How the US medical community fails Black mothers

Summary

The script is a poignant speech about maternal mortality rates in the United States, particularly the disproportionately high rates among black mothers. It tells the story of Shalon Irving, a black woman with advanced degrees and a career in public health, who died from childbirth complications. The speaker emphasizes the systemic racism and implicit bias in healthcare that contribute to these deaths, calling for action to transform the healthcare system and reduce disparities. The speech concludes with a call to acknowledge and combat inequity, and to empower black women in healthcare.

Takeaways

• 🕰️ The speaker wishes to turn back time to save Shalon, highlighting the irreversible loss due to maternal mortality.
• 🚨 Between 700 to 800 women die each year in the U.S. from pregnancy and childbirth-related complications, indicating a significant public health issue.
• 🌟 The U.S. has the highest maternal mortality rate among developed countries, with a steadily increasing trend that's alarming.
• 🖤 Black mothers, like Shalon, are disproportionately affected, with a mortality rate 3 to 4 times higher than white women, underscoring racial disparities.
• 🚫 60% of maternal deaths are preventable, suggesting that current healthcare practices are failing to protect mothers adequately.
• 🔍 The racial disparity in maternal health outcomes has remained unchanged for six decades, pointing to systemic issues.
• 💔 The healthcare system's dismissal and disregard for black women's concerns contribute to the high maternal mortality rates.
• 🎓 Shalon's story illustrates that even with advanced education and professional status, black women face bias and racism in healthcare.
• 👶 The loss extends beyond the mother to families and society, with children left without their mothers and the potential contributions they could have made.
• 🌐 The speaker calls for systemic change, emphasizing that the problem is not just with individuals or hospitals but deeply rooted in the healthcare system's foundation.
• 💪 The speaker and others have founded a non-profit to eliminate preventable deaths among black mothers, showing a proactive approach to addressing the issue.

Q & A

What is the estimated number of women who die each year in America from pregnancy and childbirth-related complications?

Between 700 to 800 women die each year in America from pregnancy and childbirth-related complications.

What is the United States' ranking in terms of maternal mortality among developed countries?

The United States has the highest rate of maternal mortality of any developed country in the world.

Which demographic is primarily affected by maternal mortality in the United States?

Black mothers like Shalon remain the primary group for maternal mortality.

What is the disparity in maternal death rates between black and white women in the United States?

Black women die at a rate of three to four times that of white women.

How many of the maternal deaths are preventable according to the script?

It is absolutely shameful that 60 percent of those deaths are totally preventable.

What is the speaker's relationship to Shalon?

The speaker is Shalon's mother, who lost her daughter to maternal mortality.

What educational and professional background did Shalon have despite her unfortunate death?

Shalon had dual PhDs in sociology and gerontology, two master's degrees, one of them in public health from Johns Hopkins, and was a lieutenant commander in the U.S. Public Health Service.

What is the root cause of disparities in health care as mentioned in the script?

The root cause of disparities in health care is the covert bias fueled by structural racism.

What steps is the speaker taking to address the issue of preventable deaths among black mothers?

The speaker has joined forces with Shalon's friends and CDC colleagues to found a non-profit that is working to eliminate preventable deaths among black mothers through various actions, including engaging stakeholders, promoting accountability measures, and empowering black women.

What is the name of Shalon's daughter and how old is she?

Shalon's daughter's name is Soleil, and she is three years old.

What is the call to action the speaker is making at the end of the script?

The speaker is calling for a collective effort to right the wrongs in the healthcare system, to eliminate racial disparities in maternal mortality, and to create a better earth, inspired by Shalon's life and work.

Outlines

00:00

😔 Maternal Mortality Rates and Racial Disparities

The speaker expresses deep sorrow over the loss of their daughter, Shalon, and highlights the alarming maternal mortality rates in the United States, which are the highest among developed countries. The script emphasizes the racial disparity, with Black mothers experiencing a death rate three to four times higher than white mothers. It points out the preventable nature of 60% of these deaths and criticizes the healthcare system for its failure to address these disparities effectively. The narrative also recounts Shalon's credentials and her repeated unsuccessful attempts to seek help from healthcare providers, illustrating the systemic racism and bias that contribute to these tragic outcomes.

05:04

💔 The Personal Impact and Societal Loss

This paragraph delves into the personal impact of Shalon's death on her family, particularly her daughter, Soleil, who only knows her mother through photographs and stories. The speaker poignantly describes the loss of a potential medical and social justice contributor, highlighting the broader societal implications of such preventable deaths. The paragraph also critiques the healthcare system's failure to address the systemic issues contributing to maternal mortality, suggesting that the problem is deeply rooted and requires more than just addressing individual cases or hospitals.

