Tonya Lewis Lee's Hulu Documentary 'Aftershock' Investigates How To Reduce Black Maternal Mortality
Black women take center stage in April, celebrating International Black Women's History Month. In addition, April 11-17 sheds light on Black Maternal Health Week to raise awareness of the disparity of mortality rates among Black women compared to their non-Hispanic white counterparts. The discussions surrounding Black maternal mortality are becoming more mainstream with Baby Dove joining Sista Midwife Productions, "a birth advocacy, training, and consulting agency," to comprise a comprehensive list of the Black Doula Directory.
Tonya Lewis Lee has become a staunch advocate of ensuring that the American public is cognizant of alarming statistics that show "Black women are three times more likely to die from a pregnancy-related cause than White women" even though 80% of "pregnancy-related deaths in the U.S. are preventable," according to the Centers for Disease Control and Prevention. Bias, racial and gender inequities are prevalent in the American healthcare system, including other disparities such as "quality healthcare, underlying chronic conditions, and structural racism," all impair marginalized patients from having the same opportunities to receive care to uphold their "economic, physical, and emotional health," the CDC reports.
According to the organization's report, approximately 700 women die in the U.S. from pregnancy or various other pregnancy-related complications. Recently, in Detroit, Michigan, Alona White, a 25-year-old mother, died after giving birth to her second daughter; White succumbed to an emergency craniotomy that caused her brain to bleed. As a patient at Ascension St. John Moross, White underwent a C-section, a medical procedure that Lee’s documentary Aftershock also explores and shows the financial benefits hospitals and doctors reap from this particular surgery, even though it may not be conducive to the birthing process.
Lee, who co-directed and co-produced with Paula Eiselt, discusses through her documentary Aftershock about Black maternal health and places several human faces to those victimized by this growing health crisis. The Hulu doc, which is a part of the streaming service's Onyx Collective, initially premiered at the 2022 Sundance Film Festival in the U.S. Doc Competition and was awarded the Special Jury Award: Impact for Change. Aftershock follows Omari Maynard and Bruce McIntyre, who both lost their partners, Shamony Makeba Gibson and Amber Rose Isaac, during childbirth, and how the two men, along with other family members, are in the streets providing advocacy and activism to eradicate this epidemic.
Using her background as a former human rights attorney, a spokesperson for the U.S. Department of Health and Human Services Office of Minority Health, and an author of the children's book Please, Baby, Please—which she co-wrote with her Academy awarding-winning husband, Spike Lee, she uses her platform to heighten the conversation of Black maternal health.
L-R Omari Maynard and Bruce McIntyre
Photo courtesy of Onyx Collective
xoNecole: Based on your research, what are the factors causing Black women's death in most hospitals? The documentary did expound on it, but if you can say it in your own words.
Tonya Lewis Lee: First, I want to say that most of these deaths happening with Black women from childbirth complications are preventable. When we were making the film, 65% of these deaths were preventable. Since then, a new statistic has come out that says 85% of these deaths are preventable. When you asked me what we discovered in our research about why this is happening? First and foremost, what keeps coming through is very clear that Black women are being dismissed and ignored when they express pain or discomfort or something is not right. A lot of these deaths are postpartum.
It's frustrating because it's not like women aren't seeking help, as you see in Aftershock. The two families that we cover, the two women who passed away, each of them were seeking help from their healthcare providers. Unfortunately, their calls for help were dismissed, minimized, and ultimately led to their death. I will say that what tends to happen is there is either too little intervention too late, or there tends to be too much intervention done too soon, which, unfortunately, often causes these deaths.
xoN: Is this something that residents are taught in medical school because, like the doc pointed out, the founder of gynecology J. Marion Sims, believed Black women don't feel pain? Is this ideology still continually introduced in medical schools?
TLL: My understanding, and I've heard, anecdotally, that it is still taught in med schools today that Black people do not suffer or have the same kind of pain that white patients do, which is insane to me that we're still having these conversations. I empathize with doctors because I think they are trained in such a way--it's a patriarchal, technocratic system. They go through rigorous training, which is great, but they're also kind of dehumanized doctors, when they're going through a process so that by the time they get to their patients, they often inadvertently treat their patients in the way they have to rush, let's get through to the problem. What's the problem? Let's solve it.
