>> CROSSLEY: WELCOME TO "BASIC BLACK."

SOME OF YOU ARE JOINING US ON OUR BROADCAST AND OTHERS OF YOU ARE JOINING US ON OUR DIGITAL PLATFORMS.

I'M CALLIE CROSSLEY, HOST OF "UNDER THE RADAR," 89.7.

TONIGHT: BLACK MATERNAL HEALTHCARE.

WE, LIKE YOU, ARE DEALING WITH THE EFFECTS OF THE CORONAVIRUS PANDEMIC.ùAND ARE TAKING PRECAUTIONS.

WE ARE WORKING WITH LIMITED STAFF, AND OUR GUESTS ARE JOINING US REMOTELY.

HAVING A BABY IS MOST OFTEN PORTRAYED AS A JOYOUS TIME WITH PARENTS IN WAITING EAGERLY ANTICIPATING THE ARRIVAL OF A NEW LITTLE ONE.

BUT MILLIONS OF BLACK AND BROWN PEOPLE WHO GIVE BIRTH ARE MORE AT RISK OF DYING IN CHILDBIRTH.

MATERNAL MORBIDITY IS A DOCUMENTED REALITY, EVEN HERE IN MASSACHUSETTS, WHERE THERE ARE CUTTING EDGE MEDICAL ADVANCES, AND GLOBALLY RECOGNIZED HEALTHCARE EXPERTS.

IS THIS A MEDICAL EMERGENCY FOR MOTHERS OF COLOR?

AND ARE NEW LOCAL AND FEDERAL POLICY INITIATIVES ENOUGH TO SAVE LIVES?

JOINING US REMOTELY: KETURA'H EDWARDS-ROBINSON, NURSE PRACTITIONER AND MANAGER OF THE MATERNAL CHILD HEALTH PROGRAM AT THE DIMOCK CENTER IN ROXBURY; REP. LIZ MIRANDA, STATE REPRESENTATIVE FOR SUFFOLK COUNTY'S 5TH DISTRICT, WHICH COMPRISES PARTS OF BOSTON'S ROXBURY AND DORCHESTER NEIGHBORHOODS-- SHE IS ALSO A CANDIDATE FOR STATE SENATOR FOR THE SECOND SUFFOLK DISTRICT; NDIDIAMAKA AMUTAH-ONUKAGHA, ASSISTANT DEAN, ASSOCIATE PROFESSOR, AND FOUNDER OF THE CENTER FOR BLACK MATERNAL HEALTH AND REPRODUCTIVE JUSTICE, TUFTS UNIVERSITY.

WELCOME TO YOU ALL.

SO I WANT TO START WITH THIS, WHAT I FIND STARTLING STATISTICS, AND CLEARLY LOTS OF FOLKS DON'T KNOW IT.

SO WE HAVE THIS 2015 STUDY THAT SHOWS THAT THE DEATH RATE -- THE DEATH RATE -- WE'RE TALKING -- THIS IS CRAZY -- FOR BLACK WOMEN IS ALMOST TWO TIMES HIGHER THAN WHITE WOMEN IN MASSACHUSETTS.

AND THEN WE HAVE ANOTHER STUDY WHICH SAYS THAT BLACK WOMEN IN THE U.S. ARE THREE TO FOUR TIMES MORE LIKELY TO DIE FROM PREGNANCY-RELATED DEATHS COMPARED TO WOMEN OF OTHER RACES.

I WANT TO BE CLEAR THAT WOMEN OF OTHER RACES ALSO HAVE HIGHER RATES THAN SHOULD BE COMPARED TO WHITE WOMEN, BUT FOR BLACK FOLKS, SPECIFICALLY, IT SEEMS TO ME TO BE OFF THE CHARTS, DR. NDIDIAMAKA.

I WANT TO TALK TO YOU ABOUT WHY THERE IS A STARK DIFFERENCE.

>> THANK YOU FOR HAVING ME ON YOUR SHOW.

THE FIRST THING I HAVE TO CALL OUT IS THE SYSTEMIC RACISM THAT OCCURS IN THE HEALTHCARE SYSTEM.

WE KNOW BLACK WOMEN ARE 243% MORE LIKELY TO DIE FROM PREGNANCY RELATED COMPLICATIONS.

THE LATEST DATA IS MORE STARK.

WHEN WE GO INTO THE HEALTHCARE SYSTEMS, THERE ARE COUNTLESS EXAMPLES OF BLACK WOMEN BEING UNDERMINED, DISMISSED, DISREGARDED, LACK OF PRIORITIZATION AROUND THEIR SYMPTOMS, AND THE URGENCIES OF WHAT THEY'RE FACING IN THEIR PREGNANCIES.

