>>> WE WELCOME YOU TO A VERY SPECIAL "NEXT UP" THIS EVENING.

DR. MARTIN LUTHER KING WHEN SPEAKING OF INEQUALITIES SAID THAT HEALTH INEQUALITIES AND HEALTH INJUSTICE IS THE MOST INHUMANE.

MATERNAL HEALTH CARE EXPERIENCES ARE NOT CONSISTENT FOR ALL MOTHER MOTHERS.

ACROSS AMERICA INCLUDING IN MISSOURI AND ILLINOIS, MATERNITY, MORBIDITY AND MORTALITY DISPROPORTIONATELY AFFECTS BLACK MOTHERS AND THOSE NOT ON PRIVATE HEALTH INSURANCE.

A MULTI-YEAR REPORT RELEASED LAST AUGUST FROM THE MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES FOUND THAT WOMEN ON MEDICAID ARE EIGHT TIMES MORE LIKELY TO DIE WITHIN ONE YEAR OF PREGNANCY THAN THEIR COUNTERPARTS WITH PRIVATE HEALTH INSURANCE.

IT ALSO FOUND THAT BLACK WOMEN IN MISSOURI WERE THREE TIMES MORE LIKELY TO DIE WITHIN A YEAR OF PREGNANCY THAN WHITE WOMEN.

JUST THIS WEEK, 9 PBS AIRED THE DOCUMENTARY "BIRTHING JUSTICE: EXAMINING THE STRUCTURES AND SYSTEMS THAT DETERMINE THE MORTALITY OF BLACK WOMEN AND THEIR BABIES."

TAKE A LOOK.

>> NICE STRONG HEART RATE.

>> A JOYFUL, EXCITING, INCREDIBLE EXPERIENCE.

>> LOOK AT THOSE LIPS.

>> THAT'S SOMETHING THAT SHOULD BE AVAILABLE TO EVERY FAMILY.

>> I LOST MY FIRST BABY LISTENING TO THIS DOCTOR.

>> IT'S NOT SOMETHING THAT WE'RE DOING THAT'S ANY DIFFERENT FROM ANYONE ELSE.

CALL IT WHAT IT IS.

IT'S RACISM.

>> THINGS WERE SPIRALING DOWN.

>> LET'S SHIFT THE NARRATIVE.

>> OUR MOMS ARE WORTH IT.

>> THIS WEEK IS BLACK MATERNAL HEALTH WEEK, AND JOINING US TO DISCUSS DISPARATES IN MATERNAL HEALTH CARE ARE DR. TYRESA HOWARD, ASSISTANT PROFESSOR AT THE BROWN SCHOOL AT WASHINGTON UNIVERSITY IN ST. LOUIS.

WELCOME, DOCTOR.

MACKENZIE LEMIEUX, THIRD YEAR MEDICAL STUDENT AT WASHINGTON UNIVERSITY'S SCHOOL OF MEDICINE IN ST. LOUIS AND JOINING US FROM DALLAS IS OKANSOA AMADOU, FIRST BLACK CERTIFIED PROFESSIONAL MIDWIFE IN THE STATE OF MISSOURI AND THE FOUNDER AND CEO OF JAMA BIRTH VILLAGE IN FERGUSON.

WE WELCOME ALL OF YOU TO "DONNYBROOK NEXT UP."

>> THANK YOU.

>> OKANSOLA CAN YOU SHARE WITH US WHY THE JAMA BIRTH VILLAGE HAS BEEN A REVOLUTIONARY PLACE TO THIS POINT?

>> YES, JAMA BIRTH VILLAGE IS REALLY AN OPPORTUNITY FOR OUR COMMUNITY TO WELCOME MOTHERS TO BIRTH IN THEIR FULL POWER AND RESPECTABLE WAY.

WE EXIST BECAUSE PRIOR TO 2015, WE DID NOT HAVE ANY SAFE COMMUNITY-BASED PLACES FOR PEOPLE TO GIVE BIRTH WITH PROVIDERS WHO LOOKED LIKE THEM.

NO BLACK WIVES SERVING THE COMMUNITY AND ONLY FIVE BLACK DOULAS PRACTICING.

DOULAS WERE ONLY AVAILABLE TO WHITE MIDDLE CLASS WOMEN.

WE FILLED IN A GAP WHERE BLACK WOMEN WERE SUSCEPTIBLE TO A LOT OF DIFFERENT MEDICAL NEGLIGENCE AND ISSUES BASED ON THEIR RACE IN OUR COMMUNITIES AND SO WE FILLED THAT VOID BY CREATING BLACK MIDWIVES IN OUR COMMUNITY, TRAINING OVER 200 BLACK DOULAS IN OUR COMMUNITY AND THEY'RE RESPECTED WHILE RECEIVING THAT CARE.

