When you see maternal mortality in any country, it’s usually an indication that there’s a broken health system, and women and children are the ones who bear the brunt of that broken system.

– Christy Turlington Burns

 

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ABOUT THIS EPISODE

In this episode, we speak with Christy Turlington Burns, the founder of Every Mother Counts. With incredible energy and passion, Christy is on the frontlines of advocacy for maternal health, with the goal of making pregnancy and childbirth safe for mothers everywhere. We discuss navigating motherhood in the midst of a pandemic and ways you can make a difference in the fight for better maternal healthcare and outcomes. Christy shares shocking facts and statistics about the challenges of our maternal health system and the inequity that is so present. She introduces ways of approaching pregnancy, childbirth, and postpartum care that focus on supporting both the mother and the child.

This episode is not just for mothers, it’s for everyone who understands that the health of our mothers and babies reflects the health of our whole society. Every Mother Counts is committed to supporting all mothers and the frontline maternal health heroes who are there for them.

 

SHOW NOTES

Every Mother Counts | Policy and Advocacy
Make a Donation to Advancing Birth Justice in 2021 | Dona International

 

 

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Episode Transcription

Christy
When you see maternal mortality in any country, it’s usually an indication that there’s a broken health system. And women and children are the ones who bear the brunt of that broken system.

Vanessa
Welcome to The NUSHU podcast. I’m your host, Vanessa Cornell. I invite you with love into this space to learn and grow with me. And for a brief moment of the day, come home to yourself. In this episode, I sit with my dear friend Christy Turlington and discuss one of my personal passions, maternal health. After giving birth to five children, it is one of my favorite topics, I could speak about it endlessly. Christie is on the front lines of advocacy for maternal health, she is putting incredible energy and passion into her goal of making pregnancy and childbirth safe for mothers everywhere through her charity, every mother counts. In this episode, Christie shares shocking facts and statistics about the challenges of our own maternal health system, the inequity in the system, and introduces ways of approaching pregnancy, childbirth, and postpartum care that focus on supporting both the mother and the child through the extraordinary process of new life coming into the world. This episode is not just for mothers, it’s for everyone who understands that the health of our mothers and babies reflects the health of our whole society. Great to have you here with us, thank you for being here. I have loved you and our friendship since we met, you have this truth teller and the way that you live your life and the way that you are with people that I’ve admired. And your mentorship and support of me has been profound, and really meaningful for me. So thank you for that. I don’t know if I’ve ever said it to you quite that way as we think. But it’s been it’s been really great for me, and I’ve admired your work for so long. And I’m so excited to be able to talk to you about it today. And share with everybody all the great work that you’re doing with every mother counts. And we will we will do that. And then also talk about what it means to be pregnant right now. Whether you’re pregnant or somebody you know and love. Because you are on the front lines of that Christy and I know you have a lot of great information. And we can’t wait to share it with everybody. So let’s start with your work and every mother counts. Tell us how you started, every mother counts why you started, every mother counts

Christy
the journey, it has been a long one, I became a mom with my daughter in 2003. She’s 16 and a half now, I had a postpartum complication, which is what sort of woke me up to the still staggering statistics are estimates globally that hundreds of 1000s of girls and women die every year from complications that are related to pregnancy and childbirth. Before becoming a mom, I had no idea that that was possible. I think like most people, you assume that in the 21st century, that it’s a very, very rare event when a woman dies in childbirth, but it’s it’s really not and not just the fatalities. It’s really like complications that happen that impact you or traumatize can traumatize a mom for a long time. So it’s so essential to have options in in your childbirth providers in location of your delivery, all things that I was able to have in place. By the time I was ready to become a mom. I knew as soon as I knew the facts that there was something that I could do, I could share my experience, I could share some of the learning and the relationships that I’d made over the course of my life to be able to to contribute in a meaningful way. And so I didn’t intend initially to start a foundation. I hoped to shed light on an issue that people weren’t really talking about and didn’t know a lot of a lot about but had a connection to. So really just sharing my story, listening to other women that hearing their birth stories that was the beginning. And then eventually, I was able to sort of see some of the work the incredible maternal health work being done outside of the United States, which inspired me to go back to school and work on a Master’s in Public Health at Columbia. And then of course, in that work, I learned that the US was doing really poorly in maternal health too, which also surprised and outraged me. So it really was kind of this experience digging into learn more making a commitment to do what I could to try to improve access to maternity care, quality trainee maternity care for more women. It’s been kind of amazing to just think about The time that’s gone in, and the all of the relationships and all the impact that we’ve made, because of the incredible work that’s being done out there, and to be able to identify models of care that are effective, that are respectful, that are equitable, that are really meeting women where they are, no matter where they are. And it’s been so important for us to kind of link what’s happening at the policy level, and sort of where decision makers are, as well as the grassroots, on the ground, at the front lines, I think we really are in a sweet spot as an organization where we have great relationships in both areas, and that having that ability to bring people together has been able to sort of pave the way for change in a meaningful way.

