Maternal Health Disparities and the JJ Way

The speaker recounts a visit with her cousin in Bristol, highlighting the shared experience and universal language of motherhood.
Motherhood as a Black woman means carrying the burden of grim statistics.

In 2019, The Embrace report indicated that Black women in the UK were five times more likely to die during childbirth or up to six weeks postpartum compared to white women.
The most recent Embrace report indicates that mortality for Black women is four times more than for white women.
If the speaker were to give birth, she would be categorized as Black African and would be at twice the risk of stillbirth than a white woman experiencing deprivation.

The speaker and her friends agreed to have babies around the same time and later discussed the statistical report, leading to shock and sadness.
The speaker felt a sense of validation regarding her feelings of nervousness during her pregnancies, which differed from the experiences of her white friends.

The speaker shares a story of a woman who experienced multiple failings during and after childbirth, resulting in her death and highlighting potential systemic issues.
The speaker believes the oppression is subtle but can become fatal when accumulated.

During her first pregnancy, the speaker doubted her gut feeling due to the awareness that Black women are often medically disbelieved and gaslit.
The speaker feared being perceived as difficult or aggressive if she voiced her concerns.
She went into labor at twenty-eight weeks, highlighting the disproportionate effect of preterm birth on Black women.

While her baby received fantastic care in the Neonatal Intensive Care Unit (NICU), the chaplains never offered her emotional support.
Black women are more likely to experience poor mental health and less likely to receive support.

The speaker had built up milk reserves and wanted to donate her excess.
She wasn't featured on the milk donor bike Facebook page, which she feels is because of the questioning if milk from a black woman was safe or suitable for their child.
This was potentially linked to generational trauma as a Black woman from when enslaved mothers were forced to abandon their babies to feed the children of their white owners.

During her second pregnancy, the speaker was hyper-aware of her behavior and tried to avoid triggering biases.
Her third child was born at home as a way to opt out of the racist oppression within the healthcare system.

The government rejected recommendations to set a target and strategy to end disparities in maternal death, indicating a lack of interest and investment.
Black Mothers Matter was started to support and celebrate Black pregnancies.
The team consists of Black women with intersecting identities pooling their skills and advocating for change.
The organization seeks support to continue their work until they are no longer needed.

As a Black British woman, the speaker realizes that she cannot mitigate the risks of her race during this important time in her life.
The speaker calls on others to look out for Black women to allow them to plan for success, not just survival.

The speaker describes physical sensations related to stress, such as heart racing, clammy palms, sweating, and shallow breath, which are linked to the nervous system releasing hormones like cortisol and adrenaline.
Chronic stress can overload the system and interfere with the body's processes, leading to illness such as heart disease and cancer.
Stress during pregnancy can cause premature labor and is linked to high blood pressure and low infant birth weight, increasing the risk for both the parent and child.

People who experience more discrimination are more likely to have poor health.
The threat of discrimination, such as worrying about being stopped by the police, can negatively impact health.
Marginalized groups experience more discrimination and greater impacts on their health.

The speaker's interest in maternal health led her to become a doula.
She observed how race and class impacted the experiences of women she supported in a public hospital in North Carolina.

African American women have different experiences than white women regarding the health of their babies.
In some parts of the country, maternal and infant death rates for Black women are similar to those in Sub-Saharan Africa.
Black women are four times more likely to die during pregnancy and childbirth than white women.
Black infants are twice as likely to die before their first year than white infants, and Black women are two to three times more likely to give birth prematurely or to underweight babies.
Native women and some groups of Latinas also experience higher rates of these problems than white women.

Even middle-class Black women have worse outcomes than their white counterparts, with the gap widening among this group.
Women of color who receive recommended prenatal care still suffer from high rates of adverse outcomes.

Discrimination leads to stress, which results in poor health, particularly for people of color.
Immigrants, especially Black and Latina immigrants, initially have better health, but it worsens over time in the US.
The "immigrant paradox" illustrates that something in the US environment makes people sick.

The JJ Way, developed by midwife Jenny Joseph, provides accessible and respectful prenatal care to primarily Black, Haitian, and Latina women in Orlando, Florida.
The method is inexpensive and doesn't require advanced treatments or technologies.
Jenny's team provides prenatal care to over 600 women annually, with almost all clients giving birth to healthy, full-term babies.

Every aspect of the clinic is supportive.
No one is turned away due to lack of funds.
Clients are not chastised for being late or talked down to.
The waiting room is designed to be welcoming and comfortable.
- Medical assistants Trina and Alexis play a crucial role, providing casual and friendly support.
- Trina communicates with clients via text about medications and other concerns.
The JJ Way focuses on creating a team of support alongside the mom and her family.
Women take their own weight and perform their own urine tests, placing responsibility and information back in their hands.

The JJ Way almost entirely eliminates problems such as premature birth and low birth weight.
Women giving birth at the same hospital, in the same demographic as Jenny's patients were three times for likely to give birth to a baby below a healthy weight.

The JJ Way is cost-effective and can be implemented in any healthcare setting.
Support, information, and care are provided by all team members, allowing Jenny to manage a high volume of clients.

Unconditional support can significantly impact the effects of racism on health, especially during pregnancy.
Creating supportive environments can help buffer the effects of racism and improve outcomes for generations.