Episode 11 (Season 1 Finale)- Black Maternal Mortality with Dr BCW

Transcript

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Most people think dying during childbirth is a thing of the past. But that depends. Of course things are better than they used to be. We have more knowledge, better training, and better equipment. All of which make childbirth much safer. However, Serena Williams, one of the greatest tennis players of all times, and black sports icon, almost died giving birth in 2017. So with all of these advancements, Why do black women die in childbirth over three times more than white women? Often it's argued that the problem is a lack of access to quality care, which is absolutely a big part of the problem. But if Serena Williams, who can access the best healthcare on the planet, almost felt victim, it's more than access. Despite her access and celebrity status, She encountered a situation that many black women face. She knew something was wrong. She told her healthcare team, and she was dismissed. If she hadn't kept insisting, she would have died in childbirth because of the invisibility that unconscious bias creates. So, what is unconscious bias? It's the social stereotypes about certain groups of people that we form on our own, without realizing it. These are the gut reactions we have to how people look, talk, and behave. Unconscious bias in and of itself is not a bad thing. In fact, It's something we all have. However, when unconscious bias systematically creates a damaging outcome for one group of people, it's something we need to look at more closely. The risk black women face in our healthcare system is a complicated topic, and there are many interacting factors. So today, I want to bring to light how race based medical practices and unconscious bias together impact Black lives. Welcome to Pulse Check, Wisconsin. Good morning, good evening, good afternoon, whatever it may be for you. This is Chris Ford again from PulseCheck Wisconsin, and I want to thank you guys for not only joining us for this episode, but also for supporting us all throughout this first season. Believe it or not, this is our season finale we are at episode 11, and for this episode we have a very special guest, a doctor who not only is known nationally, but also internationally. But she also advocates for women's health, for improvement in social determinants of health. A lot of great things, speaks to these things at a national level. TED Talks, she's had two of them. Dr. Bayo Curry Wensho. In lieu of doing a case, I asked Dr. BCW, as we call her, to share with us some of her own personal journey, not only in medicine, but also with an encounter that she had while she was delivering one of her children. And in that, kind of, Wraps up some of what we're talking about here, especially in the state of Wisconsin, where we see maternal mortality and infant mortality rates be the highest in the country. I also had her speak to some of the community supports that are had in. the national stance as well as things that are available for folks here in the city of Wisconsin. So a lot of great information that was gleaned from this and we will go ahead and start our interview with Dr. BCW.

Bayo: 4:57

So first, thank you so much for just having me here, Dr. Chris. I'm excited to be here. So I'm Dr. BCW or Dr. Bayo Curry Winchell, vwhich is Quite a mouthful. So I go by Dr. BCW, um, and, um, it really reflects who I am, which is, um, a mixture of things, the blend of things. And I'm a family medicine, urgent care physician, and also subspecialized in sexual assault and response. So I'm a medical director for a couple of hospital systems and the founder behind, um, beyond clinical walls, which is a way to provide health literacy and a digestible. Engaging and informative format. And we're doing that across the nation and just helping people. So, but also I always like to share, I'm a practicing physician as well. Um, so there's lots of things that are a part of me all rooted in helping people.

Chris: 5:50

Yeah. And I feel like that's the biggest message too, you know, on top of all those things. Kind of that bedside, you know, person to person approach of medicine in general is just invaluable that that that gift that we're able to share with people and also that opportunity we're able to have just to help people one on one. It's just that words can't describe that.

Bayo: 6:10

I agree. You know, when I be, when I decided to become a physician, my thought was I have been privileged to have all of this amazing information. What can I do to share it beyond myself? And so as I started practicing and I thought of all the advocacy work that I had always been doing, why not make it even broader? Because that's the whole point. We want to help people. And so it's It's just been fantastic to not only practice medicine, but really elevate equity in that and a variety of topics, whether it's general topics or maternal health, which you know is so close to my heart.

Chris: 6:48

Absolutely. And we'll, we'll get more into that too. Because I'm really interested in having you share that with our community because I think it is going to be, it's going to touch so many, so many lives But before we do that, can you explain kind of your journey into medicine? We've been doing this series where we have been talking to different physicians in the area, just talking about their journey for folks that are interested. And specifically what inspires you to go into your field to become a family medicine doctor?

