Inside the fight to slash the maternal mortality rate in the South | 60 Minutes

60 Minutes
1 May 202313:16
EducationalLearning
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TLDRThe United States, particularly the state of Louisiana, is facing a severe maternal health crisis with one of the highest rates of maternal death in the developed world. Women in the U.S. are twice as likely to die from pregnancy complications than a generation ago, and racial disparities exacerbate the issue, with Black and Brown women facing even higher risks. Louisiana's maternal health deserts, where access to OB-GYNs is scarce, and the recent abortion ban have further complicated care, leading to fear among healthcare providers and potentially avoidable deaths. Advocates and healthcare professionals are calling for systemic changes to prioritize maternal health, including improved access to care, addressing racial biases, and ensuring comprehensive postpartum support.

Takeaways
  • 📉 The United States is experiencing a maternal health crisis with maternal mortality rates higher than in the past generation.
  • 🏥 The U.S. has one of the highest rates of maternal death among developed countries, particularly in states like Louisiana.
  • 📚 Statistics from the World Health Organization indicate a significant disparity in maternal health outcomes in the U.S. compared to other nations.
  • 😔 Factors contributing to poor maternal health include high C-section rates, lack of access to pre- and post-pregnancy care, and untreated health conditions postpartum.
  • 🌐 Racial bias in healthcare exacerbates these issues, especially for low-income women.
  • 🔍 Dr. Rebecca Gee, an OB/GYN and former Louisiana Secretary of Health, has been a vocal advocate for better maternal care.
  • 🚑 There is a shortage of OB/GYNs in Louisiana, with a third of parishes being maternal health deserts, leading to limited access to care.
  • 🤰 Black and brown women in Louisiana are four times more likely to die during or after childbirth compared to white women.
  • 🤱 Doulas, like those from the Birthmark Doula Collective, provide essential support to marginalized families, particularly black and brown mothers.
  • 📉 The overturning of Roe vs. Wade and subsequent abortion bans have had a domino effect on maternal health care, causing fear among physicians and reducing access to necessary care.
  • 🚫 The vagueness of Louisiana's abortion ban has led to physicians being hesitant to provide standard miscarriage treatments due to legal concerns.
  • 🛡️ Doctors face a difficult choice between providing the best care for their patients and risking legal repercussions, which can include imprisonment.
Q & A

  • What is the current state of maternal health in the United States?

    -The United States is experiencing a maternal health crisis, with women in the U.S. being twice as likely to die from pregnancy complications than their mothers were a generation ago. The U.S. has one of the highest rates of maternal death in the developed world.

  • Why is Louisiana considered to have the worst maternal health outcomes in the U.S.?

    -Louisiana has the highest maternal mortality rate in the U.S. due to factors such as high C-section rates, lack of access to well-woman care before and after pregnancies, untreated chronic conditions like hypertension and diabetes, and racial bias in healthcare, which disproportionately affects low-income women.

  • What is a 'maternal health desert' and how does it impact women in Louisiana?

    -A maternal health desert is a region where there is a lack of access to obstetric care, meaning there are no OB/GYNs available. In Louisiana, a third of parishes are considered maternal health deserts, leaving over 51,000 women without easy access to care and making them three times more likely to die of pregnancy-related causes.

  • How has the recent abortion ban in Louisiana affected maternal healthcare?

    -The abortion ban has created a domino effect, causing fear among physicians who are now hesitant to offer treatments for miscarriages, as these treatments could be misconstrued as abortion methods and lead to legal repercussions, including imprisonment.

  • What are the potential consequences for doctors who violate Louisiana's new abortion law?

    -Doctors who violate the new abortion law in Louisiana could face criminal penalties ranging from at least one year to up to 10 years of imprisonment with hard labor, in addition to losing their medical license.

  • What is the role of a doula in maternal healthcare, as exemplified by the Birthmark Doula Collective?

    -Doulas, like those in the Birthmark Doula Collective, provide emotional and physical support to mothers before, during, and after childbirth. They work with marginalized families who are most at risk for poor birth outcomes, prioritizing black and brown families with low incomes.

  • Why is access to healthcare a significant issue for many women in Louisiana?

    -Access to healthcare is a significant issue due to the scarcity of medical professionals, particularly in rural areas. For example, some women have to travel over an hour to reach the nearest OB/GYN, which can be physically and emotionally taxing, especially in cases of emergency.

  • What is the statistic regarding maternal deaths in Louisiana that Dr. Rebecca Gee found particularly upsetting?

    -Dr. Rebecca Gee found it particularly upsetting that data showed 80 percent of maternal deaths in Louisiana were potentially preventable.

  • How does the lack of insurance coverage and healthcare disparities affect black and brown women in the U.S.?

    -Black and brown women are more likely to be on Medicaid, which often leads to discriminatory care and busier practices that take on more patients. This lack of personalized care and the systemic disparities contribute to poorer health outcomes, including higher maternal mortality rates.

  • What is the connection between maternal health care, reproductive justice, and abortion care?