I'll go back to the question you asked before about what's causing these deaths also, is that [birthing] is not woman-centered, and what I mean by that is, when a woman is giving birth, as opposed to listening to her desires and how she wants to give birth and who she needs in the room, what is she doing and how is it working for her? Unfortunately, a lot of times, it's more on the doctor's schedule, what works for the doctor, and what's efficient for the doctor. Why do we lay on our backs and put our legs up? Well, because it's easier for the doctor to get in there than allowing a woman to move around during her labor to help the baby work its way down. So the baby gets in position, and she's able to do what she wants to do. I think that a lot of education works against the natural birthing process.
xoN: Regarding the medical schools, is there any way we can change how they're instructed? How can we upgrade their curriculum on how they handle Black maternity?
TLL: I agree with you, and I will say, at least some of the good news; I see that with Aftershock, we've been invited by medical schools to bring the film. We were at Harvard and Columbia [to show the film] to their residents and converse with me, my co-director, and the film's protagonist. To your point, they need to be educated; differently, they're beginning to understand that and are looking at it [but] it's going to take a little bit of time to turn the ship. But at least there's a conversation that is starting to happen, but I completely agree with you that med schools need to start thinking about how they teach maternal care.
And again, even the midwifery programs, too, because I am a big advocate for midwives. Yet, they're not enough midwives in general in the United States, and they're certainly not enough Black midwives. So, to that point, we also need to work on the pipeline of doctors, Obstetricians, and Gynecologists, because there's a shortage of doctors. There's a shortage of nurses, and certainly Black nurses and doctors. We want to think about who's going to med school and how we cultivate them so that we have a workforce that can care for all of us.
Photo courtesy of Onyx Collective
xoN: To add to that point, maybe there should be a movement to have Black owned hospitals. Many Jewish communities have their own doctors and ambulances. Is that also something we need to start putting on our agenda to start creating Black-owned hospitals in these cities with a high Black population?
TLL: I think we can [have] Black hospitals; we're talking about education in general. Our issue as a community is whether we need more resources or we need to focus the resources in that way. It's worth thinking about. Looking to our HBCUs, our Black students, bringing them through to get us to a place where we could create that kind of thing. I don't think it's a bad thing. A study showed that when Black doctors treat Black infants, they have better outcomes. So I think a movement towards ensuring that we have more Black doctors, more Black nurses, a robust Black health care system to begin with, or at least doctors. Having an awesome Black hospital that's important for us would be amazing because we do not have the resources to do that.
xoN: How can we change policy as it relates to the health of Black women when they're giving birth? What can we do?
TLL: Well, the good news is policies are moving through Congress right now, the Momnibus bills, its pieces of legislation, a group of bills. One in particular that is great that I believe recently passed is making sure that women have Medicaid coverage through their first year of birthing; I think it's important that we deal with women a year postpartum because, again, as I said earlier, most of these deaths do happen postpartum. Many women who don't have coverage get lost, and they don't see doctors thereafter or are not seen. We need to ensure policies that make sure that women have the support they need. For example, doulas get covered by insurance companies and Medicaid as well.
I think midwives are really important to this process; the United States is the only industrialized nation that does not have midwifery care at the center of women's health care. So we need to ensure that when women go to midwives, they can get reimbursed. So those are some policies that can have an impact. I will say voting matters because our politicians, locally at the federal level, but particularly locally, and our state and local governments are the ones that drive the policies and our communities around birthing. I think, as individuals, we need to be out there voting, ensuring women can get the support they need.
Also, to the voting piece because many hospitals in the Black communities have been divested from [offering] the services, if they do have maternal health care at all. They don't have a lot of services. So we want to make sure that our hospitals and our communities are well-resourced so that they can provide the care they need for people, especially when they're in distress.
Photo courtesy of Onyx Collective
xoN: What was your experience when you gave birth to your children?