SO I THINK THAT'S ONE THING I HAVE TO SAY THAT EVEN IN THE SPACE LIKE THE UNITED STATES THAT HAS TREMENDOUS RESOURCES AND TECHNOLOGY, WE STILL SEE BLACK WOMEN NOT GETTING THE QUALITY OF CARE THAT WE DESERVE.

AND, SO, THAT'S ONE THING I WOULD SAY.

I WOULD ALSO TALK ABOUT THE SOCIAL DETERMINATES OF HEALTH WHICH PLACE BLACK WOMEN AT HIGHER RISK FOR A LOT OF PREGNANCY RELATED COMPLICATIONS LIKE GESTATIONAL DIABETES HYPERTENSION, THESE THINGS EXACERBATE PREGNANCY.

PREGNANCY IS ALREADY A STRESS TEST ON THE BOT BODY.

WHEN YOU HAVE UNDERLYING CONDITIONS, IT EXACERBATES THAT, AND COUPLE THAT WITH THE HEALTHCARE BLACK WOMEN SEE IN THE SYSTEM, THINGS ARE DONE DIFFERENTLY FOR DIFFERENT GROUPS OF PEOPLE.

SO WE HAVE A LOT OF CASES IN THE MEDIA, WE HAVE A LOT OF CASES THAT WE WILL NEVER HEAR ABOUT OF JUST MISTREATMENT AND FRANKLY RAWSMS OCCURRING IN BLACK AND BROWN COMMUNITIES.

>> SO, LIZ, ONE OF THE THINGS I FOUND START HINGE WAS YOUR REPORT ABOUT THE MARCH OF DIMES WHICH TALKED ABOUT ZIP CODES.

SHARE THAT, IF YOU WOULD.

>> YOU KNOW, I WALKED INTO THE STATE HOUSE IN JANUARY 2019 AND, IN MY FIRST WEEK, THE MARCH OF DIMES FOR THE REGION GAVE A PRESENTATION TO ALL WOMEN LEGISLATORS, AND IN THAT REPORT, IT TALKED ABOUT THE TEN WORST ZIP CODES WITH BIRTHING OUTCOMES, AND SIX OUT OF THE TEN INCLUDED NEIGHBORHOODS THAT WERE MINE -- THE SOUTH END, ROXBURY, DORCHESTER, AND BATTERY PARK AND MAT AHAN.

WHEN I WALKED OUT I THOUGHT OF MY SISTER WHO GAVE BIRTH IN 2017 TO A 2 21 WEEK OLD BABY WHO DIDN'T SURVIVE.

MY SISTER WAS SENT HOME AND TOLD SHE WAS ANXIOUS AND TOLD TO TAKE TYLENOL AND GO TO SLEEP AND SHE WENT INTO LABOR.

THAT WAS THE CATALYST TO ME CREATING THE COMMISSION SO WE COULD STUDY IT IN MASSACHUSETTS BECAUSE A LOT OF PUBLIC HEALTH CRISES LIKE GUN VIOLENCE AND FOOD, IT'S IN THESE COMMUNITIES.

WE HAVE THE BEST SECTORS HERE IN BOSTON AND STILL WE HAVE A PROBLEM WITH BLACK WOMEN ARE NOT BEING LISTENED TO AND REGARDED IN WAY WHERE THEIR PAIN IS PRIORITIZED.

>> KETURA'H, SPEAKING OF PAIN, WE KNOW ABOUT THIS STUDY HAT HAS BEEN DONE, SO I JUST WANT PEOPLE TO UNDERSTAND, THIS IS NOT SOMETHING YOU ALL MADE UP OR HEARD FROM FOLK AND THERE'S NO DOCUMENTATION.

THERE ARE STUDIES THAT SHOW THAT, IN THE HEALTH FIELD -- WE'RE TALKING ABOUT EXPERTS -- BELIEVE THAT FOLKS OF COLOR AND BLACK FOLKS, SPECIFICALLY, FEEL LESS PAIN THAN OTHER PEOPLE.

SO NOW IMAGINE HOW THAT WOULD PLAY OUT IN A BIRTHING SITUATION, AND KETURA'H, THAT WAS ONE OF THE REASONS THAT MOTIVATED YOU TO WRITE AN OPINION PIECE FOR HARVARD ABOUT THE CRISIS THAT'S HAPPENING IN BLACK MATERNAL HEALTHCARE.

>> YES.

