- 2 days ago
According to the Centers for Disease Control, Black women in the United States are three to four times more likely to die from pregnancy than their white counterparts. Black women are also disproportionately affected by severe maternal morbidity– unexpected outcomes in labor and delivery (e.g., hypertension and anxiety) that result in significant short- or long-term consequences to the childbearing person’s health and well-being. Engage with an advocate for change on one of the most critical issues affecting the health of Black women in this nation.
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LifestyleTranscript
00:00Judge Glenda Hatchett and President of the National Medical Association, Dr. Yolanda Lawson, M.D.
00:11Good afternoon, everyone. So I'm Yolanda Lawson, M.D. I'm an OBGYN, actually, and it's such a pleasure to have this conversation with you all.
00:35This is a topic that's near and dear to my heart, and so I always like to ground the audience a little bit when we're talking about maternal health, and we talk about maternal mortality, and that's the death of a woman within 42 days of a pregnancy.
00:49And so I'm sure many of you have heard about some of the stats in this country, that black women are three times more likely to die from a pregnancy-related cause than our white counterparts.
01:01Our black babies are two times more likely to die than our white babies, right?
01:06And then even a college degree, so sometimes education, we've looked at that, it's not protective.
01:13Black women with a college education still have a five times higher rate of death than their white counterparts.
01:21And so we're going to have a conversation today.
01:23We're highlighting what the problem is, and we're going to talk about some solutions and some of the challenges also.
01:30And so I just wanted to root us just a little bit as we begin this conversation.
01:35And Judge Hatchett almost called you doctor, almost gave you another degree.
01:40But I would like for you to just, let's explore some of the challenges with this audience.
01:45Right.
01:46I'd like to frame it, if you would, and I thank you.
01:50You could have been anywhere else this morning, this afternoon.
01:54So thank you for coming to be a part of this important.
01:57And Dr. Lawson, I'm so grateful for all the work you're doing.
02:00We don't have a lot of time, so I'm going to frame this.
02:02I want to put a human face on this first.
02:06I never referred to her as my daughter-in-law.
02:09I always referred to her as my daughter.
02:11She walked into Cedars-Sinai Hospital and never walked out.
02:17Perfectly healthy, spoke four languages, had a pilot's license, was a marathon runner,
02:24race cars, traveled extensively all over the world, owned 12 schools that taught Chinese and China.
02:32I mean, she was just an extraordinary woman and never left that hospital.
02:37She was butchered.
02:38And I did not know that the stats were so bad.
02:41I didn't know that we, as black and brown women, were dying at such horrible rates.
02:45But this is the story I want to tell you to put a human face on this.
02:51They already had a 19-month-old.
02:53They had a brand-new baby.
02:55My son is grieving.
02:57She's married to my son again.
02:58She was always my daughter.
03:00But the two-year-old now, he's almost three, wakes up one night.
03:06And he comes.
03:07I hear him wake up because I moved them back to Atlanta to live with me.
03:12And he woke up, and I went in to see about him.
03:15And this is what he said to me, Dr. Lawson.
03:19And he was almost three but very articulate.
03:21He said, Grandma G, do you have my mommy's cell phone?
03:26And I said, no, sweetie, I don't have her cell phone.
03:29He said, I need you to find it.
03:31But I need you to call God and tell mommy I want her to come home.
03:38I want my mommy home.
03:41That's why we're here.
03:42That's why we do this work.
03:44You hear me?
03:45Because we are in the business of sending mothers home with their children.
03:52I don't want any other babies to go through what they are going through without their mommy.
04:01And so, three times, the CDC is probably going to adjust that, we've heard, to four times more likely.
04:10I don't want any woman to die regardless of color, but we are dying at disproportionate rates.
04:15And what I do tell you, and I want you to hear clearly, is that 84% of these deaths,
04:24this is not me, this is not Sister Doc here, this is the CDC reporting 84% of all women who are dying after birth.
04:39It's preventable.
04:40You hear me?
04:41Preventable.
04:43And so, if we know that, why aren't we doing better?
04:46And that's what this conversation is about today.
