Episode 45: Birthing black moms in distress on social media

Dr.Sophia:
Hello everyone. Welcome to the Dr. Sophia Obgyn podcast. I'm an obgyn practicing for over 15 years in my native New York City. And I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we talk openly and with heart about all things affecting women from pregnancy, menopause periods, sexual health, fertility, and so much more. Disclaimer, this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Hello everyone, and welcome to the Dr.Sophia Obgyn Podcast. As always, I am joined by my co-host and very good friend Touseef Mirza.

Touseef Mirza
Hi, everybody. And today, unlike, I guess maybe other days, we are gonna talk about something that's happening in the news or on Instagram, which is obviously news currently, right? And so we're taping this in the week of November 17th. And so there's a couple of Instagram posts that we had to react to based on what's happening right now.

Dr.Sophia:
Well, of course, this is the Dr.Sophia Obgyn podcast. And so as such as an obgyn actively doing obstetrical care, it's part of my everyday life. And it's still probably the number one thing I love the most about being an obgyn is the fact that I get to help usher in new life every day. And I just cannot express the feeling of being so appalled by watching some of the posts over the last couple of days. And it's two, in particular, of black women in active labor. And when I say active labor, actually I really mean that the babies are about to come.

Touseef Mirza
Like momentarily.

Dr.Sophia:
Momentarily, okay? And the level of just, I have no other word but to say even harm the level of uncompassionate care, disregard incompetence. I just have so many words and maybe no words at the same time, because I'm just in such disbelief myself. Although I'm not right. Like it's not because I don't know that these things are happening. I happen to be fortunate enough because this is my world, this is my life, this is the career path that I chose, and what brings me so much joy that I stay in that joy. But it's not because I don't know that these things are happening in the world. It needs to stay in the forefront that these women were screaming in pain, screaming for help, screaming to be able to have safe and compassionate deliveries, and were being ignored or being asked questions that are completely irrelevant to what's happening in the moment at hand.

Touseef Mirza
The two videos that we're talking about, one of the video is the woman is literally about to give birth give birth, and she's in the hospital and the nurse is basically asking her questions, rudimentary questions that should not be asked at this point, because she should be actually getting her prepared literally to deliver like right then and there. So that's video number one. And then video number two is you have a woman that is in labor, that is, you can see physiologically what she is doing in terms of her breathing and her pain that the baby is literally about to come. And the hospital basically said, we can't accommodate you right now. Come back when you are further along. And they literally had to move her.

She basically left that hospital, got into the car, getting ready to go into the other hospital and delivered the baby in the car. So those are the two videos specifically that we're talking about. They're all over the place right now. And so we just felt that we needed to, to talk about it and to, to, to also talk about what is happening in that labor situation and what we can do at this moment in time.

Dr.Sophia:
So let me take it back, thanks Touseef. Let us take it back because I do want people to understand that anybody who takes care of birthing persons, like if you work on labor and delivery, if you work in a hospital where you see women giving birth all the time, I don't care if you are the cleaning lady, if you are the clerk, if you are the nurse or you are the doctor, it is recognizable that the woman who is about to give birth is in that situation.

Touseef Mirza
So when you say recognizable, let's just put it table stakes. When we say recognizable in terms of what she's going through, can you give us some like very clean cut aspects of that?

Dr.Sophia:
If she is saying things like, I feel like the baby's coming, I feel like the baby is in my butt, that it literally, it, the baby in my butt part is like, oh no, we need to get her into a room right now and hopefully we can get our gloves on. Before it comes out, before the baby comes out. You know, because it's right at the cusp. Because it's right there, it's right there. And even if it's not right there, it's the concept of a woman who is close to delivery now is not the time to be asking her mundane questions. Let's first identify how close she is to that delivery, how close she is to giving birth. And hey, we could all be wrong. Maybe instead of being fully dilated and, and ready to push a baby out, she's two centimeters. But in these two instances, these women were not even put in that situation to even evaluate them quickly enough to assess that situation.

Dr.Sophia:
This is moving quickly to assess what is actually happening. And it's like, where was that level of care in those two instances? And I think the thing that makes me so frustrated is actually knowing that they are not the only two. I know that this is happening all over our country. It's knowing that that story, these stories are not in silos. A woman in active labor, a woman who's about to give birth unmedicated, she doesn't have an epidural, she doesn't have any pain medicine on board. These are women who have strength like a mack truck, like an 18 wheeler, like legit. So they are not coming for help because they are being frivolous, or dramatic. They're coming for help because that's exactly what they need at that moment. And the help is not in 20 questions. The help is not in, is this your first time in this hospital?