SO LIKE DR. AOS CALLED OUT, RACISM WITHIN OUR MEDICAL FIELD IS WELL AND ALIVE AND WE'RE NOW SEEING THE FALLOUT OF YEARS AND YEARS OF THE SYSTEMATIC INSTITUTIONS AND THE INEQUALITIES THAT BLACK WOMEN AND OTHER WOMEN OF COLOR FACED.

AND I JUST WANTED TO DO MY PART TO CALL IT OUT.

WE NEED IDENTIFIERS WITH THOSE WHO CAN TAKE ACTION AND THAT THE ONE OF MY PRIMARY POINTS WAS THROUGH EDUCATION OF PREGNANT OF THE THINGS AS A A TERM CALLED "WEATHERING," THAT A LOT OF BLACK FOLKS, JUST BECAUSE OF THE STRESS, THE ENVIRONMENTAL STRESS ACTUALLY AGE FASTER.

IF YOUR BODY IS AGING FASTER, GOING INTO A PREGNANCY SITUATION, NOW YOU'RE AT ANOTHER RISKY ELF BECAUSE YOU'RE INVESTIGATE DEAL WITH THAT PLUS CONDITIONS LIKE DIABETES AND HEART DISEASE AND WE'VE HEARD ABOUT THAT BEFORE, AND NOW WE HAVE WHAT YOU THREE HAVE MENTIONED SPECIFICALLY IS THE BUILT-IN SYSTEMIC RACISM.

SO KETURA'H, YOU KNOW, WHAT DID YOU SAY TO PEOPLE?

BECAUSE I KNOW AFTER THEY READ YOUR ARTICLE THEY WERE SHOCKED AT THE STATISTICS THAT YOU RAISED THERE.

>> I MEAN, ONE OF THE FIRST REACTIONS THAT I GOT FROM A LOT OF PEOPLE WERE, LIKE YOU SAID, SHOCK, ALARM, AND THEN THE NEXT REACTION -- THE NEXT QUESTION I GOT WAS, LIKE, WHAT CAN WE DO?

INDIVIDUALS LIKE REPRESENTATIVES LIZ MIRANDA AS WELL AS DR. AO ARE DOING THEIR PART POLITICALLY WITH RESEARCH TO PUSH THE NEEDLE WITH POLICY AS WELL AS DATA SO OTHER CLINICIANS LIKE MYSELF HAVE AVAILABLE A GUIDANCE TO PRACTICE.

THAT'S WHAT WE NEED TO CHANGE IS HOW WE PRACTICE, HOW WE TAKE CARE OF BLACK WOMEN AND OTHER WOMEN OF COLOR BECAUSE THERE'S CLEARLY A DISCONNECT.

>> Crossley: NDIDIAMAKA, YOU'RE RUNNING THE BIG LAB AT TUFTS FOR REPRODUCTIVE AT TUFTS.

YOU'RE OPERATING WITH COMMUNITY PARTNERS.

PROVIDING EDUCATION FOR FOLKS AROUND THESE ISSUES AND TRAINING OB/GYNS.

THE RESEARCH IS CRITICAL, AS MENTIONED BY KETURA'H.

JUST RECENTLY, YOU FINISHED A REPORT WITH A STATE COMMISSION AND REPORTED BACK, WHAT ARE SOME OF THE KEY FINDINGS THAT WOULD LEAD US TO HAVE MOVEMENT IN THIS AREA?

>> YES, THANK YOU.

SO SOME OF THE WORK WE'RE DOING UNDER MY NEW CENTER FOR BLACK WOMEN'S HEALTH AND REPRODUCTIVE JUSTICE INCLUDE THE AREAS THAT YOU REFERENCED, COMMUNITY ENGAGEMENT, TRAINING OF NOT ONLY CLINICIANS BUT STUDENTS, PUBLIC HEALTH PROFESSIONALS, AND IN ADDITION TO THAT FOCUSING ON THE POLICY PIECE.

SO I HAD THE PRIVILEGE OF SITTING ON THE COMMISSION RACIAL EKE TILLS OF MATERNAL HEALTH COMMISSION, REPUBLICAN MIRANDA WAS THE HEAD OF THAT.

SOME OF THE RECOMMENDATIONS TO ADVANCE THE WORK WERE CENTERING THE ROLE OF PARTNERS, FATHERS.

TWO, REALLY FOCUSING ON IMPLILS IT BIAS.

THREE, THINKING ABOUT HOW WE CAN GET DOULA'S REIMBURSED AND PAID THE WAY THEY NEED TO BE, HOW TO DIVERSIFY THE PUBLIC HEALTH AND POLITICAL WORKFORCE.

