
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 documentaryAftershock 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
'Black Girl Magic' Poet Mahogany L. Browne Talks Banned Books And The Power Of The Creative Pivot
You know you’re dealing with a truly talented and profound voice of a generation when the powers that be attempt to silence it. As a poet, educator, and cultural curator, Mahogany L. Browne has carved out a powerful space in the world of literature and beyond.
From penning the viral poem, “Black Girl Magic,” to writing Woke: A Young Poet’s Call To Justice (a book once banned from a Boston school library), to becoming the 2024 Paterson Poetry Prize winner and a poet-in-residence at Lincoln Center—her path exemplifies resilience, reinvention, and unapologetic artistry. She's published more than 40 works and paid the bills with her craft, a divine dream for many creatives seeking release, autonomy, and freedom in a tough economic climate.
A Goddard College graduate, who earned an MFA from Pratt Institute and was awarded an honorary doctorate from Marymount Manhattan College, Mahogany offers unapologetic realness with a side of grace and empowerment. "I started touring locally. I started creating chat books so that those poems will go in the hands of the people who were sitting in the rooms," she shared.
"And then I started facilitating poetry workshops, so I used my chat books as curriculum. And that, in turn, allowed me to further invest in my art and show the community and people who were hiring me that it wasn't just a one-off, that it's not just, you know, a fly by night—that I am invested in this art as much as I am invested in your community, in your children's learning, in our growth."
Mahogany has a special way of moving audiences, and her superpower sparks shifts in perspective, post-performance introspection, and strengthening of community bonds, especially among Black women. (One can undeniably recognize her gift for arousal of the spirit and mind merely from her listening to her insights from the other side of a Google Hangout call. I can only imagine the soul-stirring, top-tier sensory encounter when watching her perform in person.)
In this chat with xoNecole, Mahogany reflects on sustaining a creative career, the aftermath of writing a banned book, and using poetry for both healing, community-building, and activism.
Anthony Artis
xoNecole: What are three key things that have laid the foundation for a sustainable creative career for you?
Mahogany L Browne: What has helped me is that I'm willing to go in being an expert at knowing poetry and knowing the way in which art can change the landscape of our lives, not just as a poet, but also as a poetry facilitator. How you move through classes, those things are mastered, right? So when I go into another space that's maybe tech-heavy, I don't mind learning and being, you know, a student of the wonder of how we can make this magic, work together.
Two, you’ve got to know how to pivot. Sometimes we say, ‘Alright, this is what my life is going to be. I'm going to be a New York Times best-selling author. I'm going to, you know, have an album that's Grammy-nominated. And then, say you get dropped from your record label. That doesn't mean you can't make an album anymore. You can also still create an album that can be submitted to the Grammys. So, what does a pivot look like as an artist who doesn't have an institution behind them? Pivot being a student of the wonder.
Relationships also really help. How do I serve the community? And in turn, that tells me how the community can show up. For me, I have long-standing ties with a community that will outlast my one life. So, what does it mean to create space where these relationships can develop, can be nurtured, can be rooted, can be cultivated? Creating space—it happens through relationships.
xoN: With today’s economic challenges, what does your current creative process look like, and what are you working on?
MB: I’m always thinking five years ahead. I just reviewed the pages for two children’s books and recently released a YA novel. I’m drafting an adult fiction manuscript now.
Anything I create is founded with the root of poetry, but it can exist in captions. It can exist in commercials. It can exist as a musical. So that's where I’m at now.
xoN: You started performing "Black Girl Magic" in 2013, had an acclaimed performance of it via PBS and the work went on to viral success shortly after. Talk more about the inspiration. And what do you think about the continued relevance more than a decade later?
MB: I wrote it as a rally cry for the mothers who had been keeping themselves truly in harm's way by, you know, being a part of the community right after the death of their child or their loved one. They are usually mothers of victims of police brutality—and just seeing how they showed up in these community spaces, they are devout to the cause but obviously still grieving.
"I wanted this poem to be just a space of reclamation, of joy and of you, of your light, of your shine, of your brilliance, in any which way in which you fashion. Every room you enter is the room you deserve to be in. What does it mean to have a poem like that that exists?"
And the first time I did the poem, the Weeping that occurred, right? It was like this blood-letting of sorts. The next time I performed it, I'm moved to tears because I'm seeing how it's affecting other women who have just been waiting to hear, ‘You belong. You deserve. You are good. We see you. Thank you, despite everything that they said to make you regret being born in this beautiful brown, dark-skinned, light-skinned, but Black body.’
