manageable level,
and so I was still in the hospital for several days.
(05:10):
After both Cameron and I were together, UM and uh
for several weeks. I was still trying to regulate my
own blood pressure. Today, both Alison and Cameron are happy
and healthy, but the six time Olympic gold medalists is
determined to not let her experience be erased. In May
of two thousand nineteen, she testified at a House Ways
(05:32):
and Means committee hearing about racial disparities in the maternal
mortality crisis. First, let me welcome this Alison Felix, United
States Track and Field star, nine time Olympic medalists, going
through this experience, UM, and just feeling so scared as
I went through it all. That was really the turning
(05:52):
point from me and talking to girl friends and UM,
just feeling like my friends are not even educated, you know,
on this topic. It really pushed me to share my story.
I'm a person who is, you know, more private, and
so it was definitely something that was out of my
comfort zone. My name is Alison Felix, and I am
(06:12):
Cameron's mom, and I would like to share the story
of the two most terrifying days of my life. What's
scary about Allison's story is that she didn't realize anything
was wrong until everything went very wrong. I had a
really great pregnancy. I was I knew I wanted to
come back to compete, so I was training. I was
(06:33):
pretty much training four or five days a week. I
was on the track, um, in the gym, in the pool,
so you know, really intentional with the idea that you know,
I was going to resume right back onto the track.
And at thirty two weeks, I went into the doctor
and I was just going for my routine checkup and
so went in and immediately when I came in, I
(06:54):
found out that I was spelling protein. And from there,
my doctor sent me straight to the hospital or further monitoring,
and um, it was not going well what they were seeing,
and so I was admitted right away and I spent
that night in the hospital. And that's when things really
started to go downhill. You know, I was diagnosed with
(07:15):
a severe case of pre clampsia, and um my blood
pressure was through the roof, and you know, the baby
was not doing well, and things happened just so quickly,
and I was trying to wrap my head around what
was happening and trying to understand what was happening, and UM,
from there after that evening the next day, it continued
(07:37):
to get worse, and UM, we realized that it was
an emergency situation and that the only way out of
it was to have an emergency c section and to deliver.
So it was terrifying, you know, it was so far
from what my birth plan was and UM, just trying
to understand, you know, what was really going on camera.
(08:00):
Just three pounds seven ounces when she was born and
was taken to the Nick you right away, where she
would stay for a month. But in addition to worrying
about her PREMI day in and day out, Allison also
had to heal from her own trauma. It was honestly
very difficult. UM, all of my energy and all of
(08:20):
my focus was really trying to be in the Nick
seven and I was so concerned with everything that was
happening with Cameron that UM, I felt very low on
that list. UM. If it wasn't for my support system,
I don't know, you know what if I would have
taken so much care for myself. But my family really
stepped up and UM, you know, made sure that I was,
(08:44):
you know, going to doctor's appointments, making sure that I
was taking my medication UM because I was still dealing
with the blood pressure even well after I was released
from the hospital. So having um other people helped me
was um enormous Because as I was spending you know,
night and day in the nick, you you could see
how someone without means, without a support system, without good
(09:08):
doctors or attentive doctors, could really fall through the cracks,
can't you so easily? I mean, and I didn't deal
with any postpartum depression, but I just kept thinking, Wow,
if that had kicked in as well, UM, how could
this have been manageable. It's just so much that it
can feel overwhelming, and so my heart goes out to
(09:29):
those two women who have to, you know, deal with
these extra things on top of having a newborn in
so many changes within your body. One of the biggest
reasons Alison has turned to advocacy is she wants to
get the message out her story can be anyone's story. Frankly,
it's something she wished she had known leading up. I
(09:54):
think that I was not UM prepared enough. You know,
I wasn't told what to look out for. I wasn't
told that I was at risk UM, and so That's
something that I wish had gone differently. You know. I
think had I known beforehand what to look out for, um,
just that I was at risk, then I could have
(10:15):
wrapped my head more around, you know, a possible stay
in the Nike You and what that means and kind
of all of these things. But it was it was
terrifying to have to go through this ordeal and straight
into you know, I was still dealing with the symptoms
UM and the after effects of what I had been through,
and straight into now my daughters in the nick You
and what does life there look like? And I'm trying
(10:38):
to manage all of that as well. And when you
say you were at risk, what made you at risk
for this? Just being a black woman? That made me
at risk? And that is something that I didn't understand before.
