All language subtitles for Born.Free.2022.1080p.WEBRip.x264.AAC-[YTS.MX]

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(soft music)

(interviewees
chattering indistinctly)

- The pain obviously,

and that's like my
fear about giving birth

that it's gonna hurt really bad.

- The whole pain thing.

I mean, when people
see documentaries
about giving birth,

they see the screaming
and the crying

and the sweating.

Yeah, I personally am
scared of giving birth.

- I think Americans and women
have really internalized

that birth needs
to be medicalized

and you have to have an epidural

and you're not supposed
to experience pain.

- Nine months, I hate throwing
up, the morning sickness,

carrying something in your body

is terrifying to me.

- The idea of giving birth,

it just seems like
all the images

I have in my head of
women giving birth

are of them like screaming

and like their faces were
really red and the sweating,

and then the husband faints
and then they're, like,

"Oh, first time dad."

Like all those movie
things that happen.

- At this point, we've
internalized that ideology

over and over again.

It's now embedded
in so many women

to think that birth is something
that needs to be treated

rather than is an experience
or is a natural thing.

(woman screaming)

- God, this hurts.

Pain! Pain!

(woman groaning)

(woman screaming)

- Sorry, I can't.
- Yes you can.

- I can't.
- Hey.

(woman screaming)

- I just can't do it!

- [Nurse] You'll hurt
the baby right now.

- Oh, I hurt. I hurt.

(women screaming)

- Oh, oh!

(women screaming)

- No, I can't, I can't do it!

- [Husband] I need you
to do it. You can do it.

(soft rhythmic music)

- [Paula] My name is
Paula James-Martinez.

I'd recently moved
to New York City

because a giant
dotcom had asked me

to be in charge of all
things fashionable.

So, like every
career-minded woman,

I fell in love and
moved to California.

(soft upbeat music)

And I can remember thinking,

it had never been a better
time to be a woman in America.

♪ I am woman, hear me roar

- [Paula] Companies were taking
real action on equal pay.

Sexual harassment was finally
being taken seriously.

Beyonce had "Lemonade."

And we were about to get
our first female president.

When I had a really
bad feeling...

(brakes screeching)

Oh, ----.

(toilet flushes)

I was pregnant.

So, I googled like my
life depended on it.

And apparently, it did.

Mothers in this country
are routinely dying.

- Can it possibly be true
that women giving birth

in our country are more at risk

than women in dozens of other
nations around the world?

Afraid so.

- A new investigation
claims the United States

is the most dangerous
place to give birth

in the developed world.

Every year in the US,
more than 50,000 mothers

are severely injured
during or after childbirth.

- [Paula] Yet, in the wake
of so many tragic stories,

I had a great birth.

That's me in labor,

and that's about as
dramatic as it got.

But I couldn't help thinking,

"Why was I such a unicorn?"

What had gone right
for me, I wondered.

Was it because I'd had a
midwife, which is unusual,

but it seemed very normal to me.

In case you hadn't noticed yet,

although my daughter
was born here in the US,

I was born in the UK,

and delivered by National
Health Service midwives.

I know, you guys
are thinking this.

- [Nun] Camilla Fortescue-
Cholmondeley-Browne?

- Yes.

- [Paula] But a
modern British midwife

does much more of this.

♪ Ah

♪ Ah, push it

♪ Ah, push it

♪ Push it good

- [Paula] In fact, in Great
Britain, France, Germany,

Netherlands, Belgium, Denmark,
Sweden, Norway and Finland,

over 75% of all babies
are delivered by midwives.

And unlike the United States,

none of these countries

have a rising maternal
mortality rate.

Birth in the UK is actually
so safe that the baby's father

is statistically
more likely to die

during his partner's
pregnancy and birth.

And British babies
are 70% more likely

to survive the experience
than in the US.

So, why was it when I told
many of my American friends

that I was having
a midwife birth,

did they look at me
like I'd suggested

some sort of witchcraft?

(gentle acoustic music)

- Our history with
midwives is complicated.

In the 1930s, as
hospitals were sort of

becoming more popularized
and springing up

all across the country,

and obstetrics as a
specialty in medicine

was starting to grow,

and hospitals became
teaching hospitals

and, you know, suddenly,
there was a shift away

from home births and midwives.

And it was almost
like, you know,

let's create a new territory,
and in order to do that,

we have to kind of
get rid of the old.

And that was probably a very
simplistic way of doing it,

but that's essentially
what happened.

It's not in our popular
culture anymore.

- You don't even
know that it exists.

When I talk to
people, they say like,

"Oh, people still do that?"

And I'm like, yes,
you don't have

to have your birth
in a hospital.

You can actually
have it in your home

or in a birthing center,
however you want,

and it's your choice.

Knowing that it's a choice.

Like, people don't know
that they have choice

in how they birth, right?

(gentle acoustic
music continues)

- I knew always that I wanted

to at least try for
a natural birth.

It just made sense to me.

Why would I not try?

And I also knew enough

that when you go
into a hospital,

that it's not going
to necessarily,

it's going to be
harder to go that way

if you're in that setting.

That just like, that's what
hospitals are created for,

that's what doctors
are trained to do,

is to intervene and to operate.

To me, it always felt
like if I don't want that,

then I should stay away,

and I think there are
more and more women

that feel that way.

(melancholy acoustic music)

♪ She's a good girl

♪ Loves her mama

♪ Loves Jesus

- [Paula] Kimberly Turbin
lives just 30 miles

away from me in Reseda,

yet her birth story is a
million miles away from mine.

It was one of the most
disturbing stories I heard

when I was researching
this project.

But not just that,

it was also one of the bravest.

♪ Living in Reseda

♪ There's a freeway running
through their yard ♪

- Rape and having sex
when you don't want to,

all that doesn't compare
to, I think, what he did.

He basically changed
my decision making

for me, my body, and my vagina
for the rest of my life.

Like, now I have
muscle spasms issues,

I have vulvodynia, which
is just vulva pain.

♪ And all the bad boys

♪ Are standing in the shadows

♪ And the good girls are home

- I was fine until I let
them know that I had PTSD

and that I had been
raped in the past.

And I think that the feeling
was starting to creep up on me,

so if they could give me
something to calm down.

Doctor came in and it's
not going fast enough.

He said, "We're going to
have to do an episiotomy."

And I'm like, "No. Why?

We haven't even tried."

It was only 5:00 PM and right
now it's only maybe 11 or 12.

And I'm like, "I haven't
even started pushing yet.

This can't be right."

Basically, he said, you know,
how dare I question him?

He's the expert here in the
room and this is what I need.

And the nurse is like, "It's
just going to be a little cut."

And I was like, "No, I don't
want you to cut me. No."

- [Nurse] Keep going, keep
going, go, go, go, go, go.

- [Kimberly] No, don't cut me.

No, why?

- [Doctor] What do you
mean why? That's my reason.

- [Kimberly] Why can't we try?

I get one contraction and
I'm not saying anything,

and I breathe out and
he just starts cutting.

- [Nurse] Push, push, push.

Keep pushing, keep
pushing, keep pushing.

Go, go, go, go,
good job. Good job.

Keep pushing. Go, go,
go, go, go, go, go, go.

Okay, and relax.

- I couldn't even,
like, really cry

or get happy over
my baby being here,

and he basically snatched that
whole moment away from me.

I don't think they
believe our pain.

Like, after I gave birth,

I asked Dr. Abbassi
for pain medication

and he told me, "No." (scoffs)

And this is that I couldn't sit.

It was like, like
someone ripped me open

and then they sewed it back up.

But you can't even
go to the bathroom

after that comfortably.

I was able to catch
full blown on video

how these doctors sometimes
are acting towards us

and what they do to our bodies,

while we're sitting there
saying, "No, don't do it."

- [Crowd] Stop the
violence! Stop the rape!

- What made me take it
further was after I had Rio,

everybody was like, "Well,
you know, "it's normal.

Sometimes they cut.

That's what they decided to do
and, you know, get over it."

But I was like, "But how?"

I can't even sit down
without being in pain.