IT'S IMPERATIVE WHERE WE KNOW IN OUR STATE THAT WOMEN ARE HARMED AS HIGHER RATES THAN WHITE WOMEN AND THAT BLACK WOMEN ARE DYING AT HIGHER RATES THAN BLACK WOMEN.

IT'S IMPORTANT THAT WE BE OUR OWN SOLUTION AND WE PROVIDE THE CARE THAT'S NEEDED FOR US, SO WE ARE ANSWERING THAT VERY IMPORTANT CALL TO SAVE LIVES AND IMPROVE BIRTH OUTCOMES.

>> ARE YOU ALREADY SEEING A REVERSAL IN TERMS OF TRENDS AND SAFETY?

>> I AM, AND I'M SO GLAD THAT YOU ASKED THAT QUESTION.

WE DO HAVE A LOT OF WORK TO DO, BUT I DO WANT TO APPLAUD OUR COMMUNITY FOR CATCHING UP.

JAMA BIRTH VILLAGE WAS FOUNDED IN 2015 AND RIGHT OUT OF THE GATE, WE WERE ADVOCATING FOR DLS AND MIDWIVES AND SOCIAL SUPPORT SERVICES, CHIROPRACTIC CARE, MASSAGE THERAPY, DIFFERENT THINGS TO SUPPORT THE BODY THROUGH PREGNANCY WE ALL NEED.

IT'S NOT A LUXURY.

I'LL BE HONEST, THE FIRST THREE YEARS PEOPLE THOUGHT THAT I WAS A BIT CRAZY.

THEY DIDN'T BELIEVE IN WHAT I WAS SPEAKING ABOUT.

IT TOOK A LOT OF CLOSED DOORS BEFORE PEOPLE STARTED WAKING UP.

SO AROUND 2018, A LOT OF PEOPLE STARTED TO GET ON BOARD WITH, OKAY, MAYBE THIS MIDWIFE DOULA THING IS IMPORTANT AND ALSO, I WOULD SAY THAT HOSPITALS AND INSTITUTIONS SUCH AS WASH U.

AND BJC WHICH SLCOLLABORATED WITH JAMA BIRTH VILLAGE, THEY ARE WAKING UP AND ENCOURAGING OTHER STAFF AND TEAM MEMBERS TO BE A PART OF THE CONVERSATION, TO BE A SOLUTION, TO ADDRESS DISPARITIES, SO THAT MEANS US TALKING ABOUT THE HARD THINGS THAT RACISM IS THE CORE OF ITS ISSUE, AND FINDING WAYS TO BE THE SOLUTION.

SO I AM SEEING PROVIDERS STARTING TO LOOK AT THEIR OWN BIASES IN RACISM.

I AM SEEING MORE PROVIDERS AND HOSPITALS BEING WILLING TO WORK WITH COMMUNITY AGENCIES LIKE JAMA BIRTH VILLAGE AND NOW THE WORD DOULA IS A HOUSEHOLD NAME IN THE CITY OF ST. LOUIS, BECAUSE OF THE WORK THAT JAMA BIRTH VILLAGE HAS DONE, WHERE PRIOR, MAYBE ONLY TWO OR THREE PEOPLE OUT OF TEN KNEW WHAT A DOULA WAS.

IF YOU ASK SOMEONE NOW I'LL TELL YOU EIGHT OUT OF TEN PEOPLE KNOW WHAT A DOULA IS AND HOW TO ACCESS A DOULA.

IT'S TREMENDOUS.

>> FOR THE TWO WHO ARE NOT AWARE OF THE DIFFERENCE BETWEEN A MIDWIFE AND A DOULA, MACKENZIE, DO YOU WANT TO TAKE THAT ONE OR OKANSOLA, WOULD YOU LIKE TO TAKE THAT >> I DON'T MIND AND MACKENZIE CAN FOLLOW UP.

I'M A CERTIFIED PROFESSIONAL MIDWIFE AND IBEGWE WHICH IS A TRADITIONAL MIDWIFE IN MY WEST AFRICAN CULTURE.

A MIDWIFE PROVIDES CLINICAL AND MEDICAL CARE FOR LOW-RISK PREGNANT PEOPLE, SO THAT'S SOMEONE WHO MAYBE DOES NOT HAVE ANY AT-RISK OR RISKS SUCH AS GESTATIONAL DIABETES OR OTHER ISSUES THAT WOULD DEEM THEM NEEDING TO HAVE AN OBSTETRICIAN OR MATERNAL FETAL MEDICINE DOCTOR.

MIDWIVES CAN PRACTICE IN THE HOSPITAL, IN BIRTHING CENTERS OR THEY CAN ALSO PROVIDE HOME BIRTH DELIVERIES WHICH IS MY SPECIALTY.