I REPRESENT LESS THAN 2% OF MEDICAL SCHOOL FACULTY THAT ARE BLACK.

HOW DO WE DIVERSIFY THE HEALTH AND CLINICAL WORKFORCE TO HAVE MORE CONGRUENCY IN THE RELATIONSHIPS.

WE HAVE A LOT OF WORK TO DO HERE WHEN IT COMES TO THE WAY PEOPLE ARE TREATED BASED ON THEIR INSURANCE TYPE, THE WAYCALLY NATIONS SEE PATIENTS, AND THESE ARE SOME OF THE THINGS WE'RE TALKING ABOUT.

I WOULD BE REMISS IF I DIDN'T LIFT UP THE FACT THAT WE NEED MORE BIRTHING CENTERS.

RIGHT NOW THERE IS A BIG PUSH TO CLOSE THE BIRTHING CENTER IN BEVERLY.

I'M ON THE NEIGHBORHOOD BOARD OF THE CENTER IN BOSTON AND WE'RE TRYING TO OPEN OUR DOORS.

PEOPLE NEED OPTIONS BESIDES HOME AND HOSPITAL-BASED BIRTH.

THOSE ARE SOME OF THE THINGS THAT CAME UP FOR THE COMMISSION.

SO THE REPORT AND THE COMMISSION ARE OFFICIALLY DONE BUT NOW IS ON THE WORK -- IS WHEN THE WORK STARTS SO I'M EXCITED TO WORK WITH MY COLLEAGUES TO GRAPPLE WITH THIS FURTHER ABOUT IMPLEMENTING SOME OF THE RECOMMENDATIONS THAT WE PROPOSED.

>> THERE'S A LOT TO UNPACK BUT I WANT TO GO TO ONE THING BECAUSE THE OTHER TWO THINGS I'M GOING TO GO TO REPRESENTATIVE LIZ MIRANDA, AND THAT IS THERE ARE STUDIES -- AGAIN, Y'ALL, I DIDN'T MAKE THIS UP -- AND IF THERE ARE PHYSICIANS OF COLOR, THEN THE OUTCOMES IMPROVE.

>> YEAH.

AND PARTICULARLY IN THE CASE OF A BIRTHING SITUATION.

JUST SPEAK TO THAT BRIEFLY, IF YOU WOULD.

>> YEAH, THE WORK OF DR. HARD DR. HARDEMAN, A GOOD COLLEAGUE OF MINE OUT OF MINNESOTA, LOOKED AT THE CONGRUENCY BETWEEN AN INFANT AND PROVIDER AND FOUND IN A CASE WHERE INFANTS WERE TREATED BY BLACK DOCTORS, THE LIKELIHOOD OF INFANT MORTALITY WAS CUT IN HALF.

THAT IS SIGNIFICANT BECAUSE WE KNOW BLACK INFANTS ARE TWICE AS LIKELY TO DIE THAN THEIR WHITE COUNTERPARTS.

I DID MY DILLSERTATION ON INFANT MORTALITY TEN YEARS AGO AND WE STILL HAVE NOT MOVED THE NEEDLE.

SO I THINK WHEN YOU HAVE SOME INSIGHT, YOU HAVE SOME BREAKTHROUGHS IN THIS WAY, THAT'S REALLY ENCOURAGING.

ONE, IT JUST HIGHLIGHTS THE FACT WHEN WE HAVE CULTURAL CONGRUENCY, THINGS MOVE BETTER AND PLAYS OUT FOR BOTH PARTIES, AND THIS FOES TO TRAINING THE NEXT GENERATION OF CLINICIANS TO DO THIS WORK.

THAT IS SOME TO HAVE THE WORK WE'RE DOING IN MY MOTHER LAB.

I HAVE THE LARGEST LAB IN THE COUNTRY.

WE ARE TRAINING NURSINGS, CLINICIANS, RESEARCHERS, SCHOLARS TO GO INTO THESE PERSPECTIVE FIELDS IN MEDICINES.

I HAVE STUDENTS THAT GRAPPLING WITH THE ISSUE.

WHEN YOU SEE THE INFANT MORTALITY RATE IS CUT IN HALF BASING THE FACT THAT THE PROVIDER AND PATIENT ARE BOTH OF THE SAME RACE -- IN THIS CASE BLACK -- THAT WAS A REAL OPPORTUNITY AND PUSH FOR US TO GET MORE STUDENTS, CLINICIANS, RESEARCHERS OF COLOR INTO THESE SPACES.

>> Crossley: LIZ, WE HAVE A FEW THINGS I NEED FOR YOU TO ADDRESS.

