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← How the US medical community fails Black mothers


Showing Revision 6 created 08/27/2020 by Erin Gregory.

  1. If could turn back the clock
    and bring Shalon back,
  2. I would literally do anything.
  3. I would happily give everything
  4. if I could see her smiling
    face once again.
  5. But sadly, even if Shalon were here,
  6. it would not change the fact
  7. that between 700 to 800 women
    die each year in America
  8. from pregnancy- and
    childbirth-related complications.
  9. The choice to have a child
    should never equate to a death sentence.
  10. The rate of maternal deaths in America
    is utterly appalling.

  11. In 2017, NPR and ProPublica reported
  12. that the United States has the highest
    rate of maternal mortality
  13. of any developed country in the world.
  14. And the United States is the only country
    where that rate is steadily rising.
  15. Black mothers like Shalon
    remain the primary group

  16. for maternal mortality.
  17. It is truly reprehensible
  18. that Black women die
  19. at a rate of three to four times
    that of white women.
  20. It is absolutely shameful
  21. that 60 percent of those deaths
    are totally preventable,
  22. as was my daughter's.
  23. And here's a shocking fact:
  24. according to the report by Health
    Resources and Services Administration,
  25. the difference in risk
    has been steadily unchanged
  26. for the past six decades.
  27. Six decades.
  28. Clearly, current efforts to address
    maternal mortality rates
  29. and the racial and health
    disparities in that area
  30. remain woefully inadequate.
  31. Only when race stops being the precursor
  32. to how Black women are treated
    or not treated in the health care system,
  33. then outcomes will be
    drastically different.
  34. I want to be abundantly clear now.

  35. The medical community is failing
    Black mothers in America.
  36. For decades,
  37. Black women have been
    dismissed, ignored, disregarded,
  38. or at the very least,
  39. they have been not taken seriously
  40. in their interactions
    with the health care system.
  41. It's not uncommon for Black women
    to experience racism and discrimination

  42. by medical providers.
  43. That racism can be blatantly overt
    or covertly subtle,
  44. but make no mistake -- it is there.
  45. It didn't matter that Shalon
    had a dual PhD
  46. in Sociology and Gerontology;
  47. it didn't even matter that Shalon
    had two master's degrees,
  48. one of them a Master's in Public Health
    from Johns Hopkins.
  49. It made no difference that Shalon
    was a lieutenant commander
  50. in the US Public Health Service,
  51. an alumnus of the world-renowned
    Epidemic Intelligence Service,
  52. a highly respected epidemiologist
    at the Centers for Disease Control
  53. and president
    of her own diversity company.
  54. She was still a Black woman.
  55. A Black woman accessing a system
    that saw her as a stereotype
  56. and responded to her as such.
  57. During the three weeks
    after her child was born,

  58. Shalon went to her health care providers
    again and again in distress.
  59. Obviously, with her education
    and training,
  60. she could and she did articulate
    her concerns very clearly.
  61. Yet her cries for help
    were minimized and dismissed
  62. by the covert bias
    of her medical provider.
  63. That very bias,
    fueled by structural racism,
  64. is the root cause
    of disparities in health care.
  65. That very bias impacted Shalon's outcome.
  66. That very bias
  67. caused my daughter
    to be among the statistics
  68. for 2017.
  69. As a result, I lost
    my beautiful little girl.

  70. My baby girl.
  71. I lost my confidant,
  72. I lost my best friend,
  73. I lost my whole world.
  74. Shalon's daughter lost her mother

  75. and all of the relationship possibilities
  76. that could have existed
    between the two of them.
  77. The society may have suffered
    the greater loss.
  78. Who knows how many medical advancements
  79. or social-justice contributions
    Shalon may have made
  80. if only her medical provider
    had listened to her
  81. and heeded her cries for help.
  82. We will never know.
  83. But this much, we do know.

  84. Behind every one
    of those 700 to 800 women who die
  85. is a family
  86. and a whole social network of loved ones,
  87. including the children
    left behind, like Soleil.
  88. Shalon's daughter Soleil
    is three years old now.
  89. She has a quick smile --
  90. every bit as brilliant
    as her mother's was.
  91. Soleil is fearless.
  92. She's determined and she's so opinionated,
  93. (Laughter)

  94. so smart.

  95. Soleil constantly amazes me
  96. at how confidently
    she is navigating her world.
  97. But Soleil only knows her mother
    through photographs
  98. and the cherished memories that I have
    and share with her every day.
  99. Yet Soleil loves her mommy,
  100. who was with her
    for only three short weeks.
  101. She tells me so each day.
  102. My heart aches each time
    Soleil cries for her mommy.
  103. It is during those times
    Soleil has said to me,
  104. "Nana, I want to go to heaven,
    so I can be with my mommy."
  105. It should not be that way.
  106. It doesn't have to be that way.
  107. It can really no longer
    continue to be that way.
  108. When I said earlier that the medical
    community is failing Black mothers,

