American Delivery

Newsreel announcer: For nine months, you will provide a snug home for him.

But if you are like the average mother-to-be, when it's nearly over, you'll be ready.

Woman: Get this birth going.

Newsreel announcer: But there isn't any doubt that the day will soon arrive when you will be going to the hospital.

Soon, your doctor arrives to take charge of things.

He will be following your progress closely.

Helpful doses of medicine may be given to you if you need them.

Try to keep your mind free of worry and hurry.

You can rely on your doctor and his helpers, you know.

Woman: Okay, one more big push.

Look, look, look!

Newsreel announcer: He will be a fine, healthy baby, announcing his arrival with a good, loud cry.

[Baby crying loudly] Hi!

Woman: There's this big fallacy in the United States.

Most women think we have the best maternity care in the world when we know that is not true, especially for women of color.

Newswoman: Amnesty International reports women in this country are at a far greater risk of dying in childbirth.

This is happening in a country that spends more on health care than any other country in the world.

Newsman: Maternal mortality is dropping dramatically around the globe.

The one exception, the United States, where the rate is actually rising.

And for Black women, it's become a literal life-or-death situation.

We've been watching this trend for almost 20 years.

When is it going to be enough is enough?

Nina: I'm a longtime investigative journalist concentrating on gender issues and women's issues.

The Lost Mothers Project is a project I did in 2017 with ProPublica and NPR examining maternal mortality in the U.S., really trying to answer the question of why the U.S. is the most dangerous place in the affluent world to give birth.

We scoured through as much data as we could find.

There wasn't a lot of it out there.

So, we decided to reach out to women.

And in a couple of days, there were already 2,500 responses.

You know, it was just a sign of the pent-up desire for women, for family members to talk about what had happened to them.

The first story we published was about a nurse named Lauren Bloomstein.

She gave birth in the hospital that she worked at.

Lauren: Daddy.

Daddy.

Nina: And her husband, who was a doctor, was there with her.

She started feeling complications of preeclampsia.

They were not recognized.

After she gave birth, her symptoms cascaded.

And she died of a brain bleed 20 hours after she gave birth.

Lauren Bloomstein was a nurse, and that hit the medical community really powerfully, because this was one of their own.

Lauren was White.

She was affluent.

She was not who the statistics eventually told us were most of the people who died, women of color and lower income.

We discovered that Black women were three to four times more likely to die in pregnancy, in childbirth, and in the post-partum period than White women.

I think we really showed providers were woefully unprepared for the major causes of deaths and complications.

Over and over again, we heard stories from women about how they had said, "This doesn't feel right.

"I know there's something the matter with me.

I know my own body."

Man: We are ready.

Woman: We are so ready.

I'm excited and nervous.

[Kiss kiss] -Ya lo tienes?

-S.

I have no idea.

-Maybe just-- -Try it again.

Jess: Morning.

I was going through a hard time trying to get pregnant for many, many, many years, through medication.

I had PCOS since I was 13 years old.

Polycystic Ovary Syndrome causes you to be infertile.

Once I got pregnant, my whole world turned upside-down, and I'm like, "Oh, my god.

Am I really ready?"

-There it is.

-Okay.

I want a baby, of course, but it's just something that you don't know what you're gonna go through.

You know, there's miscarriages.

You hear that all the time.

So, that was one of the biggest anxiety for me, was, "Is this gonna be real?"

Escuchas su corazn?

Jess: But today is the day.

Doctor: You're three to four centimeters dilated, which is great, and brought baby down.

So, that baby's head is right there.

I'm gonna start half a dose of medication.

That'll amp up these contractions.

I think we can just do the low-dose med first.

She's already contracting.

Jess: Ay yi yi yi yi.

Nurse: You feeling one?

Jess: Yeah.

It's starting to hurt.

Nurse: All of a sudden?

Two seconds of Pitocin.

Let me just see what he's doing.

Jess: Oh, my god.

[Beep] Nurse: He doesn't like the Pitocin just as much as you don't.

Let me feel your belly.

Jess: Ow.

Ow.

Hold on.

It's giving me a cramp in my leg.

Uh!

Okay.

Nurse: Yeah.