Vanessa
hearing people’s birth stories, there is nothing I like speaking about more than like labor and delivery and my birth story and like, what was your birth story? And how did it go? But I realized that there’s no space for that conversation. There’s almost a taboo around birth stories. It’s like, why are we not talking about it? And I love that you’re giving voice to those stories, because I feel like that might be part of the problem.

Christy
You’re absolutely right. I mean, there was a time where most people gave birth at home. And when you give birth at home, other children in the house are there, other family members are there to support you can hear somebody laying or laboring in the next room. And it really was sort of a group experience something you know, that’s how you learned, you sort of heard and you saw, you wouldn’t be the way that we are today where you don’t know about birth until you find yourself pregnant, where it’s like a little bit late to be learning about these things. When you’re in that state, I’ve been lucky to have my office near my children’s school. And so my daughter often will come by the office after school and just sort of sit in. And it reminded me recently, or fairly recently, when we were doing a childbirth education class for our tr team that she came in, and she sort of sat there and she listened. I thought this is what it was like where you kind of come in and you hear people talk about their experiences. And you know, you hear a range of experiences, because of course, it’s a it’s a common experience, but the way that it happens and the way that it feels to each woman, and each family is so different. So I really have always been the kind of person who the more I know, the more sort of empowered I feel, the more prepared I am. And that gives me a lot of peace. But I think not everybody is that way, I think people might imagine that knowing more is more scarier too much information to be able to hold on to. And that’s the part where I’m a bit like you like I will tell you as much as you want to know, but let me know what your threshold is.

Vanessa
Absolutely, I won’t tell you anything you don’t want to know.

Christy
And I think it’s also depends on where you are, too. Like if you’re, you know, I try to gauge who I’m talking to you about this issue? Like, are you thinking about becoming pregnant? Are you newly pregnant? Have you been trying to be pregnant for a long time? Have you lost a child like there’s so many different experiences that you want to be mindful as you frame the conversation, just because you want to make sure that you’re as inclusive and as thoughtful and as comforting as you can possibly be? Just to kind of bring us to where we are now, with his time and COVID it’s been an interesting time. Because already, you know, living in New York City, we’re in a place in our country that has some of the worst maternal health outcomes in the country. In the United States, you know, there’s an average of three to four times more women of color, or black women in particular native women who are at risk for dying from complications related to childbirth and pregnancy. But in New York City, it’s as much as 12 times more likely than a Caucasian woman. So that already exists. We are already not ranked very highly. And when you think about our city, and you think about we have the high level of facilities and hospitals and specialties, you wonder, like, how is this possible? So having this be the epicenter, seeing how the What does this shone a light on, I think, is that the health systems are broken? We know that in this country, you know, that’s when you when you see maternal mortality in any country, it’s usually an indication that there’s a broken health system, and women and children are the ones who bear the brunt of that broken system. One thing that we’ve seen is there’s very much the same sort of mission focus that we’ve always had, which is we want to make sure that every mother has the same access to the highest attainable quality of respectful maternity care. And there are a range of people who can provide that care and there are a range of places where You can receive that care. But not everybody has access to those options, or has the sense of choice.

Vanessa
And I think that’s very important that you mentioned that because I know that you don’t advocate for one type of birth over another type of birth, that you advocate for people to have full information so they can make the choice that makes sense for them.