Black women are the backbone—period. Point blank. And so, that that poem became a necessity, not just to the fortitude of Black women in the community, but like you know, in service of healing the Black women.
xoN: One of your books was banned at a school in Boston, and it was later reinstated due to parental and activist support. What was that experience like?
MB: Well, I think it happened because they were racist. That's it. Point blank. The reversal of it was empowering, right? I realized, oh, I thought we just had to sit here and be on a banned book list. But no, parents are actually the leaders of this charge.
So to see that, the parents said, ‘Nah, we're not gonna let you take this book out of my baby’s school just because it's a Black kid on the front saying, ‘Woke’ and they're talking about being a global citizen. They're talking about accountability. They're talking about accessibility. They're talking about allyship, and you don't want them to have compassion or empathy or have even an understanding, right? So no, we rebuke that, and we want this book here anyway.’ To see that happen in that way. I was, like, reaffirmed. Absolutely.
xoN: You recently organized the Black Girl Magic Ball at the Lincoln Center in New York. Honorees included author and entrepreneur Rachel Cargle and National Black Theater CEO Sade Lythcott. What impact did it have and what expanded legacy do you hope to leave with your creative works?
MB: I was really interested in not celebrating just the book, but celebrating the community that made the book possible. And so I gave out five awards to women doing that thing, like, what does it mean to be a Black girl in this world?
I just thought it was gonna be an amazing time. Everybody's gonna dress up—we're gonna celebrate each other. And boom, I then realized that it responded to like a gaping hole. There was a missing thing for Black girls of all walks of life, all ages, right?
"It's very intergenerational. That was intentional to come together and celebrate just being us."
You have all these instances where just being you is either the butt of a joke or it's diminished and not worthy of a specific title in these larger institutions. So what does it mean to just to be loved up on and celebrated?
It felt like a self-care project at first. You know, for the first couple of years, folks were coming and they were getting that sisterhood. They were getting that tribe work that they were missing in their everyday lives.
I love the Black Girl Magic Ball because we got us. If I go out with a bang, they'll remember that Mahogany worked her a** off to make sure all the Black girls everywhere knew that she was the light. We are the blueprint.
For more information on Mahogany L. Browne, her work, and her future projects, visit her website or follow her on IG @mobrowne.
Featured image by Anthony Artis
Listen, based on what I know (because I have learned to not talk about celebrities like I know them, unless I actually do), I have a lot of respect for the filmmaking phenomenon Ryan Coogler. In fact, a close friend of mine and I were recently talking about how much we enjoyed an NPR interview that he did late last month (“Ryan Coogler Paid A Steep Price For The Films He Made”).
And although I’ve heard the his movie Sinners is “that one” right now (did you know that it has crossed the $300 million mark at the time of this being published?), because I am a bit squeamish when it comes to violence and gore, I am still on the fence about personally checking it out; especially after Michael B. Jordan said himself that all of the (fake) blood even caused him to need to take breaks throughout filming. I dunno…maybe in the daytime. We’ll see. LOL.
Anyway, all of the talk about vampires — you know, due to the film — did cause me to wonder something that might seem rather random, yet that’s oftentimes how my mind works: Do vampires give each other hickeys? As I Googled for an answer, besides a book that has a title close to that name, I did notice an ABC feature from when the vampire Twilight film series was all the rage several years back. It was inquiring if teens were suddenly biting each other (back then) because of the movie(s).
The sexologist who was interviewed came to the conclusion that since biting is “an extension of the hickey” and hickeys are (typically) considered to be passionate, that’s why teens were interested in doing it. As far as what vampires do with each other? I couldn’t find a definitive answer.
I dunno. With hickeys also being called “love bites” and “suck marks” and with folks oftentimes describing vampire-themed movies as sexy, I would think that they could. Either way, what we know for sure is that those of us in the real world do it — and so, in honor/acknowledgement of that, I figured that now would be a perfect time to share some facts about hickeys. Ready?
1. Humans Are Copying Animals When They Give Hickeys
Aight, so what exactly is the origin story of hickeys? It would seem that it came from the literature of authors who wrote about what animals like lions and wolves do whenever they are showing affection towards one another. Apparently, humans saw this and eventually began to follow suit.
Hey, that doesn’t sound so crazy to me, considering doggy style continues to be a fan favorite among our species, and…have you ever seen two cats have sex before? I have, more than once, and the male cat is typically biting on the female one, in her neck region, during the act. So, when I really stop to think about all of this, it definitely tracks.
