1 00:00:00,440 --> 00:00:03,960 Speaker 1: Oh my goodness, did you see Rihanna's latest look with 2 00:00:04,080 --> 00:00:07,800 Speaker 1: that string going across that pregnant belly. Yes, she is 3 00:00:08,119 --> 00:00:11,080 Speaker 1: putting out looks that I wouldn't dare to and she's 4 00:00:11,080 --> 00:00:13,600 Speaker 1: doing it with a plus one in her belly. Yes, 5 00:00:14,000 --> 00:00:17,680 Speaker 1: she is definitely that girl, that girl. You know, it 6 00:00:17,760 --> 00:00:21,320 Speaker 1: feels only right that when our good friend Rihanna goes 7 00:00:21,320 --> 00:00:23,880 Speaker 1: through the changes, that we go through them right beside her. Yes, 8 00:00:23,920 --> 00:00:26,880 Speaker 1: I'm having sympathy pains, are you. Yes, I've been eating 9 00:00:26,880 --> 00:00:29,280 Speaker 1: a lot more, you know, feel like I'm eating for 10 00:00:29,320 --> 00:00:31,800 Speaker 1: two or maybe I'm just greedy. Who knows it could be. 11 00:00:32,000 --> 00:00:34,760 Speaker 1: I'm not gonna say with one. I'm not gonna say 12 00:00:34,800 --> 00:00:37,600 Speaker 1: what I think. Our age group we kind of grew 13 00:00:37,760 --> 00:00:40,839 Speaker 1: up with Rihanna, so it feels like a family affair. 14 00:00:41,040 --> 00:00:44,240 Speaker 1: So talking about all the motions that she's going through 15 00:00:44,320 --> 00:00:47,000 Speaker 1: it feels therapeutic for us all. And so it's only 16 00:00:47,120 --> 00:00:49,640 Speaker 1: right that we jump into what her new future will 17 00:00:49,640 --> 00:00:51,720 Speaker 1: look like and what it looks like right now in 18 00:00:51,760 --> 00:00:55,640 Speaker 1: the landscape of maternal health. I'm TT and I'm Zakiyah 19 00:00:55,760 --> 00:01:24,959 Speaker 1: and from Spotify. This is Dope Labs. Welcome to Dope Labs, 20 00:01:25,000 --> 00:01:28,679 Speaker 1: a weekly podcast that mixes hardcore science, pop culture, and 21 00:01:28,720 --> 00:01:31,280 Speaker 1: a healthy dosa friendship. Now, we've already talked about our 22 00:01:31,319 --> 00:01:33,680 Speaker 1: friend Rihanna, but we also want to remember that Mother's 23 00:01:33,760 --> 00:01:36,040 Speaker 1: Day is right around the corner, so it's only fitting 24 00:01:36,080 --> 00:01:39,080 Speaker 1: that we're talking all about maternal health this week. That's right. 25 00:01:39,160 --> 00:01:42,120 Speaker 1: We specifically wanted to know about the current status of 26 00:01:42,160 --> 00:01:45,240 Speaker 1: our maternal health care system, whether it's working, and what 27 00:01:45,280 --> 00:01:48,440 Speaker 1: we can do to better support birthing parents. And because 28 00:01:48,480 --> 00:01:50,880 Speaker 1: this is such a huge topic, we're going to have 29 00:01:50,920 --> 00:01:54,480 Speaker 1: another episode next week, a Part two, to dig in 30 00:01:54,680 --> 00:01:58,240 Speaker 1: even deeper into maternal health. Let's get into the recitation. 31 00:02:07,920 --> 00:02:10,320 Speaker 1: So what do we know? Well, I know we already 32 00:02:10,360 --> 00:02:13,560 Speaker 1: talked about reproductive health, and maternal health is kind of 33 00:02:13,560 --> 00:02:16,440 Speaker 1: related to reproductive health, but a little bit different. The 34 00:02:16,480 --> 00:02:18,360 Speaker 1: things that started coming up in that episode that we 35 00:02:18,400 --> 00:02:22,480 Speaker 1: did on reproductive health is now coming to life on 36 00:02:22,680 --> 00:02:26,720 Speaker 1: Monday of this week. So May second, it was leaked 37 00:02:26,880 --> 00:02:30,880 Speaker 1: that Row versus Wade might be or probably is going 38 00:02:30,919 --> 00:02:33,600 Speaker 1: to be overturned, which in my mind, I think I 39 00:02:33,639 --> 00:02:35,919 Speaker 1: said this in the Reproductive Health episode. I just don't 40 00:02:36,440 --> 00:02:40,200 Speaker 1: it feels like we are taking such large steps backwards, 41 00:02:40,480 --> 00:02:42,280 Speaker 1: you know, even the fact that that was a draft 42 00:02:42,320 --> 00:02:46,119 Speaker 1: opinion that uh doesn't feel good. It does not feel good. 43 00:02:46,120 --> 00:02:48,400 Speaker 1: And hopefully we'll be able to update all of you 44 00:02:48,480 --> 00:02:52,840 Speaker 1: all as more information comes out. I think we also 45 00:02:52,960 --> 00:02:57,600 Speaker 1: know that having children is a long term commitment and 46 00:02:57,639 --> 00:03:02,120 Speaker 1: it is very expensive, and so having the right resources 47 00:03:02,120 --> 00:03:05,120 Speaker 1: in place is very important. And I also know that 48 00:03:05,280 --> 00:03:08,679 Speaker 1: having children not only is expensive and a long term commitment, 49 00:03:09,000 --> 00:03:11,400 Speaker 1: it's risky. Yeah, there are so many things that come 50 00:03:11,400 --> 00:03:13,480 Speaker 1: along with it. And as more of my friends are 51 00:03:13,480 --> 00:03:16,120 Speaker 1: having kids, I'm like, that's a risk, that's something that 52 00:03:16,120 --> 00:03:19,640 Speaker 1: could happen. It's wild, honestly. And I guess that gets 53 00:03:19,639 --> 00:03:22,280 Speaker 1: into what do we want to know? And I want 54 00:03:22,320 --> 00:03:25,760 Speaker 1: to know why after all this time? You know, people 55 00:03:25,760 --> 00:03:28,560 Speaker 1: have been having babies forever. Yes, I know we say 56 00:03:28,560 --> 00:03:30,960 Speaker 1: since the beginning of time as just like a phrase 57 00:03:31,040 --> 00:03:33,679 Speaker 1: or turn phrase, but literally, since the beginning of time, 58 00:03:33,919 --> 00:03:36,520 Speaker 1: people have been having babies. And so I want to 59 00:03:36,560 --> 00:03:40,280 Speaker 1: know why we're still having all of these issues with 60 00:03:40,400 --> 00:03:44,360 Speaker 1: maternal health care and not just blanket issues. So it's 61 00:03:44,400 --> 00:03:48,960 Speaker 1: blanket risky, but then within that risk disparities whereas riskier 62 00:03:49,040 --> 00:03:52,760 Speaker 1: for certain groups? Right? Why? Yes? And then I want 63 00:03:52,760 --> 00:03:55,000 Speaker 1: to know about the stuff that is not making front 64 00:03:55,000 --> 00:03:58,000 Speaker 1: page news or is not you know, associated with some 65 00:03:58,080 --> 00:04:01,560 Speaker 1: of these really big names celebrities, that has happened to them. 66 00:04:01,960 --> 00:04:03,520 Speaker 1: I want to know about some of the stuff that 67 00:04:03,600 --> 00:04:05,840 Speaker 1: you might not know about. Yeah, day to day swept 68 00:04:05,920 --> 00:04:08,960 Speaker 1: under the rug. Absolutely, and then once we understand that 69 00:04:09,080 --> 00:04:12,120 Speaker 1: TT then what if we know all this stuff, what's next? 70 00:04:12,200 --> 00:04:13,720 Speaker 1: What can we do? I want to know what the 71 00:04:13,720 --> 00:04:17,400 Speaker 1: future of maternal health looks like. Fuja. All right, let's 72 00:04:17,440 --> 00:04:31,000 Speaker 1: jump into the dissection. Our guest for today's lab is 73 00:04:31,040 --> 00:04:31,760 Speaker 1: Simone Tate. 74 00:04:32,120 --> 00:04:35,920 Speaker 2: I'm Simone Tate. I'm the founder and CEO of poppy 75 00:04:35,960 --> 00:04:36,640 Speaker 2: Seed Health. 76 00:04:36,960 --> 00:04:40,120 Speaker 1: Poppy Seed Health is a telehealth app that connects birthing 77 00:04:40,120 --> 00:04:44,640 Speaker 1: people to duelas midwives or nurses for one on one support. 78 00:04:44,839 --> 00:04:47,279 Speaker 1: And the fact that an organization like poppy Seed Health 79 00:04:47,640 --> 00:04:52,240 Speaker 1: exists already points to some gaps in our maternal health 80 00:04:52,240 --> 00:04:55,039 Speaker 1: care system, you know, absolutely. So the first thing that 81 00:04:55,080 --> 00:04:57,800 Speaker 1: we asked Simone was to help us understand maternal healthcare 82 00:04:57,839 --> 00:05:00,640 Speaker 1: in the United States right now? Where do we stand? 