Bayo: 7:13

Well, um, I always like to start with the reason why I get to do what I do. And that all comes from my father, William Curry. So 99 year old world war two Korean and Vietnam war veteran, Chris, and I grew up going to different events and rallies and. Advocating for just a wide variety of things. And I remember holding up signs and not knowing what I was really doing there, but knew I was doing something to help someone. And that is the reason why I decided with medicine to go beyond, with, seeing patients in every way that I can to help people. And so my journey was really non traditional. So I knew I wanted to help people, but I wasn't sure at like kind of what route would be best. And so my major was actually psychology. I worked in the autism behavioral analysis program, and I found myself wanting to know more about just the inner workings of the body and What else could I do? So, uh, I saw that there was a physician assistant program and my parents were both military and I grew up actually seeing physician assistants. So I applied and got in and I, it was actually in Ohio and then did rotations and started working in occupational urgent care and family medicine. But there was this calling where I was like, I really want to do more. I really want to learn more. I want to connect those things. dots in a way that provides more depth and I want to be able to provide more, you know, just overall care. And so I took a leap of faith and I had one individual in particular, Dr. Fairmont, who just believed in me. And I said, I want to go to med school. And often we hear Chris, where people have come up to us or you hear stories of people saying, They want to go to med school and people are like, no, no, no, you shouldn't do that. Are you sure? But this man did not do that. He said, of course, of course you can do this and helped me along the way. And imagine if we had more people who just leaned into immediately when someone said, This is my dream. This is what I'd like to do. What you could accomplish when we talk about building pipelines of representation and all of those spaces. So he said, yes, he helped me. So I was working as a PA as I went through to get all of the extra classes I needed to do. Uh, left my job when I got accepted, uh, went to medical school, then did my residency back in Nevada and, helping people ever since. So a very non traditional journey. But my heart is just filled with gratitude for just the journey I was able to take. And again, all credit goes to my father, um, who just recently passed away. And, He is the reason why I get to do what I get to do. Um, he was the first start, the first person to really believe in me. And, that's, that's why I do what I do. It's, it's a love it's, this wasn't just something I started doing. I've been doing it my whole life. And, um, just. Thinking about what can I do now? What can I do to hopefully help someone in a way? That meets their needs from an individual standpoint.

Chris: 10:25

And what a tremendous journey. And thank you so much for sharing that. And God bless your father for creating such an amazing person and an amazing physician. Because, you know, like you said, it, it, it, there are so many barriers in the way, especially for minorities, especially for women in general, in terms of going into healthcare, especially to become physicians, uh, at that level. And it it's amazing what just one mentor will do. Right. I can't tell you much, much like your journey, how many people on the way said, you know, that's too hard. You should consider this, you know, and for a lot of folks, it unfortunately is that final barrier that prevents them from. Taking that next step and providing more physicians in the community where we already have a Staggering shortage at this point in time and so, um, you know kudos to you for for going on Thank you to your dad to your mentors for helping to push you And and for you for knowing that that wasn't the route for you to go you you felt like it wasn't right uh, you know when you're at your Suspected final destination of pa

Bayo: 11:27

Yeah. It just felt in my heart. I was like, I, I want to learn more, even though I was doing, I loved being able to provide care and I, Received a great foundation of information and, and being able to help patients. But I just knew, especially when I was going on rotations, even as a PA student, I was like, there's something amiss here. And when I share that story, some. People often wonder like, Oh, did you apply to med school and not get in? I did. And I just, I love the foundation of PAs where that connection and spending time, at least that was what was often socialized. And, um, so that was the calling. But then I thought I can do this as a doctor. It's part of my personality anyway. Like any patient who sees me, they know I'm going to give you my all. And so. So, um, I was able to truly give them my all by going to medical school and, and immersing myself in full education and helping people.

Chris: 12:21

Yeah, and more like you talked about. So that that personal experience, one thing that we're going to get into today is is a thing that you're you're a staunch advocate for, and a national expert at this point in time. And that's more. So maternal health, um, how was your experience as a medical professional? Both in the professional realm as a PA and then, going on to get your MD, how has that experience shaped your understanding of maternal health?