A DOULA IS A NON-CLINICAL TRAINED AND SKILLED SUPPORT PERSON WHO PROVIDES EDUCATIONAL, INFORMATIONAL, PHYSICAL AND EMOTIONAL COMFORT AND SUPPORT TO THE PREGNANT PERSON AND MAYBE THEIR PARTNER AND THEIR FAMILY.

SO THE DISTINCT DIFFERENCE IS THAT ONE PROVIDER IS A MEDICAL PROVIDER, AND THE OTHER PROVIDER IS NOT MEDICAL BUT THEY ARE ESSENTIAL, AND I WOULD JUST LIKE TO WRAP THAT UP BY SAYING DOULAS ARE LIKE YOUR GPS NAVIGATION SYSTEM, IF YOU'RE GOING ON A ROAD TRIP.

>> RIGHT.

>> SO YOU WOULD WANT TO HAVE GPS IF YOU'RE TAKING A 13-HOUR ROAD TRIP ACROSS THE COUNTRY AND DOULAS ARE VERY HELPFUL TO HELP PEOPLE NAVIGATE BIRTH.

>> IS THERE STILL PUSHBACK FROM THE MEDICAL PROFESSION ABOUT DOULAS?

BECAUSE THERE HAS BEEN FOR SURE AND OBVIOUSLY IT'S GREAT TO HEAR THAT A COUPLE OF OUR LARGER HOSPITAL INSTITUTIONS ARE SEEMING TO WORK BETTER WITH YOU.

WHAT IS THE STATE OF PLAY AS FAR AS THAT GOES?

>> I THINK ONE THING IN THAT REALM THAT WE'VE ESPECIALLY SEEN MAYBE DURING COVID IS A DOULA IS PART OF THE MEDICAL TEAM, BUT SOMETIMES THEY ARE CONSIDERED WITH THE FAMILY, AND THUS WHEN PATIENTS ARE TOLD OH, LIKE YOUR PARTNER AND YOUR MOM CAN STAY WITH YOU IN THE ROOM, THEN THE DOULA IS ASKED TO LEAVE, AND THIS IS NOT FAIR, BECAUSE THEY'RE PART OF THE MEDICAL TEAM.

THEY SHOULD BE ALLOWED TO STAY AND SUPPORT THE PATIENT ON THEIR 13-HOUR ROAD TRIP ACROSS THE COUNTRY AS THEY ARE CRITICAL TO THE PATIENT'S WELL-BEING AND THEIR ABILITY TO VOICE OPINIONS AND THOUGHTS ON THEIR MEDICAL CARE AND THAT'S SOMETHING THAT WE DON'T LEARN IN MEDICAL SCHOOL, AS A MEDICAL STUDENT.

THIS IS SOMETHING THAT I THINK OUR EDUCATION IS LACKING THE KNOWLEDGE AND UNDERSTANDING OF WHAT A DOULA AND MIDWIFE DO TO SUPPORT BIRTH FOR OUR PATIENTS.

>> AND IT'S SO INTERESTING, ISN'T IT, DOCTOR, BECAUSE MACKENZIE IS SAYING THAT THIS IS WHY SHE FEELS SO STRONGLY ABOUT A MEDICAL CAREER.

YOU HAVE COME INTO THIS PROFESSION WITH ALL OF THIS KNOWLEDGE.

ARE YOU ENCOURAGED AT THIS MOMENT BECAUSE OF JAMA BIRTH VILLAGE, BECAUSE OF THIS CAMPAIGN TO RAISE PUBLIC AWARENESS?

ARE YOU MORE ENCOURAGED?

>> ABSOLUTELY.

AND SO I MOVED TO ST. LOUIS IN THE FALL, OR THE SUMMER OF 2019 TO JOIN THE FACULTY AT WASH U AND I WAS FORTUNATE ENOUGH TO RECEIVE MY OWN FULL SPECTRUM DOULA TRAINING IN NOVEMBER OF 2020, AND SO I THINK HAVING HAD THAT EXPOSURE EVEN DURING COVID ALLOWED ME TO UNDERSTAND WHAT THE LANDSCAPE OF MATERNAL HEALTH LOOKS LIKE HERE IN ST. LOUIS, AND AS WELL AS WHAT THE COMMUNITY IS ENGAGED AND HELPING TO IMPROVE WHAT THE OUTCOMES LOOK LIKE, BECAUSE A LOT OF MY WORK IS REALLY CENTERED ON A COMMUNITY-BASED PERSPECTIVE, TO BE ENGAGED AND TO LEARN FROM THE COMMUNITY HOW TO ADDRESS AND TO RESPOND WHAT THEIR NEEDS LOOK LIKE.

I'M AN ETHICAL RESEARCHER IN THAT I DON'T THINK IT'S WISE AND ALWAYS THE BEST PRACTICE TO GO INTO COMMUNITIES AND STRATEGIZE AROUND WHAT THEIR SOLUTIONS MIGHT LOOK LIKE.