Christy
So yes, in terms of birth, people have been scared, more scared than they typically are. I mean, I think there’s always a little bit of the unknown, and some fear that naturally comes with pregnancy and childbirth, whether it’s the first time or the fifth time, right you there’s, there’s this unknown and or remembering when you get close to like, Oh, that’s right, I have to do that again. But I think now, with all of the reports, and all of the stories that have been so conflicting, and policies shifting and changing every day, sometimes you hear that you can have a partner in the room, sometimes you hear you’re not allowed to have a partner in the room. And that’s, that is scary. I mean, you you, you need your support systems in place when you’re in this stage of your life. And you do not want to be in a hospital by yourself thinking about, you know, will you will you be susceptible yourself to getting the infection, will you be causing harm to your child unknowingly by bringing them into the world in this institution? So trying to find as many alternatives to that, if you can, how do you reduce the amount of times that you see a provider early on, you know, there’s we are, we’re at a culture that does so much like almost too much in some ways with intervention and with, you know, the World Health Organization has a minimum of four visits to your provider. That’s like, two prenatal one delivery and one postpartum. Now, that’s not what we want. That’s not the goal here. But that’s like the lowest level and what we do is three times as much as that, especially towards the end. So the move or the shift to telemedicine, I think, has been a really important one, one that I think will probably continue beyond this. For those early appointments, if you are low risk, there’s a lot that you can, you can get across by having frequent conversations over video conference or by telemedicine, there’s no replacement, in my mind for human contact and touch though. And birth is obviously a very intimate experience. So we’re trying to empower the providers to be able to have access to resources that allow them to keep that continuum of care all the way through. But at the same time, not strain the systems anymore, more than they already are with having more and more people in environments that they can’t be protected in. And then you know, birth centers, but we haven’t had birth centers available in New York City for a couple of years. Now, since the birth center, where I gave her to my kids clothes that outside I West, there were so many stories out there that were either saying from the provider side, we don’t have enough protective gear, and we don’t feel safe with members of families coming in and staying. And then on the other side, you know, moms going into hospitals by themselves and not feeling that they had the opportunity to have their spouse or a doula with them, to be able to give them that comfort and provide the support that they do. So just kind of trying to simplify that clarify that for for expectant families and moms. And then also to just really clarify who is an essential birth worker and that doulas are a part of that definition. If I could give advice to any pregnant person, would be to look into finding a doula, regardless of what stage of your birth, you know, you can find a doula into the very last part. And they would just, you know, what they do is they provide this additional support for you and your family. They’re a patient advocate, essentially, but they can help navigate the health system, they can help. They’re experts in their own right, but they don’t deliver the baby themselves. But they’ve worked with every doctor and midwife and nurse and hospital and they have a lot of knowledge. And what they do also is they really work hard to build a relationship with the patient so that they understand when you’re having additional anxiety or you know what else is going on in your home setting or in your life that might be adding stress to the experience, and they really are there to kind of handhold and soothe and nurture you

Vanessa
through this experience? And that’s interesting, because I think there are a lot of people who would never have considered particularly particularly in New York having a doula. I think there’s an implication with a doula that you must have a natural birth. You have to do it one way. There’s that there’s a sort of philosophy around a doula and you’re saying there doesn’t have to be it’s somebody who can advocate for you in any situation.

Christy
Exactly. That’s exactly what they do. I mean, I’m sure I mean, when I, when I found my doula I met a couple actually before we decided my husband and I, we met with these doulas, and we talked to them. And we kind of found somebody that felt like the right fit and match for us, because we spent a lot of time with our doula throughout the pregnancies. But no, they’re a patient advocate. So they’re very much there to understand what you want, and to try to get that for you, and to support you all the way through. So they’re the people that you can call at all hours of the night. And they’re the people that you can ask all of those questions that you might be too nervous when you have your doctor’s appointment. And you’ve written down a short list and you leave and you’re like, oh, what about the, you know, they’re they’re just very accessible. And they are affordable in a lot of situations. I mean, they’re community birth, doulas, who oftentimes will have a sliding scale or my doula also would work with a sliding scale. It’s also a challenge, because they are known to improve birth outcomes. And yet they’re not compensated fairly. So I don’t want to sort of push the fact that they’re less expensive. But this idea of they’re in the work because they believe so much in the work and the need and the value that they add to the experience. And so one of the things we do advocate for is actually pushing for Medicaid reimbursement of doulas and fair compensation. You know, like, I want everybody to have one. And yet, that’s not yet possible for everyone. But you’d be surprised that especially in the New York area, there are a lot of doulas

Vanessa
so let’s talk about advocacy a little bit more. I, when I saw that, that you had been part of the consortium that pushed for birth partners to be allowed in the room with with expectant mothers, I was really happy and proud of you and everyone who worked towards that. What are the other areas of advocacy that you’re focused on, if you had to pick a couple of things that you could advocate for and see change in policy, high level that you think would really do a lot of work to shift the dynamic of maternal maternal health, particularly in the New York area, but really at large? What are those things? What are those sticking points, bottlenecks that you think could create a lot of change, positive change? Gosh,