His heart rate is just going down a smidge, but... [Beeping and whooshing sounds] -Hello.

It's Sarah.

-Call Sybil Sailofsky.

Can you just come to two?

We're deceling.

-Yeah.

-Thanks.

[Beeping] She's been hard since this has gone down.

Yeah, we can call for a terb.

So, what she's talking about is giving a medication to kind of reverse what the Pitocin did.

[Alarm tone sounds] Nurse: Urgent broadcast, labor and delivery.

[Ding] Can I have terb to birthing room two?

Terb to birthing room two.

We're gonna come on my side, okay?

Come towards me.

Doctor: We're gonna give you that medication and stop the contractions for a little bit, just to let baby recover.

Jess: That was worrying.

Doctor: It might just be early labor going on.

Your body is like, "I don't need this extra medication right now."

Baby is sounding much better now.

But baby did give us a good little dip right there.

Jess: Yeah.

Rodolfo: Better?

Jess: Yeah.

Rodolfo: It's scary, man.

Jess: I know.

Doctor: We'll get anesthesia in here, and then, once we have your epidural flowing, we can break your water.

Jess: Awesome.

Nurse: All right, little pinch and burn.

Ready?

1, 2, 3, pinch.

Burn, burn, burn.

Good job, Jess.

Perfect.

-Hey, ladies.

-This is Dr. Steed.

-So good to meet you.

-Nice to meet you.

I'm Dr. Airica Steed.

I'm the new CEO.

I'm trying to make my rounds across all of Metro.

What could I do to make your lives better?

Man: A lot of Black people and brown people don't have a lot of good conception of what Metro is.

People are refusing to even come to the hospital.

Yeah, there's a trust issue.

Dr. Steed: I am president and CEO of Metro Health here in Cleveland, Ohio.

I'm actually the first person of color, I'm the first female, I'm the first nurse to actually hold this position in nearly a 200-year history.

I know about misdiagnosis.

I'm a two-time survivor of preeclampsia.

My youngest daughter, she spent nearly four months in the neonatal intensive care unit.

She was born at a pound and a half at 29 weeks.

I was not offered high-risk pregnancy care until it was too late, until my situation was critical.

I survived something tragic to make a difference.

The city of Cleveland is the worst-ranked for women of color, mostly because of the significant and poor health outcomes.

Even though we're surrounded by the best of health-care providers, we're ranked the lowest for livability in the United States.

The progress is not fast enough.

But we are completely in control of how to change this narrative.

One of the things that I'm particularly proud of is our nurse-family partnership program.

Instead of the patient coming to us, we're going directly to you, helping you navigate becoming a first-time mom.

Woman: Any dizziness or seeing spots?

-No.

-Nothing?

Okay.

Excellent.

Jess: The first time we met, I was going through a really tough time.

I was very antisocial.

I didn't really go out of my house.

I would have attacks throughout the day.

Staying home was my safe haven.

Woman: As you continue to grow and as he continues to grow, if you're, like, out in the yard... Jess, voiceover: Without her, I think I would still feel lost.

Dionna: To trust me as their nurse, to even open up about their own medical history and, you know, hard topics of, like, miscarriage and depression and anxiety, those are monumental moments.

[Soft knock on door] Jess: Hi, Dionna.

I'm good, better.

-Better?

-Yes.

-How are you feeling?

-I'm good.

Good.

Hello.

How are you?

Doing a lot better now.

Yeah?

Yeah.

Pitocin did not work out for me.

But the nurse just told me, she was like, "You most likely won't even need it "because you're contracting so... pretty often."

Dionna: If your body is already doing its thing, I believe in the body.

It will happen.

Jess: Now it's a waiting game.

Dionna: It's the waiting game.

Hopefully within... two hours?

[Dionna chuckling] Hopefully.

I don't know, friend.

Ha ha ha!

We'll see.

I would be lying to you if I told you two hours or... because one other thing you have to think about is how well we're gonna push.

Pushing could be anywhere from 30 minutes to 4 hours.

It's called labor for a reason, friend.

You're gonna work it out.

Ha ha!

I thought this was gonna be easier.

Oh, no, no, no.

They make it look so much easier.