TO IMPACT AND CHANGE YOU HAVE TO BE ENGAGED AND CONNECTED WITH THE COMMUNITY SO THEY'RE ABLE TO INFORM YOU WHAT THEIR NEEDS LOOK LIKE AND YOU RESPOND IN ACCORDANCE WITH WHAT THEY ARE TELL YOU HOW TO BEST IMPROVE THEIR HEALTH OUTCOMES.

SO FROM MY OWN PERSONAL EXPERIENCE I MOVED HERE WHEN I WAS PREGNANT AS WELL SO I HAD A DOULA WHO WAS A PART OF WHAT MY CARE TEAM LOOKED LIKE AND MY PHYSICIAN WAS OPEN TO BEING ABLE TO HAVE THE DOULA BE A PART OF MY CARE TEAM.

I HAD TRANSITIONED FROM CARE IN NEW JERSEY WHERE I HAD BEEN LIVING PREVIOUSLY BEFORE COMING HERE AND THAT POSITION WAS NOT AS OPEN TO HAVING A DOULA AND HAVING HAD THE CONVERSATIONS.

THERE WERE CERTAIN REMARKS AND THINGS THAT WERE MADE AT THAT POINT IN TIME THAT LED ME TO BELIEVE THIS WOULD NOT BE THE MOST WELCOMING ENVIRONMENT FOR THE BIRTHING PLAN I HAD INTENTION .

I WAS THANKFUL TO DELIVER WITH A PHYSICIAN WHO WAS OPEN TO IT BECAUSE THEY UNDERSTOOD THE SIGNIFICANCE OF IT AND I THINK THAT TRANSLATES INTO HOW WE EDUCATE STUDENTS SUCH AS MEDICAL STUDENTS AND AS WELL AS IN MY DEPARTMENT WHERE I'M EDUCATING SOCIAL WORKERS AND PUBLIC HEALTH STUDENTS AND SOCIAL POLICY STUDENTS ABOUT HOW TO BE ABLE TO FULL SPECTRUM LOOK AT THE BEST WAYS TO STRATEGIZE AND COME TOGETHER AND BY THE COMMUNITY AND PRACTICES AND IN TERMS OF BETTER OUTCOMES ALL TOGETHER.

IT'S MORE THAN ONE WAY TO BE ABLE TO ADDRESS THE ISSUE AND IT TAKES I THINK A LOT OF INNOVATION AND STRATEGY TO REALLY BE ABLE TO ADDRESS IT IN A WAY THAT IS SUSTAINED.

>> I ALMOST HATE TO ASK BUT HOW MIGHT MISSOURI RANK IN THIS AREA?

I ASSUME THERE ARE NUMBERS OUT THERE, BUT EITHER ON THE MORTALITY RATE FOR WOMEN IN GENERAL OR IN PARTICULAR FOR WOMEN OF COLOR?

IT -- HOW ARE WE DOING?

>> SO PER MY KNOWLEDGE, I THINK WE ARE ABOUT 44, 45 NATIONALLY IN TERMS OF WHERE WE RANK FOR MATERNITY MORTALITY FOR ALL WOMEN, AND I ALSO RECOGNIZE THAT I THINK THE MOST RECENT DATA AVAILABLE SUGGESTS THAT BLACK WOMEN LIVING IN MISSOURI ARE THREE TO FOUR TIMES MORE LIKELY TO EXPERIENCE MATERNAL MORTALITY COMPARISON TO WHITE WOMEN LIVING IN THE SAME STATE.

>> YES.

>> IT'S A VERY HARD DOCUMENTARY TO WATCH, BUT I THINK EVERYBODY WHO IS FEATURED IN THE DOCUMENTARY IS TO BE APPLAUDED, BECAUSE THERE IS NO MINCING WORDS.

IT IS JUST FLAT-OUT RACISM THAT THESE WOMEN IN THEIR MOST VULNERABLE MOMENTS ARE EXPERIENCING.

WHICH OF YOU WOULD LIKE TO JUST GIVE OUR VIEWERS AN IDEA?

THEY HAVE NOT HAD AN OPPORTUNITY TO SEE IT.

MAYBE THEY HAVE, MANY OF THEM, TO SEE THE DOCUMENTARY, BUT WHAT A WOMAN CONFRONTS WHEN SHE IS -- WHEN SHE'S IN THIS POSITION, AND HOW IT DOES RELATE TO THAT MORBIDITY RATE?

>> YES, I WOULD LIKE TO ADDRESS THAT, AND I WOULD LIKE TO SAY AS WELL, YOU KNOW, I'M A TEXAS NATIVE, SO I HAVE LIVED IN MISSOURI FOR MANY YEARS, AND COMMUTE BETWEEN TEXAS AND MISSOURI DOING THIS GREAT WORK AND I WILL SAY THAT MISSOURI AS THE MOST RECENT REPORT IS NUMBER SEVEN ON THAT MATERNAL MORTALITY LIST, RANKING ALL 50 STATES AND TEXAS IS RIGHT BEHIND IT AT NUMBER EIGHT.