You know, I had heard. But I know, I'm a
professional athlete, you know, I trained for a living, I'm healthy,
I know how to eat right. I exercised throughout my ignancy,
(11:00):
and I was um wanting to have this beautiful natural birth,
and so I just didn't think it would be me,
you know, And that is just such a misconception that um,
that I want to bring awareness to that women of
color are at risk. According to the Agency for Healthcare Research,
(11:22):
black women are at least fifty more likely to experience
preclampsia than white women. The effects are also more severe
and present earlier than in other races. Did your doctor
ever even mentioned the term preclampsia? I don't recall, you know,
having that conversation, and so that's pretty scary looking back,
(11:45):
you know, I would have loved to know, you know,
these are the symptoms. These are things that you really
should pay attention to UM and just be on the
lookout for. Well, tell us what those are, because I
feel like people listening can learn from your experience. So
what are some of the symptoms swelling? Swelling is definitely
(12:07):
one of the big ones. But I think what makes
it also scary is that sometimes you don't have any symptoms,
and so I really feel like I fell into that category.
I mean, the swelling was one thing, but other than that,
I felt really good, and so that is really scary.
But UM headaches can be a symptom along you know,
the swelling. UM also rapid weight gain, UM, vomiting. So
(12:31):
there are some things to be on the lookout for,
but really more than anything consistent, your consistent healthcare. Because
once you go in to have your appointment and you
see that you're spelling protein, that is an indicator, um,
right there, that something is not right. Spelling protein means
protein in your urine, so there's successive amounts of it
(12:52):
and your urine. It's interesting, do they understand why Black
women are at higher risk other than just the sheer
no bursts of women who experienced preclampsia. Yes, I mean,
I'm far from an expert on this, but from my understanding,
that is what we need more research to be done,
um and to be able to understand because some of
(13:12):
the contributing factors that we know about, you know, not
having as high of healthcare, we're seeing this happen in
really privileged black women. Beyonce reveals for the first time
the harrowing emergency she had while pregnant with twins in
two thousand seventeen. Beyonce also suffered preclampsia during her pregnancy
(13:33):
and had to deliver her twins via emergency C section.
Tenn's great Serena Williams with baby Alexis Olympia shares her
harrowing ordeal for Serena Williams, it was something else Entirely
after giving birth via emergency C section, Serena had to
beg staff to take her pain and her understanding of
(13:54):
her own body seriously. She nearly died first of a
blood clot and then a hemorrhage. If Serena Williams struggles
to be heard, it's clear this isn't just a matter
of access to good care. I think a big factor
in it, as well as having to advocate for your
own for yourself UM. For some reason, either the tolerance
(14:17):
of pain or black women's pain in general is not believed,
and that is something that has to change. Do you
think racism played a role in your your experience looking back,
I it's really hard to pinpoint, but I think that
there might have been some of that implicit uh bye
(14:38):
is going on in my UM doctor's appointments previously. Really
why you know, do you think that that the doctor
whoever your doctor was, was educating, say, a white patient.
More about this, I think when when I look back,
I guess it definitely wasn't outright, that was not my
(14:59):
situation at all. But the fact that I that this
wasn't a conversation that I wasn't discussed, especially as you said,
since you were at greater risk. Yes, I feel like
every woman of color you know immediately that you should
be sat down and explained that you know, this is
something you're at risk for. Do you think had you
(15:19):
not had the resources that you have, had you not
been an Olympic athlete, had you not been able to
get the best medical care possible, that there's a chance
that you might not be here. I think it's a
possibility for sure. And that is what really is scary
to me. And that's what really wanted me to open
(15:41):
up and to share my experience in my story, because
I felt like, you know, I had the best of
the best, you know, and I still ended up in
a situation that was really scary and that we weren't
sure about. And if I'm experiencing this, someone who might
not have the best of health care, or might not
have even been heard to the level that I was,
(16:02):
might not have made it. When we come back how
some states are managing to turn their maternal mortality rates around.