Six months, I was walking slow,

I had to change my
whole diet, all fiber,

I had to retrain my
vagina how to work,

just to have a
functioning vagina at 31.

That's a huge part of
my body that I have

that somebody took
my control over.

If I ever find somebody
I love or want to marry

or make a life with,

I have to explain that I
have these ------ issues

with my vagina
and I may not ever

want to have a baby again.

(people chattering)

- I don't know how anyone
could watch that video

and not be moved and appalled
by this woman lying there

in the most submissive
position possible,

with a doctor wielding
scissors at her genitals,

and her begging not to be cut,

and him berating her
and demoralizing her

and insulting her

and then proceeding to cut
her punitively 12 times.

And it's all caught on tape

and it took us 80
lawyers to find one

that thought they could win.

- It's like a whole machine
that works together.

They decide your fate before
you even wake up that day.

And a lot of these cases
is, but is the baby okay?

There's no is the mom okay?

- What stands out
a lot for me is,

and it's happened a few times,

is the doctor not making
eye contact with the mom.

Like, entering the room,

not going up to
the mother's side,

not asking her how she's doing,

not asking her what she
needs, what she wants.

Getting straight
down to business

without any interaction at all.

Having women being
told to be quiet

when asking for what they want.

- This one particular person,

who we're now really
close friends,

I was there for
both of her children

and one started
out as a home birth

and we had to end
up transferring.

The doctor introduces herself

and the first thing she says is,

"Oh, you're so lucky
because I'm the only one

on the floor who uses forceps."

And I was like, "What kind
of introduction is that?"

Like, that's how you
introduce yourself?

Not "Hi, my name is so
and so, this is my name."

It's, "No, hey,
you're so privileged

because I'm the only
one who use forceps."

And I was like,
"Are you insane?"

(dramatic music)

- [Paula] Why don't we
know about our choices?

And where did all the
American midwives go?

We have to go back
to the early 1970s.

♪ I am woman, hear me roar

♪ In numbers too big to ignore

- [Paula] It had never
been a better time

to be a woman in America.

Companies were taking
real action on equal pay.

Sexual harassment was finally
being taken seriously.

Joni had Blue, and...

- [Pamela] At the time, the
Vietnam War was happening.

(bomb exploding)

(sirens wailing)

- We were pacifists,
we believed that people

could work out their differences

by talking with each other

and being compassionate
with each other.

- [Paula] That's Pamela.

She'd never admit it,

but she's a bit of an
American folk hero.

As a college student
moved by the message

of peaceful resolution,

she set off across the
country in a caravan

of pastoral buses
with her husband

to spread the word
of peace and love

when the country was
facing a lot of hate.

- What you put your energy
into, you get more of.

So, if we put our energy
into peaceful resolutions,

then we get more of that.

- [Paula] Eventually,
the caravan of buses

settled in rural Tennessee
to found what would become

one of America's largest
communes, The Farm,

where Pamela would
become one of the world's

most famous midwives.

So, I set off to Tennessee
to find out why midwives

are a counterculture
movement in the US.

(soft rock music)

- We didn't call
ourselves midwives.

We weren't midwives.

I had a major in art,

but we had a belief
that birth would work.

- Mind and body are one.

How the woman's mental
attitude is during the birth

is going to make
a huge difference

on how it goes physically.

And that's part of
spiritual midwifery,

you want to nurture these women,

these babies, these families.

You got to kind of give your
heart and soul to them really.

- [Paula] Joanne is also
one of the early members

of The Farm, and an
OG spiritual midwife,

who, after seeing not just how
the system had treated her,

but other women, knew it was
time to fight for a better way.

Spiritual midwifery, in essence,

is the practice of caring

and listening to
women during birth,

and also the title of
one of a series of books

written by founding
midwife, Ina May Gaskin.

These books have introduced
an entire generation

to the possibility of
peaceful, unmedicated birth.

Having sold over a
million copies worldwide,

the book from a commune has
something of a cult status.

But why now do generation
after generation of mothers

continue to press
their dog-eared copies

into each other's hands?

- [Doctor] All right. Let's
do this, let's do this.

Let's do this.

Let's do this.

- In 1965, pretty much
the standard of care,

when you first hit the hospital,
you got a shot of Demerol.

Demerol is a pain reliever.

You got a shot of scopolamine,
dries up your secretions.

You had your enema
and your prep,

which included shaving
your vaginal area.

- The nurses would call it
pit, stick, suck and split.

Pitocin, an epidural stick,

suck the baby out with
a vacuum extractor,

and bye, you know?

As quick as possible.

(baby crying)

- [Paula] Carol's story
is really disturbing,

but unfortunately, not
unusual for the time.

- I ended up having an allergic
reaction to the Demerol.

Not only throwing up, but
instead of it making me relax,

it made me tense.

At that time, when
you got fully dilated,

they would bring you
back to the delivery room

and they would give you
more drugs, more anesthesia,

and put you to sleep.

- [Paula] And it wasn't
just bad for mothers.

Studies also found behavioral
and motor issues in babies

whose mothers had received
anesthesia, including Demerol.

- And then, the doctor
did a huge episiotomy

and took the baby with forceps.

- [Paula] Now, I'm only going
to explain episiotomy once

because it makes
even me feel weird.

But it's basically when a doctor

cuts you with scissors
down there, to make, um,

the opening larger and
get the baby out faster.

- After the birth,
they put me in recovery

and just left me
alone, flat on my back,

and I ended up throwing
up and aspirating.

Luckily, one of the
nurses came back in

as I had stopped breathing.

So, that was a
horrific experience.

I really didn't know
that that wasn't

what everybody went through.

You know, I wasn't educated
enough to know the difference.

- [Paula] The
difference was, though,

these were women
looking for solutions

to stick it to the man
and take back control.

There was a movement among
women's groups in the '70s

developed to deinstitutionalize
the dependent.

Feminists argued that
childbirth was not a disease

and that childbirth did
not require hospitalization

or the supervision of an OB.

- How did I get into
midwifery, really?

Self-preservation. (chuckles)

I had my first baby in 1967

and the only real
childbirth training I'd had,

as far as seeing a
birth was "Wagon Train."

(dramatic orchestral music)

Once in a while, the
Conestoga wagons on the trail

would pull over and film from
the outside of the canvas.

You would hear a woman
scream, a baby cry

and the wagons would roll on.

So, I thought, okay, you
scream and the baby comes out.

I remembered one of
the nurses saying,

"Just think about
your breathing."

I said, "Well, how
do you breathe?"

And she said, "Just
think about your breath

going in and out."

And I tried it,
pain cut in half,

and I was like wow,
heavy magic, you know?

And then, it was
just too strong,

I thought, "I can't
do this anymore."

And it stopped. No
more contractions.

And I'm sitting there going,

somehow I'm not understanding
how intellectually,

how to get this baby out,

but my bod has gotten
pregnant, grown this baby,

well on the way to
having this baby.

I've just got to trust my body

that it's going to
get me out of this.

And as soon as I thought
that, they came back.

And pretty soon, I had to push.

- In those days, they
bring you to an OR room,

which must have been
about 45 degrees.

Everybody has layers of clothes,

and they're all yelling at me,

"Don't push because the
doctor's not there."

Right after I'd made
this deal with myself

to listen to my body.

So, I'm going, "Ah, okay,
I'll be a good girl."

I don't push.

He finally shows up
about 15 minutes later,

cuts a huge
mediolateral episiotomy

for a 6 pound, 14
ounce little girl

I should've had 15 minutes
ago with the nurses.

I couldn't sit down for a month.

I had to take a pillow
with me everywhere.

I thought there has to be a
better way than this, you know?

So, when I got pregnant
with my second,

first midwife I ever met was
a guy named Bob. (laughs)

And he asked how my
other birth had gone,

and he said, "Oh, you
can do it at home."

And I said, "Well, don't you
need to cut an episiotomy?"

And he said, "No, no,
just don't push hard."

On 4th of July, we were
going over to Sutro Park

to sleep for the night.