SO WHILE THAT IS REALLY HORRENDOUS TO KNOW, I'M BLESSED TO BE ABLE TO HAVE THE OPPORTUNITY TO WORK ACROSS THOSE LINES TO MAKE SURE THAT PEOPLE HAVE A VOICE AND OPTIONS AND RESOURCES IN THAT WAY.

I WILL ALSO AGREE THAT IT'S VERY HARD TO WATCH THAT MOVIE BUT IT'S EXTREMELY IMPORTANT.

ANOTHER THING TO REMEMBER IS THAT THOR E EISSUES WE'RE FACING WITH THE MATERNAL HEALTH CRISIS IS BECAUSE THERE'S SOMETHING INHERENTLY WRONG WITH BLACK WOMEN.

IT'S NOT THAT OUR BODIES MOVE, THINK OR OPERATE DIFFERENT THAN WHITE WOMEN.

IT IS ROOTED IN THE WAY THIS NATION WAS CREATED BUILT ON THE BACKS OF BLACK PEOPLE WITH NO RESPECT OR NO VALUE TO OUR LIVES, AND THAT HAS CONTINUED POST ENSLAVEMENT.

SO WE LOOK AT A SPECIFIC LAW CALLED THE SHEPHERD TOWNER ACT THAT WAS ENACTED IN 1920 AND STRATEGICALLY IT WAS SUPPOSED TO ADDRESS THE HIGH NUMBER OF INFANT MORTALITY IN SPECIFICALLY THE SOUTH, BUT ACROSS THE NATION, BUT REALLY WHAT IT DID WAS IT ENACTED POLICY TO DISARM, REMOVE AND ALSO CRIMINALIZE MIDWIVERY AND SUPPORT PEOPLE WHICH WERE DOULAS AT THE TIME.

THE WORD DOULA WAS NOT USED IN THE 1920s.

WE WERE JUST THERE.

MIDWIVES AND DOULAS WILL HAVE AN PART OF THE COMMUNITY, MIDWIVES HAVE BEEN THE FIRST LINE OF DEFENSE FOR DELIVERIES AND BIRTHS UP UNTIL 1920 AND MOVING FORWARD, SO THIS CRISIS IS NOT BY HAPPENSTANCE.

REALLY WHEN WE HAD OVER 10,000 MIDWIVES IN THE SOUTH SPECIFICALLY UP UNTIL THAT LAW WAS PASSED, NOW BLACK MIDWIVES ONLY MAKE UP 2% OF THE ENTIRE MIDWIVERY POPULATION.

WHEN THAT DEFENSE WAS REMOVED FROM THE COMMUNITY AND BLACK PEOPLE WERE FORCED TO GO TO CLINICS AND HOSPITALS WHERE THEY WERE PRACTICED UPON WITHOUT THEIR PERMISSION AND WERE HARMED AND INJUSTICES DONE TO THEIR BODIES BECAUSE THIS THEY WERE DEFENSELESS, BECAUSE THEIR MIDWIVES WERE REMOVED OR YIMALIZED, IT ALLOWED THAT TO PERPETUATE AND TO CONTINUE, AND THEN WE THINK ABOUT THE RISE OF GYNECOLOGY DURING THAT TIME, WHERE WHITE MEN STRATEGICALLY WERE NOT A PART OF BIRTHING PRIOR TO THE EARLY 1900s AND LATE 1800s.

THEY HAD TO PRACTICE TO LEARN SO THEY CREATED CERTAIN METHODS STILL USED TODAY OVER 100 YEARS AGO SPECIFICALLY CALLED THE DEELY METHOD WHERE THE INJUSTICES ARE HAPPENING TO HIM WHEN THEY COME INTO THE DOOR.

IF YOU LOOK AT THE PRACTICES STARTED IN THE EARLY 1900s, COUPLE THAT WITH RACISM, NOW WE HAVE THIS EXPLOSION OF MATERNAL HEALTH CRISES.

SO THE MOVIE REALLY TALKS ABOUT THE HISTORY OF HOW WE GOT HERE, THE BURDEN THAT'S ON BLACK COMMUNITIES TO PULL OURSELVES OUT OF THIS REALLY HARM OF SITUATION THAT WAS PUT ON US, BUT DESPITE THE SOLUTIONS AND THE INNOVATIONS THAT DR. TERESA MENTIONED WE ARE CARRYING THOSE OUT AND MOVING FORCEFULLY AHEAD TO MAKE SURE WE SAVE OURSELVES.

THIS IS BLACK MATERNAL HEALTH WEEK.