TLL: I appreciate that question. It's interesting. When I gave birth to my children, my daughter is now 27; my son is 25. I didn't know about midwives. So I had a wonderful doctor who was a friend of the family. But even then, I look back with a little frustration because my water broke, I went to the hospital, my family was there, and it was like, 'We can just move this thing along, let's get you on Pitocin get you going,' and I did that and stayed in the hospital overnight. Then the contractions were coming hard, as they do, especially when you're on Pitocin.
They suggested that I have an epidural, which I had. Then, my lips started to numb because they told me I was only supposed to be numb from the waist down. But I was beginning to feel numb over my entire body. I told my anesthesiologist to turn it down, my lips were numb, and she kept saying, 'Well, no, if I turn it down, I have to turn it off, and you're gonna feel pain.' I was like, I need to feel something because I'm now not feeling anything. I had to get nasty with her and didn't want to do it. Because you're laying there, you're vulnerable; I couldn't move. My mother and sister were there, and then they started noticing my oxygen levels were getting weird. I was like, 'You need to turn it off, and I had to get nasty for [the nurse to] finally turn down the anesthesia so that I can at least feel something. Thank God everything was fine, and my daughter was fine. Similarly with my son, a different doctor this time, by the way, both Black women, lovely people, but in a system, right?
With my son, the same thing happened; similarly, my water began to leak, and I was saved in a way by the nurse because at one point I was pushing, and the doctor was like, 'Okay, his umbilical cord is around his neck, his shoulders are stuck,' and she just stopped. The nurse said, 'This may hurt a little bit,' She put her hands on my stomach and pushed my son out. Again, I was fine, thank God, and the children are fine, but in retrospect, I wish I had allowed my body time to do what it wanted to do, and I think I would have been fine. I don't think I needed Pitocin. I don't think I needed the epidural if I had done it that way. But that's the way I did it back then.
But I joke with my daughter that by the time she's ready, I'm ready, and we're going to get it right this time because I don't think that surviving birth is what it should be. I think we should thrive in our births and be able to have beautiful birthing experiences that are not with trauma. And I'm not saying they don't have pain, but I believe that the pain that one goes through is what we're supposed to go through. I don't think women should suffer. But as Helena Grant, the midwife in our film, says that when a woman is birthing a baby, she's not just birthing a baby, she's birthing a mother, and it's a rite of passage that we have to go through to get on that other side. So we are prepared to take care of this young life we've just brought here.
xoN: How can women protect themselves when pregnant or about to give birth in this environment?
TLL: First of all, shop around for your healthcare provider. If you go to a health care provider and you don't connect with them, then keep looking for that health care provider that is right for you. First and foremost, ask as many questions as you can ask. Remember that you're in the power seat, you should be empowered; you're about to go through something amazing. Make sure you get the support you need. No [woman] can be doing everything in the moment of labor and birthing.
So make sure you have the right energy and people around you who can advocate for you and support you the way you need during your birthing process. I was with these people through the process of this documentary. I was able to be up close and personal with people grieving from a loss but activated by the loss. I was able to be up close and personal with people going through the birthing process themselves, trying to figure it out for themselves as well. So it's been quite a journey.
Aftershock is now streaming on Hulu.
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Feature image by Keith Williams
ItGirl 100 Honors Black Women Who Create Culture & Put On For Their Cities
As they say, create the change you want to see in this world, besties. That’s why xoNecole linked up with Hyundai for the inaugural ItGirl 100 List, a celebration of 100 Genzennial women who aren’t afraid to pull up their own seats to the table. Across regions and industries, these women embody the essence of discovering self-value through purpose, honey! They're fierce, they’re ultra-creative, and we know they make their cities proud.
VIEW THE FULL ITGIRL 100 LIST HERE.
Don’t forget to also check out the ItGirl Directory, featuring 50 Black-woman-owned marketing and branding agencies, photographers and videographers, publicists, and more.
THE ITGIRL MEMO
I. An ItGirl puts on for her city and masters her self-worth through purpose.
II. An ItGirl celebrates all the things that make her unique.
III. An ItGirl empowers others to become the best versions of themselves.
IV. An ItGirl leads by example, inspiring others through her actions and integrity.
V. An ItGirl paves the way for authenticity and diversity in all aspects of life.
VI. An ItGirl uses the power of her voice to advocate for positive change in the world.
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Do You Want To Be A Wife? Or Do You Just Want To Have A Wedding?