10:05

🚫 Addressing Systemic Failures in Healthcare

The speaker calls for a transformation in the healthcare system, emphasizing the need for acknowledgment of the systemic failures that lead to racial disparities in maternal mortality. They stress the importance of taking responsibility for these failures and actively working to rectify them. The paragraph introduces the speaker's initiative to found a non-profit organization with the aim of eliminating preventable deaths among Black mothers. The organization's strategies include engaging with stakeholders, promoting legislative changes, and empowering Black women to counteract bias and racism in healthcare. The speaker concludes by urging everyone to use their influence to make a difference and to commit to creating a better world.

15:06

🌍 Creating a Better Earth: A Call to Action

In the final paragraph, the speaker vows to create a better earth in memory of Shalon and calls for collective action to address the racial disparities in maternal health. They emphasize the importance of vision combined with action to bring about real change, drawing inspiration from Nelson Mandela's quote. The speaker invites everyone to join in the mission to eliminate preventable deaths among Black mothers and to ensure that no woman is marginalized or dies needlessly in the healthcare system.

Keywords

💡Maternal Mortality

Maternal mortality refers to the death of a woman while pregnant or within 42 days of the end of pregnancy, from any cause related to or aggravated by the pregnancy or its management. In the video, maternal mortality is a central theme, highlighting the tragic reality that between 700 to 800 women die each year in America from pregnancy and childbirth-related complications. The speaker emphasizes the urgency of addressing this issue, especially for black mothers, who face a disproportionately higher risk.

💡Racial Disparities

Racial disparities refer to the differences in outcomes and experiences between different racial or ethnic groups. The video script underscores the racial disparities in maternal mortality rates, where black mothers are noted to die at a rate three to four times higher than white women. This disparity is a critical issue that the speaker calls out as a failure of the healthcare system and a reflection of systemic racism.

💡Implicit Bias

Implicit bias refers to the unconscious attitudes or stereotypes that affect our understanding, actions, and decisions. In the context of the video, implicit bias is identified as a significant factor contributing to the racial disparities in maternal health outcomes. The speaker recounts how the daughter, despite her educational and professional achievements, was still subjected to dismissive treatment due to the covert bias of her healthcare provider.

💡Structural Racism

Structural racism is the normalization and legitimization of an array of practices that produce or reinforce inequalities between racially defined groups. The video script mentions structural racism as the root cause of disparities in healthcare, impacting the treatment and outcomes for black women like the speaker's daughter, who despite her qualifications faced a system that responded to her with prejudiced attitudes.

💡Preventable Deaths

Preventable deaths are those that could be avoided through timely and effective medical intervention, public health measures, or changes in individual behavior. The video emphasizes that 60 percent of maternal deaths are preventable, indicating a failure in the healthcare system to provide adequate care, particularly for black mothers.

💡Healthcare System

The healthcare system encompasses all organizations, people, and actions whose primary purpose is to provide essential healthcare services to individuals in a society. The video script critiques the healthcare system for its failure to address and rectify the racial disparities in maternal mortality, suggesting that the system is inadequate and in need of transformation.

💡Accountability

Accountability in healthcare refers to the obligation of health professionals, institutions, and systems to accept responsibility for their actions, to be transparent, and to be held answerable for the outcomes of their care. The speaker calls for accountability measures to be promoted and enshrined in law to ensure better outcomes for black mothers.

💡Community-Based Research

Community-based research is a collaborative approach to research that equitably involves all partners in the research process and recognizes the complexity of public health problems. The video mentions a community-based research project aimed at redefining the quality of medical care for black women, emphasizing the importance of involving the community in addressing healthcare disparities.

💡Empowering Black Women

Empowering black women in the context of the video means providing them with the knowledge, skills, and resources to advocate for themselves and counteract the bias and racism they may face in healthcare settings. The speaker discusses the importance of empowering black women and their birthing partners to navigate and challenge the healthcare system effectively.

💡Vision and Action

Vision and action are highlighted in the video as necessary components for change. Vision refers to a clear and inspiring picture of what could be, while action is the practical implementation of steps towards that vision. The speaker uses the terms to call for a commitment to both envisioning a better healthcare system and taking concrete steps to achieve it, as exemplified by her daughter's life and work.

Highlights

If given the chance, the speaker would do anything to bring back their loved one, Shalon, who died due to pregnancy and childbirth complications.