IT STARTED APRIL 11th AND ENDS APRIL 17th AND SPEARHEADED BY BLACK MAMAS MATTER ALLIANCE.

OUR THEME THIS YEAR IS OUR BODIES BELONG TO US, AND WE'RE CELEBRATING THE JOY IN BIRTH.

SO THAT IS US TAKING BACK OUR BODILY AUTONOMY, BEING, I HATE TO SAY THE WORD ARMED BUT BEING ARMED WITH DOULAS WHO CAN HOLD SPACE AND ADVOCATE FOR US, WHETHER BIRTHING IN THE HOSPITAL, HOME OR BIRTHING CENTER, WHETHER GETTING A C-SECTION, ATTEMPTING A V BACK OR PLANNING TO HAVE A VAGINAL NATURAL BIRTH.

I WANTED TO REALLY SHARE THAT WHILE IT'S HARD TO WATCH, WHILE IT'S HARD TO HEAR THESE STORIES, ORGANIZATIONS LIKE JAMA BIRTH VILLAGE AND MANY OTHER ONES ARE SHARING WHAT WE'RE DOING, ASKING FOR SUPPORT, AND REALLY HOPING TO INFLUENCE POLICY AND PROCEDURE TO GIVE US OUR RIGHTS BACK, AND TO TREAT US HOW WE SHOULD BE TREATED AS HIGH-VALUE PEOPLE.

>> SPEAKING OF POLICY, YOU THREE ARE HEROICLEALALLY ON THE FIRST LINE OF DEFENSE.

WHAT CAN EITHER A STATE GOVERNMENT OR A LOCAL GOVERNMENTS, IS THERE SOMETHING THEY CAN BE DOING.

WERE YOU THE GOVERNOR, WHAT WOULD YOU BE, WHAT WOULD BE YOUR PRIORITY LIST AND THE NEXT THING YOU DID?

>> SO I WOULD SAY IN TERMS OF WHAT SOME OF MY WORK IN PROGRAMMING LOOKS LIKE, I THINK IT'S IMPORTANT TO LOOK AT HOW WE INCLUDE PARTNERS AS A PART OF THE BIRTHING TEAM.

BEING ABLE TO UNDERSTAND WHAT IT MEANS TO HAVE PAID PARENTAL LEAVE TO SUPPORT BOTH PARTNERS DURING THAT TIMEFRAME WOULD BE REALLY CRITICAL AT THIS POINT IN TIME AND LOOKING AT THE FOURTH TRIMESTER, THE POSTPARTUM PERIOD, THAT'S A CRITICAL TIME WHEN WE HAVE A LOT OF ISSUES THAT PERHAPS MIGHT HAPPEN AND WHERE BIRTHING PEOPLE MIGHT NEED ADDITIONAL SUPPORT.

SO IF WE THINK ABOUT WHAT IT MEANS FOR A PERSON TO NOT BE INSURED AND TO ONLY BE INSURED DURING THE STATE DURING THE TIMEFRAME THEY DELIVER, WHAT HAPPENS AFTER THEY DELIVER AND THEY STILL NEED CARE AND TREATMENT?

IF WE EXPAND WHAT THE POSTPARTUM PERIOD LOOKS LIKE BEYOND SIX WEEKS AND WE EXPAND ACCESS TO COVERAGE, THAT WOULD WORK IN TERMS OF HAVING PERHAPS TREMENDOUS BENEFITS TO BEING ABLE TO CONTINUE TO SEE PEOPLE WHO DELIVERED DURING THE FIRST YEAR OF A CHILD'S LIFE SO WE CAN UNDERSTAND WHAT THAT BIRTHING PERSON MIGHT FURTHER NEED IN TERMS OF ADDITIONAL CARE AND TREATMENT, BUT IF THEY DON'T HAVE ACCESS TO THE INSURANCE, IF THEY'RE UNDERINSURED THE LIKELIHOOD FOR THEM TO CONTINUE TO ENGAGE IN CARE AND TREATMENT DURING THAT FIRST YEAR IS DIMINISHED, WHEN MOST OFTENTIMES YOU HAVE ISSUES IN TERMS OF THE COMPLICATIONS AROUND MORTALITY THAT MIGHT HAPPEN WITHIN THE FIRST YEAR OF LIFE.

SO THOSE ARE MY THOUGHTS ABOUT REALLY TANGIBLE WAYS THAT WE CAN LOOK AT ADVANCING POLICY TO SUPPORT IMPROVED MATERNAL HEALTH.

>> I THINK WHAT'S REALLY STRIKING ABOUT THE DOCUMENTARY AND WHAT I RESPECTED SO MUCH ABOUT IT, AND WHY IT WAS SO IMPACTFUL WATCHING IT IS THE TONE IS NOT CONCILIATORY.

THE TONE IS NOT, PLEASE HELP US.

THE TONE IS, YOU WILL HELP US.