Started having contractions,

called the Good Earth Commune.

One of the ladies came
over with her baby and was,

what you would call
nowadays, my doula.

And got me in a tub, talked
me through some contractions,

and then I pushed
him out and she said,

"He popped out."

All the fireworks in
San Francisco went off.

(fireworks exploding)

It was the most empowering thing

that ever happened in my life.

It was so different
from my first birth.

I just felt like I
could do anything.

(gentle music)

- [Paula] So, that was it.

Women could do anything.

We were free.

Free to choose the birth
we wanted to try for.

Free to push when we wanted to.

Free to say no to drugs or yes.

Free to give birth
at home or not.

Free to be heard.

Free from dangerous
procedures we didn't need.

Free to take back control.

Okay, maybe not.

I might have got a little
carried away there.

The conflict over home birth
proved one of the most bitter

between the medical
establishment and
the women's movement.

And while no state
forbade home birth,

ACOG actively discouraged it.

Doctors have participated
in home births

by offering backup
in an emergency

were threatened with loss
of hospital privileges

and even losing their
medical license.

- Our Tennessee law had
been on the books since 1898

and it was one little sentence
in the Medical Practice Act

that said, "Midwifery is not
the practice of medicine."

And that let midwives
practice openly in Tennessee.

Not all states were like that.

- [Paula] In fact, very
few states were like that.

- The midwives in the South
were keeping midwifery alive.

They were keeping
home birth alive.

These home birth midwives
knew what they were doing.

- Midwives, especially
in the Southern region,

have been the champions
of our community

and there was a very
intentional break.

Midwives were holding a lot
of power in our communities,

and these were Black women,

and granny midwives as we
call them in the South.

- [Paula] Grannies were healers

and valued by slave owners,

as more healthy
babies meant, well,

more people to enslave.

But as slavery was abolished...

- [Joanne] They made it illegal

or retired them and then made it

illegal in Alabama
and Mississippi and
Florida. (chuckles)

- [Pamela] What it
looked like to me

is the Alabama medical system

didn't want those babies
to be borne by midwives.

They wrote a law and they put

all those midwives out of work.

And Alabama still
has very backwards

in their thought
about midwifery.

- Midwives are being attacked.

Being told that we're not safe,

but yet majority of
the unsafe births

are happening in hospitals.

- [Paula] And even though
the work of Black midwives

in America has been whitewashed

out of most of our cultural
understanding of birth,

there's a growing number
of midwives of color,

like Barbara, who are
putting their lives on hold

to become qualified,
often against the odds,

to provide holistic care
within their community

and transform our perceptions

about what midwife
care really is.

- Culturally, in African
culture or Caribbean culture,

a midwife wasn't just a
person that caught babies.

They were the medicine woman,
they were the counselor,

they were the, you know,

they were everything centered
around the community.

They uphold the family.

- [Carol] Historically,
if you look back,

midwives have been a threat

and midwives have
been the healers,

the people who
deliver the babies

and the women who empower
the women to give birth.

And there is no reason

that there shouldn't
be midwives everywhere.

- [Paula] And because
American tales

are often wild and winding,

the biggest community these
progressive hippies served

as midwives were,
well, the Amish?

- Now, the Amish are interesting

because they don't
really educate

their women about childbirth,

but the girls grow up
seeing their mother

having baby after
baby after baby.

And so, somewhere back there,

they know that that's normal.

- So, those women are
in our statistics,

you know, grand multips.

We've delivered a lady's
19th baby at 49 years old,

and that's not low risk.

- I don't think that the
hospitals can brag about that.

I think that the hospitals
are having a hard time

because they're doing
so many interventions.

- [Paula] But interventions
are also lifesaving,

which is why it's
vital that midwives

are able to be supported
by doctors if needed,

a model known as integrated care

in most developed countries.

- We made those
connections in 1971.

Lovely doctors who are very
willing to work with us

and have helped us a lot.

(birds chirping)

- For seven years, I was a
backup for six wonderful,

dynamic lady midwives.

At one point, they even told
me I was an honorary midwife.

I just happened to be there.

I was a midwife who could do

a ceasarean delivery
if I needed to.

I was always the last
person they wanted to see

because if I showed up,

it meant that something
hadn't gone the way

they wanted it to.

- If there is an
emergency, okay, yo,

let's go to the hospital.

If there's a C-section that
is necessary and needed,

as long as that keeps baby
and mommy safe and whole,

let's go do it.

(gentle acoustic music)

- [Paula] Washington has some

of the most integrated
care in the US,

and the best survival rates
for both mothers and babies.

In Jen's case, modern
medicine saved three lives.

- I was 24 weeks pregnant

when I thought I was just having
Braxton Hicks contractions.

Called my doctor,

I had mentioned that
the contractions hurt

and they said, "Oh, actually,
they shouldn't hurt.

You should come in."

It got serious really fast.

I hardly had time to fully
understand what was happening.

(machine beeping)

When I woke up in recovery,

I knew I wasn't pregnant.

I knew they were born,
I knew they were tiny,

but I didn't really
understand what that meant.

It really wasn't
until I was allowed

to see them the next
day that, kind of,

that severity of the
situation really hit me.

It was three months

and we were talking
about tracheostomies.

It was six months and we were
talking about more surgery

and lifelong therapy needs.

We saw what was coming with
the medical repercussions

while the boys were literally

fighting for their
life in the NICUs.

(gentle acoustic
music continues)

- [Paula] Yet even with
the incredible care

Jen's family received,

there was one very
stark difference

between her story
and those of mothers

in all other developed nations.

- The boys went in for heart
surgery at six weeks old

and I know that bill came
in at around $260,000,

which honestly, we just
kind of laughed. (laughs)

Put it in a drawer.

We don't have that.

There were so much that
was really expensive.

Being in the NICU, just the
room itself is $10,000 a day,

plus I had two kids,
so that was doubled.

That didn't include the
doctors, the nurses,

the therapists, the
treatments, the medications.

There were a lot of things
that weren't covered,

but we we didn't start
to realize some of that

until several months, even
several years down the road.

I was very naive
at the beginning

in that I just assumed
that since we had

comprehensive medical care

and I paid my insurance
bills every month

and I had an employer
that sponsored this plan,

that it would be okay.

My biggest mistake was actually
trying to pay everything.

We did everything we
could to pay our bills

and to stay current.

So, we liquidated our
401ks, we sold our house,

we sold our cars, we
sold our furniture.

We ended up declaring bankruptcy

to write off about
$400,000 worth

of personal medical debt.

But even after that, their
medical bills were still so high

that we just couldn't keep up.

This is America.

I had no idea we could
fall into a gap like this.

(melancholy music)

- [Paula] Does the insurance
system affect outcomes?

- People in the United States

no longer even know what
the cost of medical care is

because it's so
hidden in these copays

and you're being charged
X only because they know

they're only going to get Y
from the insurance repayment.

But if you're paying
for it directly,

all of a sudden,
there's a new price of B

that was never even part
of the conversation.

So, I think that we don't
live with real numbers

and that's all a part of
the capitalistic system

that sort of supports

the medical industry
and establishment.

It wasn't about safety

or what the women
wanted or anything.

It was all about profit.

- Here, it's a business.

You become a commodity, your
child becomes a commodity.

How can I thereby make
money off of that?

I don't have time for you
to be in labor for 72 hours.

No.

The capitalist
structure of this nation

is based on the
industrialization of motherhood.

- The people in charge now

seem to want to make
it into shift work.

They have employed
laborists, they call them,

who are watching,

actually more ladies
than ACOG says

a doctor should be
watching in active labor.

But they are watching
numerous ladies in labor

and just intervening
whenever somebody crosses

whatever arbitrary
line has been created.

- Obstetrics is getting
better at this in recent years

but there was a period
of time where inductions

were really done for any
old, almost no reason at all.

A convenience of scheduling.

- Well, I'm sorry,
but our bodies

don't work like that as women.

We're not on a schedule.

We're not on a schedule.

Try to put a woman
on a schedule.