04:50We can and we must do better because not only is this the social implication,
04:56because we're right here in the Black Economic Forum,
05:00the economic implications for not just this generation.
05:05Because a lot of these mothers are head of house.
05:09What happens to their babies?
05:11What happens generational?
05:13And that's what we're here to talk about today.
05:15Absolutely.
05:16And so, one of the things, if you don't walk away with many things today,
05:20so a lot of times, I'm in Washington, D.C. a lot, so I do a lot of advocacy.
05:25I'm advocating for women broadly.
05:27One of the things, when you look at the United States and you look at high-income countries,
05:33all women in this country fare worse from childbirth than other highly developed countries.
05:39But it's just for our black women, we even have this more worse disparity.
05:45And this disparity has been going on over 100 years, right?
05:48I am, it's hard to find hope, right?
05:53Because it's challenging work.
05:55But at least we are working towards public awareness.
05:58That's another reason why we're here today.
06:00And I'm so excited we're on this platform and having this opportunity.
06:04Let's talk about some of the challenges.
06:06Yes.
06:07What are the challenges?
06:09Well, and you certainly, let me just say, I want to make sure you all know who this wonderful person is, right?
06:16You all have seen me on TV for years and years and years.
06:19She is the president, understand, of the National Medical Association.
06:26You know, Ann was just in the White House last week having conversations about these critical issues.
06:35So not only is she a practicing physician and OB-GYN in Dallas, Texas, she is advocating all over this country for her, for us.
06:44And I want you to hear me say, I appreciate you.
06:50So we don't have much time.
06:53Let's talk about the challenges.
06:57Challenges are people, the stereotypes.
07:01Kira had every advantage.
07:05She was at one of the world's greatest hospitals.
07:09She had insurance.
07:12She was not a poor woman who didn't get prenatal care, right?
07:16So let's forget all those stereotypes.
07:19But part of the problem is access.
07:21I live in Atlanta, Georgia.
07:23Georgia ranks 48th, 49th every year because also so many women don't have the proper access to medical care during their pregnancies, right?
07:34And then are ignored when they do show up at the hospital.
07:38Quick story.
07:40I was in Washington Monday.
07:42A journalist told me that there was a white couple.
07:45The husband ran down the hall to the doctor and said, my wife is in crisis.
07:51My wife is in crisis.
07:54The doctor responded.
07:56The same doctor, the same hospital, a Hispanic man and a black woman, the Hispanic man ran down the hall to try to get help because his wife was in crisis.
08:09He got arrested.
08:12And the wife died.
08:14And I can tell you a zillion of these stories.
08:18And so there has got to be a sea change in the way that medical help is provided and that we as black people are not ignored.
08:29So the challenges are going to get worse during Roe, right?
08:33Because now there are women who are forced to carry pregnancies that they wouldn't carry and are going to be in trouble.
08:40And for whatever reasons, right?
08:44Fifty-three percent of the women die after they leave the hospital.
08:49Think about that for a minute.
08:52So what the call to action today is in your states, how long does Medicaid provide support for women postpartum?
09:05How long?
09:07Six weeks is not enough.
09:10Dr. Lawson can speak to that better than I can.
09:12So we've got a lobby for Medicaid to be extended.
09:16And then, should I go into the HHS thing about the?
09:19Sure.
09:19So the HHS, this is shouting news.
09:24Shouting news.
09:25I'm about to stand up on this one.
09:26I'm going to stand up on this one.
09:27Shouting news.
09:30HHS, for the first time in the history of this country, has opened an investigation into Cedars-Sinai Hospital.
09:39Yes, sir.
09:42It took us seven years.
09:44I've been in Washington, D.C. more since Kira died than I have been altogether in my life.
09:50And my son particularly.
09:51And I'm going to sit back down.
09:53Because, you know, I'm black and Baptist.
09:54I get to going.
09:55But what I'm going to tell you is that they are now investigating the disparities between black people, women dying, and white women dying after childbirth.
10:07And until the federal government ties funding, you hear me, federal dollars to outcomes, we're not going to see a difference.
10:17And so that opened up last May, May of 2023, and that's the good news I've come to share with you.