Between 700 to 800 women die each year in America from pregnancy and childbirth-related complications.

The United States has the highest rate of maternal mortality of any developed country, and it's the only one where the rate is rising.

Black mothers like Shalon are the primary group affected by maternal mortality, with a death rate three to four times that of white women.

60 percent of these maternal deaths are preventable, highlighting a significant healthcare issue.

The risk difference for black women has been unchanged for six decades, indicating a persistent systemic problem.

The speaker calls for race to no longer be a precursor to how black women are treated in the healthcare system.

The medical community is failing black mothers, with a history of dismissal and disregard for their concerns.

Racism and discrimination in healthcare are overt or subtle but present, impacting the quality of care black women receive.

Despite Shalon's advanced degrees and professional achievements, she was still subject to bias as a black woman in healthcare.

Structural racism is identified as the root cause of disparities in healthcare, impacting patient outcomes.

The speaker's granddaughter, Soleil, only knows her mother through photographs and memories, highlighting the personal impact of these losses.

The speaker emphasizes the broader societal loss due to the preventable deaths of women like Shalon, who could have contributed significantly.

The speaker argues that the problem is systemic and not just about individual actions or specific hospitals.

Improvements in data accuracy, algorithms, checklists, and apps are necessary but not sufficient to address the issue.

Implicit bias training without accountability measures will not make a difference in improving outcomes.

Leaders in the medical community must take steps to transform the healthcare system and acknowledge its failures.

The speaker has founded a non-profit to eliminate preventable deaths among black mothers through action and advocacy.

Empowerment of black women and their birthing partners is key to counteract bias and racism in healthcare.

The speaker calls for collective action and influence to address and change the systemic issues in maternal healthcare.

Vision with action can change the world, and the speaker vows to create a better earth for black mothers in healthcare.

Transcripts

[Music]

foreign

[Music]

if i could turn back the clock and bring

shalon back

i would literally do anything

i would happily give everything if i

could see her smiling face once again

but sadly even if shalon were here

it would not change the fact that

between

700 to 800 women die

each year in america from pregnancy and

childbirth related complications

the choice to have a child should never

equate to a death sentence

the rate of maternal deaths in america

is utterly appalling

in 2017 npr and propublica

reported that the united states has

the highest rate of maternal mortality

of any developed country in the world

and the united states is the only

country

where that rate is steadily rising

black mothers like shalon remain the

primary group

for maternal mortality it is

truly reprehensible

that black women die at a rate of three

to four

times that of white women

it is absolutely shameful

that 60 percent of those

deaths are totally preventable

as was my daughters and here's a

shocking fact

according to the report by health

resources and services administration

the difference in risk

has been steadily unchanged

for the past six decades

six decades clearly

current efforts to address maternal

mortality rates

and the racial and health disparities

in that area remain woefully inadequate

only when race stops being the precursor

to how black women are treated

or not treated in the health care system

then

outcomes will be drastically different

i want to be abundantly clear now

the medical community is failing

black mothers in america

for decades black women have been

dismissed

ignored disregarded or at the very least

they have been not taken seriously

in their interactions with the health

care system

it's not uncommon for black women to

experience racism and discrimination

by medical providers that racism can be

blatantly overt

or covertly subtle but make no mistake

it is there it didn't matter that shalon

had dual phd in sociology

and gerontology it didn't even matter

that shalon had two master's degrees

one of them a master's in public health

from johns hopkins

it made no difference that shalon was a

lieutenant com

commander in the u.s public health

service an

alumnus of the well world-renowned

epidemic intelligence service

a highly respected epidemiologist at the

centers for disease control

and president of her own diversity

company

she was still a black woman a black

woman

accessing a system that saw her as a

stereotype

and responded to her as such

during the three weeks after her child

was born

shalon went to her health care providers

again

and again in distress

obviously with her education and

training

she could and she did articulate her

concerns very clearly

yet her cries for help were minimized

and dismissed by the covert bias

of her medical provider that

very bias fueled by structural racism

is the root cause of disparities in

health care

that very bias impacted shalon's outcome

that very bias caused my daughter

to be among the statistics

for 2017.