83 00:05:00,960 --> 00:05:05,960 Speaker 2: Maternal healthcare in the US is what I like to 84 00:05:06,040 --> 00:05:12,120 Speaker 2: call perfectly antiquated. We haven't evolved in the same ways 85 00:05:12,240 --> 00:05:16,960 Speaker 2: as some of the other developed countries we are still addressing, 86 00:05:17,640 --> 00:05:22,800 Speaker 2: especially populations that are underserved in a lot of the 87 00:05:22,839 --> 00:05:25,960 Speaker 2: same ways that we were doing twenty thirty and forty 88 00:05:26,040 --> 00:05:26,600 Speaker 2: years ago. 89 00:05:27,040 --> 00:05:29,400 Speaker 1: So basically, it's still the game of Thrones if you're 90 00:05:29,560 --> 00:05:31,640 Speaker 1: on the maternal healthcare journey. I wish I knew a 91 00:05:31,640 --> 00:05:36,479 Speaker 1: game of Thrones reference shame. That's the one that I 92 00:05:36,520 --> 00:05:39,960 Speaker 1: think of all the time. Shame on the healthcare system. 93 00:05:39,600 --> 00:05:43,160 Speaker 2: For being like that what we see happening in maternal 94 00:05:43,160 --> 00:05:47,120 Speaker 2: healthcare today as it leads to the rise in maternal 95 00:05:47,160 --> 00:05:51,279 Speaker 2: mortality and morbidity cases, especially for women that look just 96 00:05:51,400 --> 00:05:53,800 Speaker 2: like us, right, black and brown women in the US, 97 00:05:54,240 --> 00:05:59,240 Speaker 2: and in near misses, which means that you might have 98 00:05:59,320 --> 00:06:03,720 Speaker 2: complications or something that's literally a near miss that could 99 00:06:03,720 --> 00:06:04,200 Speaker 2: be fatal. 100 00:06:04,279 --> 00:06:06,919 Speaker 1: In a lot of ways, morbidity and mortality are often 101 00:06:06,920 --> 00:06:10,720 Speaker 1: grouped together. Morbidity refers to health issues, and when we 102 00:06:10,760 --> 00:06:14,159 Speaker 1: say maternal morbidity, we're referring to health issues due to 103 00:06:14,200 --> 00:06:18,080 Speaker 1: pregnancy you're giving birth, whereas mortality is death and that's 104 00:06:18,160 --> 00:06:21,200 Speaker 1: death from health issues during pregnancy or given birth, or 105 00:06:21,240 --> 00:06:25,120 Speaker 1: within six weeks after a pregnancy ends. The US spends 106 00:06:25,160 --> 00:06:28,960 Speaker 1: the most money on maternal health in the world, but 107 00:06:29,080 --> 00:06:32,680 Speaker 1: has one of the highest mortality rates among developed countries. 108 00:06:32,839 --> 00:06:35,640 Speaker 1: According to the CDC, each year, around seven hundred birthing 109 00:06:35,680 --> 00:06:39,080 Speaker 1: people die from pregnancy or birth complications, and that risk 110 00:06:39,240 --> 00:06:41,880 Speaker 1: is three to four times more likely for black women. 111 00:06:42,160 --> 00:06:45,320 Speaker 1: So we ask simone to break down what is included 112 00:06:45,560 --> 00:06:46,479 Speaker 1: in maternal health. 113 00:06:46,800 --> 00:06:49,719 Speaker 2: As soon as you go to see your doctor, which 114 00:06:49,839 --> 00:06:54,359 Speaker 2: is typically somewhere between eight to nine weeks pregnant, you 115 00:06:54,720 --> 00:06:57,880 Speaker 2: are then in the maternal healthcare system in the US, 116 00:06:58,160 --> 00:07:00,880 Speaker 2: and that doesn't matter who you are right where you 117 00:07:00,920 --> 00:07:04,480 Speaker 2: are on the spectrum of health insurance, commercial health insurance, 118 00:07:04,680 --> 00:07:08,159 Speaker 2: or medicaid. As soon as you're identified in the system, 119 00:07:08,240 --> 00:07:12,560 Speaker 2: there is a maternal healthcare journey that you are immediately 120 00:07:12,600 --> 00:07:12,960 Speaker 2: put on. 121 00:07:13,240 --> 00:07:16,360 Speaker 1: For most people, this looks like twenty minute monthly appointments 122 00:07:16,360 --> 00:07:18,320 Speaker 1: with your OBGYN. 123 00:07:17,960 --> 00:07:22,240 Speaker 2: That might include having a sonogram. There's some major milestone 124 00:07:22,320 --> 00:07:25,440 Speaker 2: tests that you're also getting along the way. One of 125 00:07:25,440 --> 00:07:28,000 Speaker 2: the big ones that most people know of is the 126 00:07:28,080 --> 00:07:32,240 Speaker 2: anatomy scan, when they scan and measure the entire baby. 127 00:07:32,520 --> 00:07:36,880 Speaker 2: There's your gestational diabetes test, which is another big milestone, 128 00:07:36,960 --> 00:07:41,200 Speaker 2: and then there's labor and delivery. Once you have that baby, 129 00:07:41,520 --> 00:07:44,840 Speaker 2: you are effectively out of the maternal healthcare system. 130 00:07:45,080 --> 00:07:48,800 Speaker 1: It happens really fast. The federal requirement for insurance coverage 131 00:07:49,040 --> 00:07:52,360 Speaker 1: after the delivery of a baby is only sixty days, 132 00:07:52,600 --> 00:07:55,600 Speaker 1: so that's a really short window to get your things 133 00:07:55,640 --> 00:07:58,840 Speaker 1: together and to have appointments. You know. Yeah, And on 134 00:07:58,960 --> 00:08:01,600 Speaker 1: average the points are to minutes twenty minutes over ten months. 135 00:08:01,640 --> 00:08:03,880 Speaker 1: It's only two hundred minutes worth of time eyeball to 136 00:08:03,920 --> 00:08:07,720 Speaker 1: eyeball with a doctor. And that's if it's eyeball to eyeball, girl. Hello, 137 00:08:08,160 --> 00:08:11,520 Speaker 1: If it's eyeball to eyeball, that would make me very nervous. 138 00:08:11,560 --> 00:08:14,840 Speaker 1: That doesn't seem like enough time, especially considering all the 139 00:08:15,000 --> 00:08:17,520 Speaker 1: changes that are happening to your body. And now it's 140 00:08:17,560 --> 00:08:20,360 Speaker 1: a whole new person here too, exactly, like who go 141 00:08:20,560 --> 00:08:22,840 Speaker 1: look out for this thing? They just got here. 142 00:08:23,640 --> 00:08:28,160 Speaker 2: Once you have the baby, the entire thing shifts and 143 00:08:28,680 --> 00:08:32,160 Speaker 2: you have follow up appointments for your baby. But the 144 00:08:32,200 --> 00:08:36,600 Speaker 2: birthing person typically is only going to see their doctor 145 00:08:37,000 --> 00:08:40,880 Speaker 2: at that fateful six week mark when you get to 146 00:08:40,920 --> 00:08:42,800 Speaker 2: find out if you can have sex again or not. 147 00:08:43,360 --> 00:08:47,000 Speaker 2: That's what most people know that appointment for. And then 148 00:08:47,080 --> 00:08:49,360 Speaker 2: you're back into your normal health care. 149 00:08:50,280 --> 00:08:53,400 Speaker 1: I think I would have a lot of follow up questions. Yes, 150 00:08:54,040 --> 00:08:56,600 Speaker 1: I would want that doctor to move in with me, 151 00:08:56,840 --> 00:09:00,160 Speaker 1: And I think that's what Simone is advocating for. Holistic care, 152 00:09:00,240 --> 00:09:02,640 Speaker 1: a doctor or provider to look after your body and 153 00:09:02,760 --> 00:09:06,080 Speaker 1: mind considering the major event that just took place. Yes, 154 00:09:06,480 --> 00:09:09,760 Speaker 1: birth pushing a whole body out of your body. 155 00:09:10,320 --> 00:09:15,480 Speaker 2: Yes, the maternal health care system is really focused on 156 00:09:15,559 --> 00:09:19,520 Speaker 2: the baby. We want to focus on both the baby 157 00:09:19,600 --> 00:09:23,959 Speaker 2: and the person. So your emotional mental health support, which 158 00:09:24,120 --> 00:09:28,800 Speaker 2: is healthcare, is just as important as your physical care. 159 00:09:28,960 --> 00:09:33,599 Speaker 2: And also having the kind of evidence based information and 160 00:09:33,840 --> 00:09:38,600 Speaker 2: knowledge that helps you to understand what's actually happening with 161 00:09:38,720 --> 00:09:43,439 Speaker 2: your body as you go through one of life's biggest milestones. 