(soft dramatic music)

- As society advances
and medical care in
general advances,

there's probably an
underlying belief

that every technology
that gets developed

is going to improve childbirth

and the care of pregnant women.

I think that's just a value

and something that's
not necessarily
proven scientifically.

- We are a country
that likes to sue

whenever there's an outcome
that is not optimal.

And so, we have a
reactionary healthcare field

where we tend to not
push the envelope,

allow somebody to do something

that's outside the
normal standard of care

because we're really
concerned about a lawsuit.

It is absolutely
driving decision-making

in healthcare right now.

But it's also helping drive
the maternal mortality crisis

because we tend to
intervene out of concern

that we might be
heading down a path

where we might see
an adverse outcome

if we're not
listening to people,

if we're not hearing
what they're saying,

if we're missing
important clues,

not just during their
pregnancy and birth,

but in their postpartum period,
we see adverse outcomes.

- If I had a wish,

it would be that we would
have a birthing system

that was set up
for and by women,

and that women were in control
of the birthing process.

Because I think that
there are things

that the largely male
administration of most hospitals

and the boards of directors
of insurance companies

just don't get about birth.

In an ideal world, I
would love for all OBs

to have midwifery training

so they could understand
the process of normal birth

as opposed to the
medicalization of birth.

- [Paula] One of the
most vulnerable moments

of my life was during labor,

and I can't imagine
doing it without support,

particularly that of my doula.

If I'm honest, I
don't really remember

anyone else being there,

but my husband
assures me he was.

You might be wondering
what a doula is.

No, a doula is not a handbag,

a weird deer or a
part of your brain.

It's not exactly what
Ali Wong suggests either.

- I'm very, very
scared of childbirth.

That's why I'm going
to hire a doula.

You know what that is?

You know what a doula is?

That's a white hippie witch
(audience laughs)

that blows quinoa
into your pussy

to Keyser Soze
all the pain away.

- The doula is for physical
and emotional support.

So it's what we used
to do centuries ago.

Back in the day, our
sisters, our mothers,

our grandmothers, our
cousins, our aunts,

all the women before us who
had babies helped us birth.

They were there, they
were rubbing our back,

they were talking to us,
they were singing to us,

they were doing
all of these things

that helped us
through childbirth,

and we just don't do
that for women anymore.

And so, I think the doula
fills that spot now.

- So, I think that doulas
are extremely important

and I may be a little biased
in that because I am a doula,

but I understand
how important it is

for women to have support,

for us to be able to
take care of each other

during this journey
to motherhood.

♪ But I need a
place to command ♪

♪ Somewhere quiet
and somewhere warm ♪

- [Paula] And as much
as you might think

doulas are in the same
category as kale facials

or jade vagina eggs,

it's statistically proven

they can have huge
benefits for mothers.

In fact, a large scale
study of over 15,000 women

from 17 countries found that
compared to birthing people

with no labor support,

those with a labor
companion such as a doula

were more likely to
have a shorter labor,

less likely to need
drugs to speed up labor,

less likely to use any pain
medication while giving birth

and less likely to have
their babies admitted

to a special care nursery.

- Having come from a long
line of teen parents,

I had always really been drawn

and had a heart for
teens, pregnant teens.

You know, thinking
of all these girls,

well, first thinking of my
family, my mom, who with me,

took a bus to the
hospital to get induced

and then took a taxi
home at 18-years-old.

All my aunts who gave
birth at 15, 16, 17.

I thought about them
and what that experience

must have been like for them

and how different it
was from my experience.

That is what made me go
and do my doula training,

because I wanted to serve them

and other, you know,
underserved women.

There's rarely a girl that
says no to a free doula.

Do you want someone
who's going to be there

and help educate you
leading up to your birth

and then she'll join
you during your birth

and she'll help massage
you and comfort you

and give you all the
information you need?

Do you want this person?

Yes.

Yeah, of course.
And who wouldn't?

And a lot of them
don't even know

that they have these choices
and that they can speak up

and that they can walk into
a hospital and have a plan.

Most of the doctors
who they work with

and nurses do not
expect them to walk in

knowing what they know.

And they would prefer
that they didn't ask

and that they would prefer

that they didn't
know these things.

- Our work becomes more
in the realm of advocacy

in really trying to advocate

for this person's
basic human rights.

Just the human right
to just be who you are

and to have bodily
autonomy over yourself

until you birth
your babies in a way

that is affirming to you.

(gentle music)

- Doulas have been proven
to improve outcomes

and the system is starting
to recognize that.

It's a Band-Aid
on a broken system

when what we should be doing

is spending all of that money
and time fixing that system.

- What care ideally
should look like

is that the woman who
comes in to have her baby

is asked questions around
what is important to her

and what those things are
that she's really looking for

along the journey of her birth.

Where we're respectful,

if somebody's
having a contraction

to stop talking and to
support her through that

rather than being focused
in our computer systems.

Where we are high
touch and low tech,

where every woman's
birth has a goal

of being as low
intervention as possible

and not as managed.

And culture change
is where hospitals

can make the greatest impact.

But society has just as great
a role in how we portray birth

before somebody ever
comes into that system.

- I stopped doing
obstetrics last December,

which still is sad for me.

I came to that decision

because I just
couldn't any longer

practice in a place where
women's goals were so dismissed.

The chairman of our department

actually said that they
were going to have protocols

and all ladies would get the
same care no matter what.

And so the chance to
individualize care
for a given patient

went out the window.

And I couldn't, in
good conscience,

take patients, who,
over the years,

had entrusted me to
be their advocate

and to make medical decisions
for them, knowing them,

to have to give up not
so much my autonomy,

but their autonomy
was too heartbreaking.

It wasn't what I went
to medical school to do.

- When you get a
medical education,

you are apprenticed
in some of the basics

and presumably, over the
course of your career,

you're going to keep
learning and advancing

and as the field changes,
you keep along with it.

You get trained to
practice in a certain way

and you get a
certain familiarity

with clinical scenarios
that are common.

And you basically learn this
is how I treat scenario A

and this is how I
treat scenario B.

To practice in a way
that is different

in the way that you are trained

or different in a way
that you are familiar with

becomes very uncomfortable

because you're not
necessarily used to

or familiar with
what's going to happen

if I don't do these things.

And our position as
obstetricians is going to be

well, that's too bad.

You're just going to
have to figure out a way

to survive it and
get through it.

This is the only thing
that we can offer you.

I just came to feel
that we had taken

a wrong turn somewhere,

and how did our
specialty get to a place

where the experts in childbirth
cannot deliver a baby?

and how did our
specialty get to a (soft dr)

- [Paula] How do the rest of
us learn about childbirth?

(baby crying)

(people chattering indistinctly)

- All right.

Well, I'm going to set
up a quick sonogram

and see if we can find
out about the baby.

It looks like we will be
having a happy, healthy baby.

First thing I'm going to do

is I'm going to
give mother cabbage

a large dose of imagicillin.

Now this does not
hurt nor harm her,

just loosens her leaves and
helps for an easier delivery.

And the next thing
I'm going to do

is I'm going to
check to make sure

she's exactly 10 leaves apart.

She's going to need your help

with a quick breathing exercise

to help her relax a little,

so I'm gonna need you
all to breathe in.

(people inhaling)

And out.
(people exhaling)

And in.
(people inhaling)

And out.
(people exhaling)

All right.

Now she is ready to push,

but she's going to need
your help one more time.

So, on the count of three,

can I get you all to
push as loud as you can.

One, two, three.

- [All] Push!

- [Instructor] All right.

One more time, just
a little bit louder.

One, two, three.

- [All] Push!

- [Child] Oh, he's so cute.

- [Instructor] Here's
our lilele boy.

- [Audience Member] Yay.

- [Instructor] So, I'm
just going to wrap him up,

and tell you a couple
of things about him.

- [Child] So cute.

(soft eerie music)

(insects buzzing)

- [Pamela] When your
body goes into labor,

you have a hormone, oxytocin.

In labor, it rises
and rises and rises.