Even though it’s my life, sometimes I look at it and totally trip out over certain things.
For instance, even though I am aware that both Hebrew and African cultures put a lot of stock in the name of a child (because they believe it speaks to their purpose; so do I) and I know that my name is pretty much Hebrew for divine covenant, it’s still wild that in a couple of years, I will have been working with married couples for a whopping two decades — and boy, is it an honor when they will say something like, “Shellie, we’ve seen [professionally] multiple people and no one has been nearly as effective as you have been.”
Yep, me. Little ole’ never-been-married-before me. Yeah, y’all better quit letting people tell you what you’re called to do in this world. That is between you and the One who made you.
Okay, but let me stay on track. When it comes to the engaged couples specifically, who have crossed my path, something that I believe I’ve said to each and every one of them (especially the bride-to-be) is — “You better enjoy every single minute of your wedding day because you deserve a big ‘ole party for all of the work that you’re about to do.” And then I look at the woman as intensely as I can and say, “And you? Remember, you are a bride for a day. You are a wife for the rest of your life.”
Why do I emphasize that point so much? It’s because those two things are not one and the same. Hmph. Let me tell it, a huge reason why 70 percent of divorces are initiated by women, however, is because a lot of them think that it is. And so, in the effort to do my part to help make marriages last longer and cause the divorce rate to go down, I think it’s important for more women to ponder if they really want to be a wife — or if they just want to throw a big party (a wedding), go on a trip (a honeymoon) and not much more than that.
Buckle in. This one might be a bit of a ride (for some, at least).
It’s Time to Stop “Living for the Fairy Tale”
GiphyIf you’ve been reading my content for a while (and if so, thank you), it will not shock you in the least that I’ve spent many years studying the origins of things as they directly relate to marriage. I know that the engagement ring is not about love but about a jewelry company that was about to go bust. So, they came up with the slogan “A diamond is forever” and then made some serious bank from it (you can read about that here).
I know that white wedding dresses have nothing to do with purity and virtue; in fact, women in the Bible often wore lots of bright colors during their more-than-one-day wedding celebrations. Actually, white comes from Queen Victoria making it famous back in the 1840s. I also know that a lot of people were pretty obsessed with evil spirits back in the day because things like wearing a wedding veil and bridesmaids wearing the same dresses were all about hiding from said spirits. Another pretty popular wedding day tradition? Well, I’ll just let you read Insider’s “Here's the horrifying truth about why grooms carry brides across the threshold,” if you’re interested.
And as far as marriage goes, don’t even get me started on the whole “I’m living for the fairy tale” narrative that gets pushed incessantly. I’ve said in other articles before that "fairy tale" literally means “a story, usually for children, about elves, hobgoblins, dragons, fairies, or other magical creatures” and “an incredible or misleading statement, account, or belief.” Who wants to live for childish stories that are incredibly misleading? And the ones that have a character like Prince Charming in it? The Bible literally says that “charm is deceitful” (Proverbs 31:30).
Know what else the Bible says? It states that death and life are in the power of the tongue (Proverbs 18:21). So, what’s up with all of this wedding/marriage rhetoric that’s so popular and also, so… “silly” is the first word that comes to mind, “unrealistic” is the second and “unnecessary” is the third?
Why are there so many expectations, especially when it comes to the wedding day, that push folks to the point where a whopping 49 percent of couples end up going into debt right after jumping the broom — all because they wanted to live for the fairy tale and throw a big party that they basically couldn’t afford? SMDH.
It really is wild, just how much human nature tends to do things without even really knowing WHY it does it — even when it comes to marriage. And so, if you are someone who desires this type of union, be honest with yourself: what is your “why”?
When it comes to becoming a wife someday, WHY do you want to do that?
A man needing to spend three times his salary on an engagement ring, WHY?
When it comes to having a big traditional wedding, WHY is it necessary?
Marriage is a goal for you (and don’t get me wrong, marriage is a beautiful thing) — WHY is that the case?