Bayo: 12:46

It has just really provided a new perspective. So as I mentioned before, of course, advocating, I've been in this work of health equity for a long time. And I remember as I was going through PA school and through medical school, things that were Just not right. And I would think to myself, why are we looking at people based on the color of their skin? And more importantly, when I say that, I mean, why are we treating people based on the color of their skin? Why do we have certain algorithms, different things? Based on that, and then really understanding, you know, race is a social construct. But why are we saying you get this medication because of the color of your skin versus the individual pieces? And as I went through PA school and med school, I just, again, continued to kind of formalize these thoughts and thought, what can I do? And a lot of people don't know, even before social media, you know, really started, I was already advocating for these things and just trying to, um, put the word out. And you mentioned with all the intersectionalities that. Everyone carries, but as a black woman in medicine, it is very difficult sometimes to just even be able to be seen, be heard, and then even when you have those two pieces to be able to put it forward. And so the evolution of seeing the things that I knew weren't right. And continuing to push to make a change has just been really enlightening. And also. The challenges that I continue to face and have faced in the past fuel me to get stronger and just think of different, different ways to reach people. And then one more example is we're so politicized. There's so many different things that really trigger people. And so I thought with all the learnings that I've seen, all the challenges that I faced, if I can find a way to share information in a disarming way and make it digestible. That is one way to move the needle when we talk about disparities and inequities, and that's why I created the series that I did, and that's why I do the work that I do. I just reshape the information you and I know, but I put it in a way that people can take in and feel like they're not being talked to, but they're a Part of the conversation and that way, then they can make the decision themselves. And so through all of that, it's just been amazing. And, you know, those challenges, which I know we'll get into have also, um, ignited me even more to see what I can do.

Chris: 15:26

Yeah. And you bring up a couple of good points there too, especially, you know, in the populations that are affected the most by health disparity, um, and healthcare complications, you know, in the African American community. There's a lot of mistrust that feeds into some of those disparities and as you've spoken to very eloquently in some of your TED talks and some of your interviews, There's a lot of historical context to that too. Right. And having someone, you know, like, like yourself in that position to be able to break down those barriers and to be able to give it in a palatable way that folks understand folks don't feel like they're being talked that folks don't feel like they're being experimented on as, you know, you commonly hear, um, you know, when you're doing bedside medicine, those things are going to be the way forward that we help break down those walls of those healthcare disparities and break down all those barriers that are in place.

Bayo: 16:16

It's so true. And it's interesting because we know those stories exist. And I often bring forward the fact that I got to hear it firsthand because my father being 99 years old, that's what the age he was when he passed away. I heard his mistrust. I saw the mistrust. I also saw how he was treated in the healthcare system, even as a veteran. And so, I use that to think of how can I lean into positivity because there's so many different things that are a problem in our healthcare system. But if I can find a way to create a positive lens and help people. That is a win win when you're trying to kind of climb this hill.

Chris: 17:04

And one thing you brought up there too is that lived experience, right? And one thing that you spoke to as well in the past was kind of your own journey in that, right? Specifically with in terms of maternal health and maternal health complications. Um, can you share your personal experiences with childbirth complications and what challenges did you face even after that?