as a result i lost my beautiful little

girl

my baby girl i lost my confidante

i lost my best friend i lost my whole

world

shadon's daughter lost her mother and

all of the relationship possibilities

that could have existed between

the two of them

the society may have suffered the

greater loss

who knows how many medical advancements

or social justice contributions

shalon may have made if only her medical

provider

had listened to her and heeded her cries

for help

we will never know but this much we do

know

behind every one of those 700 to 800

women who die

is a family and a whole social network

of loved ones

including the children left behind like

soleil

shalon's daughter soleil is three years

old now

she has a quick smile every bit as

brilliant as her mother's was

soleil is fearless she's determined

and she's so opinionated and

so smart so lake constantly amazes me

at how confidently she is navigating her

world

but soleil only knows her mother through

photographs

and the cherished memories that i have

and share with her every day

yet soleil loves her mommy who was with

her for only

three short weeks

she tells me so each day

my heart aches each time soleil cries

for her mommy it is during those times

soleil has said to me nana

i want to go to heaven so i can be with

my mommy

it should not be that way

it doesn't have to be that way

it can really no longer

continue to be that way

when i said earlier that the medical

community is failing black mothers

some may have wondered if i'm painting

with too broad a brush

after all it's individuals who are to

blame here right

or perhaps we should say that a relative

handful of hospitals

which happen to be the ones that are

largely used by black women

and other minorities are at the

epicenter of maternal mortality in

america

but i would argue that focusing on a

handful of

individuals or a handful of hospitals

is defining the problem way too narrowly

the problem behavior isn't about the

actions of specific individuals or

hospitals

it's much more systemic than that

what's more the prevalence of the

problem

is deeply entrenched embedded

in the very foundation of our health

care system

it is this broad-based failure that

continues to allow disparities in

maternal

health and death which result in black

women

just like shalon dying at rates

300 percent higher than white women

it's been well documented year after

year

decade after decade generation

after generation and nothing

effective has been done to fix it

how do we fix it

is there a definitive answer to

eradicating disparities in maternal

mortality

well improvements in data accuracy

are critical but not nearly enough

algorithms checklists apps

they all play an important role but

they're no panacea either

and i really can't emphasize enough

that implicit bias training without

explicit explicit

measures of accountability will make

absolutely no difference at all

it is time it is long

past time that leaders in the medical

community

take steps to transform the health care

system

status quo the first step must be

acknowledging

that the inherent problem in the health

care system

is more than a problem it's a failure

the next step requires taking

responsibility

and owning that failure but the most

important step

is actively taking the necessary actions

to right the wrongs created by that

failure

a wise woman once told me if you want

something different

you have to do something different

my daughter was committed to doing

something different

shalon was known as a woman of great

integrity and

high moral values when asked about her

driving principles in life

she would respond i see in equity

wherever it exists

i'm not afraid to call it by name and i

work hard to eliminate it

i vow to create a better earth

shalon put those words into action every

day of her life

former surgeon general david satcher

once said

leaders must care enough leaders must

know

enough leaders must be willing to do

enough

and leaders must be willing to persist

until the work

is done shalon was such a leader

though there will never be another

leader like shalon

we can each persist until the work is

done

here's what i'm doing to persist until

the work to say

black mothers is done to get things

started

i joined forces with several of shalon's

friends and cdc colleagues we founded a

non-profit

we're working hard to eliminate

preventable deaths

among black mothers and here's how we're

doing it

with action action and more

action we're engaging stakeholders at

every point of the public health and

health care spectrum

we're actively working with the

legislative office

we're promoting accountability measures

and postpartum bills

and we want them enshrined in the law

we're embarking upon a community-based

research project which will redefine

quality of medical care for black women

ultimately we will tilt more power

into the hands of black women how are we

going to do that

by empowering black women and their

birthing partners

to effectively counteract the bias and

racism they experience

at any given point during pregnancy

child

birth and postpartum

look around you each one of us

in this room has a circle of influence i

invite you to consider

how powerful an impact we could make if

we

focus that collective influence

on this problem on making a difference

what if we like shalon acknowledged

inequity

wherever it existed in our communities

and we weren't afraid to call it by name

what if we were each committed and

passionate

about using the full range of our

resources

to eliminate that inequity could we

change things could we

really overturn centuries of prejudice

and decades of bad practice

i know we could i know

we could if we were

focused on that issue if we

focused that collective energy

to quote nelson mandela when people

are determined they can overcome

anything but

action without vision it's only passing

time

vision without action is merely

daydreaming

but vision with action can

truly change the world

shalon's life was the perfect embodiment

of the vision shalon's death

is our call to action so today

let each of us vow to do whatever we can

let us vow to right this wrong

let us vow to be a part of the solution

until black women are no longer

marginalized

and dying needlessly in the health care

system

and like my daughter dr shalon maureen

irving

let us each vow to create a better earth

thank you