And at the time
you have the baby,

you have the most
amount of oxytocin

going through your system of
any other time in your life.

And that oxytocin
is a pain killer.

- [Paula] It's not just a
better understanding of birth

for those having
babies that's needed.

Partners are also a vital
part of the process, too.

(child crying)

- [Charles] Let me see.

Which one? Which one is it?

- [Child] This one.

- [Charles] Which
one is it? This one?

- [Child] Yes.

- [Charles] Let me see.
You need a new finger?

- [Child] Yes.

- [Charles] All right.
Let me check my pocket.

What's tonight, guys?

- Taco.
- Taco what?

(child mumbles)

- [Charles] Taco Tuesday.

- [Friend] You
want some tomatoes?

- [Child] Oh.

We had this with... (mumbles)

- [Friend] You did. Do
you want the tomatoes?

- [Charles] This
is a table I had.

This is actually, before we met,

this is like the table
that Kira and I had.

- Yes.
- In the place here, so...

For weeks, we moved in,
and so she'd walk in,

I'd be sitting at this
table, like eating,

like, a grown man who's
like, all the time, like...

- That's amazing.

- Langston is in, what
I call the toaster,

the little incubator,
just taking a nap.

Kira is resting in her bed.

As I look down, I begin
to see the catheter

at Kira's bedside begin
to fill with blood.

And I was, I was
alarmed, frankly,

and I brought it
to the attention

of the staff and the nurses.

And they came in,
they assessed Kira.

They ordered a series of tests,

including blood work
and an ultrasound

and also very importantly,

a CT scan they were
supposed to perform stat.

I'm concerned, but I'm thinking,

"You know what?

My wife is healthy.

My baby's healthy, and
we're at Cedars-Sinai."

The blood work comes
back, it's abnormal.

It's showing that all of her
blood levels are dropping.

When they do the ultrasound,

they can see that her abdomen

is beginning to fill with fluid.

So, keep in mind, this
is shortly after 4:00.

The doctor comes
in, he looks at her,

feels around her stomach.

She's in intense
pain, and he says,

"We'll just see what happens."

Right? And walks
back out of the room.

And I'm asking, "Well,
where's the CT scan?"

They're telling me,
"It's coming, it's
coming, it's coming."

7:00 comes. By this time,
Kira's shivering uncontrollably.

She's beginning to
become very pale.

They do another ultrasound,

they see that there's even
more blood in her abdomen,

and I'm asking still,
"Where is the CT scan?"

And at which point a
staff member tells me,

"Sir, your wife just isn't
a priority right now.

Your wife just isn't
a priority right now."

9:00 comes, 10:00 comes.

No CT scan. Kira's condition
is continuing to deteriorate.

And they said, "So, we need to
give her a blood transfusion

so that we can keep her stable."

And I'm saying,
"Keep her stable?"

Just a couple of minutes ago,

somebody tol tme that
she wasn't a priority.

What are you talking
about, "Keep her stable?"

Hours continued to go by.

10:00 comes, 11:00 comes.

It wasn't until after midnight

that they finally took
Kira back to surgery.

I'm angry, I'm frustrated,
but I'm thinking,

"Finally, they're
going to do something.

They're going to do something.

They're going to fix it."

(machine beeping)

On the way to the operating
room, I'm holding her hand,

and she's saying,
"Baby, I'm scared."

And if you know Kira, there
was not a lot that scared Kira.

We're talking about a
woman that raced cars,

who ran marathons, who
was an avid skydiver.

But she's holding my hand, she's
saying, "Baby, I'm scared."

And the doctor says,
"It's no big deal."

He says, "I'm going to go back
in through the same incision

that I made earlier when
I did the ceasarean.

I'm going to find
out what's going on

and I'm going to fix it."

He told me that she would
be back in 15 minutes.

(melancholy music)

After they took Kira back
to the operating room,

they took me out
to a waiting room,

the same waiting room we
had entered that hospital in

at 1:30 that afternoon.

And at 1:30 in the afternoon,

that room was full of life.

It was full of
mothers and balloons

and families that were excited

to welcome these precious
gifts and these new babies.

And they put me in that
waiting room and it was empty.

All I could hear was
the janitor's vacuum.

My eyes are fixed on
this set of double doors

because I know when somebody
comes to give me some news,

they're going to come through
that set of double doors.

Finally, those doors open,

a set of residents
walk towards me

and they say, "Mr. Johnson,
we need you to have a seat."

So, I sit down and they tell me,

"Mr. Johnson, we couldn't
be back there any longer

without letting you
know what's going on.

When he made the
incision to open her up,

there was a lot of
blood and Kira coded."

And I'm saying, "What?"

She coded, but her
situation is critical

and they're continuing
to work on her.

There was hope. They
were working on her.

And in my mind, I
honestly, at that point,

I thought that she was
gonna be okay, right?

Because you're working on her.

And this is Kira,
right? She's...

She's amazing.

That set of doors open again
and those same two residents,

along with a doctor that
I'd never seen before, came.

They told us that Kira had died

and there was nothing that
they could do to save her.

♪ My darling time
to shut your eyes ♪

♪ And leave the day
behind and slumber ♪

♪ Tomorrow waits for you rise

♪ So rest your weary head
and dream of wonder ♪

♪ It's not goodbye,
it's just good night ♪

(gentle music)

♪ I'll meet you on
the other side ♪

- [Charles] When they took
Kira back into surgery,

and that doctor opened her up,

there were 3.5 liters
of blood in her abdomen

and her heart
stopped immediately.

♪ So much to tell you

♪ So much I want to show you

♪ I'll always be right here
beside you to hold you ♪

♪ It's not goodbye,
it's just goodnight ♪

♪ It's not goodbye,
it's just goodnight ♪

- Yay, give me hugs.

Oh, I love you,
sweetness. You're my baby.

Mwah.

I love you. Mwah.

- A woman like Kira,

a woman that's
perfectly healthy,

having access to care,
who has a healthy child,

who didn't have a
high-risk pregnancy,

walking into a hospital like
Cedars-Sinai Medical Center,

and not walking out to
raise her precious sons,

I thought that she
was an anomaly.

(singer vocalizing)
(birds chirping)

(birds chirping)

- [Paula] I wondered
if those in power

were starting to hear the voices

of those who felt so powerless.

- I'm here first and foremost

as not just a man and a husband,

but a dad to a
beautiful, healthy

little five-and-a-half-
year-old girl

that is missing the most
important thing in the world

for every little girl,
and that's a mom.

My wife took her life 41 days
after my daughter was born.

No where on that
death certificate

was a box checked that he
had given birth to a baby.

There's two words: hanged
and hanged herself.

My daughter has to look
at that death certificate.

I'm running out of stories to
tell her about what happened.

The reality of the matter
is I'm scared to death

she's gonna blame herself.

But it's not her fault and
it wasn't her mother's fault.

It's the system's fault.

It's healthcare's fault.

My wife did not
suffer in silence.

She was extremely vocal about
what was going to happen.

We went to seven
different hospitals

and different facilities in
the last 13 days of her life,

each one turning her away
for one reason or another.

All the doctors she talked to,

the answer every time was
the same and never changed.

"You're fine.

You're not crazy.

You don't belong with them.

Just go home and be with
your friends and family.

This will pass."

Postpartum depression is twice
as common as breast cancer.

Now, imagine that.

Imagine you just get
diagnosed with breast cancer,

you walk into a
hospital and they say,

"I'm sorry.

We don't offer
services for that.

Just go home. You'll be fine."

It's too late for my wife,

but it's not too
late for my daughter.

We have an opportunity

to make sure that my
daughter's generation,

that women after my wife,

get the care they need,
the care they deserve.

And I always emphasize
all the time,

it is not a women's
health issue,

it is a family health issue.

If mom is not okay,
everybody suffers.

(melancholy music)

- [Paula] Postpartum depression
is not a small problem,

yet far too many
suffer in silence.

Not only are mothers
not being heard,

but also there's this guilt

if you say you're struggling,
that you're a bad mom.

- I think you're starting
to see men step up

and talk about it,
and we have to.