When it comes to being married, WHY do you think it will better serve you than your single state?
Motivational speaker Eric Thomas once said, “When you find your ‘why’, you will find a way to make it happen.” And when it comes to something as big (and supposed to be lifetime lasting) as marriage, perhaps a big part of the reason WHY so many of them do not go the distance is because there aren’t enough “why” questions, on the front end, that are asked (which is why you should partake in premarital counseling before your wedding day). Oh, but there should be.
Because saying “why” you want a huge wedding is nothing more than “because I want to” or “why” you chose the man that you did is simply “I love him” — I’ve been doing this couples work thing long enough to assure you that those answers simply aren’t good enough. You need to know what it means to be a wife and why a marriage and a wedding are not the same thing…not by the longest country mile that you can imagine.
What It Means to Be a Wife
GiphyIf you’ve been reading my content for a while now, you know that I’m good for throwing some Scripture in; it’s a part of my foundation and I make no apologies for it. And so, when it comes to what it means to be a wife, the first word that’s used to define it in the Bible is “helpmate” (Genesis 2:18). A helpmate is a companion, a helper and someone who assists another individual — in this case, a husband.
While we’re here, a helper is not helping unless the help is actually needed and it’s good. Lawd, I can’t tell you how many wife clients I’ve had who have totally missed that part. So, what does “good help” look like?
- A good helper ASKS the person they are assisting what they need.
- A good helper does not try to control another person or make them do what they want.
- A good helper gets that needs can shift based on what is transpiring at any given time.
- A good helper makes things easier and less stressful.
- A good helper learns how to master good listening, effective communication, and wise timing.
And yes, in many ways, this is what it means to be a good wife. So, if you are someone who desires marriage, when it comes to what is required to be not just a wife but a GOOD WIFE, how much have you factored helping your man into the dynamic?
Not mothering him. Not bossing him around. Not trying to manipulate him into being a version of a husband that you would prefer. No, how much thought have you put into “Am I equipped to help another person be their best self? Am I ready to be supportive, encouraging, and nurturing? Was it even modeled to me, while growing up, to know what a proper helpmate looks like? Have I realized how much sacrifice goes into that type of role? Am I even selfless enough to be a consistent helper?”
I know this is probably gonna ruffle some feathers yet, you know something that I’m not big on? Women saying that their man should give them the “princess treatment.” Every time I hear that, the first thought that comes to my mind is “Fathers make their daughters princesses while men make their wives a queen” — and little girls are treated differently than grown women. And to that, Proverbs 12:4(NKJV) says, “An excellent wife is the crown of her husband, but she who causes shame is like rottenness in his bones.”
My point? There is a MATURITY that is to come from going from princess to queen. A queen does have more privileges, yet, at the same time, she also has way more responsibility. It’s not about sitting around and being catered to all day long. Queens have work to do — and it’s not always comfortable or pretty. Same thing goes for being a wife.
Y’all, I could go on and on (and on and on and on) about what it means to be a wife in a marriage. For now, I’ll just end this part of the article with, “If you’re not ready to help, each and every day of your relationship, you’re not ready to be a wife.” Plain and simple.
Weddings Are Not Marriages (and Vice Versa)
GiphySo, why do so many people jump brooms (I’m writing this with Black folks in mind first; jumping brooms is for us only), only to turn around and get divorced a few years later? Oh, I could go on and on as well about how a lot of people don’t have much integrity when it comes to the promises that they make. Listen singles, when you’re dating someone, pay very close attention to whether the person you’re seeing keeps their word — and if you do the same.
It makes absolutely no sense to keep letting someone slide when it comes to reneging now, only to act shocked when they do the same thing after saying “I do.” And while we’re here, being a man or woman of your word is a character issue. Maybe folks are not strong in character when it comes to this.
Yet another reason why folks will get all dolled up, stand before God, family, and friends, look someone straight in the eye, and promise to never leave, only to do just that, is because many people honestly don’t see past their wedding (and maybe their newlywed years). That is why you will hear so many people describe their perfect wedding day, down to the last detail, and yet, if you ask what their five-year plan for their marriage is, they have absolutely not one clue.
