

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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Your September 2023 Horoscopes Are All About Much-Needed Closure And Positivity
September is bringing things full circle. This year has had a lot of ups and downs. There have been some major wins in the start, but there have also been a lot of moments of growth, some more uncomfortable than others. With September beginning in Virgo Season, with Mercury retrograde in Virgo, and Venus retrograde in September, there is a balance needed to be had with what is falling away and what is coming in.
The insights are powerful in Virgo Season, and there is also an underlying energy of pressure to get it together. Remember this time is not about overworking or overthinking and that the energy of the month is more about bringing things together and coming to positive conclusions.
September 2023 Horoscopes: An Overview
Venus officially goes direct in Leo on September 3rd and will remain direct in this fire sign until October 8th. Venus in Leo is inspiring, creative, and bold. Take what you have learned in love, especially about yourself in love, and use this energy to create more abundance and happiness in your life.
Jupiter goes retrograde in Taurus the following day, facilitating a different set of areas of growth and influencing finances as well as love. Jupiter will be in retrograde until December 30th, so the rest of this year is really about planning thoroughly financially while also setting your intentions and believing in miracles for yourself here.
On September 14th, there is a New Moon in Virgo, and this New Moon is bringing a fresh perspective. This is a time of harvest, and many will be seeing the manifestations they have been working on since springtime, bloom for them now. This Virgo Moon is here to create divine order and stabilize blessings.
With Mercury moving out of retrograde and going direct in Virgo the following day, the Virgo energy this month is creating impactful change, a new beginning, and much-needed closures of what wasn’t working. This is a month of turning a new leaf and standing in your power.
Finally, before the month ends, the Sun moves into air sign Libra, and Libra Season officially begins. Libra Season is different from Virgo Season as in Virgo Season, we are inspired to work, get it together, and take care of everything we have been putting off. In Libra Season, we are inspired to love, tend to our relationships, and create beauty and art in the world that Virgo Season helped us build and manifest.
On the last day of the month, there is a Supermoon in Aries, and just when you thought the energy was settling, some big changes and closures occur.
Keep reading to learn what September has in store for your zodiac sign.
September 2023 Monthly Horoscopes for Each Zodiac Sign
ARIES
In September, you are being reawakened, Aries. This is an eye-opening month for you and a time when a big impact is being made in your life. You are seeing things in a new light, and you are spiritually evolving. Jupiter goes retrograde at the start of the month and highlights your financial zone. This month is the starting point of a four-month-long journey of defining your values, your integrity, and planning for the future.
Toward the end of September, the Sun moves into your 7th house of love, and you get some more time to spend on your relationships, your pleasure, and your heart. You are getting redirected this month and putting yourself on the path that is going to serve you and your goals the most. Before the month ends, there is a Supermoon in your sign, and you are truly breaking free and stepping into your power.
TAURUS
September is a much-needed reality check, Taurus. You are getting the answers you are looking for, but it’s taking some time to adjust to new perspectives. What you thought was put in the past is being brought to your attention again, and thankfully, you are ready to put down the defenses and come to some important conclusions. Venus moving out of retrograde and going direct on September 3rd will be helping you facilitate that new beginning, especially in the home.
The most important transit happening for you this month is Jupiter in Taurus going retrograde from September 4th until December 30th. For the rest of this year, you will be unpacking, processing, and getting to know yourself better. Jupiter wants to open your eyes to more of who you are, and this time is all about showing up, using your voice, and honoring your multi-faceted, growing self. Surrender to the unknown, knowing the universe is supporting you every step of the way.
GEMINI
A chapter is closing in your life this month, and you are ready for a change, Gemini. This transformation you are moving through in September couldn’t have come at a better time because you are tired of the emotional stagnation you have been feeling. Jupiter goes retrograde in your house of endings, healing, and closure this month for the rest of this year, and this is helping you heal. You are making sense of the patterns and stories that have been playing out in your life and are moving on.
Your ruling planet has been retrograde since late August and goes direct on the 15th of this month. With this breath of fresh air coming into your life in mid-September and a Supermoon in your 11th house of community and friendship the week following, you will have moments of freedom, connection, and acceptance that are profound. Even though you are moving through some changes that are, at times, uncomfortable, you can clearly see the good you are creating in your life as well this month.
CANCER
September is a month of happiness for you, Cancer. The Sun is shining, and you are elated with its beams shining on you. This is an inspiring month and a time when you are seeing the happy outcomes you have been wishing for. You deserve to feel good, to feel healthy, and to be in your power, and this month is reminding you of that. The New Moon, happening on September 14th, is a new beginning for you in regards to open communication, and you are liking what you are hearing this month.
Moving further into September, the energy shifts as the Full Moon occurs in your 4th house of home and family and helps you open your eyes to where you can gain more stability in life and where you can put more of your efforts. The key this month is to not let anyone steal your joy or your shine but to also give a helping hand and to use your newfound inspiration to help better the lives of others as well. Your life is expanding, and it’s beautiful.
LEO
Your dreams are coming true, and it’s time to act as if it’s already so. Your belief systems are key this month, and your guidance is to focus on what you want and to believe and know that it’s yours. You have come so far and are reaching some important achievements and milestones this month, Leo. The month begins with Venus in Leo finally moving out of retrograde and allowing you more room to breathe in self-love rather than the self-criticism that has been more prevalent as of late.