I cannot imagine going
through that period

with a new addition to our
family without my wife there.

I can't imagine it for me.

Obviously, your entire
life would be upended.

I can't imagine it for our
three-year-old little daughter

or our one-year little boy.

I can't imagine the
stories that I have heard

from husbands and dads that
have told their own stories.

What compels me to try
to speak up about this

is to know that we can
do something about it.

- [Paula] But is anyone in
Congress doing anything?

- We're 47th in the developed
world for maternal mortality

and it's getting worse.

So, then, the next
question is why?

Like, why are we the 47th
and why is it getting worse?

And why are some states
even worse than others?

You know, if you're an African
American woman in New Jersey,

I admit almost, to
them, where it's like,

should we try and let
them have birth elsewhere?

It's mind blowing, in
21st century America

that that's happening.

So, these groups started saying,

"Well, we can't answer
the question fully.

"We need maternal
mortality review committees

in every state.

We have to investigate
every death."

- [Paula] In a moment
when it feels like

we're unable to agree on
anything as a country,

two mothers from either side
of the aisle said, "Enough."

- [Jaime] We pushed
and pushed and pushed

many different angles.

The coalition, Charles was
willing to tell his story.

- I just started
lobbying for it.

I sttearted writing letters.

I started making phone calls.

I started making visits
to Washington, D.C.

Taking meetings with anybody
that would meet with me.

Trying to tell Kira's story,

trying to get
people's attention.

I'm not asking at this point.

I stopped asking
a long time ago.

When I go into these offices,

I'm respectfully
demanding their support.

I'm respectfully
demanding that this bill

go to the floor for a vote.

Because there's two types
of people in our country,

either you are a
mama or you have one.

Poured my heart out to Congress.

People on both sides of
the aisle are in tears.

For those that choose to stand
in opposition to this bill,

you don't owe me an explanation,

you owe an explanation
to my boys.

You owe Tara Hanson's
son an explanation.

(melancholy music)

It passed with flying colors,

unanimous support in the House.

It passed to the Senate.

And so H.R.1318 is a law.

- Because I've been at
the table doing policy

while I've gone through
challenging pregnancies

or typical pregnancies,

or now, we're doing this
with a midwife, right,

so get a little
bit of everything.

I think it adds to
my perspective when
I'm making policy.

So, I bring that to the
table, and we need it.

I guess part of the problem

is maybe there haven't
been as many people,

I don't know, giving
birth while in Congress?

- [Paula] Well, it's
certainly an issue

that some of our lawmakers
are less shy about discussing.

Lawmakers like Tammy Duckworth,

a senator, a veteran
who lost both her legs

while deployed in Iraq
and a working mom of two.

- And exerting even more
control over women's bodies.

It's sexist, regressive
and flat out dangerous.

But even while this
administration's
agenda is a travesty,

it's not an anomaly.

Rather, it's just
the latest step

in the far right's long march
to strip away women's rights.

And I'm tired of it.

Sick of them trying
to shame women

when they are the ones
who should be ashamed.

So, enough with hypocrisy,
with the misogyny,

with some men in
hallowed halls in D.C.

arguing that they know
better than moms in Illinois,

or Arizona or Missouri.

We can and we must do better.

That means fighting for
everything from equal pay

to better parental leave.

It means proving that
we care about women

every day of the year, not
just on one Sunday in May.

That's the least
that our mothers

and daughters and
sisters deserve.

Thank you.

The rising maternal mortality
rate in the United States

is really an issue of disparity.

And it becomes an issue
of disparity of resources.

And I think that the push
to go after organizations

like Planned Parenthood,
the abortion debate,

the choice debate has
really allowed those folks

who are very extreme
on the far right

to stop the funding
stream that goes

to a lot of these
healthcare practices

that really serve
underprivileged and
lower income women,

and that's really causing
the rates to spike.

- [Paula] It's reported
that nearly a quarter

of rural hospitals are
on the brink of closure.

Being 90 miles from
your nearest ER

can't be good for
anyone's health.

- [Reporter] Data used
by the LeapFrog group

ranked the Lehigh Regional
Medical Center at the bottom,

an F for patient safety.

- [Reporter] Georgia
mothers are dying.

Our state ranks last when it
comes to maternal mortality.

- [Paula] And even if
your hospital stays open,

unfortunately, the lower
your neighborhood income,

the less likely your hospital is

to have a good safety grade,

as resources are strained
and staff are overworked

and under supported.

- I've had a long
journey to motherhood.

It took me 10 years
of infertility

to try to have my children.

I know how precious
they are to me.

And so it really is something

that I can't imagine a child
growing up without her mother

because her mom
died in childbirth.

I can't imagine that
we, as the richest,

most powerful nation on the
Earth, can't solve this problem.

I can't imagine that
continue to take back control?e

The more I connected grassroots
workers in maternal health,

the more I saw how hard it
was for them to be heard

beyond those who already
knew we have a problem.

In answer to this
is Mom Congress,

a group of mothers,
fathers and birth workers

who came from every
state in the nation

to collectively take
a series of bills

to their representatives.

- I think that's really
all of our goals.

And if we want to highlight
specific disparities

and things like that, we
can absolutely do that.

- [Speaker] I think we have to.

Because the majority
of, you know,

when we have 78.3,
78% of, you know,

people of color, then
that's the issue.

- [Paula] Well, it's all the
symptom of the same thing.

They aren't listening to women.

And they're deaf to Black women.

- When it comes to
women in general,

we're just not
being listened to,

we're not being heard.

Our children are not being heard

and not being taught about
themselves, about their bodies,

and we're not being educated.

So, then, you grow
up to be an adult

who then becomes pregnant,

and we don't think about
pregnancy until then.

- [Speaker] Right.

- All right, so let's bounce,

let's get through security,
and let's get this done.

(group members chattering)

- [Group Member 1] Some of us,

some of the moms are not here.

- Too many moms, right?
- Three moms are not here.

- [Group Member
1] And that's why

we're here today.

(group members chattering)

(people chattering indistinctly)

- [Paula] Imagine if, and
just hear me out here,

two men died every
day in America

as a result of reproduction.

If their contributions
to the birthing process

were a game of Russian roulette,

would we stop having sex
without medical help?

Would we tell them, "Well,
you know it's a risk

if you choose to
become a daddy?"

Would we brush these
stories under the rug

and chalk them up
to the original sin?

Well, if the industry
that created Viagra

was anything to go by,

I'd say that's a probable no.

(crowd chanting indistinctly)

And what about feminism?

Why is that a complicated word?

- [Interviewer] How do you
make sure that younger people

feel like they can
embrace the word feminist?

- Send them to the
dictionary because, if-

(people laughing)

No, seriously, because
it has been demonized

by Rush Limbaugh and company
into feminazi and man hating.

There are synonyms.

We don't have to all
use the same word.

There's mujerista, womanism,

women's liberation, girrrls
with two or three Rs,

which I love, I
think that's great.

- [Paula] Mother?

I wonder why I'm not
seeing my feminist allies

show up for the
maternal health crisis.

- I think that motherhood

is the most extreme
expression of femininity,

and so it is challenged.

When we talk about motherhood,

we're talking about both
I think of a relationship

that a parent has with a child

and the act of
birthing children.

But really, we're
talking about how women

are symbolized in society

or rather that women have
value when it's based

upon the life of someone else.

- [Speaker] Sex and race,
because they are easy,

visible differences have
been the primary ways

of organizing human
beings into superior

and inferior groups

and into the cheap labor on
which this system still depends.

We are talking about a society

in which there will be no roles

other than those
chosen or those earned.

We are really talking
about humanism.

- [Paula] And if you're
shocked to discover

that women don't have equal
rights under the Constitution,

you're not alone.

(singer vocalizing)

- [Paula] When I first
heard about the work

of National Advocates
for Pregnant Women,

I was like, "How are
these cases even real?"

But on talking to their
founder, Lynn Paltrow,

I discovered the need
for legal support

for pregnant women was
terrifyingly important.