10:25Because if we can see a sea change there, and it doesn't get undermined after the election.
10:34Do I need to say anything else on that?
10:37No, you said it.
10:39So that investigation has to go forward.
10:42Because with that investigation, it will be a domino effect so that federal funding for all hospitals in this country will be tied to outcomes and disparity against black and brown women.
10:56And that is some shouting news I've come to tell you about today.
11:00So I want to reiterate something she said.
11:03This is important.
11:04Again, you guys walk away with pearls and nuggets.
11:07It's 53% of maternal deaths occur the day after birth.
11:13So many people focus on just the birth process and labor.
11:17That's important.
11:1940% of women don't receive postpartum care.
11:2440%!
11:24Do you hear that?
11:25Do not go back for that postnatal visit.
11:28So when you're talking about the legislative win over this last few years has been the extension of postpartum Medicaid, right?
11:39And so the largest insurance payer in this country for births really is Medicaid.
11:44So we know we can move those numbers.
11:47And so when you think about that many women not achieving postnatal care, what's killing people after birth?
11:54Cardiovascular disease, mental health, and blood clots.
12:00It's imperative that folks get that care after the fact.
12:05Right now there are about three states that have about limited restrictions on that.
12:10One state, Arkansas, doesn't have any of the extension.
12:14The rest of the states are following suit.
12:16That's reassuring and that's a win.
12:18So we're going to pivot a little bit and let's start really exploring and talking about
12:22what are some of the solutions to this problem.
12:25Right.
12:25So I'll tell you, I'm an OBGYN.
12:27I'm a black female OBGYN in the South.
12:31Six or seven, eight years ago, we've been advocating.
12:33You heard me say black women have been dying for 100 years.
12:37We've been advocating just for the awareness around this.
12:40And so I thought, well, now that everybody knows, the government knows, agency knows,
12:46we're going to fix it, right?
12:48No one's figured it out to this point, right?
12:51That's a problem.
12:53People are investing in it.
12:55I think HHS is, CMS, there are some programs, but we must do more.
13:01And so let's talk about some of the solutions that we see to move the needle.
13:07Because you're talking about life and death.
13:10We're talking about moms and babies.
13:12For me, when you think about maternal and infant health,
13:16that's the most important marker of the health of a society.
13:19And so solutions, you mentioned some of the restrictive reproductive health laws.
13:27For me as an OBGYN, for me, the manifestation is the impact it's having on obstetric care.
13:34So what happens when these laws start going into effect?
13:37We start seeing more deaths.
13:39And remember, a woman can die first trimester, ectopics.
13:43Ectopics, you can hemorrhage from a miscarriage.
13:47So let's think about, as you go back to your local areas, you're advocating.
13:52Let's think about what we're really advocating for.
13:56And what I'm talking about, for me, I frame this broadly around women's health, right?
14:02Maternal health is a piece of that.
14:03But if you have a child, and let's say you do survive, but you survive and you're disabled, that's still a problem.
14:11I want women to leave the hospital whole, and I want their babies to leave the hospital alive and able to thrive.
14:20So I'll let you give a little bit of, ask your perspective on some of the solutions that we need to be pursuing in this country.
14:27Right. First of all, we, it's the whole adage that if we know better, we're going to do better, right?
14:35And so I considered myself well-read, but I did not understand until Kira died in 2016 that this was an issue.
14:46I honestly did not know that this was an issue.
14:49So that's why we're sounding the alarm, and we have to continue to have these conversations.
14:53But it's not just enough for us to be stuck in just, oh, it's terrible, and wringing our hands.
15:01We had to move forward.
15:02So my challenge for all of us today is to go back and research your states.
15:07What is happening with the Medicaid provisions about postpartum care?
15:14And if it is not at the 12-month mark, then I need you to be working with the women's caucuses and your state legislatures,
15:24with advocates, with the medical associations, with the law associations, because we need to all be in this conversation to change the tide.
15:37Then secondly, from a legal perspective, because that's, you know, that's my wheelhouse, is that I, just to be honest,
15:48for a long time, I could not take on these cases, Dr. Lawson.
15:53It was too raw.
15:54It was too hard.