162 00:09:43,679 --> 00:09:47,199 Speaker 2: That's a cultural shift that's going to take time, and. 163 00:09:47,160 --> 00:09:50,800 Speaker 1: These opportunities for birthing people to get that emotional mental 164 00:09:50,800 --> 00:09:55,200 Speaker 1: health and support should happen throughout a pregnancy, not just 165 00:09:55,360 --> 00:09:58,160 Speaker 1: during the twenty minute appointments with their doctor. It's also 166 00:09:58,160 --> 00:10:01,160 Speaker 1: important to have continued support after birth too. 167 00:10:01,480 --> 00:10:06,000 Speaker 2: That first year of postpartum is so critical. For example, 168 00:10:06,040 --> 00:10:08,840 Speaker 2: if you look at the Nordic countries or even the UK, 169 00:10:09,480 --> 00:10:12,400 Speaker 2: you get sent home from the hospital after having a baby, 170 00:10:12,559 --> 00:10:16,640 Speaker 2: and within just a day or two, a nurse or 171 00:10:16,679 --> 00:10:20,160 Speaker 2: a doula shows up on your doorstep and they are 172 00:10:20,280 --> 00:10:23,720 Speaker 2: with you for the first four to six weeks, sometimes 173 00:10:23,760 --> 00:10:26,960 Speaker 2: eight weeks after you have the baby, just showing up 174 00:10:27,200 --> 00:10:31,520 Speaker 2: taking care of you and also taking care of the baby. 175 00:10:31,679 --> 00:10:34,240 Speaker 2: So there are so many points that we can improve 176 00:10:34,320 --> 00:10:37,640 Speaker 2: on for the whole person for the best of health outcomes. 177 00:10:38,000 --> 00:10:40,120 Speaker 1: We've been talking about what maternal health can look like 178 00:10:40,160 --> 00:10:42,959 Speaker 1: if everything goes right with pregnancy and birth birth and 179 00:10:42,960 --> 00:10:45,880 Speaker 1: people are looking at ten monthly appointments, a six week 180 00:10:45,960 --> 00:10:48,520 Speaker 1: follow up, and then they're pretty quickly back into their 181 00:10:48,520 --> 00:10:51,760 Speaker 1: regular health care. But we know healthcare access and quality 182 00:10:51,800 --> 00:10:54,560 Speaker 1: are not equal for all people in this country. According 183 00:10:54,559 --> 00:10:57,160 Speaker 1: to Simone, there are three main bottlenecks when it comes 184 00:10:57,200 --> 00:11:00,000 Speaker 1: to accessing care within the maternal health care system. 185 00:11:00,320 --> 00:11:04,360 Speaker 2: So the first one is when we think about showing 186 00:11:04,440 --> 00:11:08,760 Speaker 2: up to appointments. That means that you are able to 187 00:11:09,000 --> 00:11:11,960 Speaker 2: leave your job, take the time off. If you have 188 00:11:12,080 --> 00:11:15,840 Speaker 2: other children, you're able to get child's care. It also 189 00:11:16,040 --> 00:11:20,320 Speaker 2: means that you have a car or transportation, and I'm 190 00:11:20,320 --> 00:11:23,320 Speaker 2: talking about these twenty minute appointments. But let's be honest, 191 00:11:23,360 --> 00:11:25,720 Speaker 2: we show up to the doctor's office and we're usually 192 00:11:25,760 --> 00:11:27,800 Speaker 2: there for way more than twenty minutes. 193 00:11:27,960 --> 00:11:30,480 Speaker 1: If you think about taking two hours out of your 194 00:11:30,559 --> 00:11:34,160 Speaker 1: day every month for ten months, that's around twenty hours. 195 00:11:34,360 --> 00:11:36,600 Speaker 1: That's a lot of time spent not working. Not everyone's 196 00:11:36,640 --> 00:11:39,000 Speaker 1: allowed to do that. Not everyone is allowed to do that, 197 00:11:39,320 --> 00:11:41,800 Speaker 1: and even if they're allowed, not everyone can afford to 198 00:11:41,800 --> 00:11:44,720 Speaker 1: do that, exactly because time off is money lost. So 199 00:11:44,760 --> 00:11:46,560 Speaker 1: then we have to ask what are the outcomes for 200 00:11:46,600 --> 00:11:51,119 Speaker 1: a birthing person who's unable to attend those monthly appointments exactly. 201 00:11:51,240 --> 00:11:53,839 Speaker 1: And this relates to the second bottleneck in our current 202 00:11:53,880 --> 00:11:57,760 Speaker 1: maternal health care system, the lack of remote care options. 203 00:11:57,880 --> 00:12:01,160 Speaker 2: Our infrastructure and maternal health care is not set up 204 00:12:01,320 --> 00:12:04,840 Speaker 2: for both the digital space and the in person space. 205 00:12:05,120 --> 00:12:09,640 Speaker 2: I take a strong stance that holistic care and a 206 00:12:09,679 --> 00:12:13,760 Speaker 2: new care model is both in person and not in 207 00:12:13,800 --> 00:12:18,719 Speaker 2: person to make sure that people are taken care of 208 00:12:19,040 --> 00:12:21,160 Speaker 2: wherever they are. 209 00:12:21,480 --> 00:12:24,800 Speaker 1: So we've seen COVID increase access to telehealth right, but 210 00:12:24,880 --> 00:12:26,959 Speaker 1: that's a double edged sword because there are still these 211 00:12:27,000 --> 00:12:30,520 Speaker 1: disparities that exist. For example, who has a computer right 212 00:12:30,600 --> 00:12:32,800 Speaker 1: and who feels like they're able to connect with their doctor. 213 00:12:33,040 --> 00:12:36,280 Speaker 1: So on one hand, it may be beneficial to have 214 00:12:36,320 --> 00:12:38,560 Speaker 1: some appointments over telehealth. On the other hand, it may 215 00:12:38,559 --> 00:12:40,360 Speaker 1: be beneficial to have them in person. And so I 216 00:12:40,360 --> 00:12:43,880 Speaker 1: think that's why Simona is suggesting a blended model absolutely, 217 00:12:43,920 --> 00:12:47,240 Speaker 1: because there are some things that are lost through, you know, FaceTime. 218 00:12:47,600 --> 00:12:50,200 Speaker 1: We know that just from our social interactions with people, yes, 219 00:12:50,440 --> 00:12:54,080 Speaker 1: and sometimes just being able to be like physically in person, 220 00:12:54,160 --> 00:12:56,439 Speaker 1: looking your doctor in the eye gives you a certain 221 00:12:56,520 --> 00:12:59,760 Speaker 1: level of comfort in your ability to explain what's going 222 00:12:59,800 --> 00:13:02,959 Speaker 1: on with you and the service that you may require 223 00:13:03,000 --> 00:13:05,360 Speaker 1: from them, And that leads us right to the third point. 224 00:13:05,640 --> 00:13:08,840 Speaker 1: Simon says, the third bottleneck is maternal health care deserts. 225 00:13:09,000 --> 00:13:11,280 Speaker 1: That means someone lives ninety miles or more from their 226 00:13:11,320 --> 00:13:13,359 Speaker 1: closest healthcare provider or hospital. 227 00:13:13,520 --> 00:13:16,160 Speaker 2: If you live in an urban area or major city 228 00:13:16,200 --> 00:13:19,240 Speaker 2: in the US, we're all in bubbles. It's hard to 229 00:13:19,400 --> 00:13:23,760 Speaker 2: imagine that your home is that far away from a 230 00:13:23,800 --> 00:13:30,080 Speaker 2: hospital or your closest provider. So this is rural America. 231 00:13:30,160 --> 00:13:35,240 Speaker 2: It's also the majority of where people are living that 232 00:13:35,480 --> 00:13:39,800 Speaker 2: need paternal health care. We also are seeing a decrease 233 00:13:40,200 --> 00:13:45,960 Speaker 2: in obgyns in these areas and also in doctors who 234 00:13:46,040 --> 00:13:48,840 Speaker 2: go through med school and decide to become obgyns. 235 00:13:49,000 --> 00:13:51,600 Speaker 1: This is all really interesting, but one thing that jumped 236 00:13:51,640 --> 00:13:55,440 Speaker 1: out to me is the obgyn shortage. Why is there 237 00:13:55,480 --> 00:13:57,840 Speaker 1: a shortage? It seems like there's a lot of factors. 238 00:13:57,960 --> 00:14:01,640 Speaker 1: It's a supply and demand kind of thing. You know. Interestingly, 239 00:14:01,960 --> 00:14:05,200 Speaker 1: when we look at our population over time, the number 240 00:14:05,280 --> 00:14:09,640 Speaker 1: of women over eighteen has really increased, but the number 241 00:14:09,679 --> 00:14:12,560 Speaker 1: of positions when we think about obgyn training, so first 242 00:14:12,640 --> 00:14:16,080 Speaker 1: year residency positions, is not growing at the same scale. 243 00:14:16,120 --> 00:14:19,920 Speaker 1: So you're having fewer obgyns even able to push through 244 00:14:19,920 --> 00:14:21,720 Speaker 1: the training, and then you have more women who need 245 00:14:21,760 --> 00:14:24,920 Speaker 1: to be served. That's just the baseline, the basic layer. 