On TV, right?

Yeah.

"Just have a baby.

It's perfect."

All right, look, you let me know if you need anything.

I will.

Thank you so much for coming.

- No problem.

-I missed you.

I know.

It's been a long week.

I know.

It has been.

Rest.

Okay.

I'll be back.

Bye.

Nurse: With each contraction, we're gonna bear down.

You're gonna grab behind your legs, like, right here, and you're gonna curl around your baby like you're, like, doing a crunch, okay?

Yep.

And push.

Woman: Empuja!

Nurse: Two, three, four, five, six, seven, eight, nine, ten.

Respira por la nariz y agarra tu fuerza.

One more time.

Again, push.

Two, three.

Keep going.

Yes.

Four, five, six, seven, eight, nine, ten.

Woman: Ms, ms, hija, un poquito ms.

Good job.

He's right there.

Woman: Agarrate.

Agarra fuerza, para que salga el nio bien.

Okay, one more big push.

Here he comes.

Two, three, four.

Look, look, look!

Delivery!

[Indistinct voices] [Baby crying] [Kiss] Here you go, baby.

Here's your mama.

[Kissing] Woman: We would like you to have as much time with him as possible on the skin.

It helps baby to adjust to life outside.

Newsreel announcer: It might look like the moon, but it's something even more way-out.

It's a picture of a human fetus inside its mother's womb.

Woman: It was the 1950s when we shifted to thinking that anything medical was the preferred approach.

It was considered progress to have things all tech.

And when I was a nurse in labor and delivery, working night shift, I bought into all of it.

It was kind of fun.

You're in charge.

You make it happen.

You're not intentionally trying to hurt anybody.

I watched a video, women giving birth in the squatting position.

What I saw in that video was that the body knew how to have a baby.

I did this 180.

I was like, "Whoa.

"I'm here to just support.

I'm not here to take over."

Dominique: Well, all the statistics out there for women of color, it's very scary that you might have birth in a hospital.

So, it was...it's always a scary thought.

We looked up the Brooklyn Birthing Center, and they gave you other alternatives besides straight to Pitocin to induce labor.

We're just happy that we landed here.

Nurse: And the water was clear when it broke?

Um, it was a little clear.

There was a little blood in the...just a little.

Nurse: You're just gonna feel my touch and a little bit of pressure.

So, you're one centimeter, about 50% of faced, okay?

So, we do have a little work to do.

Dominique: Get this birth going.

Stretch.

Ha ha ha!

Almost.

Ha ha ha!

We don't know.

We're gonna find out.

Whoo!

This is a workout.

-Walk a couple of times.

-Okay.

Blow it out.

I'm breathing.

[Breathing deeply] Okay.

I need to sit down.

[Breathing deeply] Whew.

When you have the contraction, what I want you to do is rock from side to side.

Okay.

Got to get that baby in that right position to just rotate and come out.

But if it gets too uncomfortable on your knees, let me know.

We'll switch out the position, okay?

Okay.

Oh... Dr. Veridiano: Childbearing and pregnancy are normal things.

I came to this country in 1965 to further my career, a specialty in obstetrics and gynecology.

One Friday morning, after a busy night, I said to one of my colleagues, "David, if I open a birth center, will you bring patients to me?"

He looked at me and said, "You should go home and sleep."

Ha ha!

He says, "Because I think you are getting crazier and crazier."

1999 was when we moved in to start our business.

Hospitals are very important, but I think that's a place for people who really need them, people with complications of pregnancies.

But that's not the majority of pregnant women.

Malcolm: Gonna be dancing in a second.

Dominique: Hmm.

We are dancing.

We're having a party.

Woman: A birthday party.

Malcolm: Right?

Woman: Our special guest is late.

Ha ha.

Malcolm: Still has to break out of the pinata.

[Laughter] [Breathing deeply] Malcolm: That one was seven minutes apart.

The last one?

Oh, wow.

Okay.

Just keep it up.

Ha ha ha.

I was made for this.

You were.

Just take some big steps, wide steps.

Let's go, baby.

-Let's go.

-Come on, baby.

Woman: I'm here today because my daughter-in-law, Dominique, is giving birth to my grandbaby, and I have been the doula for all of my grandchildren.