Show me your insurance card. It's like, let's get you in the room and get you ready. Period. And even in places where, because I've been in this situation in a hospital where all of the labor rooms are full, all of the triages are full. And guess what? We have to create a corner. We have to create a space, whether we are putting up curtains in order to deliver a baby and still give that woman a level of dignity and respect and compassionate care, then that's what needs to be done. So it's not even, the answer is not even, well, we didn't have rooms. That's still not the answer.

Touseef Mirza
You make room.

Dr.Sophia:
That's right. You make room. And the elephant in the room right now is that these were black women. Black women. This is, there's no happenstance here. There's no coincidence that these are the stories that are coming to the forefront. This is not to say that these things cannot happen to all women. The reality is that women in general obviously don't get the care that they need. But we are talking about black birthing persons, black women, and the fact that they are three to four times more likely to die in childbirth. And these are perfect examples of why-

Touseef Mirza
Three to four times more versus white women.

Dr.Sophia:
Versus white women and other, you know, non-black women.

Touseef Mirza
This is not something imaginary.

Touseef Mirza
Or that we're being overly dramatic here. Like, these are the facts, not making this up.

Dr.Sophia:
This is a reality. And all of those, though those videos just simply elicit the thing that people are like, oh, does that really happen? Yeah, yeah. That really happens. Here's an example, let me show it to you.

Touseef Mirza
I mean, the first time I ever heard that stat, it was unbelievable to me because I'm like, but why? You know, why is that? And then obviously a lot of it has to do with systemic racism. And that's not just in black
maternal health, but just in all different aspects of-

Dr.Sophia:
Medicine.

Touseef Mirza
Of black people, and also black people and-

Dr.Sophia:
The black experience.

Touseef Mirza
Even if we know the stat, but then when we see it in real life, it's just like, okay, this is like, we know it's real, but it makes it even more real. I don't know how to say that. But it just, it needs to be, it brings it back to really what's happening and what do those stats actually mean.

Dr.Sophia:
Yeah. What does it look like? It makes it palpable. The reality is, it needs to stay palpable. Because if we're going to create any kind of change, people need to feel it. They need to see it, they need to understand that it really happens. That it's not just a statistic and everybody needs to see it.

Touseef Mirza
Even if it's uncomfortable,

Dr.Sophia:
Even if it's uncomfortable, even if it gets me riled up , you know, even if it boils your blood. I think the fact of the matter is that it needs to boil our blood so that we are moving in a direction that helps us to, so that this statistic doesn't keep happening. I don't want to be here talking about the fact that the treatment of black women is so terrible, but here I am talking about it. The reason why I'm talking about it is because we want to change it. So that way we can start to think about, not just, let me rephrase that. I don't wanna start to think about, 'cause I know I'm there on the ground doing the work, but we all need to be doing the work. It's not only a black obgyn, it's not only a black nurse, and it's not only a white nurse.

Because when we talk about implicit bias, when we talk about structural racism, there are times where that's happening even among ourselves. So if we are not taking on the responsibility of owning what compassionate care looks like, no matter who we are, then we are not a part of the solution.

Touseef Mirza
And when we say implicit, we're basically saying that you're doing something without realizing that you're doing it. You're not aware of it. But we've been brainwashed to believe a certain way that we just act without much judgment, and it just comes out naturally. And so if we realize that there is the implicit bias, or another way to say it is unconscious bias, that's another way to put it as well. We would benefit from each other, calling it out when the other person doesn't see it.

Dr.Sophia:
We have to call it out. We have to call it out. And it doesn't matter where it comes from, whether it is the clerk, whether it is the cleaning woman, whether it is the nurse, whether it is the tech, whether it is the doctor, whether it's the patient themselves, whether it's their family, it's the advocate, it's the support person, it's the doula. We have to call it out if we're going to make actual movement in the change that needs to happen.