YOU WERE TALKING ABOUT WHEN YOU FIRST GOT TO THE STATE HOUSE AND THREE AND A HALF YEARS AGO YOU INTRODUCED LEGISLATION AND PART OF IT HAD TO DO WITH HELPING TO ESTABLISH MORE DOULAS.

KETURA'H IS ONE.

WE NEED TO EXPLAIN WHAT THAT IS.

BUT JUST WHY THAT WAS IMPORTANT AND WHY YOU PUSHED THAT IN YOUR FIRST PIECE OF LEGISLATION.

>> SO WHAT YOU'RE TAKING ABOUT IS THE MATERNAL AND EQUITIES COMMISSION THAT WAS THE FIRST AND ONLY BLACK WOMEN'S CENTERED AND LED COMMISSION IN THE ENTIRE COMMONWEALTH, AND I WANT TO THANK THE BOSTON PUBLIC HEALTH COMMISSION AND COMMISSIONER HALL, SABA, DR. NDIDI, MANY PEOPLE, BLACK WOMEN ARE LEADING IN COMMUNITY AND THEY COME TO THE LEGISLATURE BECAUSE THE LEGISLATURE HAD ONE BLACK WOMAN BEFORE I GOT THERE, AND NOW WE HAVE FIVE BLACK WOMEN, SO I GUESS THAT'S GROWTH.

BUT WE'RE STILL VERY MUCH UNDER -- UNDERREPRESENTED.

AND WHEN THAT PIECE OF LEGISLATION CAME TO ME, I DIDN'T KNOW HOW TO WRITE A BILL, AND, SO, I WAS WALKING INTO A PROBLEM THAT I DIDN'T KNOW ABOUT.

YOU KNOW, I'M NOT A MOTHER YET, AND, SO, I WAS THINKING TO MYSELF, COULD THIS REALLY BE A CRISIS?

AND WHEN WE MET FOR THE LAST YEAR, WE DID FOUR LISTENING SESSIONS, AND PART OF THE WORK THAT CAME OUT, DR. NDIDI SHARED SOME OF THE RESULTS, WAS THAT I ALSO FILED A BILL TO REIMBURSE AND IMPROVE THE WORKFORCE OF DOULAS.

WHY?

DOULAS ARE SHOWN AS SORT OF HEALTH NAVIGATORS WITH BIRTHING PEOPLE TO HELP THEM HAVE THEIR VOICE HEARD IN THE SPACE OF HEALTHCARE.

THE OTHER THING WE HAVEN'T TALKED ABOUT REALLY IS BIRTHING PEOPLE OF COLOR, PARTICULARLY THE BLACK DIASPORA, MANY WOMEN WHO REPRESENT A BLACK DIASPORA OR COMMUNITY, IF THEYIN' LATINX OR HAITIAN, SPEAK ANOTHER LANGUAGE.

MANY ARE GETTING CARE IN COMMUNITY HEALTH CENTERS AND THE FIRST TIME THEY'RE MEETING THE OB/GYN FOR THE TEAM HELPING THEM GIVE BIRTH IN THE BIGGER HOSPITAL IS WHEN THEY'RE GIVING BIRTH.

THERE'S ISSUES WITH LANGUAGE ACCESS, CULTURAL COMPETENCY, THERE'S ALSO AN ISSUE THAT WE TRAIN PEOPLE ON IMPLILST BIAS WHEN THERE'S EXPLICIT BIAS, YOU KNOW, THAT THAT'S ENGRAINED IN OUR EDUCATIONAL SYSTEM, OUR GOVERNMENT.

TWO OTHER PIECES THAT I THINK ARE INCREDIBLY IMPORTANT OUT OF THE COMMISSION IS THAT THEY WANT TO FORM A PERMANENT TASK FORCE.

THIS WAS A TEMPORARY COMMISSION AND THE THE ISSUE OF INFANT MORTALITY AND MATERNAL MORBIDITY AND MORTALITY IS NOT GOING TO BEVOLVED IN ONE CALENDAR YEAR.

CREATING A TASK FORCE IS GOING TO BE REALLY IMPORTANT.

THE OTHER IS MASSACHUSETTS NEEDS TO JOIN THE OTHER 27 STATES THAT HAVE A -- SYSTEM.

300 BABIES DIE EACH YEAR, MOST BLACK AND BLN IN MASSACHUSETTS, WE HAVE 351 CITIES AND TOWNS AND MANY DON'T EVEN COUNT OUR CHILDREN.

OUR CHILDREN AND FAMILIES MATTER TO US.