(16:23):
In Part one, we met Deborah Bingham, a registered nurse
with a doctorate in public health who spent her career
focusing on improving the health of moms and babies. In
two thousand and six, as the founding executive director of
California's first Maternal Quality Care Collaborative, Deborah learned that California's
maternal mortality rate had actually been going up. We then
(16:46):
sought permission to talk about this in small groups. As
we went around organizing the California Maternal Quality Care Collaborative,
I would hear gaps in the room from the clinicians
in that space, so that would be physicians, registered nurses,
and midwives who were running hospitals leading uh and also
(17:08):
public health leaders literally gasping at this was brandon news.
Nobody had expected this. We did not think that it
would be on our watch that we would see this rise.
Deborah and her committee of experts reviewed three years of
maternal deaths that occurred in the state, and one of
the things they found was that death by hemorrhage could
(17:31):
often be prevented. We found that there was quite a
bit of denial and delay had led to these deaths,
meaning that women were not um the severity of the
hemorrhage was not recognized early enough. They We're not getting
blood early enough, which is life saving. Obviously and um
(17:53):
and so a lot of our efforts became around how
to eliminate this denial and delay, how to better recognize hemorrhages,
how to better prepare. What Debora ultimately did was to
help create a standardized action plan to help tackle potentially
fatal complications like hemorrhage. Debora refers to these plans as
(18:16):
quality improvement toolkits or safety bundles. They can be implemented
in hospitals in different ways, but they typically include a
checklist of the four rs or steps to improve readiness, recognition, response,
and reporting so that women receive life saving medications and
treatments in time. In addition to the hemorrhage safety Bundle,
(18:39):
there's also one for preclampsia and reduction of C sections.
And I think my years of being in a frontline
position in the hospitals and actually running hospitals and knowing
how busy you are in those in those roles, helped
me put together a model that would be very practical,
(18:59):
uh and also just kind of cut through a lot
of cripheral information and what would it take to actually
really save lives and what did people really need to do?
Safety bundles also include preparation protocols like running simulation drills
and huddling with staff and family as the mother is
being admitted to the hospital to assess possible risks she
(19:21):
may have. California is one of the only states that
has seen a rise in maternal mortality and also a
decrease in fact um. Their data shows that in a
five year period UH that there was about a fifty
decrease in pregnant in maternal mortality, and that was unbelievably
(19:46):
unexpected that we would see that decrease so quickly. Back
in two thousand and six, California's maternal mortality rate was
just shy of seventeen deaths per one thousand live births. Today,
that number, according to an investigation by USA Today, has
dropped to four deaths in one hundred thousand. That's the
(20:09):
lowest maternal mortality rate in the country, and now other
states are trying to follow suit. New Jersey has one
of the highest national rates, at thirty six point two
deaths per one hundred thousand live births. Deborah Bingham has
joined a team in New Jersey to turn that around.
The initiative, launched in two thousand nineteen is called Nurture
(20:31):
New Jersey. New Jersey is the medicine cabinet of America
and has some of the finest hospital systems in the
United States. First Lady Tammy Murphy is the driving force
behind this new initiative. So my naive assumption was that
this all centered around access to prenatal care. And you know,
(20:55):
it became immediately clear after going on a listening to
her all around the state and speaking with all stakeholders,
whether they be the hospital systems, foundations, nurses, dulas, midwives,
any stakeholders who were out there, that the problem was
much more complicated than I had assumed. Um, the problem
(21:19):
is truly if you're going to look at this, it's
systemic racism and implicit bias, and it brings in all
the social determinants of health. And so our goal is
to uh not only reduce maternal mortality by over five years,
but it's also to eliminate racial disparities and birth outcomes.
(21:43):
Tammy Murphy says, despite the new challenges posed by the
coronavirus pandemic, the work of Nurture New Jersey continues, and
considering the fact that racial health disparities have only been
exacerbated by the spread of COVID nineteen. She says this
work is more relevant and necessary than ever. There's good
(22:04):
news for pregnant women and mothers all over the country.