Touseef Mirza
The interesting part about this is because when a woman is in the process, like momentarily given birth, it's also such a vulnerable place to be. So at the same time, we wanna call it out. I'm talking more literally like the woman who is about to give birth and their family members. They wanna make sure they wanna get the care. So they also don't want to offend people. And at the same time, they wanna make sure that they call out for what they need at that moment in time. So that is sort of like a delicate balance. I feel that you have to navigate-

Dr.Sophia:
You are between a rock in a hard place. And I fully agree with you because take for example, those women, you are battling what's going on in your body at that moment. You're about to give birth. You are battling being called an angry black woman or aggressive. You are battling having security called because you've raised your voice and, and actually advocating for yourself. And this is all happening in the background in your mind. Like, what can I really do to help myself?

There's such a helplessness because of how we are seen, how we are portrayed. And the reason why it almost feels impossible to stand up for yourself is because standing up for yourself doesn't look like that. When you're black, it looks like you're being confrontational. It looks like you're being aggressive. It looks like you're just looking for some type of fight when what you're really fighting for is your life.

And we have to change the narrative that a black woman who is expressing exactly what she's going through and how she feels is not an angry woman, is not a woman who feels no pain, is not a woman who's being aggressive. She is a woman who is telling you that she needs help. She is a woman who is telling you she needs care. And the response needs to be compassionate, empathetic, understanding. And in that moment, she needs to trust that the person on the other side actually wants to take care of her, is there for her, is going to get her through safely. And I don't know how to make that happen.
Touseef Mirza
I mean, I think also what you're saying is, you know, when we talk about unconscious bias and structural racism, like those are such big concepts and challenges that it's not like we can change, change things overnight. 'cause that's been with us for a very long time.

And even if we really start to look at it, to start to view it from different angles, like for the people who are listening that are maybe not in the shoes of a, of a black woman or the of a black woman that will, who wants to have kids, or that's in the medical field. What I find interesting, we were, we were doing the research on this and to recognize that when we say implicit racism, it doesn't mean that you are making slurs to somebody. And if you're not making slurs, then you're totally fine. But the implicit bias can come just by not believing a black person. And to actually delay care to them, that is a form of implicit bias,
Dr.Sophia:
Or the structural racism or the racism that you have, are you holding onto that you don't even realize that you're holding onto the bottom line.

Touseef Mirza
Yeah. So it doesn't, it's not like I'm not a racist because, you know, I talk to them and I'm not telling them off or saying slurs, but that's, there's many shades of gray here. It's not like zero or 100. But some people are very aware of the way they react, and some people are not. But these sort of unconscious ways of dealing with other people in terms of not believing them or denying them care right away, those are, might seem little, but they are actually stemming from the same place of implicit bias as it pertains through systemic racism.

Dr.Sophia:
I think taking ownership of the fact that when you are not providing respectful, candid, vulnerable care, empathetic care offering comfort, if we are not taking ownership of not being able to do that in medicine, then we also have to understand that, that we are operating from a place of implicit bias and we need to check it. We need to first look at ourselves and how we are interacting and see, is there something else I need to be doing? How can I show more compassion? How can I be more understanding? See this person who's in front of me as if they were myself. But many people don't actually look at themselves. Those women who are just saying, yeah, let me ask you. These 20 questions are not looking at that woman who was in labor as if they were the person sitting in that chair in that wheelchair.

Touseef Mirza
As you're saying that, I think it would be really good to have like underneath, maybe it's like a backdrop of their laptop or their system. You know, how providers have you know, their platform that they input all different information. Sometimes it's on an iPad, sometimes it's on a laptop, sometimes it's on a phone. But the background image is just like a word that says, are you comforting them? You know, something like that, that forces you to get out of your zone to recognize, okay, this is my role right here, no matter what. That's my role is am I, am I comforting them? Period. It is to try to bring it back to center with everybody.

Dr.Sophia:
Yeah. We have to bring it back to humans. Like this, we have to bring it back to the self to understand that we are all the same. We have to be able to bring it back to treat one the way that I want to be treated, like the golden rule. And I just can't see a place where that is even more needed than when a woman comes in labor and to give birth. She is bringing in a new life. What other place can we provide more care, love, support? And so I'm just, I'm just so baffled.

Touseef Mirza
Well, I think for you it's even more intense because you are an obgyn and you, you literally deliver babies all the time. And so you understand what these women are going through. Like you're put in that situation almost on a daily basis. So you feel it even more viscerally.

Dr.Sophia:
Yes. Do I feel it viscerally? Absolutely. I mean, I feel like it even can bring me back really to even my own birthing experience with my two sons, because I, I for sure remember when I had to be hospitalized with Tyler and I was young and I didn't have the language.