MY SISTER STILL THINKS ABOUT HER DAUGHTER AND IT'S IMPORTANT FOR ME TO ENSURE THAT WE HAVE A FEMUR SYSTEM, DOULAS IN THE COMMONWEALTH BUT ALSO EXTEND POSTPOSTPARTUM COVERAGE FOR A YEAR.

>> Crossley: LET ME INTERRUPT YOU TO SAY THE REASON THAT IS IMPORTANT MEANING THAT PERIOD RIGHT AFTER WOMEN HAVE GIVEN BIRTH IS ONE-HALF OF MATERNAL DEATHS HAPPEN AFTER BIRTH.

JUST WANT TO UNDERSCORE THAT.

CONTINUE, REPRESENTATIVE LIZ.

>> AND WE DON'T TALK ENOUGH ABOUT LIVING IN AN ENVIRONMENTAL INJUSTICE COMMUNITY.

I GREW UP IN THE DUDLEY TRIANGLE.

OUR ASTHMA RATE IS FIVE TIMES HIGHER.

WE DIE 30 TO 33 YEARS AHEAD OF PEOPLE WHO LIVE IN THE BACK BAY.

WHEN YOU TALK ABOUT WEATHERING, WE HAVE LIVED GENERATIONAL WEATHERING.

MY MOTHER HAD ME AT 18.

SHE DIDN'T GET WHAT SHE NEEDED.

MY GRANDMOTHER CAME TO THIS COUNTRY AS AN AFRICAN IMMIGRANT, SHE DIDN'T GET WHAT SHE NEEDED.

THE RATES, I WANT TO SAY ONE MORE PIECE OF BAD NEWS, BUT WE HAVE A LOT TO BE HOPEFUL FOR, WHEN YOU SEE A BLACK MATERNAL HEALTH SYSTEM, RESEARCH AND LAB AT TUFTS UNIVERSITIES, WE'RE GOING SOMEWHERE.

WE SEE A MATERNAL EQUITIES COMMISSION FILE A REPORT THAT'S GOING TO LEAD TO A BIRTHING JUSTICE OMNIBUS BILL, WE'RE GOING SOMEWHERE.

THE OTHER THING I WANT TO SHARE, AS I GET EDUCATED, LIVE IN A BETTER PLACE, MAKE MORE MONEY, THE RATES STILL DON'T CHANGE.

>> EXACTLY.

WHAT WOE KNOW, IT IS ABOUT RACISM.

THIS IS NOT A SITUATION WHERE, IF YOU ARE SMARTER, HAVE A PARTNER, MAKE MORE MONEY AS A BLACKWOMAN THAT ACTUALLY YOUR OUTCOMES ARE GETTING BETTER.

SO WE NEED TO FOCUS ON ADDRESSING THE RACISM THAT IS STRUCTURAL IN OUR INSTITUTIONS.

>> KETURA'H, YOU ARE A DOULA.

I WANT TO BE CLEAR ABOUT DOULA, MIDWIVES AND NURSE PRACTITIONER.

YOU HAPPEN TO BE A NURSE PRACTITIONER AND A DOULA.

A DOULA IS PSYCHOLOGICAL, EMOTIONAL ADVOCATE FOR THE BIRTHING PERSON, BUT NOT NECESSARILY WITH MEDICAL KNOWLEDGE.

YOU HAPPEN TO HAVE ALSO ANOTHER ROLE AS A NURSE PRACTITIONER SO YOU'RE TRAINED MEDICALLY.

A MIDWIFE -- AND THERE USED TO BE TWO KINDS OF MIDWIVES IN MASSACHUSETTS, ONE THAT DID NOT HAVE MEDICAL TRAINING BUT NOW ALL OF THEM PRETTY MUCH DO, THAT WAS A STRUGGLE IN MASSACHUSETTS, BY THE WAY, TO GET TWO MIDWIVES.

SO IT'S NOT UNUSUAL GETTING TWO DOULAS WOULD BE ANOTHER TURN.

AND THEN, OF COURSE, YOU HAVE NURSE PRACTITIONERS LIKE YOURSELF AS WELL AND DOCTORS.

SO WE WANT TO LAY THAT OUT FOR FOLKS AND THE REASON DOULAS HAVE BECOME MORE IMPORTANT TO FOLKS OF COLOR IS THEY'RE USUALLY ETHNICALLY COMPATIBLE, RACIALLY COMPATIBLE AND CAN BE THAT VOICE AND ADVOCATE FOR THE BIRTHING PERSON.

BUT KETURA'H, TALK ABOUT HOW IMPORTANT IT'S BEEN IN YOUR ROLE AS A DOULA, BECAUSE YOU DIDN'T HAVE TO TAKE ON THAT, YOU'RE ALREADY A NURSE PRACTITIONER.

