In “Aftershock,” a new documentary now streaming on Hulu that highlights the black maternal mortality crisis in the United States, Felicia Ellis, a pregnant black woman in Oklahoma, makes a chilling analogy as she prepares for childbirth.
“A black woman having a baby is like a black man in a traffic stop with the police,” says Ellis. “You have to pay close attention to what’s happening every step of the way.”
The United States has the highest maternal mortality rate of any industrialized nation, at 23.8 deaths per 100,000 live births, and black women are three times more likely than white women to die during or after pregnancy, according to 2020 data from the Centers for Disease Control. and Prevention. Most pregnancy-related deaths are preventable, and racial disparities are the result of structural racism and implicit bias, along with underlying chronic conditions and disparities in access to quality health care, the CDC reports.
After the Supreme Court’s decision to overturn Roe v. Wade last month, public health experts say those rates are likely to get worse. A study published last year in the journal Demography estimated that a nationwide abortion ban would increase pregnancy-related deaths by 21% over time and by 33% over time for Black people.
Aftershock, which premiered at the Sundance Film Festival earlier this year and was co-directed by Paula Eiselt and Tonya Lewis Lee, primarily follows the families of two young black women who died after giving birth in New York City. just six months apart: Shamony Makeba Gibson, 30, died of a pulmonary embolism in October 2019, two weeks after giving birth to her son, Khari, at Woodhull Hospital in Brooklyn, and Amber Rose Isaac, aged 26, died in April 2020 after an emergency caesarean section to give birth. to her son, Elias, at Montefiore Medical Center in the Bronx.
The film’s focus on the families of the victims shows the “aftershock” of maternal mortality, Eiselt said: “There are ripple effects … for, of course, the parents, the family, the community and the country.”
The film also traces the history of how Black women have been mistreated in US health care and highlights ongoing efforts by midwives, doulas and birthing centers to reduce racial disparities in maternal mortality. and give pregnant women more agency in their childbirth experiences.
The Washington Post recently spoke with Eiselt and Lewis Lee about making the film and how it should improve maternal health care in the United States.
This interview has been lightly edited for length and clarity.
Q: We are almost a month away from the Dobbs decision. Experts have said that maternal mortality rates will likely worsen in light of state abortion bans, and maternal mortality rates are highest in states where abortion bans have already gone into effect. What kind of additional resonance do you think the film acquires in this new reality?
Eiselt: When we talk about maternal health, maternal health is abortion care is health care: it’s all a conversation. Many times, unfortunately, it bifurcates: we talk about childbirth and abortion as if they were two completely separate things, but as we know, they are very intertwined.
It is a human right to choose to have a pregnancy or not, and if one chooses to have that pregnancy, it is a human right not only to survive but to have a safe and dignified birth, and neither of those things is happening in this country.
Q: Based on the research you did to make this film, what do you think policymakers in states that ban abortion should do to reduce maternal mortality?
Lewis Lee: Maternal health care in general, women’s health care in general, needs to be improved in general. I think that, as we talked about in the film, the integration of midwives in women’s health care, for example… would help a lot in the results in all areas. Midwives aren’t just there to catch babies: they can help a woman throughout her life cycle.
I think, in general, communication with health care providers, between health care providers, is another: really listening to women, seeing them and listening to them. As Dr. Neel Shah says in the movie, it’s not a luxury, it’s the key to saving lives.
Q: The film also delves into the history of how Black women have been systematically mistreated by doctors in the American health care system. Why is this story important to understanding where we are now?
Eiselt: The historical part was something that we absolutely had to have there, because the maternal mortality crisis didn’t come out of nowhere, it’s part of a historical continuum that has devalued and dehumanized black women since 1619, since the days of slavery. . And that has continued after slavery, with the turn of the 20th century, when white men came along and really took over the birthing profession and eradicated midwifery. And that was a racist campaign, it was really aimed at black midwives.
That eradication of [Black] midwives, and that stigma, that was a very successful marketing campaign, because today you talk about midwives and people say: ‘You’re crazy’ or: ‘You’re going to die. Your baby is going to die. They are not professionals. You have to be in the hospital. They don’t know what they are doing. They’re so stigmatized, and that racist campaign affected, of course, not just Black midwives and the communities they served, but the entire country… because we don’t have integrated midwifery because of that, and that’s where we went. off the slopes
Some hospitals, depending on the state, welcome midwives, but not many, and they don’t have the same privileges as doctors. … So our system is completely different, and it’s because of that story that’s told in our movie, that’s how we got here. And if we don’t know how we got here, we don’t know how to fix it.
Q: The film also follows Felicia Ellis, a black woman from Oklahoma who gives birth at a birthing center. Why was it important to show her journey?
Eiselt: It really shows the promise of what childbirth can be when a woman is empowered, when she is in control of her choices, when she has options.
When we met Felicia, she was going into hospital delivery. Around 35 weeks, she decided that, you know what, she wants [give] birth in a maternity center. She made that turn, changed, and we said, ‘We’re with you. Let’s follow that. …she chose that new path, had an amazing doula, and had this beautiful and empowering birth.
We really wanted to show what real birth and labor might look like. [in the film]. It’s a long scene, you’re really there with [Felicia]. We wanted to reclaim that, because it’s not something that the media shows you, in terms of who we are at birth. It was very important to actually sit there for those few minutes and be with her, even though it might be awkward for viewers who hadn’t seen that before. It was very important to show how it really is and how magical it could be, if that’s what you choose.
Q: Why do you think this crisis still hasn’t galvanized Americans the way police brutality against Black people has in recent years? Do you think the tide is turning?
Lewis Lee: I think part of the reason that, for example, police brutality gets more attention is that people are filming [police encounters]. People have cameras. They can see what is happening.
With black women in particular in the health system, often [something] it happens and we can talk about it with each other, and then we wonder about something that is a larger topic. The wonderful thing about this film is that it allows people to be validated. … Many people have stories of birth trauma. They may have survived, but a doctor didn’t listen, someone didn’t pay attention, something had to be demanded, they treated you that way, they fired you, they talked to you like a woman.
I think maybe the tide is turning. People will now be more open to sharing their stories, they will not feel responsible for what is happening to them and they will understand that they are part of a system.