Mercury is retrograde in your 2nd house of income and finances until September 15th, and once Mercury goes direct, you are seeing yourself in a better position financially than when you started this retrograde in late August. You are learning more about the importance of valuing yourself and your dreams this month and are overall seeing the positive progress that has come from you just believing in yourself and your vision for your life.
VIRGO
Happy Birthday, Beautiful Virgo. The Sun is in your sign for most of September, and you are feeling the creativity, passion, and divinity in your life. New paths are opening up for you, and you are the perfect one to pave the way. You are inspiring others, shining your light, and creating experiences in your life that not only benefit you but those around you as well. The New Moon is in your sign this month on the 14th, and this further signifies the new beginning and magic you are personally bringing into your life this month.
September is a great time to manifest and focus on creating what works for you and what lights you up. With Mercury being retrograde in your sign for the past few weeks, you have had to deal with miscommunication, delays, and disagreements. Mercury goes direct on September 15th, and you are seeing things clearer than ever and communicating with more clarity and strength than before. Through the challenges you have been through, you have only come out of it stronger and more fierce.
LIBRA
September is about protecting your energy and using your time wisely, Libra. You have figured out who and what you want in your life and what you don’t- and there is no going back now. The more you can choose yourself, choose your values, and choose self-love, the greater impact the decisions you are making can have. The energy begins to move into your sign this month, and the focus turns on you, however, it’s up to you what you do with it.
Libra Season officially begins on September 23rd this year, and you are done with moving mountains and are ready to enjoy the view at the top. You have shown yourself what is possible for you in life, and you have stood your ground on the things that are important to you. On September 29th, there is a Supermoon in your opposite sign, Aries, and you are coming full circle in love. What goes around comes around, and your good karma in love is coming around.
SCORPIO
September is a spiritual month for you, Scorpio. The month begins in Virgo Season, and you flow well with this earthly energy. You are focused on stabilizing your emotions and really understanding your thought processes and inner discoveries this month, and it’s serving you well. Jupiter has been in your 7th house for the past few months, opening your eyes in love and blessing your relationships overall. This benevolent planet goes retrograde at the beginning of the month, and you may be feeling more tested over the next few months to see if you have done the work here.
The decisions you have made and the paths you have walked have all led you to where you are right now, and you are making sense of it all this month in a more vulnerable way. You are lighting your way forward, and the New Moon on the 14th is inspiring you to new heights. Manifestations are appearing, and you are recognizing your power as a creator. Before the month ends, there is a Supermoon in your 6th house of health, work, and routine, and you are taking care of business as the month ends.
SAGITTARIUS
This month is all about working smarter, not harder, Sagittarius. The potential for overworking or overthinking is likely this month, and you are being guided to take things one step at a time. You haven’t gotten to where you are now without your stamina and determination, and that energy isn’t going away now. With the Sun in your 10th house of career for most of the month, you are thinking about the legacy you want to lead right now.
Your ruling planet, Jupiter, goes retrograde this month and will be moving in retrograde motion in an area of your chart having to do with your daily life and well-being. Taking care of your health, planning thoroughly, and leaving room for growth in your working life is what this time is all about. A Supermoon is happening on the 29th before the month ends, and you are ready to focus more on love, your happiness, and the romance that you are being inspired by in your life right now.
CAPRICORN
Success is yours this month, Capricorn. This is a dynamic, powerful, and abundant month for you, and your efforts are being acknowledged. Something is shifting in your life in September, and you are truly feeling appreciated for who you are. You are inspired by the beauty you see in others, knowing this is a direct reflection of yourself, and you are claiming your blessings in September. Own your power, own your purpose.
The New Moon happening this month is occurring in fellow earth sign, Virgo, and it’s creating a new sense of adventure in your life. You are not attracted to the norm right now and are ready to step out of the box, learn new things, and connect with people who support you. The Supermoon on September 29th will be closing a chapter in your life, and this chapter has to do with your home, family life, emotional well-being, and sense of security. This month is about balancing your home and personal life with your professional one and knowing there is a difference.
AQUARIUS
September is all about patience, Aquarius. The work you have been putting in will show fruition, but more time and dedication may be needed this month. This is a good time to develop your skills and talents, expand your mind, and take intentional action on the things you are looking to grow in your life right now. With the Sun in your 8th house of commitment for most of the month, there is a lot on your plate, so remember to ask for help or support when you need it.
Mercury goes direct on the 15th in the same area the Sun currently is, your 8th house. With Mercury going direct mid-month, you are starting to see new developments, more ease, and greater balance in your close relationships. Intimacy feels like it’s blooming into something beautiful in your life, and you have been moving through an emotional transformation. Before the month ends, there is a Supermoon in your house of communication, and you can expect a message from the universe at this time. Listen to the guidance that is coming through for you this month.
PISCES
September is a month to take a step back, process, and gain some renewed energy before moving forward again, Pisces. Mercury is retrograde in your 7th house of love until mid-September, so for the first half of the month, you may be dealing with some communication challenges and a lack of understanding of the heart. Your love life is going through a change, but you need time to process and define what that is truly going to mean for you in the long run.
Jupiter, one of your ruling planets, is also going retrograde in September and will be moving retro in your house of communication until the end of this year. Jupiter overall will be helping you find your voice and encouraging you to take up space. Remember that sometimes being you is more important than being understood. There is a New Moon on September 14th, and this is a good time to set your intentions for where you want to see your love life and relationships head, where the support is in your life, and how you can grow with love.
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