Touseef Mirza
This is before you were an obgyn.

Dr.Sophia:
Before I was an obgyn. And I did not have the language or the knowledge of how to express the fact that I had a level of discomfort with the people who were taking care of me. And at the moment I thought it was because, oh, they must be treating me the way they're treating me because they think I'm a teen mom or something like that. Which at the time I wasn't, but I couldn't wrap my head around necessarily. Or maybe it's just because I'm black, you know, or, or the double whammy that she's black and she's young.
Touseef Mirza
But you knew something was off.

Dr.Sophia:
I knew something was off with some of the nurses who were taking care of me. I knew something was off. And I don't know if it's that embedded trauma that I instead kind of reverse and try to bring forth a much better experience. And that's, I mean, that's to all of my patients, I really do try to be the same. But I have to admit that when it comes to my black women, that there is a little extra sauce, there's a little extra care, because I don't know that they're getting it from anywhere else.

Touseef Mirza
So you wanna give that to them.

Dr.Sophia:
And they deserve it. We need to wake up as a society, and if we have to see another 20 million videos, I don't want it to get to that point. I wish that after seeing two videos like this, that we are so appalled that we move into action.

Touseef Mirza
And just to be clear, just because these two videos came out, obviously doesn't mean that it wasn't happening before. It just so happens that these were taped and became viral for, I don't know who pushed it out in what way, but it happened. And so now everybody can see it.

Dr.Sophia:
We have an opportunity now to put images. Because, you know, sometimes people really just need to see it. It's not the same as reading things on paper. It's not the same as saying, oh, this is the, the statistic. These are real life experiences that are happening every single day. We now have faces, images to put with it. And I, I hope that everybody is feeling that same level of frustration. And the thought process behind it needs to be, what are we doing? What am I doing to make sure that that's not happening to someone that I'm taking care of that in my capacity, whoever I may be, whether I am a clerk, a nurse, a tech, a doctor, a midwife, a nurse practitioner, I don't care who you are in the chain, but to see those videos and then turn around and then ask yourself, how would I have behaved in that moment?

Touseef Mirza
So that's more from a perspective of the healthcare provider and the environment in which it's happening. On the other side of the coin, there's also people that are with the birthing mother that can also help as well by advocating for her.

Dr.Sophia:
Absolutely. It's the reason why it's so imperative that black women not be alone. It's so imperative that they have a support person with them. It's so imperative that they have things, whether it's a husband, a partner, a family member, a doula, a friend. But it's imperative that someone is there with them. Because in those moments, those women cannot speak up for themselves. That they have someone who's there with them, who can, who knows their wishes, and not even just their wishes, but who can just say, hey, this woman needs help.

Touseef Mirza
And the reason why they can't speak for themselves is because they're huffing and-

Dr.Sophia:
And puffing and-

Touseef Mirza
Puffing and moaning and having a baby coming out of their vagina.

Dr.Sophia:
That part. That part that they need to be focused on. Their contractions, their breathing, and how they're keeping themselves and their baby safe in that moment.

Touseef Mirza
Obviously we wanted to raise our voice with everybody else in solidarity in terms of what's happening right now. And it might take a long time, it might not, but the whole point is to keep moving forward with this and keep talking about it, and keep using what we have all the time if we need to if we need to use our phones to, to document so that people are aware and eventually, I mean, it has to get better.

Dr.Sophia:
It has to get better. It has to get better. We have to embrace our black women, our embrace our black birthing persons embrace how we are taking care of women in the most vulnerable time of their life. What's supposed to be the most beautiful time in their lives? We have to do better.

Touseef Mirza
That's pissing me off even more now, like, yes, all of that atrocity, but then on top of that, it is such a beautiful moment that needs to be cherished. And how dare other people steal that from you?

Dr.Sophia:
We gotta bring back the joy.
Touseef Mirza

We gotta create the joy, and we have to keep amplifying the joy.

Dr.Sophia:
For those women who had their babies under those horrible circumstances. I pray for you. I pray for your baby. I pray that your future experiences are met with compassion, competence, love, understanding, joy, that we can embrace you, and that you can embrace yourself at a time that is special and deserves to be celebrated. We're gonna keep putting this at the forefront. We have to take care of black women. Thank you for listening to the Doctor Sophia ObGyn podcast. Bye for now.

Touseef Mirza
Bye.

Dr.Sophia:
This is General medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.