Christy
well, there’s been an really an unprecedented amount of bills introduced and legislation, some passed, but looking at are including maternal health, which is surprising in this time, in a way. You know, after 10 years of working on this issue, there were two bills that were passed at the end of 2018. In a time when, when nothing in women’s health was moving forward. And so we took a long time, but we were really excited about that. And there’s a lot that needs to be done. But I would say, you know, there’s been some glaring gaps in the time that I’ve been an advocate, the postpartum period is a very, very big gap. Typically, we don’t see a provider, whether it’s a midwife, or a doctor for six weeks or so after delivery, and a third of maternal deaths happen postpartum. So it’s a really important time, it’s a time when women feel isolated. It’s a time when women don’t feel comfortable reaching out, don’t understand what’s normal, what’s not normal, aren’t talking enough about what they’re experiencing, really. And so, you know, there’s some legislation that’s really been pushing for extending coverage, up to a year after the baby is born, which is very ambitious, but it needs to be extended significantly. And so hopefully, we’ll land somewhere close to that. But you know, anything but the six weeks period that most people have, it’s just a dangerous time to not have something.

Vanessa
I don’t think anybody who’s ever become a mother thinks I need a little bit of support for six weeks, and then no more, right? When you become a mother, you need a lot of support. There’s so much that’s new. There’s so much information. There’s so much you’re insecure about so many unknowns, so many things happening in your body. So that is I think it’s ambitious, but I agree with you. It’s so important.

Christy
And then the coverage part that I was talking about, I mean, both doulas and midwives and midwives people also are confused about what they do. And midwife does the same exact things as the doctor does. But they don’t do surgery. So if you have a low risk pregnancy, and you are, you’re not planning to have a C section, you are in good hands with a midwife, but we don’t have enough midwives in this country. yet. We don’t have enough people who understand what they do and know that that could be a safe and really high quality option. And they’re not enough of them to go around. If everyone were to say Today I want to midwife there wouldn’t be enough midwives to be able to handle everyone

Vanessa
and to become a midwife in this country, correct me if I’m wrong, you have to be a registered nurse. Is that correct?

Christy
You will there are two different certifications. There is a certified nurse midwife, which is a nurse and then there’s a midwifery degree on top of it. And then there is a lay midwife, which is slightly different and and that has been problematic historically, in some respects. It has, but you can easily when you’re looking for a midwife. And when you’re if you were looking to what is what is accessible for you in your state, because again, state by state, it might be different in terms of what is available to you, you can understand better, like what are you looking for, I mean, to be able to give birth in a hospital with a midwife, they’re going to be nurse certified nurse midwives, and home birth midwives might not be, but not always.

Vanessa
I wanted to touch on something you mentioned before, I have a friend who’s pregnant, who was somewhere not where she lives, and she had a hard time getting a doctor to see her. It was you know, she called everybody on the phone back and she would need a prenatal appointment and had a hard time. You mentioned telemedicine, which I know is really become important in this time. So if there’s anybody who wouldn’t know how to approach or begin to approach telemedicine, is there a place they can go? Or what would you recommend in order to if you cannot get providers where you are you can’t see the doctor that you want to see.

Christy
Hopefully, you’re you already have some provider in your life whether it’s your regular doctor, an OB GYN that you see any kind of provider that you have an existing relationship, but I would start there and reach out first to say like, are you practicing tell telemedicine What do you recommend? I know of a few different platforms that people have been using. The founder of Maven is a friend of mine. And they have been talking about a sort of virtual platform, a virtual clinic for some time. And it’s one where you can look in your area. These are midwives, these are doctors, these are doulas and you can kind of you can sort of seek them out and have a conversation and see if there’s a good fit. I think you do want to still have you want to have a phone call or some kind of way to, you know, establish like, is this the right fit for me? Yeah, um, before just making a choice and jumping in. If you go the route of looking for a doula, because sometimes a doula can help navigate the choices that you make. I mean, I met my midwives and chose my birth center because of the doula that I that I hired. You can look for a doula in your area. Dona is one of the certified doula associations, professional organizations and you can find in your area or through your provider because a lot of doctors will recommend doulas if you’re interested. And then during this time, I’ve seen a lot of people just say, I will be there for you. Like you don’t have to even be my patient. But if you have questions and concerns, you can come to me.