IT IS 2023, AND THESE WOMEN AND THEIR BABIES, THEIR LIVES, AND YOU KNOW, IN A TIME WHEN WE HEAR THINGS LIKE PRO-LIFE AND ALL OF THIS, IT'S THROWN AROUND IN THE POLITICAL ARENA.

THIS IS THE FASTEST WAY TO PROVE THAT YOU ARE IN FACT PRO-LIFE, BECAUSE TO WATCH THESE WOMEN WHO ARE IN 2023 TERRIFIED OF DYING BECAUSE NO ONE IS LISTENING TO THEM, IT'S UNACCEPTABLE.

SO JUST THAT SORT OF WE'RE NOT GOING TO -- WE WILL NOT BE SILENCED ANYMORE, THAT'S THE MESSAGE, ISN'T IT, MACKENZIE?

>> YES, WE WERE HAVING A DISCUSSION WITH SOME DOULAS WITHIN THE COMMUNITY AT WASH U AND THEY WERE SAYING THAT OFTEN THEIR BLACK PATIENTS COME TO THEM AND THE FIRST THING THEY SAY IS "I DON'T WANT TO DIE," AND THAT'S SOMETHING YOU NEVER WANT YOUR PATIENT TO COME TO YOU SAYING AND THAT'S TERRIFYING THAT'S THE FIRST THOUGHT THAT HAPPENS WHEN YOU THINK ABOUT BIRTH AND BECOMING PREGNANT.

IT SHOULD BE A CELEBRATED TIME, IT SHOULD BE HAPPY AND I THINK ONE THING THAT BIRTHING JUSTICE ALSO HIGHLIGHTS IS AGAIN, PUTTING THE AUTONOMY IN THE PATIENT'S HANDS BECAUSE YOU DO WANT AUTONOMY OF YOUR BODY AND AUTONOMY TO DECIDE HOW YOUR BIRTH PLAN SHOULD LOOK AND I THINK DOCTORS CAN DO A GOOD JOB OF SOMETIMES MAKING YOU FEEL LIKE YOU DON'T HAVE AUTONOMY, WE'RE GOING TO DO THIS NEXT AND THIS NEXT AND THIS NEXT AND THAT'S NOT HOW I WANT TO PRACTICE OBGYN IN THE FUTURE.

I'D LIKE SHARED DECISION-MAKING WITH MY PATIENTS BUT WEARING A WHITE COAT MAKES IT HARD ARE FOYE PATIENT TO SEE THAT AND THAT'S WHY I THINK TALKING ABOUT MIDWIVES AND DOULAS IS SO IMPORTANT BECAUSE THOSE PEOPLE CAN BE AT THE SAME LEVEL AS THE PATIENT MORE EASILY AND BIRTHING JUSTICE HIGHLIGHTS THAT, AND PATIENTS OFTEN FEEL COMFORT WITH THESE PROVIDERS CARING FOR THEM.

SO I THINK THOSE ARE IMPORTANT POINTS TO TAKE AWAY FROM THE MOVIE AS WELL.

>> I AM CERTAIN THAT OUR VIEWERS AT 9 PBS ARE SOME COMBINATION OF MOVED AND ENRAGED BY WHAT YOU ARE DISCUSSING.

WHAT CAN THE AVERAGE CITIZEN, OUR VIEWER, WHAT CAN OUR VIEWERS BE DOING THAT WOULD BE HELPING YOUR WORK RIGHT AWAY?

>> YES, AND I'LL START BY ANSWERING THAT.

I WOULD SAY SUPPORTING ORGANIZATIONS LIKE JAMA BIRTH VILLAGE.

WE ARE A 50K C3 NOT-FOR-PROFIT ORGANIZATION AND WE ARE TURNING 8 THIS YEAR.

SO WE HAVE BEEN DOING THIS WORK FOR A VERY LONG TIME BEFORE IT BECAME A VERY NATIONAL MOVEMENT.

WE WANT PEOPLE TO CONTINUE TO INVEST IN OUR WORK AND SUSTAIN OUR WORK SO WE CAN CONTINUE TO BE THE SOLUTION.

JUNETEENTH OF 2020, WE RESPONDED AS REVOLUTIONARIES AT JAMA BIRTH VILLAGE BY OPENING MISSOURI'S FIRST BLACK-LED MIDWIVERY CLINIC RIGHT IN THE HEARD OF FERGUSON.

I CONSIDER FERGUSON AS FERTILE GROUND TO MAKE THAT CHANGE.

SO WE HAD HUNDREDS OF PEOPLE FROM AS FAR AS AUSTRALIA WHO DONATED TO JAMA BIRTH VILLAGE TO HELP US PURCHASE THE BUILDING IN 2018 AND RENOVATE THE BUILDING AND FURNISH THE CLINIC AND TO GET THE CLINIC OPEN IN 2020, JUST 100 YEARS LATER AFTER THE ACT WAS PASSED TO ERASE PEOPLE LIKE ME AND PEOPLE LIKE OUR DOULAS AT JAMA BIRTH VILLAGE.