2. Hickeys Are Oftentimes a Low-Key Power Play
Ah, perfect. If you click here, you will actually see a picture of two cats having sex, and — like I just said, the male cat is biting the female cat. One reason why is because male cat penises have barbs on them which can make the entry or exit of intercourse literally painful for the female. And so, the male cat holds her in place by biting her, so that she doesn’t run away. And yes, along these same lines, some believe that hickeys can serve as their own power dynamic shift, even among humans — especially based on where a person decides to put one. I guess it would be like “peeing on your territory” in a way — hmph, which is something else that animals tend to do.
3. Hickeys Are Nothing More than a Bruise
Okay, so what actually causes a hickey to happen? Well, when someone sucks and gently bites on your skin, it can break some of the surface blood vessels that are underneath your skin to break. When that happens, it results in a bruise. If someone does this to you for about a half a minute, you should notice a hickey emerge in a matter of minutes and, depending on how “good” of a job they did, a hickey can stick around for as much as a couple of weeks.
4. “Temperature Play” Speeds Up the Healing Process of Hickeys
Again, depending on how “good” of a job someone did at giving you a hickey, it could last between two days and two weeks. If you want yours to fade faster, because, again, hickeys are a bruise, it’s a good idea to bring some temperature play into action. What I mean by that is, start off by putting an ice pack on your hickey for up to 10 minutes, twice a day, for the first two days.
Then, after 48 hours, apply a warm compress for 10 minutes a few times a day. You might also want to apply a bit of peppermint oil to your hickey and gently massage that area as well; that will help to bring more blood flow to the spot, so that your skin can heal faster.
5. If You Take Blood Thinners, Hickeys Will Last Longer
If you’re someone who takes blood thinners, that will keep hickeys aren’t for a longer period of time. That’s because blood thinners are specifically designed to slow down the blood clotting process that’s in your body. So, if you’re big on hickeys and you even take aspirin on a fairly regular basis, you’re gonna have to accept that the “hickey healing hacks” may not actually work for you (at least not as quickly or effectively).
6. Certain “Natural Things” Can Make Them Last Longer Too
Speaking of blood thinners, even if you aren’t on any meds, did you know that certain foods provide blood-thinning effects as well? Some of those include ginger, garlic, aloe, turmeric, and cayenne pepper, and even supplements including vitamin E and melatonin. Just something to keep in mind. (By the way, vitamin C and the bromelain in pineapples can help to heal hickeys as far as supplements and foods go).
7. No, Hickeys Will Not Give You Cancer
It actually wasn’t until I was doing research for this article that I even heard the myth that hickeys can give you cancer. What in the world? Yeah, if you heard that somewhere before, pay that tale no mind, because science absolutely says otherwise. For the most part, hickeys are relatively harmless.
8. They Can Give You an Infection, Though
And why did I just say, “for the most part”? Yeah, you caught that, huh? Well, there is an extreme instance where a woman had a stroke due to a hickey because it happened on top of a major artery — that’s hella rare, though. What is more common is oral herpes transmitted through hickeys.
Not to mention the fact that a hickey is usually a bruise more than a wound; however, if your skin does end up being broken or you’re giving a hickey and blood is somehow transmitted…well, I’m sure you could see how this could be potentially problematic. Bottom line, get — and stay getting — tested. Just to be on the safe side. Hickeys or not.
9. A Dream About Getting a Hickey Is Actually a Warning
Remember how I said earlier that sometimes the person who is giving the hickey is doing so as an act of power? Well, along those same lines, if you happen to dream that someone is giving you a love bite, keep in mind that it probably isn’t about anything sexual; usually, it means that you are either in a toxic or stressful situation and you’re trying to figure out if you should approach it with logic or emotion. The more you know.
10. Sometimes Pain Creates Pleasure
Someone who enjoys being tortured or humiliated during sex, they fall into a category that is known as sexual masochism — and no, that is not what I am referring to here. What I am speaking about is the fact that, because pain and pleasure sensations are housed in the same part of the brain, when mild pain is felt, that could be why it arouses you — and that could be why you may enjoy receiving hickeys (I mean, if you actually do). They both have been proven to create a dopamine and opioid surge, which can intensify your sexual responses and reactions.
____
Hickeys do tend to create a very polarizing response: folks either adore them or loathe them. Either way, now you know what they’re all about, so if you’re on the “A” team, share it with those who are also in your club.
It could make them appreciate hickeys — love bites, suck marks — that much more, chile.
Dig in. #wink
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Featured image by Giphy