How the US medical community fails Black mothers

In the US, Black women are nearly 300 percent more likely to die as a result of childbirth than white women. Sharing appalling statistics on maternal mortality as well as her own tragic story of loss, Wanda Irving explains how racism and bias in health care minimizes and dismisses Black women's pain -- and makes a personal plea for leaders in the medical community to take steps toward reform.

If 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 daughter's.

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 a 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 commander

in the US Public Health Service,

an alumnus of the 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 confidant,

I lost my best friend,

I lost my whole world.

Shalon'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,

(Laughter)

so smart.

Soleil 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 inequity 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 save
Black mothers is done.

To get things started,

I joined forces with several
of Shalon's friends

and CDC colleagues.

We founded a nonprofit.

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,
childbirth 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 focused 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,

(Voice breaking)
Dr. Shalon MauRene Irving,

let us each vow to create a better earth.

Thank you.

(Applause)