246 00:14:25,280 --> 00:14:27,440 Speaker 1: The other part is when we consider we have aging 247 00:14:27,520 --> 00:14:31,280 Speaker 1: populations that are retiring, and additionally, when you look at 248 00:14:31,280 --> 00:14:35,120 Speaker 1: surgical residencies, obgyns are not getting paid a lot. And 249 00:14:35,280 --> 00:14:36,960 Speaker 1: you know the other part is that they want to 250 00:14:37,000 --> 00:14:39,360 Speaker 1: live in urban areas too, So then this doesn't help 251 00:14:39,640 --> 00:14:43,080 Speaker 1: that shortage that we see in rural areas. Most of 252 00:14:43,120 --> 00:14:45,240 Speaker 1: the training is in urban areas. Like when you think 253 00:14:45,240 --> 00:14:48,840 Speaker 1: about where med schools are right and where major hospitals 254 00:14:48,880 --> 00:14:51,160 Speaker 1: are I think I saw something that said people are 255 00:14:51,400 --> 00:14:53,880 Speaker 1: likely to stay in the same place where they did 256 00:14:53,880 --> 00:14:54,680 Speaker 1: their residencies. 257 00:14:55,440 --> 00:14:59,400 Speaker 2: So these maternal healthcare deserts are becoming a major concern 258 00:14:59,440 --> 00:15:02,480 Speaker 2: in the US. And just to put that in perspective 259 00:15:02,560 --> 00:15:07,480 Speaker 2: for you, that affects about seven million birthing people in 260 00:15:07,560 --> 00:15:08,000 Speaker 2: the US. 261 00:15:08,400 --> 00:15:12,880 Speaker 1: That's wild. Ninety miles is the lower limit. Twelve miles 262 00:15:12,920 --> 00:15:15,880 Speaker 1: in DC is forty five minutes, truly, and you could 263 00:15:15,880 --> 00:15:19,280 Speaker 1: speak on Atlanta. Oh, I know that traffic is wild. 264 00:15:19,680 --> 00:15:19,960 Speaker 2: Man. 265 00:15:20,520 --> 00:15:23,360 Speaker 1: They're doing crash cars on the highway right, They're doing 266 00:15:23,400 --> 00:15:26,360 Speaker 1: monster trucks. And so even if you think about how 267 00:15:26,360 --> 00:15:28,280 Speaker 1: long is it going to take? Is there public transit? 268 00:15:29,400 --> 00:15:31,600 Speaker 1: What I feel safe getting in like a car service, 269 00:15:31,680 --> 00:15:33,720 Speaker 1: you know, like Luber or Lyft? Can I afford to 270 00:15:33,760 --> 00:15:37,040 Speaker 1: do that? There are so many compounding factors. Absolutely. I 271 00:15:37,080 --> 00:15:40,480 Speaker 1: recently saw a TikTok of a woman who was pregnant 272 00:15:40,520 --> 00:15:42,200 Speaker 1: and she was trying to get to a doctor's office. 273 00:15:42,200 --> 00:15:45,160 Speaker 1: She doesn't have a car, and to use public transportation 274 00:15:45,600 --> 00:15:48,400 Speaker 1: it would probably take her half of a day a workday, 275 00:15:48,440 --> 00:15:50,840 Speaker 1: so like four hours just to get to the doctors. 276 00:15:51,320 --> 00:15:53,880 Speaker 1: And so she was saying that she kept asking friends 277 00:15:53,920 --> 00:15:56,400 Speaker 1: for help, and every time they would say yes, and 278 00:15:56,440 --> 00:15:58,960 Speaker 1: then it would eventually fall through. So she had already 279 00:15:59,080 --> 00:16:02,960 Speaker 1: missed two two months of appointments, and she was very 280 00:16:03,000 --> 00:16:05,520 Speaker 1: nervous that this would negatively impact her health and the 281 00:16:05,520 --> 00:16:07,720 Speaker 1: health of her baby. And when you think about stories 282 00:16:07,800 --> 00:16:10,240 Speaker 1: like that, Simone is basically telling us that this is 283 00:16:10,360 --> 00:16:13,960 Speaker 1: not just a one off. This is happening to millions 284 00:16:14,000 --> 00:16:18,160 Speaker 1: of Americans that are pregnant. And this really makes me 285 00:16:18,200 --> 00:16:21,320 Speaker 1: start thinking about how all these bottlenecks can then be 286 00:16:21,400 --> 00:16:26,480 Speaker 1: further exacerbated or directly linked to socioeconomic status. Absolutely, if 287 00:16:26,520 --> 00:16:28,880 Speaker 1: gas prices are up and your doctor is ninety miles 288 00:16:28,880 --> 00:16:32,400 Speaker 1: away or more, maybe that's adding up. It now costs 289 00:16:32,440 --> 00:16:33,720 Speaker 1: way more to get to the doctor. 290 00:16:33,960 --> 00:16:38,400 Speaker 2: Furthermore, fifty percent of the birthing population in the US 291 00:16:38,600 --> 00:16:43,160 Speaker 2: are on Medicaid, which means they don't have equal and 292 00:16:43,320 --> 00:16:46,680 Speaker 2: equitable access to the best care. 293 00:16:47,240 --> 00:16:49,320 Speaker 1: This is a really important point that Simone is making, 294 00:16:49,360 --> 00:16:51,840 Speaker 1: and we are going to do an even deeper dive 295 00:16:51,920 --> 00:16:56,040 Speaker 1: into Medicaid and access to equitable care in next week's 296 00:16:56,080 --> 00:16:58,800 Speaker 1: episode in our part two. Okay, so back to the 297 00:16:58,840 --> 00:16:59,960 Speaker 1: population on Medicare. 298 00:17:00,480 --> 00:17:05,399 Speaker 2: So for that population specifically, those folks aren't even showing 299 00:17:05,520 --> 00:17:08,880 Speaker 2: up into the maternal health care system until they're somewhere 300 00:17:08,880 --> 00:17:13,840 Speaker 2: between twenty to twenty three weeks pregnant, so almost half 301 00:17:14,040 --> 00:17:18,119 Speaker 2: or more than half of your pregnancy without prenatal care 302 00:17:18,680 --> 00:17:23,440 Speaker 2: definitely affects health outcomes. But we need to stop blaming 303 00:17:23,800 --> 00:17:28,399 Speaker 2: and shaming the person and look at the systems and 304 00:17:28,440 --> 00:17:31,720 Speaker 2: the infrastructure that are lacking to begin with. 305 00:17:32,119 --> 00:17:34,280 Speaker 1: Those are a lot of cars to have stacked up 306 00:17:34,320 --> 00:17:36,960 Speaker 1: against you. Yeah, that seems like more than just one deck. 307 00:17:37,000 --> 00:17:39,679 Speaker 1: It seems like a few decks of cards stacked against you. 308 00:17:39,920 --> 00:17:49,960 Speaker 1: Blackjack six dicks, mm hmm. We wanted to learn more 309 00:17:49,960 --> 00:17:52,920 Speaker 1: about some of the disparities in maternal health and why 310 00:17:52,960 --> 00:17:56,800 Speaker 1: black and brown communities face more challenges in receiving care. 311 00:17:56,760 --> 00:17:59,959 Speaker 2: So the CDC was not reporting on maternal health care 312 00:18:00,160 --> 00:18:03,399 Speaker 2: outcomes for a decade, and when they did report on 313 00:18:03,480 --> 00:18:07,119 Speaker 2: maternal healthcare outcomes and morbidity rates in the US, it 314 00:18:07,280 --> 00:18:10,480 Speaker 2: showed that black and brown women are three to five 315 00:18:10,680 --> 00:18:14,280 Speaker 2: times more likely in some parts of our country who 316 00:18:14,280 --> 00:18:18,480 Speaker 2: have died from preventable deaths. That means that there were 317 00:18:18,560 --> 00:18:24,359 Speaker 2: medical interventions that happened that escalated and resulted in a 318 00:18:24,480 --> 00:18:27,440 Speaker 2: preventable death. The other side of that is that there 319 00:18:27,480 --> 00:18:32,840 Speaker 2: were no medical interventions that happened and resulted in preventable deaths. 320 00:18:33,080 --> 00:18:35,480 Speaker 1: Things can go bad if people get involved, and then 321 00:18:35,600 --> 00:18:38,280 Speaker 1: things can go bad if they don't. Right, It's a 322 00:18:38,320 --> 00:18:41,280 Speaker 1: scary situation to be in because you see two doors 323 00:18:41,320 --> 00:18:43,480 Speaker 1: and there might be some bad behind both. 324 00:18:43,760 --> 00:18:48,680 Speaker 2: Yeah, not only was it shocking, but it was truly unexpected. 325 00:18:48,840 --> 00:18:52,080 Speaker 2: And that is because when we look at how our 326 00:18:52,160 --> 00:18:56,639 Speaker 2: neighboring countries are doing, we see that maternal mortality rates 327 00:18:56,760 --> 00:18:59,920 Speaker 2: are really low or non existent. 328 00:19:00,440 --> 00:19:02,920 Speaker 1: So my question is why is this happening in the 329 00:19:03,040 --> 00:19:06,320 Speaker 1: United States. Simon told us that the US pours the 330 00:19:06,359 --> 00:19:09,560 Speaker 1: most money in the world into the maternal healthcare system. 331 00:19:09,640 --> 00:19:11,639 Speaker 1: Clearly something isn't working. 332 00:19:11,920 --> 00:19:15,359 Speaker 2: And as we know in our maternal healthcare system, in 333 00:19:15,400 --> 00:19:20,360 Speaker 2: our healthcare system as a whole, the deep, deep racial 334 00:19:20,400 --> 00:19:22,119 Speaker 2: bias that exists. 