    -Maternal health care, reproductive justice, and abortion care are interconnected. Understanding this intersectionality is crucial for improving maternal health outcomes. Reproductive justice includes the right to have children, not have children, and to parent children in a safe and healthy environment.

  • What challenges are doctors facing in Louisiana due to the new abortion ban?

    -Doctors are facing a difficult choice between making decisions that may not be in the best interest of the patient or risking jail time. The vagueness of the abortion ban has caused fear among physicians, leading to situations where they are hesitant to provide necessary care for miscarriages.

  • What is Every Mother Counts, and how does it relate to maternal health in the U.S.?

    -Every Mother Counts is a maternal advocacy group founded by model Christy Turlington after her own childbirth complications. The organization aims to raise awareness about maternal health issues and has distributed funds to groups focused on strengthening maternal care in the U.S.

Outlines
00:00
🤰 Maternal Health Crisis in the United States

This paragraph discusses the alarming state of maternal health in the United States, highlighting that the risk of maternal death due to pregnancy complications has doubled compared to a generation ago. The U.S. ranks poorly in terms of maternal death rates among developed countries, with Louisiana having the highest mortality rates. The paragraph emphasizes the impact of poverty, lack of healthcare access, and racial biases on maternal health. It introduces the efforts of women in Louisiana to improve maternal healthcare and the exacerbation of the situation due to the recent abortion ban. The narrative also includes insights from Dr. Rebecca Gee, a former state health official, on the need for better maternal care and the preventable nature of many maternal deaths.

05:02
👩‍👧‍👦 Doulas: A Beacon of Support for Marginalized Mothers

The second paragraph focuses on the work of doulas, particularly the Birthmark Doula Collective in New Orleans, which provides emotional and physical support to mothers during childbirth. It emphasizes the collective's dedication to assisting marginalized and at-risk families, especially black and brown mothers who face higher risks of poor birth outcomes. The paragraph also touches on the challenges faced by these women, including inadequate healthcare coverage and discriminatory treatment. The impact of doula support on improving birth outcomes for black women is noted, and the work of Every Mother Counts in advocating for better maternal care is highlighted. The story of Caitlyn Joshua, a community organizer, illustrates the devastating impact of the abortion ban on maternal healthcare, as she was denied proper medical care for a potential miscarriage due to the fear and confusion surrounding the law.

10:03
🏥 Fear and Confusion in Maternal Healthcare Post-Abortion Ban

This paragraph delves into the chilling effect that Louisiana's abortion ban has had on maternal healthcare providers. It discusses the fear and uncertainty among doctors regarding the treatment of miscarriages, as the same methods used for miscarriage care can also be used for abortions, potentially leading to legal repercussions. The paragraph includes accounts from physicians who feel threatened by the new legislation and the impact this has on their ability to provide necessary care. The director of the New Orleans Health Department, Dr. Jennifer Avegno, shares her concerns about the potential worsening of maternal health outcomes due to restricted access to care and the fear among healthcare providers. The paragraph underscores the critical need to understand the interconnectedness of maternal health care, reproductive justice, and abortion care to effect meaningful change.