>> YES, SO I HAVE BEEN A NURSE PRACTITIONER FOR GOING ON TEN YEARS IN WOMEN'S HEALTH REAR HERE IN ROXBURY, AND THERE WAS ALWAYS SOMETHING IN THE BACKGROUND FOR ME, LIKE, WHAT ELSE CAN I DO?

AND MISS CALLIE, YOU MENTIONED IT EARLIER, THAT THE FIRST TIME THAT MANY OF MY PATIENTS ACTUALLY SEE THE TEAM THAT'S GOING TO HELP THEM BRING THEIR CHILD INTO THE WORLD IS AT THE TIME OF THAT BIRTH, AND THE PSYCHOLOGICAL IMPACT AND THE MENTAL STRESS THAT CAN PUT ON THE BIRTHING PERSON AS WELL AS HER FAMILY.

SO I WANTED TO JUST DO MORE, AND THAT'S HOW I DISCOVERED BECOMING A DOULA.

HERE IN MASSACHUSETTS, FORTUNATELY, THIS IS A WEALTH OF EXPERIENCED DOULAS WHO HAVE BEEN DOING THE GOOD WORK FOR A VERY LONG TIME THAT I'VE HAD THE HONOR AND PLEASURE OF LEARNING FROM AND WORKING WITH, AND IT HAS COMPLETELY TRANSFORMED HOW I PROVIDE CARE AS A CLINICIAN, AND IT'S ALSO -- IT ALSO HAS INFLUENCED HOW I HAVE BEEN PRECEPTING AND TRAINING FUTURE CLINICIANS LIKE DR. AO'S WORK IS SURROUNDING, BECAUSE THAT IS, AGAIN, WHERE IT COMES DOWN TO.

LIKE, I FORGET WHO SAID IT EARLIER, BUT THE DOULA COORDINATES, HAVING A DOULA WITH THE SAME BACKGROUND AS WELL AS HAVING AN IMPACT, THAT'S NOT GOING TO SAVE THAT WOMAN'S LIFE.

IT'S RACISM AND WE NEED TO ADDRESS THAT, AND, AGAIN, IT COMES DOWN TO THE PRACTITIONERS OF MATERNAL CHILD HEALTHCARE AND HOW THEY PRACTICE.

>> Crossley: PICK UP SOMETHING THAT REPRESENTATIVE LIZ BROUGHT UP WHICH IS ABOUT THE SOCIAL-ECONOMIC STATUS.

SO PART OF THE WORK THAT YOU'RE DOING, REPRESENTATIVE LIZ, IS TO TRY TO GET REIMBURSEMENT FOR DOULAS, BUT THERE ARE A NUMBER OF FOLKS OF COLOR WHO ARE WITHOUT THE KINDS OF RESOURCES THAT THEY NEED, SO THEY, THEREFORE, GO, DON'T EVEN GET INTO PRENATAL CARE UNTIL LATER.

LET'S JUST PUT THAT ON THE TABLE.

BUT IN A 2016 ANALYSIS OF FIVE YEARS OF DATA, BLACK COLLEGE EDUCATED WOMEN, PEOPLE WHO GAVE BIRTH IN LOCAL HOSPITALS, WERE MORE LIKELY TO SUFFER SEVERE COMPLICATIONS OF PREGNANCY OR CHILDBIRTH THAN WHITE WOMEN WHO NEVER GRADUATED FROM HIGH SCHOOL.

AND THEN THERE IS SERENA WILLIAMS, DR. NDIDI, SERENA WILLIAMS HAS ALL THE MONEY IN THE WORLD, EVERY POSSIBLE RESOURCE, SHE'S IN THE HOSPITAL, THEY DON'T BELIEVE HER THAT SHE'S IN PAIN AND SHE ALMOST DIED.

>> ABSOLUTELY.

YOU KNOW, IN THE CASE OF SERENA WILLIAMS IS SO STARK, AND I JUST WANT TO LIFT UP TWO MORE CASES NEAR AND DEAR TO MY HEART AND THEY ACTUALLY DIDN'T MAKING.

DR. SHALAN IRSPRING AND SHANISE WALLACE.

IT'S THE SIGNIFICANT BECAUSE THE CASE OF SERENA WILLIAMS COULD HAVE GONE DIFFERENTLY QUICKLY.

SERENA WAS BEING TREATED FOR PULMONARY EMBOLISMS BEFORE SHE WAS PREGNANT.