335 00:19:22,520 --> 00:19:25,439 Speaker 1: There are these myths when it comes to black people 336 00:19:25,720 --> 00:19:29,240 Speaker 1: and birth right about black women being able to withstand 337 00:19:29,240 --> 00:19:31,480 Speaker 1: a lot of pain, or that all black people are 338 00:19:31,520 --> 00:19:35,399 Speaker 1: all medicaid, and we know Medicaid isn't giving equal and 339 00:19:35,520 --> 00:19:38,800 Speaker 1: equitable care, and we'll talk about that more next week. 340 00:19:39,119 --> 00:19:41,800 Speaker 1: But I think all of that stuff just distracts us 341 00:19:41,840 --> 00:19:45,119 Speaker 1: from these disparate health outcomes that black and brown people 342 00:19:45,160 --> 00:19:48,000 Speaker 1: are experiencing in the healthcare system. 343 00:19:48,080 --> 00:19:54,359 Speaker 2: And historically speaking, we also know that black women were 344 00:19:54,480 --> 00:19:59,400 Speaker 2: used for experiments. We know that black women, pregnant black 345 00:19:59,440 --> 00:20:04,840 Speaker 2: women's specifically were used in the medical industry to create 346 00:20:05,280 --> 00:20:11,080 Speaker 2: all sorts of life saving surgeries. Yet these same things 347 00:20:11,200 --> 00:20:13,880 Speaker 2: aren't being used today to save our lives. 348 00:20:14,160 --> 00:20:16,640 Speaker 1: We've talked about racism and medicine on the show before, 349 00:20:16,800 --> 00:20:19,720 Speaker 1: and so you got to understand that obstetrics and gynecology 350 00:20:19,760 --> 00:20:24,800 Speaker 1: are no exception. Take us back intom TT. James Marion Simms, 351 00:20:24,880 --> 00:20:29,520 Speaker 1: who's been called the father of modern gynecology, performed experiments 352 00:20:29,560 --> 00:20:34,280 Speaker 1: on enslaved black women without anesthesia in the eighteen forties 353 00:20:34,400 --> 00:20:38,440 Speaker 1: until the procedures were safe enough for white women. Later, 354 00:20:38,480 --> 00:20:42,679 Speaker 1: he became the president of the American Medical Association in 355 00:20:42,720 --> 00:20:44,960 Speaker 1: the American Gynecological Society. 356 00:20:45,359 --> 00:20:48,280 Speaker 2: I want to relate this to this narrative that I 357 00:20:48,520 --> 00:20:52,320 Speaker 2: would love us to smash. We are not stronger than 358 00:20:52,520 --> 00:20:58,640 Speaker 2: every other woman out there. We absolutely feel pain, we 359 00:20:58,760 --> 00:21:02,919 Speaker 2: know pain and were reporting pain. We need that to 360 00:21:03,119 --> 00:21:09,440 Speaker 2: be taken seriously and currently because of racial bias, we 361 00:21:09,560 --> 00:21:12,199 Speaker 2: know that Black women are not getting the kind of 362 00:21:12,320 --> 00:21:15,480 Speaker 2: pain control or the kind of attention what we say 363 00:21:15,960 --> 00:21:21,200 Speaker 2: that we are in discomfort, So being disregarded in that 364 00:21:21,280 --> 00:21:24,800 Speaker 2: way can be fatal. There's a higher rate of pre 365 00:21:24,960 --> 00:21:28,280 Speaker 2: eclampsia that happens for Black women. 366 00:21:28,520 --> 00:21:32,199 Speaker 1: Preclamsia is a pregnancy complication that usually occurs during the 367 00:21:32,280 --> 00:21:35,680 Speaker 1: second half of pregnancy, after twenty weeks. If left untreated, 368 00:21:35,760 --> 00:21:38,480 Speaker 1: it can be fatal for the birthing parent and baby, 369 00:21:38,840 --> 00:21:42,280 Speaker 1: so it needs to be carefully monitored and managed until delivery. 370 00:21:42,400 --> 00:21:46,120 Speaker 1: The most common symptoms are high blood pressure and excess 371 00:21:46,160 --> 00:21:51,440 Speaker 1: of protein in your urine. Some people also experience headaches, dizziness, nausea, 372 00:21:51,520 --> 00:21:52,439 Speaker 1: and blurred vision. 373 00:21:52,760 --> 00:21:55,359 Speaker 2: If there are any symptoms that you feel that just 374 00:21:55,480 --> 00:21:59,280 Speaker 2: don't feel great, you're swelling or bloating, or something that's 375 00:21:59,600 --> 00:22:02,600 Speaker 2: very out of the norm for you, make sure that 376 00:22:02,680 --> 00:22:07,400 Speaker 2: you're calling your doctor immediately, but keep a pulse, keep 377 00:22:07,440 --> 00:22:11,320 Speaker 2: a check on your own body, and make sure that 378 00:22:11,720 --> 00:22:15,320 Speaker 2: you know that you're not the only person responsible for 379 00:22:15,400 --> 00:22:19,520 Speaker 2: your health, but that you have places and partners and 380 00:22:19,560 --> 00:22:22,560 Speaker 2: that kind of network that can really support you. 381 00:22:22,840 --> 00:22:25,040 Speaker 1: And thinking about what Simone just said, it really ties 382 00:22:25,080 --> 00:22:27,439 Speaker 1: back to those bottlenecks we talked about earlier, and if 383 00:22:27,480 --> 00:22:30,040 Speaker 1: we think about do you have social support, do you 384 00:22:30,119 --> 00:22:32,960 Speaker 1: have somebody else that's responsible for your health or is 385 00:22:33,000 --> 00:22:35,320 Speaker 1: it just you? Right? Do people believe you when you 386 00:22:35,320 --> 00:22:37,280 Speaker 1: say things? Are you able to get to a doctor 387 00:22:37,720 --> 00:22:40,199 Speaker 1: to address all of these concerns? I mean, because so 388 00:22:40,240 --> 00:22:41,919 Speaker 1: many changes are happening, how do you know if it's 389 00:22:41,960 --> 00:22:44,560 Speaker 1: a normal change that comes with pregnancy or a life 390 00:22:44,560 --> 00:22:47,720 Speaker 1: threatening change? And twenty minutes once a month is not 391 00:22:47,800 --> 00:22:50,000 Speaker 1: a lot. Let's take a break and when we come back, 392 00:22:50,040 --> 00:22:52,480 Speaker 1: we'll talk about what we can do to support birthing people, 393 00:22:52,600 --> 00:22:55,720 Speaker 1: maternal health policy, in the future of maternal health care. 394 00:23:15,240 --> 00:23:18,520 Speaker 1: We're back. We've been talking with Simon Tate about maternal 395 00:23:18,520 --> 00:23:21,000 Speaker 1: health and some of the challenges facing birthing people in 396 00:23:21,040 --> 00:23:24,399 Speaker 1: the US. Next week, we're continuing this conversation because this 397 00:23:24,520 --> 00:23:26,439 Speaker 1: is such a big topic, and we're going to be 398 00:23:26,480 --> 00:23:30,560 Speaker 1: focusing on the historical and political context to help us 399 00:23:30,640 --> 00:23:33,560 Speaker 1: understand these disparities more. All right, so let's get back 400 00:23:33,600 --> 00:23:36,240 Speaker 1: to the lab. Let's talk about maternal health in a 401 00:23:36,440 --> 00:23:39,040 Speaker 1: post birth context. We know that there's a six week 402 00:23:39,119 --> 00:23:42,200 Speaker 1: check up after birth, but what other resources are necessary 403 00:23:42,240 --> 00:23:43,280 Speaker 1: for birthing. 404 00:23:42,960 --> 00:23:46,320 Speaker 2: And the weeks and months after that, there's not really 405 00:23:46,359 --> 00:23:49,320 Speaker 2: anyone checking in on you, which is why it's so 406 00:23:49,440 --> 00:23:53,440 Speaker 2: important to consider having a duela, making sure that you're 407 00:23:53,560 --> 00:24:00,480 Speaker 2: leaning into your support network. I oftentimes suggest to never 408 00:24:00,600 --> 00:24:05,600 Speaker 2: bring flowers. If you're going to visit someone who's just 409 00:24:05,680 --> 00:24:09,400 Speaker 2: had a baby, please lend a hand. That could be 410 00:24:09,640 --> 00:24:14,359 Speaker 2: baby sitting the other kiddos, or cooking a delicious, nutritious meal, 411 00:24:14,480 --> 00:24:17,480 Speaker 2: or doing a load of laundry. Don't make the whole 412 00:24:17,520 --> 00:24:20,240 Speaker 2: thing about the baby. Don't make the whole thing about 413 00:24:20,280 --> 00:24:24,200 Speaker 2: the bump. Ask them how are they doing, and really 414 00:24:24,280 --> 00:24:27,639 Speaker 2: mean it and really listen, because that's so important to 415 00:24:27,680 --> 00:24:28,920 Speaker 2: show up for that person. 