Stand.

Breathe through it.

Stand.

[Breathing deeply] Marjorie: A doula is a person who supports a woman and her family in labor.

She's pretty flexible.

So, hopefully we can get those centimeters opening up.

Nicole: I'm gonna do another pelvic exam because she'll be at the 24-hour mark.

When your water breaks, after 24 hours, you're at increased risk for developing an infection.

At that time, we may have to have the hard conversation of "Do we transfer to the hospital "because she may need some augmentation for the labor, or can she stay at the birth center?"

If she has not gone into active labor, that's when we'll have to make the decision.

Nina: In many countries, most affluent countries, in fact, midwives are the primary deliverers of care, and then, when there is a complication, that's when you bring in the doctor.

So, what can we learn as Americans from other countries?

One of the ways that maternal deaths have come down noticeably in Europe is by standardizing care, making sure that providers know what to do if an emergency happens.

And it's also not just true in industrialized countries.

It's also countries that have far fewer resources.

[Speaking Swahili] [Speaking Swahili] [Fingers snapping] [Speaking Swahili] Okay.

[Fingers snapping] [Speaking Swahili] [Speaking Swahili] [Speaking Swahili] [Snapping fingers] [Women speaking Swahili] [Baby crying] Debra: 2006 was the first time I learned that maternal mortality rates had increased in California.

We formed the California Maternal Quality Care Collaborative, and it became a rally cry.

There were so many different issues that needed to be addressed, but we honed in on what were the most preventable deaths.

Deaths from hemorrhage-- almost every one of those deaths was preventable.

What I helped implement was the importance of measuring blood loss and nurses really stepping up to say not just, "I think she's bleeding a lot," but "here's how much blood she's lost."

We reduced the maternal mortality rate by 50% in 5 years.

Deborah: Who do we have in here?

We have a baby boy.

Ah.

Nice.

So, any anxieties or fears associated with your health or your pregnancy?

Anything that we can do for you?

Lindsey, voiceover: The first time I did get pregnant, I had a miscarriage.

That was probably the first time I was, like, "Oh, well...not as easy maybe as you think."

And then I was pregnant the following month.

Parker was born on August 11th.

He seemed small, but he went home with us.

Zach: It's okay.

It's okay.

Lindsey: At his one-month pediatric appointment, he wasn't gaining weight.

We packed bags and went to the hospital to live there for an unknown amount of time.

Finally genetic testing comes back.

Parker has a deletion in his third chromosome.

No one had for-sures on anything.

They just knew that they really could not heal... Parker.

Parker, are we headed home?

We are.

We wanted to give him the best possible life.

And for us, that was to bring him home on hospice and wake up each day and find something new to do and for him to experience.

I feel fortunate to have gotten to know Parker and to have been his mom.

We got to enjoy every single day.

[Beep] Okay.

Whatever mom needs in the particular moment in her birthing... in her birthing story, I'm willing to do for her, whether it's sit and cry with her, hold her.

She just needed her feelings validated, grief and hopefulness.

Man: All right.

One, two, three.

Ouch.

Just take your breath.

You're okay.

Good job.

Nice, easy breaths.

You okay?

Good.

He's all done.

We have Lindsey Hartsough for a repeat caesarean section.

We have hemorrhage meds in the room.

No contraindications to hemorrhage meds.

Her blood pressures have been a little elevated.

-Let's avoid methergine.

-Okay.

No methergine.

-Thank you.

-Time in.

You're gonna feel a lot of pressure for one second.

Deborah: All right, we've already started.

Everything's going really well.

You have a bit of scar tissue, but we're just taking our time through it.

[Indistinct] -It's a little tight.

-Yeah.

[Suction sounds] Clear.

All right.

Here it comes.

[Indistinct] Breathe, breathe, breathe, breathe.

I see a little baby hair.

Ooh, a baby head.

I've got your little baby head.

Oh, oh, oh.

Oh, my goodness.

It's a baby thorax, and it's a boy!

[Baby crying] [Indistinct voices] [Baby crying loudly] Zach: You've got mama right here, yeah.

[Baby crying loudly] Hey, buddy.