  109. some may have wondered
    if I'm painting with too broad a brush.
  110. After all, it's individuals
    who are to blame here, right?
  111. Or perhaps we should say
    that a relative handful of hospitals,
  112. which happen to be the ones
    that are largely used by Black women
  113. and other minorities,
  114. are at the epicenter of maternal
    mortality in America.
  115. But I would argue that focusing
    on a handful of individuals
  116. or a handful of hospitals
  117. is defining the problem way too narrowly.
  118. The problem behavior
    isn't about the actions
  119. of specific individuals or hospitals --
  120. it's much more systemic than that.
  121. What's more,
  122. the prevalence of the problem
    is deeply entrenched --
  123. embedded in the very foundation
    of our health care system.
  124. It is this broad-based failure
    that continues to allow disparities

  125. in maternal health and death,
  126. which result in Black women,
    just like Shalon,
  127. dying at rates 300 percent higher
    than white women.
  128. It's been well documented,
  129. year after year,
  130. decade after decade,
  131. generation after generation,
  132. and nothing effective
    has been done to fix it.
  133. How do we fix it?

  134. Is there a definitive answer
    to eradicating disparities
  135. in maternal mortality?
  136. Well, improvements
    in data accuracy are critical
  137. but not nearly enough.
  138. Algorithms, checklists, apps --
  139. they all play an important role,
  140. but they're no panacea either.
  141. And I really can't emphasize enough
  142. that implicit bias training
    without explicit,
  143. explicit measures of accountability
  144. will make absolutely no difference at all.
  145. It is time --
  146. it is long past time
  147. that leaders in the medical community
    take steps to transform
  148. the health care system status quo.
  149. The first step must be acknowledging

  150. that the inherent problem
    in the health care system
  151. is more than a problem;
  152. it's a failure.
  153. The next step requires
    taking responsibility
  154. and owning that failure.
  155. But the most important step
  156. is actively taking the necessary actions
  157. to right the wrongs
    created by that failure.
  158. A wise woman once told me,

  159. "If you want something different,
  160. you have to do something different."
  161. My daughter was committed
    to doing something different.
  162. Shalon was known
    as a woman of great integrity
  163. and high moral values.
  164. When asked about her driving
    principles in life,
  165. she would respond,
  166. "I see inequity wherever it exists.
  167. I'm not afraid to call it by name,
  168. and I work hard to eliminate it.
  169. I vow to create a better earth."
  170. Shalon put those words into action
    every day of her life.
  171. Former Surgeon General
    David Satcher once said,
  172. "Leaders must care enough,
  173. leaders must know enough,
  174. leaders must be willing to do enough
  175. and leaders must be willing
    to persist until the work is done."
  176. Shalon was such a leader.
  177. Though there will never be
    another leader like Shalon,

  178. we can each persist
    until the work is done.
  179. Here's what I'm doing to persist
  180. until the work to save
    Black mothers is done.
  181. To get things started,
  182. I joined forces with several
    of Shalon's friends
  183. and CDC colleagues.
  184. We founded a nonprofit.
  185. We're working hard to eliminate
    preventable deaths among Black mothers.
  186. And here's how we're doing it:
  187. with action, action and more action.
  188. We're engaging stakeholders
  189. at every point of the public health
    and health care spectrum.
  190. We're actively working
    with the legislative office.
  191. We're promoting accountability
    measures and postpartum bills,
  192. and we want them enshrined in the law.
  193. We're embarking upon
    a community-based research project
  194. which will redefine quality
    of medical care for Black women.
  195. Ultimately, we will tilt more power
    into the hands of Black women.
  196. How are we going to do that?
  197. By empowering Black women
    and their birthing partners
  198. to effectively counteract the bias
    and racism they experience
  199. at any given point during pregnancy,
    childbirth and postpartum.
  200. Look around you.

  201. Each one of us in this room
    has a circle of influence.
  202. I invite you to consider
    how powerful an impact we could make
  203. if we focused that collective
    influence on this problem,
  204. on making a difference.
  205. What if we, like Shalon,
    acknowledged inequity
  206. wherever it existed in our communities
  207. and we weren't afraid to call it by name?
  208. What if we were each committed
    and passionate
  209. about using the full range
    of our resources
  210. to eliminate that inequity?
  211. Could we change things?
  212. Could we really overturn
    centuries of prejudice
  213. and decades of bad practice?
  214. I know we could.
  215. I know we could,
  216. if we were focused on that issue,
  217. if we focused that collective energy.
  218. To quote Nelson Mandela,

  219. "When people are determined
  220. they can overcome anything."
  221. But "action without vision --
  222. it's only passing time.
  223. Vision without action
    is merely daydreaming.
  224. But vision with action
    can truly change the world."
  225. Shalon's life was the perfect
    embodiment of the vision.
  226. Shalon's death is our call to action.
  227. So today, let each of us vow
    to do whatever we can.
  228. Let us vow to right this wrong.
  229. Let us vow to be a part of the solution
  230. until Black women are no longer
    marginalized and dying needlessly
  231. in the health care system.
  232. And like my daughter,
  233. (Voice breaking)
    Dr. Shalon MauRene Irving,
  234. let us each vow to create a better earth.
  235. Thank you.

  236. (Applause)