At the end of two thousand eighteen, Congress passed groundbreaking
legislation called the Preventing Maternal Deaths Act. The law addresses
one of the fundamental problems at the heart of the crisis,
the severe lack of reliable data about what actually kills
American mothers. That was a very important piece of legislation
(22:28):
that Congress passed. Again, Nina Martin, the set aside a
lot of money for states to create maternal mortality review committees,
to standardize them UM, to make them much more robust,
much more helpful, um much more efficient than they have
been in the past. That's really incredibly important. A lot
(22:50):
of states when we started this process didn't even have
maternal mortality committees, and now almost all of them do.
The ones that did have them have UM improved to them,
and so that's a that's a huge change. We're learning
so much from that process. Some states are also trying
to tackle the issue of insurance Medicaid finances. Nearly half
(23:13):
of all births in the United States, Yet new mothers
on Medicaid are only guaranteed care for two months after
they deliver. What states are trying to do is to
change the rules that allow women to continue to have
Medicaid for the full year along with their babies postpartum.
And so that means, you know, a lot of support
(23:36):
for mental health, for substance use disorders, for cardiac problems,
all the things that we know are killing women in
that first year. What we know from the from the
data is that most maternal deaths don't happen during pregnancy.
They don't happen in the hospital. They happen um when
(23:57):
women go home, they go They happen in the postpartum period. Um,
they happen, you know, sometimes it's a week, sometimes it's
two weeks, Sometimes it's a month, Sometimes it's up to
a year. So it's incredibly important for women to understand
that and for doctors and nurses and midwives and everybody
(24:18):
to understand how risky the postpartum period is, and also
to give women the information that they need to be
able to recognize concerning symptoms. According to the c d C,
thirty six percent of pregnancy related deaths occur up to
(24:40):
one week after giving birth, and then another thirty happen
up to a year postpartum, and it's impossible to predict
which women will suffer such fatal complications, which is why
Deppa being Him says it's important that all women are
educated on symptoms. Her organization, the Institute for Perinatal Quality Improvement,
(25:02):
is helping hospitals do just that. We actually made one
hand out called Savior Life hand Out, which it outlines
all of those post birth warning signs. So that's to
help empower women to know when to seek care. Warning warning.
My name is Stephanie. I'm going to be your discharged
that I needs to meet you. Congratulation. N y U
(25:25):
Land Gone in New York City is just one hospital
that has put Deborah Savior Life hand out to use
as part of its postpartum discharge education. But sometimes it's
hard for overwhelmed new moms to absorb critical information about
life threatening health issues. So n YU now sends families
home with a Savior Life Magnet, which reminds moms so
(25:47):
the symptoms they need to be aware of. I have
this really helpful acronym here, it's post birth. So p
IS stands for a painting your chest, OH stands for
obstructive breathing or shortness of us. S stands for seizures,
and T stands for thoughts of harming yourself or your
baby the birth part. I really encourage all women that
(26:10):
if they just aren't feeling like things are right, to
not give up asking for someone to intervene, someone to
look closer, who not just ignore their symptoms. A lot
of women are very good at ignoring their symptoms. For
most women, the first time they see a doctor is
six weeks after giving birth, which is why the postpartum
(26:32):
period can be so dangerous. But there's a way to
fill this alarming gap in healthcare. According to Monica Malcolmore,
the reproductive health Injustice researcher we heard in part one,
she says insurance can make room for other systems of
support like midwifery. For example, they see people three days postpartum,
they see them seven days postpartum, they see them ten
(26:55):
days postpart there's a more frequent visitation postpartum and also
do us. Doulas are lay professionals in community that provide spiritual, informational,
and physical support to pregnant people across the pregnancy. In
my mind, they are an essential member of the healthcare team,
(27:15):
and we need to integrate team based care because those
are individuals who can move with pregnant people through time,
as opposed to managing the time of birth, which is
a lot of what we do clinically. There are another
pair of eyes to sort of help us keep pregnant
people safe and alive, and we need to own that
at some point and figure out how to finance that.
(27:36):
The other crucial element here to keep mothers safe after
giving birth is making sure they don't have to rush
back to work. I like to remind people that we
actually have no paid family leave in the United States.
If people can have the time that they need knowing
that they're not going to lose their job or that
they don't have to go back to work too soon,
then we could go a really long way in reducing
(27:57):
maternal death in the postpartum period rate. When Alison Felix
decided in two thousand eighteen that she wanted to be
a professional athlete and a mother, she was in the
midst of contract negotiations with her long time sponsor Nike.