15:56It was just emotionally too hard.
15:59I'm at a different place now.
16:01I'm prayed up about this, and I am in it.
16:05I am in these fights, and I am taking on maternal death cases all over the country.
16:11But I'm not going to do them traditionally.
16:14This is very important.
16:16I'm not suing just on medical malpractice grounds.
16:20I am suing on civil rights grounds.
16:24I am bringing civil rights claims because of the disparity.
16:30You can't tell me that as a brown and black woman that we walk into these spaces and that we don't come out and our white counterparts do.
16:39If that is not discrimination, if that is not a continuation of the discrimination that we have seen historically in this country, I don't know what does.
16:47So I'm doing it very differently.
16:49I'm catching hell, but I don't care.
16:55Because until there's accountability and until there is change in this nation, these little babies will still be waking up wondering why their mother can't come home from heaven.
17:08I can't explain that.
17:09I can't, I'm a grown woman.
17:11I can't explain why Kira's not here and why she's in heaven.
17:15How do I expect a precious child to understand this?
17:20We're in the business of sending women home.
17:24And then there was something else we were going to talk about, about the strategy.
17:28What else were we going to talk about?
17:29It's okay.
17:30I pulled some numbers for you all.
17:32I looked at, we're in Louisiana, so I have to honor Louisiana, right?
17:3937% of the births in this state are black women, but black women attribute to 65% of the deaths.
17:50So when we say go back home, go back home and really look at what's happening where you are and advocate with whoever you want.
18:01Advocate with the black doctors, the black nurses.
18:05We're all trying to solve this problem.
18:08Come in with a solution base.
18:10Right.
18:11Because the U.S., right, we're the powerhouse of this world.
18:15And if we can't solve this problem, as much money as we spend on health care, right, as much money and the resources that we have and the things we're able to do.
18:28And so for me, this is a value proposition.
18:31Yes, yes, yes, yes.
18:32It is a value proposition.
18:33It is a value proposition.
18:34And think about it.
18:36If we're losing black mothers, what is the implication for our black communities?
18:42There you go.
18:43If we are losing black mothers, 84%, I'm going to say it again, I'm going to keep saying it, 84% of these women who are dying, it was preventable.
18:55It was preventable.
18:57And so as my son reminds me, Mom, that means that we've got a lot of good work to do.
19:04That if there's 84% of them dying, then that means that we got 84% that we ought to be saving.
19:10And that has got to be our mentality.
19:12Last thing, quickly, is that don't go into a hospital alone.
19:17Have somebody.
19:17Have an advocate.
19:18Got to have an advocate.
19:20And my son was advocating.
19:21But you know what Kira said?
19:23Baby, don't get upset.
19:25I don't want them to get.
19:27She was afraid that they were going to get with him and put him out.
19:32I had left the hospital with the baby to go home, the 19-month-old, to go back to the condo.
19:37If I had been there and understood all of that, I would have turned to the hospital.
19:41I probably would have gotten arrested.
19:42But my point is, we've got to be smart.
19:45We've got to advocate.
19:46Don't go.
19:48And if you're in labor, you've got to have somebody with their shifts.
19:51The person gets tired.
19:52They go home.
19:53They can't leave you there because you've got to have somebody advocating.
19:57Even though Kira had advocates, she still died.
20:01And we have a chance to change this.
20:03And I'm so grateful for Alfonso and the team really putting this together.
20:10I don't see him, but I want to thank you for doing this.
20:15We want to thank Alfonso and the Global Black Economic Forum.
20:17Yes, thank you.
20:19Because this has very serious, not only social implications for our families, but serious economic.
20:27Because how many of y'all know black women who are head of household?
20:31You see my point?
20:32So, if we're losing them, then what does that mean for the vitality, the viability, economic viability of our families?
20:43Because I did want to bring it back to the economic piece.
20:46And you see that sign behind you, vote?
20:48If you all saw me yesterday, I came in with my vote t-shirt.
20:51Now, let me tell you, I do wash it, but I'm wearing that from now to November.
20:55We have got to vote.
20:59Too much is at stake.
21:02Thank you all.
21:03Thank you all.
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