I mean, I get it — to a certain extent. A wedding is a big party where you get to dress to the nines, have people come to celebrate you and you get to have everything go your way — down to the font on the programs and reception napkins. Oh, but what a “trick” that can be if you think that your marriage is going to move like that, all of the time, moving forward. I liken it to The Bachelor franchise. Who wouldn’t feel like they are falling for someone when they’re able to live in a mansion with no bills, have fantasy dates that cost thousands of dollars, and a big ole’ rock that a famed jeweler donates?
Meanwhile, folks should watchUnREAL (the television series from several years back where some former producers of the franchise talk about what really happens behind the scenes) to get a reality check. To a certain extent, the same thing goes for marriage: while weddings produce this belief that marriage will be one big party where everyone focuses on you and everything goes your way, that isn’t even close to being the reality of being married.
Honestly, the real deal is 1) if you don’t want to learn how to love on a supernatural level; 2) if you don’t want your strengths to be refined and your weaknesses to be challenged; 3) if you don’t want to be held accountable in ways that you would never be if you remained single; 4) if you don’t want to compromise on a daily basis and, 5) if you don’t want to be challenged to become a truly selfless individual — marriage isn’t for you.
You’d be far better off just throwing a big ass party for yourself, just because (and no, I don’t mean marry yourself; you are already “one” with you; no need for that), and call it a day. Spare yourself and another person the heartache of divorce because…divorce is A LOT to go through.
Lawd, I can only imagine how much drama could be spared if folks simply took into their spirit that weddings ARE NOT marriages and marriages ARE NOT weddings. Weddings are a party to celebrate your union — yet your union? That requires daily energy, effort, and time. It’s not a party. It’s a relationship. BIG DIFFERENCE.
Please Don’t Get Married Until You’re Sure That You Want…BOTH
GiphyAnd this is why, whenever someone tells me that they are going to get married, I don’t immediately respond with, “Congrats! That’s awesome.” NOPE. The very first thing that comes out of my mouth is something along the lines of, “For real. Why?” WHY? Because, it never fails that, about 7.5 times outta 10, folks will be caught off guard and say, “What do you mean ‘why’?” and then follow that up with, “Because I’m in love” or…they don’t really know what to say at all.
Is being in love a good answer? I mean, it explains why you picked the person that you did; it doesn’t really explain why you are choosing to commit to them for the rest of your life, on a marital level, though. Are you getting married because you know that the two of you will make each other better people? Are you getting married because you want to raise your children in a two-parent dynamic? Are you getting married for biblical reasons like wanting to love like Christ loves his bride (the Church and the Church sent him through A LOT — Ephesians 5)?
Are you getting married because you think you’ve gone as far as you can in your evolution as an individual without the assistance of another? Are you getting married because you want to serve another person as they do the same for you (perhaps not in the same ways because you’re both different people)?
Is that asking the most? Chile, that’s not asking enough. I don’t care how much people mock marriage in the media by changing partners like they change cars or homes. I don’t care how much divorce has been normalized. I don’t care how much folks like to act like a husband is a 2.0 boyfriend (it’s not) and having a wife is a 2.0 girlfriend (it’s not) — marriage is special, sacred, and needs to be honored as such. A wedding should be seen as a happy occasion where two people publicly acknowledge what I just said…not simply a time to get a lot of attention and presents only to come home and go from heaven to hell in six months.
And honestly, that’s a bit part of the reason why I do what I do: it’s because I actually think the covenant of marriage is SO MAGNIFICENT that I want to make sure that people know, as much as possible, what they are signing up for — not an endless wedding; a very real relationship that will challenge them and mature them like nothing else ever will in this lifetime.
____
This was a lot. I already know. Still, it beats spending thousands of dollars on a wedding to stand before a chaplain only to spend thousands of more dollars several years later on a divorce lawyer and therapy while standing before a judge.
Weddings are awesome; you’ll get no argument from me there. Still, I think if I was to narrow all of this down into one statement, it would simply be this: “When it comes to marriage, if the thought of being a wife doesn’t excite you more than being a bride — wait. You’re not ready yet.”
Thank me later, sis. YOU WILL.
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