This time around, she wanted to ensure that she was
protected during and after pregnancy. The way athletic contracts are
(28:23):
structured as a lot of it is performance based, and
so you need to perform to a certain level or
you will have a reduction in your salary. Obviously, when
you have a baby, you need a bit of time
to get back to talk performance um and at at
the time when I was negotiating, they were unwilling to
grant that time. UM and other athletes had experience also
(28:45):
when they became pregnant that their contracts were actually paused,
meaning that they were not receiving any pay um at all,
and their likeness was still being used. They were still
required to make appearances, they were still training with the
intention of coming back. It's an issue that I had
seen repeatedly throughout my career UM and the culture was
(29:07):
really silent surrounding it, you know, it was just something
that women would go through, and I got to the
point where I felt like I had to speak on it.
I had to share my experience because things I felt
like things would not change if I didn't. Alison asked
Nike to guarantee in her contract that she wouldn't be
(29:28):
punished if she didn't perform at her best in the
months before and after childbirth, Nike declined. In May of
two thousand nineteen, Allison broke ties with Nike and wrote
a powerful op ed in The New York Times detailing
her experience. By the end of the month, Nike announced
it would end financial penalties for pregnant athletes. By July,
(29:53):
Allison signed with Athleta, an athletic wear company owned by
Gap that wanted Allison explicitly for her outspoken advocacy. Are
you proud of yourself for speaking up? I know that
you have talked about your upbringing. You were raised in
a very Christian family. UM, probably taught to be respectful,
(30:15):
to respect authority, to not be a troublemaker, etcetera, etcetera.
So did it kind of go against your brain Allison,
to say, Hey, this isn't right, I'm speaking out. It
was completely against when against the grain. It was, UM,
so far out of my comfort zone. UM. Not only
you know, am I more of a private person, but
(30:35):
everything you just mentioned was completely true for me, and
so it just felt very scary. But after I did
speak out, the encouragement from so many people, UM really
reassured me. And more than anything, it was my daughter.
You know, she was the one who helped me find
my voice, and it really when I thought about her
life and her growing up and the things that I
(30:57):
didn't want her to have to you know, fight for UM.
That definitely just gave me the booth that I needed.
When we return messages of empowerment for today's pregnant moms
and their families. That's right after this. A lot of
(31:23):
what we face right now with the coronavirus pandemic is scary,
but it makes some maternal health crisis and the inequities
around giving birth in this country more urgent than ever.
It's important to share the stories we've heard so that
we can honor those who have been affected and possibly
save others from the same fate. So here are some
(31:44):
of the lessons from those who have experienced the unimaginable. First,
Alison Felix, no matter who you are, educate yourself. You know,
be fully prepared, have a birth plan, um, but don't
be married to it. For me, that was a big issue.
So just understand that issues may arise and um, you know,
(32:06):
be willing to um go with the flow. But but
educate yourself and be prepared and listen to your body. Right.
I mean, I think you even probably discounted the swelling
you experienced. Had you known you were at high risk,
I think you would have said, oh, I need to
call my doctor right away about this. Right, definitely, definitely, Um,
I would have gone right and immediately had I known
(32:28):
what to look for, and like you said, listen to
your body and if anything doesn't feel right, make sure
you're hurt, and don't stop. Be persistent. I wish that
I had understood walking into the hospital that day, that
this was even a potential outcome from my wife. Again,
Charles Johnson, this never even crossed our minds. We had
(32:51):
no clue, and we consider ourselves progressive informed people that
women were dying, you know, almost twice a day from
childbirth in this country. I wish that I had known.
Reporter Nina Martin says, there's power in that knowledge. I
think it's really important for people to know the worst
(33:14):
case scenario possible, because if you don't, then you will
not trust yourself, your advocates will not continue to push
in the way that they need. To believe what you're
feeling in your own body and and then make somebody
listen to you if possible, or to help get your
(33:37):
the help of your advocates, to make them be listened
and don't give up if possible, because it really could
be the difference between life and death. Tragically, there's only
so much a mother and her family can do. As
we've learned, sometimes all the knowledge and the support in
(33:59):
the world simply isn't enough. That's the heartbreaking thing about
Charles Johnson's story is that he pushed, and Kia pushed
and it wasn't enough. But you know what, if maybe
Kira were still alive and she were giving birth, now
people would listen to her right because they would know
that that this happens. And you know, it's that's the
(34:24):
heartbreak of it, um but it's also what he's been
able to accomplish in what the work that he's done.