Vanessa
Great, thank you. We have a couple of questions that I wanted to get to from Carrie. Since the covid, 19 pandemic, I’m seeing seeing many women starting to choose home birth over hospital, do you feel this could be an opportunity for a real shift in mentality? Thanks and Peace? And I wanted to add, is there anyone who shouldn’t consider a home birth?

Christy
I mean, again, if you have any kind of serious medical condition, if you’re someone who is considered high risk, then I would say probably not. But a birth center or a home birth, there’s always a referral kind of situation, backup plan, like all births, you have to think about scenarios and the what ifs, I think in a in a in a time right now where the system is. So I’m sort of strained, it’s a hard time to be thinking about, okay, if I decide to be at home, and then I need an ambulance, and then I need to go to the emergency room like is that whole set of choices that I may have to make is that would that be worth it. And that’s a serious thing to consider, you know, home birth or a natural childbirth or birth center birth is not for everyone. So you really want In fact, they make you kind of commit to doing additional childbirth work to make sure that you’re you’ve asked yourself all of those questions to have to make a last minute you know, move to another facility in an emergency situation would not be ideal. So oftentimes, you want to have those sites to be close to a hospital and know that they have a referral relationship and that things can happen quite quickly.

Vanessa
Tell us what you’re most proud of in what you’ve accomplished, either specifically or generally, but you know, you’ve come a long way and brag a little bit to us. accomplished what you’ve done.

Christy
I mean, there’s so much that I feel really proud of, I feel really proud of right now, the work that my team has been able to do even in this time, I mean, we’ve all had to take a bit of a pivot. And again, just really deepen our focus and our attention to certain aspects of what we do. You know, coming into our tenure, we had some really big plans about, you know, we’ve been taking all of this sort of stock into learnings that we’ve, you know, through our grant giving through our advocacy work, we’ve really, like looked really deeply at all that we’ve done. We’ve had deep conversations with our grantee partners, we really were like, let’s take all this information. And let’s, let’s like internalize it and like sort of figure out like, what does that look like? What does success look like for us in 10 years, that we might be able to come back to that, but I think this has been so much of like, this is where we need to put our time and attention. It looks one way in New York City. And it looks one way in New Mexico with our our partner there. And it looks one way in Florida. And then it looks very different in Tanzania, India, Bangladesh, and Guatemala and Haiti. So trying to, to help our partners in those countries who don’t yet know the impact and how severe the impact will be, but getting them in a place but they feel prepared, and connected and supported as their needs shift and change. The team that I have, as well as the community that’s been with us really all along who’s been kind of helping us to grow and build and believe so much in what we do. And in our mission, that just every time I every time I see people sort of come out, or where every mother counts on their shirt or on their sleeve, or you know, run a race or make a purchase or sign a petition, like every single action and gesture, or sharing of their story. All of that means so much at this point. Now, I don’t know if there’s millions, but there’s many, many, many 1000s of them. And if I see that kind of energy, or that kind of enthusiasm for what we do, or that kind of, you know, I want to make a difference. And I don’t know them personally, that always blows me away, you know, like to see runners run the New York City Marathon, and I don’t know most of them personally, in the beginning, you know, you start with your circle and your friends and your neighbors and your sisters. And at a certain point, it gets much bigger than than just you and I didn’t start the organization to be about me and what happened to me and my story, I wanted to make that connection and let other people highlight what they had experienced, to make it better for others and just beyond what I ever imagined would be the impact of of what I started when we when we got going.

Vanessa
Thank you for your amazing work. Also, please tell us how can we support your mission.

Christy
So we have a really awesome website. It’s a resource of information, the guidelines that I told you about around COVID, but also legislative guidelines and legislative activations, to take action page to take action slash advocate on every mother counts.org. We have a bunch of events throughout the year, usually with running and screening events and things like that, which we’ve now of course moved to be virtual ones, but we’re gonna keep a very robust calendar of events throughout the year as long as we need to. And we’ve found that they’re as effective and in fact, sometimes more so this way.

Vanessa
Well, thank you, Christy, for being here today. Thanks for all the work that you do. You really are a tireless warrior in this and you’ve accomplished so much. And it’s just a pleasure to watch you do what you do and make real progress. It’s been such a pleasure seeing you today. As I said, it’s just lovely to see your face. You too. Thank you for listening. If you enjoyed this episode, we welcome you to stay close and discover more of our offerings. Check us out on Instagram at an issue or visit nushu.com for more