You're doing a good job.

-Can I have a wrap, please?

-Yep.

[Baby crying] It's okay, buddy.

I'm right here.

Dad's right here.

Dad's right here.

Mom's right behind you.

Debra: C-sections can save lives.

So, having safe C-sections is really important for our country.

It's the overuse of C-sections that is causing harm to moms and babies-- infections, blood clots, hemorrhage-- and abdominal surgery leaves adhesions, and that can cause lifetime pain.

If you're part of the group that has complications, then thank heavens for the technology.

But we also need to have the soft skills of labor support and know when to intervene and when not to intervene.

I want women to have all the options.

Man: Here at the University of Kentucky, we've tried to eliminate those kind of barriers, where it's just a midwife patient or just a high-risk patient.

It's all hands on deck to get the best outcomes.

That kind of collaboration that goes both ways is a really beautiful thing.

The safest method to practice is certified nurse midwives who are experts in normal, physicians who are experts in pathology and surgery working in our own lanes and crossing the lanes when it is best for the patient.

Waller, can you have a few more bites, please?

Yes, ma'am.

We'll share.

I'll eat the rest, and you eat this bite.

You know what?

I need some good growing food today.

I've got work to do.

Waller: Even if you're... even if the baby is coming out?

Chrissie: That's right.

I'll have a lot of work to do at that point.

My sister had her two babies with midwives, which rocked my world.

I consider myself extremely healthy, and so, I do think I'm a great candidate for birthing in the woods behind my house.

But I choose not to do that because I know the realities, that things can happen and do happen.

Midwives specialize in low-risk birth, and I think what midwives do, too, is making women feel like they're not on an assembly line of birth.

You think we got both eyeballs?

Joanne: I think we got both eyeballs.

My sense is she's agreeable, but she just needs a little encouragement.

And exhale.

Baby is sunny side up.

So, we want to spin the baby so that the smallest diameter of her head is what's navigating the pelvis.

Had a patient one time when I did this go, "That is the nicest thing anybody has done for me this whole pregnancy."

[Laughter] Slow, deep breaths.

Shoulders sink down.

Yes, we're telling you to move.

-Did she wiggle?

-Mm-hmm.

Come this way.

Oh, yeah, yeah, yeah.

You're...Ha ha.

There.

Look.

That's a midline baby.

Mwah!

Stay put.

Bon appetit.

Who doesn't love a good tater tot?

See you.

11:00?

Woman's voice: Breathe in.

Breathe out.

A little less.

-Okay.

-There we go.

[Exhales deeply] [Water splashing] [Monitor whooshing] Lisle: I can see she's getting lower.

[Indistinct] Uh!

Joanne: Everybody hates this part.

That means you're getting close.

You're focused and in control.

I'm about to lose my marbles.

That means you're close.

Look at me.

You've got this.

Collect yourself.

Yep.

[Breathing deeply] You're good at this.

I know it sucks.

Chrissie: Oh, oh, oh!

Oh.

Yep.

Yep.

I do need those to catch your baby.

Sorry.

I think it's time to get out.

I think so, too.

Ah, don't squeeze.

Do squeeze.

Joanne: Good job.

Good job.

Yep.

She's right there.

You've got a little bit of a lip that I feel like I can just push back, and you're gonna have a baby.

Chrissie: Oh, God.

Here we go.

Uh.

Joanne: Bring her down.

There it is.

That's it.

I see her head.

I see her head, Chrissie.

She's right there.

[Groaning loudly] Lisle: Good job, honey.

[Groaning loudly] Lisle: There she is!

Oh!

[Baby cries] Lisle: She's here!

Joanne: Yeah.

Here.

Pick her up.

She's got a short cord.

Chrissie: Hi there!

Joanne: Oh, you're cute.

Oh, my god.

Woman: She's bigger than I thought she was gonna be!

Look at all that hair.

You did it like a boss.

[Baby crying and laughter] "I love you, mom.

I love you already."

Aw... [Laughter] Hi.

I made you.

Joanne: You did, and then you pushed her out.

Lisle: Look at her nails.

Chrissie: I'm so glad that's over.

[Laughter] [Baby crying] All right.