416 00:24:29,320 --> 00:24:31,639 Speaker 1: This is such a great point because you know, the 417 00:24:31,640 --> 00:24:34,320 Speaker 1: baby's cute. We're all inside of the baby's heare. We 418 00:24:34,440 --> 00:24:37,040 Speaker 1: want to see it, and you know, be vaccinated before 419 00:24:37,040 --> 00:24:39,480 Speaker 1: you visit the baby, of course, to create that cocoon 420 00:24:40,119 --> 00:24:43,159 Speaker 1: of health and safety. But someone just went through a 421 00:24:43,280 --> 00:24:49,000 Speaker 1: very traumatic experience, not in that oh they're traumatized. Some are, 422 00:24:49,040 --> 00:24:52,359 Speaker 1: but I mean your body, their bodies are going through 423 00:24:52,440 --> 00:24:55,840 Speaker 1: so so much, and some people can't really walk well, 424 00:24:56,200 --> 00:24:58,520 Speaker 1: they can't move around, they can't bend down, they're in 425 00:24:58,560 --> 00:25:01,600 Speaker 1: a lot of pain, they're uncomfort so lending a hand 426 00:25:01,680 --> 00:25:04,239 Speaker 1: is definitely better than bringing in those flowers that are 427 00:25:04,240 --> 00:25:05,840 Speaker 1: gonna die in two days. 428 00:25:06,000 --> 00:25:08,719 Speaker 2: And the other thing that I want us to consider 429 00:25:08,800 --> 00:25:12,440 Speaker 2: here is what happens, what is actually happening to your body. 430 00:25:12,720 --> 00:25:15,840 Speaker 2: I'm not a doctor, I'm not a medical professional, but 431 00:25:16,359 --> 00:25:20,640 Speaker 2: I can tell you as a jewel of myself though 432 00:25:20,880 --> 00:25:24,600 Speaker 2: hormones are all over the place after you have a baby, 433 00:25:24,960 --> 00:25:30,080 Speaker 2: and you cannot control what's happening between your brain and 434 00:25:30,119 --> 00:25:30,760 Speaker 2: your body. 435 00:25:31,720 --> 00:25:34,000 Speaker 1: As soon as the baby and the placenta are delivered, 436 00:25:34,119 --> 00:25:37,479 Speaker 1: progesterone and estrogen decrease. So you might remember those from 437 00:25:37,560 --> 00:25:41,000 Speaker 1: Lab forty one on birth control. Yep, oxytocin surge is 438 00:25:41,000 --> 00:25:44,520 Speaker 1: immediately following birth to compensate for those drops in progesterone 439 00:25:44,520 --> 00:25:47,760 Speaker 1: and estrogen. And so this is what's responsible for what's 440 00:25:47,760 --> 00:25:51,399 Speaker 1: known as like the strong mothering instinct. How they've lifted 441 00:25:51,400 --> 00:25:56,440 Speaker 1: those cars. Yes, or maybe that's adrenaline. That's adrenaline, but 442 00:25:57,960 --> 00:26:00,439 Speaker 1: will allow it, will allow it. But then and you 443 00:26:00,480 --> 00:26:02,960 Speaker 1: still have to consider that oxytocin working itself out of 444 00:26:02,960 --> 00:26:05,040 Speaker 1: the system, and so then you're still going to get 445 00:26:05,080 --> 00:26:07,800 Speaker 1: some of those baby blues in those first few days postpartum, 446 00:26:08,000 --> 00:26:10,640 Speaker 1: And that's just those three hormones. We're not even talking 447 00:26:10,680 --> 00:26:13,320 Speaker 1: about breast milk production and the hormones involved in that. 448 00:26:13,359 --> 00:26:16,159 Speaker 1: We're not even talking about the physical pain as your 449 00:26:16,160 --> 00:26:18,040 Speaker 1: body tries to heal me are even talking about your 450 00:26:18,040 --> 00:26:20,719 Speaker 1: immune system. Right, all your organs got to get back 451 00:26:20,760 --> 00:26:24,320 Speaker 1: to the right location. Baby they lost in there no 452 00:26:24,480 --> 00:26:27,720 Speaker 1: math Cupid shirt on trying to find the right, to 453 00:26:27,960 --> 00:26:38,199 Speaker 1: the left, to the left, to the now kick. Then 454 00:26:38,280 --> 00:26:41,160 Speaker 1: it could take months for hormones to settle to pre 455 00:26:41,280 --> 00:26:45,480 Speaker 1: birth levels, and that can have a lot of big 456 00:26:45,520 --> 00:26:49,080 Speaker 1: effects on your mental health. According to the CDC, about 457 00:26:49,160 --> 00:26:52,720 Speaker 1: one in eight women experienced symptoms of postpartum depression, and 458 00:26:52,800 --> 00:26:55,200 Speaker 1: really that number could be hired earlier. We learned that 459 00:26:55,240 --> 00:26:58,199 Speaker 1: many people just have that one six week follow up 460 00:26:58,200 --> 00:27:01,760 Speaker 1: after birth, So you might not even have captured it, honestly, 461 00:27:02,080 --> 00:27:07,119 Speaker 1: because what if your issues with postpartum depression happen at 462 00:27:07,160 --> 00:27:10,160 Speaker 1: seven weeks or eight weeks, you're not a part of 463 00:27:10,160 --> 00:27:10,840 Speaker 1: that study. 464 00:27:11,320 --> 00:27:16,600 Speaker 2: After having the baby, it's sometimes really hard to focus 465 00:27:16,720 --> 00:27:20,479 Speaker 2: on yourself and how you're feeling. And one of the 466 00:27:20,520 --> 00:27:24,879 Speaker 2: things that's so important to focus on is your mental health. 467 00:27:25,359 --> 00:27:27,919 Speaker 2: I know it sounds crazy to try and fit that 468 00:27:28,040 --> 00:27:32,440 Speaker 2: in in between perhaps sleepless nights and a million feedings 469 00:27:32,480 --> 00:27:35,800 Speaker 2: a day, but it is important for you to know 470 00:27:36,320 --> 00:27:40,639 Speaker 2: when you have postpartum mood disorder or the kinds of 471 00:27:40,720 --> 00:27:45,960 Speaker 2: feelings that don't feel safe for you or the baby. 472 00:27:46,240 --> 00:27:49,560 Speaker 2: Those can be very lonely and isolating in dark days 473 00:27:49,600 --> 00:27:53,480 Speaker 2: for people. We also know that that is the number 474 00:27:53,520 --> 00:27:58,800 Speaker 2: one reason why people who've just had babies have thoughts 475 00:27:58,840 --> 00:28:03,320 Speaker 2: of suicide, are harming themselves. So getting this kind of 476 00:28:03,359 --> 00:28:07,560 Speaker 2: help is really important, and even if you don't realize 477 00:28:07,600 --> 00:28:10,520 Speaker 2: it for yourself in the moment, it's important that your 478 00:28:10,560 --> 00:28:13,719 Speaker 2: partner does, your support system whoever is around you. 479 00:28:14,240 --> 00:28:16,959 Speaker 1: That's if somebody is around you. There are a lot 480 00:28:17,000 --> 00:28:20,480 Speaker 1: of assumptions about what birthing looks like, right. We see 481 00:28:20,480 --> 00:28:22,640 Speaker 1: it on television, and it don't always look like that right. 482 00:28:22,720 --> 00:28:25,960 Speaker 1: Sometimes you give birth in you are with a person 483 00:28:26,000 --> 00:28:30,000 Speaker 1: who is abusive. Sometimes it's just you. Sometimes it's just 484 00:28:30,240 --> 00:28:33,680 Speaker 1: you and you're not able to do the necessary things 485 00:28:33,680 --> 00:28:36,320 Speaker 1: to check in with yourself because you never have time off. 486 00:28:36,920 --> 00:28:39,920 Speaker 1: I've never had a child, but it looks time consuming 487 00:28:40,160 --> 00:28:43,360 Speaker 1: and so that becomes the question, how do we consider 488 00:28:43,840 --> 00:28:47,840 Speaker 1: all of these different context in which birthing happens, in 489 00:28:47,960 --> 00:28:50,640 Speaker 1: all of these needs that can look different for different people. 490 00:28:51,040 --> 00:28:53,760 Speaker 1: What type of public health interventions are in place to 491 00:28:53,800 --> 00:28:54,960 Speaker 1: address these issues. 492 00:28:55,280 --> 00:28:58,240 Speaker 2: Let's talk about the Black Maternal Health Caucus and the 493 00:28:58,280 --> 00:29:03,280 Speaker 2: Black Maternal Health Momnibus, which is a historical legislation. It 494 00:29:03,440 --> 00:29:08,280 Speaker 2: was originally led by our now Vice President Kamala Harris. 495 00:29:08,480 --> 00:29:13,000 Speaker 2: We work very closely with Rep. Lauren Underwood's office on this. 496 00:29:13,720 --> 00:29:16,200 Speaker 2: But the reason why this is so historic is because 497 00:29:16,200 --> 00:29:21,200 Speaker 2: the Momnibus has legislation in it very specifically to increase 498 00:29:21,320 --> 00:29:27,600 Speaker 2: funding around getting doulas in to our communities, our hospitals, 499 00:29:27,720 --> 00:29:33,840 Speaker 2: our healthcare networks, to support black and brown birthing people 500 00:29:34,440 --> 00:29:38,440 Speaker 2: across our country. This is really important in bridging the 501 00:29:38,480 --> 00:29:42,200 Speaker 2: gap in the everyday lives of pregnant and postpartum people. 