- We really want to ensure

that pregnant people
are recognized

as having their own personhood

and are fully included
in the US Constitution.

We live in a country
that has a constitution

and it's been interpreted
to protect the right

to bodily integrity and
medical decision making.

And these are decisions
that appear to be,

and apply to all people.

But the more cases we deal with,

the more apparent it becomes

that people think
of pregnant women

as a separate and
unequal class of persons

who really have
no rights at all.

- I never thought
I could be arrested

for experiencing a tragedy.

I lost my daughter and then
I was prosecuted for it.

- A pregnant woman
shot in the stomach,

now facing possible
manslaughter charges

for the death of her fetus.

The shooter not
charged in this case.

Critics calling it a cruel
and dangerous new step

by the state to
criminalize pregnancy.

- [Reporter] Marshae Jones'
arrest came some six months

after the 28-year-old,

who was five months
pregnant at the time,

was shot in the stomach.

According to the
grand jury indictment,

Jones intentionally
caused the death

of her unborn baby
by initiating a fight

knowing she was five
months pregnant,

concluding it was caused in
a sudden heat of passion.

- [Paula] Yes,
this is real life,

not a made- for-TV horror movie.

And even if a criminal
complaint could be complex,

what about a medical one?

- A young mother of three is
suing a New York hospital.

She claimed she was given

a cesarean section
against her will.

- [Reporter]
35-year-old Rinat Dray

is the mother of three boys.

Her first two were delivered
by cesarean section,

which involved
difficult recoveries.

- Then he said,
"It doesn't matter

that there's good progress.

"I don't think it's
going to be natural.

I don't have the
whole day for you."

I was begging all the way,

"Don't do it.

I feel my baby.
Everything's fine.

Don't do it. Don't do it."

His answer was
just, "Don't speak."

- She didn't say, "I
refuse to have one."

If you tell me, give
me any information

that my baby's really in
jeopardy, I'd agree to it.

But I'm not seeing anything
from anything you're telling me,

the doula isn't seeing anything

that says I need to
have it right now.

Unbeknownst to Rinat, the
hospital had a written policy,

not just the practice,

that authorized doctors
to perform surgery

without a woman's consent.

In fact, over her
explicit, clear refusal

if they believe that the
fetus' life was in jeopardy.

And the next thing she knew,

Rinat Dray was wheeled in,

forced to undergo
cesarean surgery,

and in the process, they
damaged her bladder.

The defense of what they did,

cutting this woman open
over explicit refusal,

and, I should add, that
they were so confident

in their right to
deny an adult woman

of her medical decision making,

that they wrote
in her records...

- [Reporter] "I have decided
to override her refusal

to have a C-section."

- And the hospital's claims,

their absolutely vigorous
defense of what they did to her,

over and over says, well yes,

there is a Patient Bill
of Rights in New York

that requires us to inform
patients of all of our policies,

including the maternal refusal,

we get to cut you open
without your consent policy,

but it doesn't specifically
include pregnant women.

Their position was pregnant
women aren't protected

by the New York
State Bill of Rights.

Their position is women

aren't protected by
the Constitution.

They're not protected
by common law rights.

That by becoming pregnant,

a woman takes on the obligation

to do whatever is in the
best interests of the fetus,

as determined by doctors,
judges, anybody but her.

There are definitely
many powerful people

who believe that
undergoing major surgery

that is a risk to your health,

is just the burden women bear
because they are pregnant.

We really have not
accepted the idea

that healthcare is a
human right for everyone,

including the people
who can get pregnant,

and that maternal and
reproductive rights

aren't separate, special rights,

but they are what half of
all the human beings need

in order for their survival,

and what all human beings need

for the survival of the species.

- Most of our laws
around abortion

are kind of understood through
the lens of Roe v. Wade.

When you read the
Supreme Court decision,

it actually is less
naming women's ability

to have access to abortion,

and more saying that
a woman has the right

to determine when and whether
to continue a pregnancy.

So, it's as much
giving women autonomy

over choosing motherhood

as it is choosing when
not to be mothers.

- There are many people
who are fundamentally

genuinely opposed to abortion

for religious, moral,
ethical reasons,

who have not thought through
what the consequences

of their position is
if it becomes law.

Because if it is illegal
to have an abortion,

then the woman who
wants a home birth,

but somebody thinks it
endangers the life of the fetus,

is committing a crime.

The woman who refuses
cesarean surgery

is no better than
the murdering woman

choosing to end her pregnancy
early through an abortion.

The woman who chooses
to continue working

so she can have healthcare

to support the children she'll
have, and her prenatal care,

could be endangering the
life of her unborn child.

It is about taking
away every right

we associate with personhood

from the people who
can get pregnant.

- In the United
States, pregnancy,

the only coverage
you get for pregnancy

in a workplace situation
is a disability.

You become a little bit
of a second class citizen.

You're not fully capable
of executing things.

That's an example of
a lot of the language

used around birth and
parenting and pregnancy.

It's a little manipulative,

and I think it's meant
to sort of keep people

in a not so much fearful state,

but in a dependent state.

A dependent state upon
a medical institution

that knows what's
right for women.

You also become
free public domain.

I mean, any pregnant woman
talks about how all of a sudden

everybody can come up
and touch your belly.

People can have comments
about what you're eating

and can comment on
what you're drinking

and what you're doing, and
you shouldn't be lifting that.

All of a sudden, your personhood
is up to public scrutiny.

You think that mothers have
full choice over their lives,

and they don't.

- Equal rights.

Equal rights to have a
job, to have respect,

and not be viewed
as a piece of meat.

- We get distracted by abortion

because we think of it
as needing our support

more than mothers
need our support.

But if you look at, you
know, a slew of laws

that have come out in
the last several decades,

they've been very subtle,

but they've essentially
taken the rights of mothers

out of mothers' control.

(melancholy music)

- There are many women
who are just ignored

every day in society,

and they tend to be Black
women and poor women,

and we just sort of don't
see their experience.

And so, I think
when we talk about

the treatment of pregnant women,

we're often talking about
the treatment of, sort of,

white privileged people,

and what's different is that
that community of people

is used to not being scrutinized

as much as other populations.

- [Paula] Remember those closed
door conversations in D.C.?

Well, one thing came
up again and again.

- [Speaker 1] I think it's
important to understand

where these numbers
are coming from,

are really a part
of systemic racism.

And if you don't admit that,

then we're never
going to be able

to change any of these numbers.

We can talk about them, we
can be aghast about them, but-

- [Speaker 2] You
have to acknowledge-

- [Speaker 1] We
have to acknowledge

the source of the problem.

(gentle music)

- [Paula] Although
many communities

are marginalized in
many different ways,

there's something
disproportionately going wrong

for Black and Native women
when it comes to childbirth.

- African American women are
facing maternal mortality

in such a desperate way
because racism is real.

The system of white
supremacy is real,

and it permeates every
sector of our lives.

And so we can't think that the
medical industrial complex,

it doesn't affect that as well.

And so we have to
know that when folks

are walking into their
doctor's offices,

when folks are
going in for care,

going in to ask questions,

going in to get what
they need for themselves,

their families, that
racism, unfortunately,

meets a lot of
folks at the door.

- [Paula] Monica came to her
place in reproductive justice

through civil rights work.

She's also a doula
and uniquely placed

to talk about the
intersecting needs

of Black mothers in the South.

- It is astonishing that
we are not understanding

the history that is
connected to this issue.

And sometimes, we see that
as a side issue and it's not.

- For several weeks now,

we, the Negro citizens
of Montgomery,

have been involved in
a nonviolent protest

against the injustices
which we have experienced

on the buses for
a number of years.

- [Crowd] Black lives matter!

Black lives matter!

- Hands up!
- Don't shoot!

- Hands up!
- Don't shoot!

- Hands up!
- Don't shoot!

- Hands up!
- Don't shoot!

- [Crowd] No justice, no peace!

No justice, no peace!

No justice, no peace!

No justice, no peace!

- It's all connected.