Hey, Stacy, will you have Dr.

Edge come in?

I just told her I want to do an ultrasound afterwards.

Woman: Can I get Dr.

Edge?

-And the ultrasound.

-And an ultrasound.

Yeah.

I think we have a large placenta that part of it is detaching.

The placenta is coming out, but I can tell it's not detaching normally.

Her bleeding is brisk.

And so, that tells me there might be membrane still left inside.

Chrissie, push for me.

Yep.

Here we go.

Shh... Go ahead and do that ultrasound and make sure because she's... Lots of pressure there So sorry.

She said she thought there was something still, like, in the body of the uterus, so... Man: There's a little bit more tissue there.

Joanne: Are you okay if we give you the methergine?

-Yeah.

-Okay.

Joanne: I need to stop her bleeding, and I don't want her to be in pain.

That's all I'm thinking about in that moment.

We're just being patient.

Afterwards, that's when I have the waterworks.

Mmm... She had everything she wanted in that birth, and when I have a complication, we solve the problem, and she's okay.

Oh.

Ha ha.

Get all verklempt again.

You're so awesome.

Oh, my gosh.

You're here.

I'm so glad you're here.

Woman: You rocked that.

[Crossing alarm ringing] Woman: Being born and raised here and knowing firsthand a lot of the problems that my community suffers with, I can speak to exactly what affects us here in Dayton, Ohio.

We are considered deserted.

We didn't have access to grocery stores on the part of town where I grew up.

We didn't have access to acute care centers.

They closed two major hospitals in this area, which was detrimental, not just in terms of accessible health care, but the jobs that went with that.

This is the clinic that I work at.

Eri, we get to do a lot of baby-holding.

This is Darren.

Look at you, just sitting up there like a little man.

Say, "I just want to see stuff."

When I was in midwifery school, my nursing advisor was like, "You're gonna be the only Black midwife in southern Ohio," and I was like, "What?"

Feeling like I'm gonna make history, right?

So, I'm going everywhere, telling people, "I'm gonna be the only Black midwife."

And one of the midwives said to me, um, "Ask yourself why you're gonna be the only Black midwife."

Ohio is not the friendliest for midwives.

So, there's not a lot of jobs for midwives here, ones that don't look like me.

So, then there's me, really, really, you know, fighting to be able to provide for women and be with women, especially women who look like me who need me.

All right, I'm gonna feel on your neck here.

We provide care for people regardless of their ability to pay.

So, our patients have many other issues that are going on.

They're worried about, "Where am I going to sleep?

"How am I gonna feed myself?

How am I going to feed this child?"

We listen to what our patients are saying, and through that, we're able to kind of transform our practice.

[Indistinct voices] Toni: Our bra bank, our diaper bank-- we get to do all of these wraparound services for the women.

Now, my focus is breastfeeding, because I'm like, "How can I impact infant mortality, "racism, and give the mother some control over the situation?"

And so I started a Black breastfeeding support group.

For our--especially for our new moms-- The ones of you who are already breastfeeding or have breastfed for a long time, help me encourage these women, like, your why.

You're breastfeeding why?

It's really good with bonding, and, like, if the baby gets sick, your body will give out medicine for the baby.

-Really?

-Mm-hmm.

This group is Black Breastfeeding Support Group, right?

Black babies die here in Montgomery County at about four or five times the rate of White babies.

And so, if you breastfeed, you decrease your baby's risk of infant mortality.

A lot of women initiate breastfeeding, and they don't make it to six months.

That's the purpose of this group.

When the naysayers are in your ear, when you're struggling in the middle of the night and you want to give up-- because it's gonna happen-- we all are in this together.

[Laughter] [Newsreel music playing] Newsreel announcer: A few days or a few weeks after your baby is born, you may feel depressed.

Perhaps you feel that you can't cope with all your new duties or that your husband doesn't show enough interest.

Don't worry about these blues.

Get out to a beauty parlor.

Nina: In those days, post-partum depression was still called "the baby blues."

You had it for a couple of days, and then you were done.

We now understand that more than half of maternal deaths happen in the post-partum period.

But after a woman gives birth, she goes home, and everybody forgets about her at a time when she needs attention and care.