Mindmap
Keywords
💡maternal health crisis
The term 'maternal health crisis' refers to the alarming situation where women, particularly in the United States, are experiencing higher rates of maternal mortality due to pregnancy complications. This crisis is characterized by a lack of adequate healthcare services, disparities in care, and systemic issues that disproportionately affect certain demographics. In the video, it is highlighted by the fact that a woman in the U.S. today is twice as likely to die from pregnancy complications than her mother was a generation ago, with Louisiana having one of the highest maternal mortality rates in the developed world.
💡maternal mortality rate
The 'maternal mortality rate' is a measure of the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination or childbirth. It is a critical indicator of the quality of maternal health care in a region. The video emphasizes the high maternal mortality rate in the U.S., particularly in Louisiana, which is indicative of a failing healthcare system and disparities in care. The statistics show that 39 out of every 100,000 mothers in Louisiana die during or shortly after childbirth, highlighting the severity of the issue.
💡healthcare deserts
A 'healthcare desert' is an area where there is a lack of access to basic healthcare services, including medical professionals and facilities. In the context of the video, it is used to describe regions in Louisiana where there is an absence of essential maternal health services, such as OB-GYNs, which puts pregnant women at a higher risk. The script mentions that a third of Louisiana parishes are maternal health deserts, leaving more than 51,000 women without easy access to care and increasing their risk of pregnancy-related death.
💡racial bias
Racial bias refers to the prejudice or discrimination against individuals or groups based on their race or ethnicity. In the context of the video, racial bias in healthcare is a significant factor contributing to the maternal health crisis in Louisiana, where black and brown women face a higher risk of poor birth outcomes and maternal death. The video explains that racial bias can manifest in discriminatory care, with black women in Louisiana being up to four times more likely than white women to die during or after childbirth.
💡postpartum care
Postpartum care refers to the medical care and support provided to women after childbirth, which is crucial for monitoring and addressing potential health complications. The video emphasizes the importance of postpartum care in preventing untreated conditions such as hypertension, diabetes, and depression. However, it is noted that 50% of the time, women do not receive this essential care, contributing to the maternal health crisis in Louisiana.
💡abortion ban
An 'abortion ban' is a legislative act that prohibits or severely restricts access to abortion services. In the video, the implementation of an abortion ban in Louisiana is described as having a domino effect, impacting women's healthcare and potentially worsening the maternal health crisis. The ban has created a climate of fear among healthcare providers, leading to reluctance in offering necessary treatments and care due to the risk of legal repercussions.
💡doula
A doula is a professional who provides emotional, physical, and informational support to a mother before, during, and after childbirth. In the video, the work of doulas is highlighted as particularly important in supporting marginalized and at-risk families, especially black and brown mothers who are more likely to face poor birth outcomes. Doulas can help bridge gaps in care and provide continuous support, which is crucial in areas with limited access to comprehensive maternal health services.
💡maternal advocacy group
A 'maternal advocacy group' is an organization that works to promote and improve maternal health and wellbeing. These groups often focus on raising awareness, influencing policy, and providing resources to address issues related to pregnancy and childbirth. In the video, the maternal advocacy group Every Mother Counts is mentioned, which was founded by model Christy Turlington after her own experiences with complications during childbirth. The group aims to document and address the challenges women face in giving birth and to strengthen maternal care in the U.S.
💡physician fear
The term 'physician fear' refers to the anxiety and concern that medical professionals may experience due to potential legal or professional repercussions. In the context of the video, this fear is a result of the abortion ban in Louisiana, which has led to uncertainty and apprehension among doctors when providing care related to miscarriages and other pregnancy complications. The fear of criminal charges and loss of medical licenses has paralyzed maternal healthcare, with doctors struggling to interpret the vague language of the ban and balance patient care with legal risks.
💡intersectionality
Intersectionality is a concept that describes the overlapping and interrelated nature of social categorizations such as race, class, and gender, and how these categories contribute to systems of discrimination and disadvantage. In the video, the term is used to highlight the complex relationship between maternal health care, reproductive justice, and abortion care. Understanding this intersectionality is crucial for addressing the disparities and improving outcomes for all women, regardless of their background.
💡morbidity and mortality rates
The 'morbidity and mortality rates' refer to the rates of illness (morbidity) and death (mortality) in a population. These rates are important indicators of the overall health of a community and the effectiveness of healthcare services. In the context of the video, the concern is that the maternal health crisis in Louisiana, exacerbated by the abortion ban and fear among healthcare providers, may lead to an increase in both morbidity and mortality rates among women.
Highlights

The United States is experiencing a maternal health crisis, with women today twice as likely to die from pregnancy complications as their mothers were a generation ago.

According to the World Health Organization, the U.S. has one of the highest rates of maternal death among developed countries.

Women in the U.S. are 10 or more times more likely to die from pregnancy-related causes than mothers in Poland, Spain, or Norway.

Louisiana has the highest maternal mortality rate in the U.S., with racial biases and healthcare deserts contributing to the crisis.

Dr. Rebecca Gee, an OB/GYN and Louisiana's former Secretary of Health, has advocated for better maternal care throughout her career.

High C-section rates, lack of access to well-woman care, and untreated chronic conditions contribute to poor maternal health outcomes.

Racial bias in healthcare disproportionately affects low-income women, with black women in Louisiana four times more likely to die during or after childbirth than white women.

Dr. Gee helped expand postpartum Medicaid coverage and pushed for tracking how race impacts care and maternal outcomes in Louisiana.

80% of maternal deaths in Louisiana were found to be potentially preventable.

Prioritizing motherhood as a country, ensuring affordable childcare and access to well-woman care, is crucial for improving maternal health.

Access to care is a significant hurdle for many women in Louisiana, with a third of parishes being maternal health deserts.

The Birthmark Doula Collective provides emotional and physical support to marginalized families at risk for poor birth outcomes.

Every Mother Counts, a maternal advocacy group, distributed over a million dollars to strengthen maternal care in the U.S. in the past year.

The overturning of Roe vs. Wade and Louisiana's subsequent abortion ban have had a domino effect on maternal health care in the state.

The vagueness of the abortion ban has caused fear among physicians, with some afraid to offer treatments for miscarriages due to legal implications.

Dr. Jennifer Avegno, director of the New Orleans Health Department, has seen how the abortion ban has paralyzed maternal health care across Louisiana.

Physicians in Louisiana are facing a difficult choice between making decisions that may not be in the best interest of the patient or risking jail time.

The fear and lack of clarity surrounding the abortion ban are worsening maternal health outcomes and access to care in Louisiana.

Transcripts

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Maternal HealthHealth CrisisU.S. StatisticsLouisianaAbortion BanPregnancy ComplicationsRacial BiasWell Woman CareHealthcare AccessPostpartum CareMaternal MortalityHealth DisparitiesPolicy AdvocacyReproductive JusticeMedical FearHealthcare Deserts