And if we're not
understanding that Black women

are still at the bottom
of the economic scale,

if we're not understanding

that there is a
deep, deep history,

especially in the
southern region,

we can't be surprised
that, unfortunately,

rates of maternal mortality

are gonna continue to increase,

and that we're going to see
disparities continue to rise.

- When we think about the
history of the United States

and people of color
in the United States,

the medical model of care

was never created to
treat people of color.

It wasn't.

If you think about
the enslavement

of African people
and the emancipation,

now you have people
who are "free."

Now you have Jim Crow laws.

So, now, everything is separate.

Sometimes you didn't
even have access

to get into the hospital.

This conversation now
around maternal mortality,

Black people have been dying.

Black women and children
have been dying since,

I mean, I started
this work in 2008,

and the premise of this work
was on the foundation of

wow, Black women and
children are dying.

- [Lynn] In America, Black
women are three to four times

more likely to die due to
pregnancy- related causes

than white women.

And in New York City,

they are 12 times
more likely to die.

- [Paula] Chanel
runs Ancient Song,

a community doula
service in Brooklyn.

She is also an educator
leading the charge

on how to combat racial
biases in the medical system.

And probably needs
her own TV show.

- What we continue
to see perpetuated

within the medical model
of care is this structure

that is based on racial ideals

or perceptions of
racial identity

for Black and brown people
that are false concepts.

- [Reporter] The American
College of Obstetricians

and Gynecologists
acknowledge that,

"The racial and ethnic
disparities in women's health,

including high
rates of preterm birth

and maternal mortality,

cannot be reversed without
addressing racial bias,

both implicit and explicit."

- [Paula] Bias by
nature is complex.

But basically, explicit
bias is conscious,

like thinking you're
better than someone

because of the color
of their skin or sex.

But implicit bias is mostly
subconscious and not as obvious,

like assuming the doctor you're
about to see will be a man.

There are many assumptions,
both explicit and implicit,

about why people are more likely

to die in childbirth
than others.

- Even after we do the
adjustments for income,

for education, this is
true across the board.

This is true for well-educated
African American women,

for wealthy African
American women,

and the best studies
that I've seen

put it down to just
one thing: prejudice.

- Today, a wealthy, well
educated African American woman,

one with a college degree,

is still more likely to
die during childbirth

or to have her baby die,

than a poor white woman

who does not have a
high school diploma.

And you can't explain
that by location,

you can't explain
that by education,

you can't explain
that by income,

you can't explain
that by wealth.

You can't explain that
other than by acknowledging

the fact that there
are still vast

and deep racial disparities
in our healthcare system

and across our country.

- Doctors, or people in general,

just don't believe that
Black people suffer,

or we're strong enough
to take the pain.

- [Reporter] Several studies,

including from the
University of Pennsylvania

and in The New England
Journal of Medicine,

found that Black patients

with the same
symptoms as white ones

receive less pain medication

and are referred to
specialists less often.

In a national survey
of over 2,000 women,

21% of Black mothers
reported poor treatment

from hospital staff,

which they attributed
to race, ethnicity,

cultural background or language.

Just 8% of white mothers
reported similar poor treatment.

- My wife was not
here to raise her sons

because of the
color of her skin.

One of the things that I
struggle with all the time is,

what else could I have done?

What could I have
done differently?

What could I have done more of?

Maybe if I had grabbed
the doctor by his collar,

maybe if I had gotten irate,

maybe if I had
turned over a table,

maybe if I had made a scene,

maybe they would have
taken Kira more seriously,

maybe they would have
moved with more urgency.

But in the moment,
I was thinking,

"I'm a Black man
at this hospital

and I have to stay under control

because I don't want to
be seen as a threat."

Because if I'm seen as a threat,

and I get removed
from the hospital,

then who's advocating
for my wife?"

- Interesting thing about
white supremacy and capitalism,

it's not this one answer, right?

It's so intricate.

It's so deeply
thought out in detail.

Put the light skin
against the dark skin.

Put the old against the young.

Put the men against the women.

- You know, I have two
sons, I have four daughters,

and I have to consistently worry

about how the world sees them

and their perception
of a young Black man

or their perception
of young Black women.

You know, when you
become pregnant,

you shouldn't have
to think about that.

Your choice shouldn't
have to be based on

do I want to have a
child and think about,

well, you know, right
now, they're cute,

and you see them as cute
'cause they're a baby.

But when they're 10-years-old,
they're a threat.

And I'm tired of just living
in a mode of survival.

Like we now are
at a point of, no,

we need to thrive, you know?

And that is only
going to come with,

with people, with allies,

with individuals
purposely stepping aside

or either stepping up and saying

we need to open these doors.

We need to change
these frameworks.

We need to deconstruct
these ideals

and our perceptions of
one another based on,

you know, these
socialized ideals

to see one person
above the other.

Because at the end of the
day, we all bleed the same.

At the end of the day, we
all live and we all die.

And all people ever
really want to do is just,

you want to know that
you can live in a place

where you feel free.

(soft dramatic orchestral music)

- [Paula] Given that things
are continuing to get worse,

I felt like we just couldn't
sit back and do nothing.

So, I wondered if we
could fight the system

of a lack of education and fear
by changing the conversation

the American way:
with advertising.

So, I approached Ad Age's
2019 Agency of the Year,

Mother, to ask them
why they thought birth

was so badly
branded in a country

where it was a
commercial enterprise.

As non-mothers, we feel like
they know a lot about the word.

What do you think about that?

(all laughing)

- When I was pregnant,
my mom said, I quote,

"They cut me from hole to hole."

- [Chanel] What?

- So, that was, like, made me
so excited about giving birth.

- I don't know if I want
to have kids or not,

but I was like, there's no way

I would survive a
birth like that.

And I didn't have that recently.

I had that thought
when I was younger.

I don't know where
that came from,

but I was like, "There's no way.

That looks crazy."

- How do we change
that conversation,

that every time
you speak about it,

doesn't mean I'm about
to become pregnant,

or something disgusting
is going to happen,

or men don't, suddenly, they
just like shrink, you know?

I'm like how do we change that?

How can we have a normal
dialogue about it as mothers,

non-mothers, as human
beings in society?

It's really hard to
advocate for mothers.

You know, it's hard to
get brands onboard for it

because it's not exciting.

It doesn't feel contemporary.

They're like, "Mothers, you
guys have been around a while."

You know?
(all laughing)

You're not a new thing.

- [Chanel] They're
gonna go out of style.

- So, that's also
the big challenge,

how do we make this
feel fresh for people

and something that they
should be revisiting?

- Women should be entitled

to have whatever type
of birth they want,

but it's harder to kind of
know what those resources are

from the industry standpoint,

but also when the
cultural ecosystem

and narrative ecosystem
is so narrow minded

and scary for women.

And when you create
that cultural fear,

you're more likely to
just relinquish control.

You walk into the
hospital, you're like,

"Put me under.

Give me the epidural.

I don't care what you do,

I just want this to be over."

Which, like, is not how
anyone, I don't know,

that's not what birth should be.

Birth is an amazing thing.

- We just put big
bold billboards of

"We have hope,"

and people are like,
"Is this a cult?"

(all laughing)

Like, "No. Pregnancy."

You have to have hope
for your children,

you have to have
hope for yourself.

You know, it's an act
of hope in itself,

to bring another
person into the world.

- And to want to see them...

You know, I know for
me, doing this work,

I want to see my children
be able to live in a world

where they are seen and
they can have hope, too.

They can have some kind
of foundation that,

yeah, sees the humanity.

Where we see the humanity
in each other, right?

And it just resonates
in such a way where,

I don't know, maybe I'm
being idealistic and utopic,

but, you know, that
just can bring pure joy

to someone's life on
a consistent basis.

Because when you look
in children's eyes

and you see the level of just
purity that comes across,

it's like why wouldn't
you treat the vessel

that produced that
with the same level of,

of sanctity that it deserves?

If you can see how
joyful children are,

and it's that sheer, like,
pure, unconditional love,

why wouldn't you want the person

that is going to be carrying
that to have that same thing?

(gentle orchestral music)