502 00:29:42,360 --> 00:29:46,320 Speaker 2: Dulas are your emotional and well being best friend that 503 00:29:46,360 --> 00:29:48,920 Speaker 2: you never knew that you needed. I became a dula 504 00:29:49,080 --> 00:29:53,320 Speaker 2: myself when I was thinking about launching poppy Seed Health, 505 00:29:53,840 --> 00:29:56,920 Speaker 2: and it's work that you're called to, but it's also 506 00:29:57,200 --> 00:30:02,960 Speaker 2: really emotional and physical work. For example, my shortest birth 507 00:30:03,120 --> 00:30:07,000 Speaker 2: was twenty seven hours that's not something that people can 508 00:30:07,040 --> 00:30:11,000 Speaker 2: do every single day, and folks don't really realize that, 509 00:30:11,120 --> 00:30:13,680 Speaker 2: plus all the prenatal appointments and all the things that 510 00:30:13,720 --> 00:30:15,480 Speaker 2: you're doing with your clients. 511 00:30:15,280 --> 00:30:18,120 Speaker 1: When you have a doula, there's a sixty five percent 512 00:30:18,280 --> 00:30:21,520 Speaker 1: decrease in interventions that happen when you're going into labor 513 00:30:21,560 --> 00:30:25,120 Speaker 1: and delivery. But I mean, is a doula covered? You know? 514 00:30:25,400 --> 00:30:28,440 Speaker 1: Is that right something that's accessible for everyone. I don't 515 00:30:28,480 --> 00:30:30,160 Speaker 1: know if that's on the healthcare plan, they don't talk 516 00:30:30,200 --> 00:30:32,720 Speaker 1: about it. If it is. Air Kabadu is a doula, 517 00:30:33,560 --> 00:30:37,280 Speaker 1: I bet she's expensive. I'll put in a special request. 518 00:30:37,960 --> 00:30:40,720 Speaker 2: For a very very long time, the narrative has been 519 00:30:41,120 --> 00:30:45,560 Speaker 2: that only wealthy women, which dulas are not covered by insurance, 520 00:30:45,800 --> 00:30:49,600 Speaker 2: that can pay somewhere between fifteen hundred to sometimes upwards 521 00:30:49,600 --> 00:30:53,280 Speaker 2: of four to five thousand dollars out of pocket to 522 00:30:53,400 --> 00:30:57,440 Speaker 2: have a doula. The great thing about everyone paying attention 523 00:30:57,520 --> 00:31:01,440 Speaker 2: to doulas now is that at the state level, it's 524 00:31:01,720 --> 00:31:07,160 Speaker 2: very exciting to see so for example, in New York City, 525 00:31:07,440 --> 00:31:12,920 Speaker 2: Mayor Adams just announced that we will be rolling out 526 00:31:13,000 --> 00:31:17,400 Speaker 2: a DULA pilot, which I'm very excited about. To help 527 00:31:17,440 --> 00:31:22,040 Speaker 2: about five hundred families in this pilot for every single 528 00:31:22,080 --> 00:31:25,280 Speaker 2: one of them to have dulas and very specifically for 529 00:31:25,400 --> 00:31:28,520 Speaker 2: those dulas to be making a livable wage. 530 00:31:28,800 --> 00:31:31,080 Speaker 1: So then you know, this sounds great, but are there 531 00:31:31,120 --> 00:31:32,680 Speaker 1: similar programs in other cities. 532 00:31:32,880 --> 00:31:35,920 Speaker 2: One of the other pieces of legislation that was actually 533 00:31:36,040 --> 00:31:41,840 Speaker 2: passed in twenty twenty one was for veteran mothers to 534 00:31:41,920 --> 00:31:47,000 Speaker 2: be able to support them through their pregnancies. The Momnibus 535 00:31:47,360 --> 00:31:52,160 Speaker 2: is so historic because for the first time at the 536 00:31:52,200 --> 00:31:57,760 Speaker 2: federal level, we are focusing on solving for bringing those 537 00:31:57,800 --> 00:32:02,160 Speaker 2: preventable mortality rates from where they today down to zero. 538 00:32:02,560 --> 00:32:05,120 Speaker 1: Protective moms who served act as the Veteran Mother's Act. 539 00:32:05,120 --> 00:32:09,640 Speaker 1: She just reference and that passed the Senate with unanimous 540 00:32:09,640 --> 00:32:12,920 Speaker 1: consent and then the House with four fourteen to nine. 541 00:32:13,000 --> 00:32:14,680 Speaker 1: And the cool thing about this bill is that it 542 00:32:14,720 --> 00:32:17,560 Speaker 1: gives a fifteen million dollar investment from the VA to 543 00:32:17,640 --> 00:32:21,120 Speaker 1: improve maternal health care for birthing veterans and that includes 544 00:32:21,160 --> 00:32:25,960 Speaker 1: parenting classes, nutrition counseling, and breastfeeding support. It will commission 545 00:32:26,080 --> 00:32:29,760 Speaker 1: a first ever comprehensive report on maternal mortality and severe 546 00:32:29,840 --> 00:32:33,920 Speaker 1: maternal morbidity among pregnative postpartum vets, and those are things 547 00:32:33,920 --> 00:32:36,240 Speaker 1: that we have no clue about, and it will additionally 548 00:32:36,240 --> 00:32:39,280 Speaker 1: focus on racial and ethnic disparities in the outcomes for 549 00:32:39,280 --> 00:32:40,080 Speaker 1: those vets too. 550 00:32:40,440 --> 00:32:44,480 Speaker 2: The other thing is that for the first time, VP 551 00:32:45,240 --> 00:32:49,960 Speaker 2: Harris actually had the very first historic Maternal Health Care 552 00:32:50,560 --> 00:32:55,240 Speaker 2: Day at the White House, and they focused on the 553 00:32:55,280 --> 00:32:58,360 Speaker 2: BMNI bus. They also focused on some of these pieces 554 00:32:58,360 --> 00:33:02,640 Speaker 2: of legislation. But it is an open national and public 555 00:33:02,800 --> 00:33:09,160 Speaker 2: conversation about improving maternal health care in our country, especially 556 00:33:09,200 --> 00:33:11,320 Speaker 2: for underserved populations. 557 00:33:11,640 --> 00:33:14,000 Speaker 1: This feels like the right trend. Rihanna has turned our 558 00:33:14,000 --> 00:33:16,080 Speaker 1: eye to maternal health. I mean, maybe for some people 559 00:33:16,120 --> 00:33:18,800 Speaker 1: it wasn't Rihanna. For some people, it was VP Harris's 560 00:33:18,840 --> 00:33:21,400 Speaker 1: policy and some of the other policies that are going through. 561 00:33:21,560 --> 00:33:23,720 Speaker 1: And we're just coming off Black Maternal Health Week, which 562 00:33:23,760 --> 00:33:28,320 Speaker 1: was mid April. I mean, I'm excited. The possibilities feel limitless. Yes, 563 00:33:28,440 --> 00:33:31,440 Speaker 1: Black Maternal Health Week takes place every year from April 564 00:33:31,440 --> 00:33:35,000 Speaker 1: eleventh to April seventeenth, and it was officially recognized by 565 00:33:35,000 --> 00:33:38,240 Speaker 1: the White House on April thirteenth of twenty twenty one. 566 00:33:38,520 --> 00:33:41,840 Speaker 2: And so I'm excited about what's happening at the national 567 00:33:41,920 --> 00:33:46,840 Speaker 2: level policy takes time, but it also takes politics, and 568 00:33:47,520 --> 00:33:52,240 Speaker 2: that doesn't always mean that things get solved for immediately. 569 00:33:52,720 --> 00:33:56,840 Speaker 2: And for that reason, it is just as important that 570 00:33:56,920 --> 00:34:01,320 Speaker 2: the everyday person has the reason versus in their community 571 00:34:01,560 --> 00:34:05,440 Speaker 2: to be able to have the best possible health outcomes. 572 00:34:05,800 --> 00:34:08,279 Speaker 1: With all that we know now about the maternal health 573 00:34:08,280 --> 00:34:11,319 Speaker 1: care system, some of the disparities that are there, we 574 00:34:11,400 --> 00:34:15,600 Speaker 1: act Amone to share her perfect world for maternal health 575 00:34:15,600 --> 00:34:17,600 Speaker 1: care and her visions for the future. 