How These Women Are Saving Black Mothers' Lives | National Geographic

My name is Brianna Green. I'm a perinatal community health worker. Every day is heavy, and it is life and death. The issue at hand with maternal mortality is primarily the disparity that exists between Black women and White women in this country, and particularly in D.C. That disparity is great.

[Laughter] I actually am trained as an attorney. I had my first daughter in law school. I ended up having an unnecessary c-section; that was kind of my first experience with disappointment in childbirth. I felt devastated because I felt like I had prepared, I had done everything that I needed to do, and I still had that experience taken from me to have the birth that I wanted.

Hey, Dash, a couple years later, my sister got pregnant and had my nephew.

"Can you help me set the table, man?"

"Yeah, do you want to come help get the plate there? Or actually get a little bowls?"

“Wait, but were you the first birth?”

"I actually went to other than your own."

"Other than my own?"

"Yeah, that maybe that's what it is because that was, I think, the first—I guess Dash was the first time I actually saw somebody have a baby that wasn't me on a table. Yeah, he was born at home with midwives and a whole birth team at home. I was there supporting her for her birth, and I was like, I want to be a midwife. You know, not even a year later, I happened to hear about Mama Toto Village, and I said, that's what I want to do. I want that type of training."

[Music]

Well, I'm grateful I can be here today because I've never been able to make it to a family. So, Mama Toto was started specifically for by women of color, with this idea in mind. The doula training was insufficient in meeting the needs of women of color more broadly; that it really didn't speak to anything cultural. We provide comprehensive support for women prenatally through postpartum.

"Okay, so what about the baby?"

"Baby's looking good. This is the most active child I've ever had."

The women that we serve not only are they presenting with clinical issues, so physical health issues, but they're also presenting with social issues, which puts them at a higher risk for mortality.

[Music]

You know, the district—it's like the tale of two cities. Women east of the river have limited resources; they are more likely to have dropped out of high school. There are higher rates of single-parenting homes. Women are more likely to be on some level of social assistance. The same opportunities just aren't there. In order for the maternal mortality rate to start to decrease, there has to be a deep culture shift around how care is delivered.

So we're not just looking at quality in terms of like, did you have a person who lived? You know, like, did you have a positive outcome? But we're also looking at did your patient feel that they were treated as a human with some level of dignity and respect? I absolutely feel like the odds are against women of color when they're dealing with maternal health in general. I mean the statistics don't lie. You know, we can look at different factors—poverty, homelessness, food insecurity, things of that nature. But upper-middle-class Black women, they have the same outcomes as Black women who are in poverty. A mom will go in and say, "I'm concerned about this issue," and their concerns are dismissed or diminished, and I've seen that go very wrong.

"A simple spur stroke."

"My fur."

"My name is Fantasia Grime, and I'm from southeast. And, well, where I'm from is ghetto." When I met her, she had a son that was two years old. She was pregnant with her second child; it was a girl, Orianna. Throughout that pregnancy, she did express concerns.

"I was in and out the hospital. I was like sick—like dying sick. And like they just ignored me. It's like, you know when I checked in, you know, they're like, okay go back home, everything is fine. And I knew, like, deep down in my heart, everything was not fine because my body was just giving up. Like in so much pain."

I was at my grandma's house, and you know, getting ready for school, I just saw like blood, and I knew that something was wrong and I told my grandmother, and she was like, "Go to the hospital, like now." When I got there, they did an ultrasound, and they told me that they didn't hear a heartbeat. The nurse pretty much told her, "I'm sorry, your baby has passed away," and advised her to go to the waiting room and to wait for a doctor to be able to see her. She was in the waiting room just crying uncontrollably, and no one really did anything for her. She sat there for several hours.

"I felt depressed. I felt sad. I felt hopeless. It was the day before Thanksgiving. She got there around 10, 11 o'clock in the morning, and I got a call from the receptionist, and we sat— we sat there until five o'clock, 5:30. Pretty much all the patients had been seen, and then the doctor called her back and they basically told her, okay, you can go to labor and delivery right now, and you can deliver your baby now, or you can wait until after the holiday if you want to have Thanksgiving and then come back."

"I just went through something so tragic and got bad news. You asked me a question like that? There was no point in me keeping a deceased baby in me, you know?"

That was the first time that I really felt the significance of my role for her because I could literally feel the weight of her loss on me. I think that's probably one of the hardest things I've ever done for anyone.

And then I also worked with her during her third pregnancy, and now, you know, she's welcoming a new baby—baby Josiah—right around the same time that she was losing her other baby. This time of year for her, I’m sure, it’s very difficult.

"Well, I had plans for Thanksgiving, but I went into real labor at five in the morning."

"Ugh, reach out for your baby. You're amazing. He's beautiful."

[Music]

You know, when I look at the teen moms who are breastfeeding their babies, when I look at the mom who was homeless who now, you know, has a security job, when I look at the mom who's gone through domestic violence and was able to feel support to be able to get out of that abusive environment and to make a better home for her family and her children, it's worth me doing going out every day and trying to make a difference with even one mom, or in my case, 50 some odd moms a year.

I genuinely believe that the outcome for them is going to be exponentially better because they've had the opportunity of having the support from me, from Mama Toto, from my village that we've created.

[Music]