[Children playing] Child: Ha ha ha!

Nina: I wish we could create a system that's not a medical system; it's a care system.

We wouldn't just save lives because we would be recognizing physical symptoms and giving women medicine.

We would be saving lives because we would be giving them help and nurturing.

[Baby crying] Jess: So, today I talked to my psychiatrist.

She wants me to try Prozac and see if that helps the mood, because she gets worried about the post-partum.

The last time I talked to her, I was, like, crying on the phone because I'm like, "This is really, really hard.

Like, I didn't know motherhood was this tough."

I get, like, two hours of sleep.

And if I want to take a nap, I just can't, because I get worried that he's gonna throw up and, like, suffocate.

It is good to know that you do have, like, the, like, medication support.

I just don't want you to get so hard on yourself.

A lot of people will say the same thing, like, "I wasn't expecting it to be this hard."

But it is, especially in the beginning.

What are you doing for yourself these days?

We don't really do much.

Sitting on the porch at all?

No, you don't go outside?

Mm-mmm.

I just want to chill.

You do know...you do know it's okay to go outside.

Even if you put him down and he's fussing, it's okay.

Air, come back, reset.

Now we'll step out.

Oh, it is nice outside.

-Isn't it beautiful?

-Mm-hmm.

Listen to nature, the birds.

You know, those moments kind of like get your mind to kind of think a little bit, like, off what's happening now.

Anything to get your mind to kind of step outside the box.

Dominique: You always want things to go according to plan, especially your birthing story-- no drugs, all natural-- and she had other plans.

I just wasn't dilating.

So, when it was determined that we had to go to the hospital, I immediately was like, change of plans, like, I'm in a car while having contractions, writing up a birth plan, like, "We've got to make sure they do this."

And as soon as we pulled up to Woodhull Hospital in Brooklyn, my contractions hit me even stronger.

And when the doctor came in and was like, "Her heart rate has been dropping.

The best bet is to go C-section," I broke down because I thought I was the reason why I couldn't give birth naturally.

But it was because the umbilical cord was around her neck.

That's why I wasn't dilating, and that's why she wasn't allowing me to get to that point where I could push or anything, because her life was at stake.

[Indistinct] [Indistinct] Malcolm: It wasn't our goal, wasn't our plan, but it worked out for the best, and she was here.

I was determined to breastfeed since day one.

In the hospital setting, they were pushing the formula thing on me a little bit.

But I was determined.

I was like, "Give me a breast pump."

And I was adamant about my pumping schedule.

I was breastfeeding by the end of discharge day.

I just love the connection that we have, and I'm happy that my body is able to produce for her to live healthy.

It is long past the time that we rang the alarm.

It is time that we did something about this.

And this, ladies, is our moment!

[Applause] Thank you for joining Cleveland's first Women's Health Fair and Empowerment Expo.

A lot of what happens in health care is not just within the four walls of the hospital.

There are social drivers of health, like food insecurity, like housing insecurity, like addressing education gaps.

I want to treat the community as the patient.

We need change from a policy level.

We need more resources poured into underserved communities.

The statistics are unacceptable in a nation as technologically advanced as the United States.

Nina: Maternal health has become really politicized over the last few years.

And now you have Dobbs disrupting health care, disrupting education.

You can't silo reproductive care in its own little box and separate it from maternal care and infant health and well-being and family health and well-being.

All these things are connected.

We're at a moment where systemic change is going to take time, but all that other change is possible at the state level, at the hospital level, at the advocacy level, at the research level, and the personal, human level.

We can actually push change by joining forces with each other.

And it's possible because we want to do it, not because somebody is telling us to do it.

It's because that's what people want and that's what they know, and they can make it happen, we can make it happen.

Guess how much he weighs.

Nine pounds, eight ounces.

-Oh, my god.

He's big.

-He is big.

There you go.

Here's that break we were talking about, right?

Dominique: I want women to speak up.

If you ever feel anything off about your body, speak up about it.

Don't hold it in.

Don't say, "I don't think that it's that big of a deal."

Speak on it.

Let them know that "I'm feeling this, and I never felt this before.

What's going on?"

Because nobody knows your body better than you.