576 00:34:17,840 --> 00:34:21,080 Speaker 2: I take a bold stance and that maternal health care 577 00:34:21,160 --> 00:34:24,560 Speaker 2: in our country needs to be equitable and accessible for 578 00:34:24,840 --> 00:34:29,400 Speaker 2: every single birthing person, no matter what their socioeconomic background is, 579 00:34:29,440 --> 00:34:32,279 Speaker 2: no matter how they identify, no matter where they live 580 00:34:32,320 --> 00:34:35,520 Speaker 2: in our country, and so it doesn't matter if you're 581 00:34:35,560 --> 00:34:39,640 Speaker 2: a Medicaid or you have commercial insurance. Everyone should be 582 00:34:39,760 --> 00:34:44,080 Speaker 2: able to get the same exact care. And that new 583 00:34:44,160 --> 00:34:49,480 Speaker 2: way forward includes both in person and also virtual care. 584 00:34:49,920 --> 00:34:54,880 Speaker 2: So hybrid health is not only good for the birthing person, 585 00:34:55,040 --> 00:34:58,560 Speaker 2: but it's great for the entire family. We have to 586 00:34:58,600 --> 00:35:02,959 Speaker 2: consider what telehealth looks like in a really innovative way 587 00:35:03,040 --> 00:35:06,920 Speaker 2: to be able to support people exactly where they are 588 00:35:07,000 --> 00:35:10,640 Speaker 2: in the journey it's important to me that the future 589 00:35:10,640 --> 00:35:16,080 Speaker 2: of maternal healthcare for the person feels like they have 590 00:35:16,400 --> 00:35:21,520 Speaker 2: almost no questions about the kind of support, and they 591 00:35:21,560 --> 00:35:26,080 Speaker 2: have no questions about the safety and the trust, and 592 00:35:26,719 --> 00:35:30,319 Speaker 2: that is so important for someone who is going through 593 00:35:30,360 --> 00:35:34,600 Speaker 2: life's biggest moments in their pregnancy, as a first time parent, 594 00:35:34,760 --> 00:35:37,920 Speaker 2: as a partner, and as families. 595 00:35:38,360 --> 00:35:40,640 Speaker 1: I think all of these things are so important for 596 00:35:41,160 --> 00:35:45,400 Speaker 1: understanding all the different ways that we need to serve 597 00:35:45,600 --> 00:35:49,480 Speaker 1: folks who are giving birth, from pregnancy to the birthing 598 00:35:49,520 --> 00:35:53,120 Speaker 1: experience even after it. And it's really incredible what Simone 599 00:35:53,160 --> 00:35:55,720 Speaker 1: has been doing to make a change in the system, 600 00:35:55,960 --> 00:35:58,680 Speaker 1: absolutely because I mean, I think we see a trend 601 00:35:58,680 --> 00:36:00,320 Speaker 1: in a lot of the labs that we done in 602 00:36:00,360 --> 00:36:03,440 Speaker 1: the past is that the policy isn't in place for 603 00:36:03,520 --> 00:36:05,440 Speaker 1: a lot of reasons, and one of the major reasons 604 00:36:05,480 --> 00:36:09,319 Speaker 1: being that politicians historically have been white and male, and 605 00:36:09,360 --> 00:36:11,919 Speaker 1: we know that they don't care about stuff that don't 606 00:36:11,960 --> 00:36:15,680 Speaker 1: affect them directly. And so now that we're seeing this 607 00:36:16,040 --> 00:36:19,640 Speaker 1: increased focus on maternal health care and bettering the maternal 608 00:36:19,640 --> 00:36:23,080 Speaker 1: health care space, I think it's really great that you know, 609 00:36:23,280 --> 00:36:26,040 Speaker 1: everyone's voice is heard, black and brown, folks are also 610 00:36:26,080 --> 00:36:28,759 Speaker 1: given a microphone to say the issues that they have, 611 00:36:29,120 --> 00:36:32,560 Speaker 1: people that are living in rural areas, people of lower income. 612 00:36:32,920 --> 00:36:35,359 Speaker 1: Everybody needs to have the opportunity to say their lived 613 00:36:35,400 --> 00:36:37,799 Speaker 1: experience so that we can make this world a better 614 00:36:37,840 --> 00:36:41,560 Speaker 1: place for everyone that is bringing another life into this world. 615 00:36:48,480 --> 00:36:51,120 Speaker 1: All right, it's time for one thing tt I want 616 00:36:51,120 --> 00:36:52,880 Speaker 1: to hear from you. What's your one thing this week? 617 00:36:53,120 --> 00:36:55,120 Speaker 1: My one thing this week is a movie and it's 618 00:36:55,160 --> 00:36:59,720 Speaker 1: called Everything, Everywhere, All at Once. I saw it last 619 00:36:59,719 --> 00:37:03,319 Speaker 1: week mm hmm, and it is phenomenal. It is such 620 00:37:03,400 --> 00:37:06,959 Speaker 1: a good movie. It has such a good story, and 621 00:37:07,400 --> 00:37:09,600 Speaker 1: there was so much thought put into it. It kind 622 00:37:09,640 --> 00:37:11,919 Speaker 1: of lends itself to a little bit of science where 623 00:37:12,000 --> 00:37:16,440 Speaker 1: it kind of references the many World's theorem that some 624 00:37:16,480 --> 00:37:19,600 Speaker 1: people subscribe to, and that's the idea that there's an 625 00:37:19,640 --> 00:37:22,200 Speaker 1: infinite amount of worlds and an infinite amount of like 626 00:37:22,520 --> 00:37:25,920 Speaker 1: use that there are just based off of little minute 627 00:37:25,960 --> 00:37:28,759 Speaker 1: differences in your life, so like depending on you know, 628 00:37:29,120 --> 00:37:31,800 Speaker 1: if you put on a certain shirt a versus another shirt, 629 00:37:31,800 --> 00:37:34,520 Speaker 1: it changes the trajectory of your life, and that, you know, 630 00:37:34,680 --> 00:37:39,000 Speaker 1: creates a different world that becomes. But every iteration in 631 00:37:39,040 --> 00:37:42,360 Speaker 1: between also exists, and it is just such a beautiful 632 00:37:42,400 --> 00:37:46,439 Speaker 1: story and it's so well done, and it really had 633 00:37:46,440 --> 00:37:49,760 Speaker 1: me hooked this movie. It felt like I was inside 634 00:37:49,760 --> 00:37:52,840 Speaker 1: of it, mm like you were invested in the storyline, 635 00:37:53,040 --> 00:37:56,800 Speaker 1: very invested, and then also just like engulfed by the production. 636 00:37:57,200 --> 00:37:59,600 Speaker 1: It's so good. It's just really really good in The 637 00:37:59,600 --> 00:38:02,319 Speaker 1: story is good, and so I really enjoyed it. I 638 00:38:02,360 --> 00:38:05,080 Speaker 1: don't watch movies more than once, but I feel like 639 00:38:05,080 --> 00:38:08,520 Speaker 1: I would watch this movie multiple times because it was 640 00:38:08,640 --> 00:38:10,920 Speaker 1: just so well done. Give them all the awards they 641 00:38:10,960 --> 00:38:22,640 Speaker 1: deserve it. I'll have to check it out. That's it 642 00:38:22,640 --> 00:38:25,319 Speaker 1: for Lab sixty two, where you just as shocked as 643 00:38:25,360 --> 00:38:27,359 Speaker 1: me about some of these things we learned about our 644 00:38:27,360 --> 00:38:30,520 Speaker 1: maternal healthcare system. Call us at two zero two five 645 00:38:30,640 --> 00:38:32,799 Speaker 1: six seven seven zero two eight and tell us what 646 00:38:32,840 --> 00:38:35,239 Speaker 1: you thought, or give us an idea for a lab 647 00:38:35,280 --> 00:38:37,840 Speaker 1: we could do this semester. We really like hearing from you. 648 00:38:38,000 --> 00:38:41,080 Speaker 1: That's two zero two five six seven seven zero two eight, 649 00:38:41,440 --> 00:38:43,840 Speaker 1: And don't forget that there is so much more to 650 00:38:43,880 --> 00:38:46,520 Speaker 1: dig into on our website. There'll be a cheat sheet 651 00:38:46,560 --> 00:38:50,000 Speaker 1: for today's lab, additional links and resources in the show notes. 652 00:38:50,239 --> 00:38:52,480 Speaker 1: Plus you can sign up for our newsletter check it 653 00:38:52,520 --> 00:38:56,040 Speaker 1: out at Dope Labs podcast dot com. Special thanks to 654 00:38:56,040 --> 00:38:59,360 Speaker 1: today's guest expert, Simon Tape. You can find and follow 655 00:38:59,360 --> 00:39:02,600 Speaker 1: her on Twitter at Simone Tate That's s I M 656 00:39:02,880 --> 00:39:06,279 Speaker 1: M O N E T A I T T and 657 00:39:06,400 --> 00:39:09,080 Speaker 1: learn more about her work at Poppyseed Help. And you 658 00:39:09,120 --> 00:39:12,120 Speaker 1: can find us on Twitter and Instagram at dough Blabs podcast. 659 00:39:12,320 --> 00:39:15,160 Speaker 1: T T's on Twitter and Instagram at d R Underscore 660 00:39:15,239 --> 00:39:18,080 Speaker 1: T s h O. And you can find Zakiya at 661 00:39:18,200 --> 00:39:21,920 Speaker 1: z said So. Dope Labs is a Spotify original production 662 00:39:22,080 --> 00:39:25,040 Speaker 1: from Mega Owned Media Group. Our producers are Jenny Radlett 663 00:39:25,040 --> 00:39:28,560 Speaker 1: Mask and Lydia Smith of Wave Runner Studios. Our associate 664 00:39:28,560 --> 00:39:31,680 Speaker 1: producer from Mega Oh Media is Brianna Garrett. Editing in 665 00:39:31,800 --> 00:39:36,480 Speaker 1: sound design by Rob Smerciak, mixing by Hannes Brown. 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