In the years since Cura's death, Charles Johnson started a
nonprofit dedicated to maternal mortality advocacy for Cure four Moms.
It's an organization that I found it too honor Cure
(34:44):
as well as the tens of thousands of women that
we have lost due to this maternal mortality crisis, and
so I truly believe that although there's nothing I can
do to bring Cure back the highest honor, that I
can pay her to do everything that I can to
send other mother's home with their precious babies for care
of four moms also helps provide support to families left behind,
(35:08):
providing babies, supplies, child care services, legal support, and even
grief counseling, because Charles and his young boys know all
too well what that's like. As they get older, they're understanding. Uh,
it grows and they ask questions, and I do my best.
(35:31):
I made a decision very early on that I would
do my best to celebrate here and everything that we do.
If you come into our home, there are huge pictures
of her everywhere. Uh. We deal with Mommy's memory head on.
We tell stories. When Prince comes on the radio, we
turn it up the full brast and we say that,
you know, Mommy loved this song. When we go places,
(35:52):
we talked about Mommy took you here. When we watch
Race Car Drive and we talked about how much Mommy
loved to race cars. But it doesn't matter, because it's
still this immense void, and it still doesn't prevent Charles
from waking up in the middle of the night, just crying,
just saying that he wants his mommy. It doesn't prevent
(36:13):
Langston asking the question, well, why can't mommy come to
my school? And so I do my best to explain that, well,
mommy is in heaven and you know she's doing important work.
But there's nothing that can prepare you for what it's like.
When you tell a two year old dad mommy is
in heaven and he says to you, well, Daddy, I
(36:33):
want to go to heaven, all right. That just rips
your heart right out of your chest. And at the
end of the day, if I can prevent one other
father of having the conversation with their children that I
have to have with mine, then it's all worth it.
If you'd like to support families like the Johnson's, you
(36:54):
can visit for Kira for moms dot com. We started
reporting this story long before COVID nineteen infected hundreds of
thousands of people across the country, not to mention millions globally.
It's a public health crisis of historic scale and one
that frankly, this country was not prepared for what the
(37:18):
coronavirus pandemic will mean for the maternal health crisis. We
may not know for a very long time, but the
fact is right now, tens of thousands of women are
giving birth in unprecedented circumstances, sometimes alone and often without
the support networks and in person care they need to
stay healthy before, during, and after birth. Meanwhile, COVID nineteen
(37:44):
is only underscoring already existing racial disparities that put black
and underserved Americans at greater risk. While it's terrifying to
think of the damage this pandemic could do to the
maternal mortality crisis, there are still so many people, healthcare
professionals and advocates who are working tirelessly on behalf of
(38:06):
pregnant women. To that in We've compiled a resource this
section around the maternal mortality crisis, including people, information and
organizations mentioned in these episodes. You can find that in
my morning newsletter wake Up Call, and I'll link to
it on my social media channels. If you'd like to
get Wake Up Call every morning in your inbox, you
(38:27):
can subscribe at Katie Currek dot com to share this
important series or to subscribe to Next Question. Find us
on an Apple podcast, the I Heart radio app, or
wherever you listen until next time and my Next Question.
I'm Katie Couric. Next Question with Katie Kurik is the
(38:50):
production of I Heart Radio and Katie Currek Media. The
executive producers are Katie Kurik, Courtney Litz, and Tyler Klang.
The supervising producer is Lauren Hanson. Our show producer is
Bethan Macaluso. The associate producers are Emily Pinto and Derek Clements.
Editing by Derrek Clements, Dylan Fagin and Lowell Berlante, Mixing
(39:11):
by Dylan Fagan. Our researcher is Gabriel Loser. For more
information on today's episode, go to Katie Curik dot com
and follow us on Twitter and Instagram at Katie Currik.
For more podcasts for My Heart Radio, visit the I
Heart Radio app, Apple podcast, or wherever you listen to
(39:32):
your favorite shows,
Host
Katie Couric
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