WHEN SHE WAS PREGNANT SHE HAD TO STOP THE MEDICATION.

SHE GAVE BIRTH TO A BEAUTIFUL BABY AROUND WAS FEELING TIGHTNESS IN HER CHEST AND SAID SHE NEEDED A CT SCAN.

THE NURSE DISMISSED HER.

SERENA IS GIVING BIRTH AT A HIGH QUALITY, SEEMINGLY REALLY RESOURCED INSTITUTION.

IN THAT MOMENT, SHE WAS COMPLETELY DISREGARDED AND DISMISSED.

WHAT'S MOST INTERESTING TO ME WHEN I TELL THE STORY IS IT WAS DOCUMENTED IN HER MEDICAL RECORDS THAT HE HAD A HISTORY OF P.E.s, AND IF SHE HAD NOT PERSISTED, CAN YOU IMAGINE THE TRAUMA THIS WOMAN HAS BEEN THROUGH, YOU JUST GAVE BIRTH, YOU'RE SUPPOSED TO BE ENJOYING, THE ENDORPHINS ARE THROUGH THE ROOF, YOU'RE LOOKING AT YOUR BABY, I REMEMBER POSTPARTUM YOU'RE FEELING AMAZING.

BUT THEN YOU HAVE TO ADVOCATE TO PERSIST TO PUSH TO GET THE CT THAT IF SHE HAD NOT GOT IT, SHE WOULD HAVE DIED.

SHE HAD A BLOOD CLOT THAT WAS DEVELOPING IN HER LUNGS.

SO WHAT A STAIN THAT WOULD HAVE BEEN ON THE FABRIC OF THIS COUNTRY TO LOSE A GLOBAL -- SERENA DOESN'T JUST BELONG TO UNITED STATES, SHE BELONGS TO THE WORLD.

WHAT A STAIN THAT WOULD HAVE BEEN ON THE FABRIC OF THIS COUNTRY, A PERMANENT STAIN, INDELIBLE, TO LOSE AN ATHLETE, A WOMAN, BIRTHING PERSON, BLACK WOMEN LIKE SERENA BECAUSE TO HAVE THE DISMISSIVENESS TO HAVE THE HEALTHCARE SYSTEM.

HER STORIES IS SO POIGNANT AND THEN WE HAVE THOSE WHO DIDN'T MAKE IT.

I'M ON THE BOARD OF DR. SHALAN.

WE ARE LIFTING UP HER NAME, KEEPING HER NAME ALIVE AND BRINGING AWARENESS.

WE'RE CREATING AN APP CALLED HEAR HER, WHEN A BLACKWOMAN TELLS YOU THE SYMPTOMS, YOU NEED TO HEAR HER.

ADVOCACY IS PUSHING FOR THOSE WHO ARE NO LONGER HERE TO PUSH FOR THEMSELVES.

I HAVE MANY EXAMPLES OF PEOPLE WHO SHOULD BE HERE RAISING THEIR CHILDREN BUT ARE NOT.

>> Crossley: V.P.

KAMALA HARRIS PULLED TOGETHER A CONFERENCE AND SAID HE WANTED TO DONATE THREE DOLLARS BILLION TO ADDRESS THIS ISSUE.

WE JUST HAVE SECONDS TO GO.

ARE YOU IN FAVOR OF THAT AND HAPPY ABOUT THAT?

>> I THINK IT WAS IMPORTANT FOR HER TO HAVE A CAUSE OF ACTION BUT I WANT TO LIFT UP THE BLACK MATERNAL HEALTH CAUCUS LED BY CONGRESSWOMAN UNDERWOOD AND CONGRESSWOMAN PRESSLEY WHO REALLY PUSHED THE FEDERAL GOVERNMENT TO PASS THE OMNIBUS BILL THAT HAD 12 LITTLE PIECES OF LEGISLATION THAT HAVE LED TO US LOOKING AT THE CONTINUUM FROM REPRODUCTIVE HEALTH TO POST APARTMENT CONGRESS.

4.

POSTPARTUM COVERAGE.

4.5 FOR HEALTHY START DOULA PROGRAMS IS A START.

THE $470 MILLION THAT THE PRESIDENT PUT TOWARD THIS ISSUE IS A START.

>> Crossley: WE HAVE TO LEAVE IT THERE.

WE'LL CONTINUE.

THAT'S THE END OF OUR BROADCAST AND THE END OF OUR SHOW.

THANK YOU FOR JOINING US AND NOW STAY WITH US AS WE CONTINUE OUR CONVERSATION ON OUR DIGITAL PLATFORMS, FACEBOOK AND YOUTUBE.

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