HERE WE ARE THREE YEARS LATER AND WE'RE ONE YEAR INTO A CAPITAL CAMPAIGN TO BUILD MISSOURI'S FIRST BLACK-LED BIRTH CENTER IN POSTPARTUM RETREAT HAVEN.

THIS IS A $1 MILLION PROJECT AND IT'S NOT JUST YOUR AVERAGE BIRTH CENTER, YOU KNOW.

THE EXPANSION OF IT AS DR. TERESA POWER MENTIONED IS THAT POSTPARTUM CARE IS IMPORTANT.

WE THINK ABOUT BIRTHING AT THE HOSPITAL AND BEING SENT HOME WITH LITTLE INSTRUCTIONS AND WE KNOW WE'RE LOSING LIVES WITHIN 72 HOURS, SO ONE WEEK POSTPARTUM AND IT'S HAPPENING MORE TO BLACK WOMEN OR PEOPLE ON MEDICAID, WE WANT OUR BIRTH CENTER TO BE A SAFE HAVEN.

THAT MEANS AFTER YOU DELIVER AND GIVE BIRTH, YOU DON'T GET SENT HOME THAT SAME DAY.

YOU DON'T GET SENT HOME THREE DAYS LATER.

WE HAVE A POSTPARTUM RETREAT HAVEN WHERE WE HAVE BIRTHING HUTS WHERE THEY CAN STAY IN THOSE AMAZING RETREAT SPACES FOR SEVEN DAYS, FOR ONE WEEK TO BE CARED FOR, NURTURED, FED, AND NOURISHED AND THEY CAN HAVE THEIR FRIENDS OR FAMILY MEMBERS VISIT THEM FOR THEIR BABY SO THEIR FRIENDS AND FAMILY MEMBERS CAN ALSO SEE HOW WE SHOULD BE CARING FOR AND INVESTING IN NEWLY POSTPARTUM PARENTS.

SO I WILL SAY DEFINITELY FOLLOWING JAMA BIRTH VILLAGE ON SOCIAL MEDIA, SIGNING UP FOR A NEWSLETTER, CHOOSING TO DONATE CONSISTENTLY OR ONCE TO HELP US BUILD THE BIRTH CENTER AND TO CHANGE BIRTH EXPERIENCES FOR ST. LOUIS FAMILIES.

>> WHO WOULD LIKE TO TALK ABOUT THE SCREENING THIS WEEKEND?

WE HAVE ABOUT 30 SECONDS LEFT.

>> YES, SO WASH U AND A BUNCH OF OTHER GROUPS WITHIN WASH U WE'VE PARTNERED WITH THE GROUP THAT CREATED THE FILM "BIRTHING JUSTICE" AND THE MAIN HOST IS THE JAMA BIRTH VILLAGE AND WE ARE JUST THE SPACE AS WASH U TO HAVE THIS INCREDIBLE EVENT SCREENED ON SATURDAY FROM 11:00 'TIL 2:00 AND WE'RE GOING TO HAVE AN INCREDIBLE DISCUSSION AFTERWARDS WITH MANY DIFFERENT PEOPLE FROM LEADERS AT PLANNED PARENTHOOD TO PROFESSORS FROM WASH U D, INCLUDING DR. HOWARD HERE AND HEALTH PROFESSIONALS FOR THE STATE AND FROM THE CITY OF ST. LOUIS.

I THINK IT WILL BE AN INCREDIBLE DISCUSSION AFTER THE FILM AND ALSO SOME TIME TO REFLECT ON HOW -- >> AND WE ARE ALREADY, WE ARE LINKED, WE ARE LIMPBING THE EVENT TO OUR WEBSITE, 9PBS.ORG, IF YOU WOULD LIKE SOME MORE INFORMATION AND GET INVOLVED, THEY STILL HAVE OPENINGS AND THEY'D LOVE TO SEE YOU AND EDUCATE YOU.

OCANSOLA AMADOU LIVE FROM DALLAS, THANK YOU SO MUCH.

>> YOU'RE WELCOME.

>> MACKENZIE LEMIEUX, THANK YOU DR. HOWARD FOR BEING HERE.

THANK ALL OF YOU FOR WATCHING 9 PBS AND OF COURSE "NEXT UP" RAY HARTMANN AND THE CREW, I'M WENDY WIESE HAVE A TERRIFIC WEEK.

LET'S SEE HOW MANY TIMES I CAN SAY TERRIFIC.

>> "DONNYBROOK" IS MADE POSSIBLE BY THE SUPPORT OF THE BETSY AND THOMAS PATTERSON FOUNDATION AND THE MEMBERS OF 9 PBS.