Bayo: 17:25

So, uh, we all know, we've heard the statistic of Black women dying at the highest rate during childbirth or shortly thereafter. And it's really interesting because, of course, I've always known this statistic, and I've been advocating for maternal health and health equity all throughout. Um, But to have a personal lived experience of it a whole nother story. And to your point, that lived experience. And I decided to share what happened to me because when we hear about inequities and disparities, you often hear it's an access issue. We need to have more access. That's going to be the change factor, or we need to have more insurance options. That will be the change. And that's a part of it. But the piece that isn't. Talked about is the bias in healthcare, the racism in healthcare. And when I say bias, often it's not of malice. It's just a part of us. And by sharing what happened to me, I'm able to tell all of the elements that I faced. It's not a one directional piece. And I think that's the part that I really want to highlight when we talk about this crises. So I had just delivered my second child. I. Come out of the O. R. And I knew. I didn't feel the same as I did after my first delivery. I was having a hard time speaking. And if you know me, even through different things, I smile. I'm a positive person, but I just felt this extreme fatigue and inability to really Articulate and, and concentrate. So I shared that with my nurse and I said, something's wrong. Can you call my doctor? And she said to me, you look fine, Byo everything looks okay. This is normal. And so I sat with that and then it started to get even worse. And I said to her, I don't even know the time that lapsed, but I said, it's getting worse. I am not feeling well, something's something's wrong and I'll never forget. All right. She's like, your vital signs look fine. You look good. This is how you're supposed to feel. And so I'm sitting in that and it's getting worse. And I'm asking my husband, I said, can you just call my OB? And luckily physician to physician, of course I have his number in my phone. Phone and he called him and said, can you come over and see bio? Something's wrong. And he came over and he knew that I wasn't myself. And I say knew in the fact that he took in that I, he, he just knew that something was wrong. So they took me back to the OR. I was bleeding internally. I'd retained products. I was transfused five units of blood. I was hospitalized for two weeks. So I almost died and. I share this story even though it's painful in hopes that I can save another woman's life by knowing that I had the most access in the world as a physician, as a medical director, and that did not help me. So we have to think about how this goes beyond access. It goes within bias. And I think, you know, with the nurse, it's not that she was necessarily trying to hurt me by any means, but in her mind, Her assessment was based on what she felt like look like in pain, what she felt like that imagery of someone who needs help. And that's the part we have to invest in because if we don't, we're going to miss the mark on why this crisis keeps happening because we hear about, Oh, we built these amazing centers or we have all of these wonderful professionals to help advocate. This is still happening. So it's many elements that we have to, that we have to invest in. And I am sorry. I still, it still takes me back every time I share this story, but it's worth it because I just want to help people.

Chris: 21:36

Absolutely. And thank you so much for being so brave to share that. And I'm sorry to conjure up those, those feelings down

Bayo: 21:43

hear.

Chris: 21:43

but like you said, that's going to help someone. And, and I feel like what you spoke to most was even in the best of circumstances, you know, like you said, you were a medical director, you were a medical professional. you knew the OB, how many people are going to have that ability to contact and how many people are going to have that, you know, so to speak that internal pull to say, Hey, something is not right. And they're sent home or, you know, they, they wait in the hospital until things go wrong. Um, and so, you know, I think the biggest thing that I've, I've learned from hearing you speak and from watching some of your interviews and things like that, if something doesn't feel right, Definitely speak up. You are an advocate. You are worthy. You, you know, you, you know your body, right? And I can't tell you how many times like that has been life saving for a lot of patients and had similar experiences like yourself.

Bayo: 22:35

And it's interesting that you say that. So with all the work that I've been doing with equity and, and raising awareness, my advocacy piece from that experience has gone threefold. And because when we think about. There'll always be sexism, racism, all of these things that are fractured in our healthcare system. But what I try to do through all of the mediums that I'm sharing health information, I tell you about it, but in a way that's digestible, I raise awareness, but I also help you know how to advocate for yourself in that moment, because that is how you're going to move that needle. And so if I can create content, which I'm able to do, that helps you say, Oh, this is. About this topic. Now I know what questions to ask. I know what I should be getting and what I'm not getting. That is powerful. And that is health care. And I think that's the part that I am just hopeful that more people look at because that's how we're going to really get there. Produce change.

Chris: 23:39

Yeah, absolutely. And, you know, I'm going to plug everything, uh, beyond clinical walls to this episode, because, you know, the information that you're giving and especially that lived experience is, is paramount and, you know, I feel as though making it palatable for so many folks that are going through similar, avenues is, is, is the way forward.

Bayo: 23:59

It is. And people are often surprised, you know, they want to know like, cause what you see on online can be different from behind the scenes. And so I'll share with you, I mentioned I'm a practicing doctor, but I write all my own content. Of course, my husband is an engineer for a company, but he does. The videos at like 1 AM, like this is a small, but mighty team, all rooted in what can we do to help people? And the part, the reason why we have it that way is there's a level of authenticity to what we are putting out there. There's not this overlay of extra pieces. It's a physician, a black woman who is sharing information and hopes to fold, help that health literacy, but build that representation. Because if a black or brown girl can see someone that looks like me, because you don't see my face, someone who looks like me on always on national TV or all these other platforms. Then maybe you're going to think I can do this. Or you're someone who's facing an illness. I see someone that looks like me and she can help me in a very digestible manner and is approachable and is actually seeing patients. That's a win win in so many different ways. And that's why I do what I do.

Chris: 25:16

Absolutely. Absolutely. One thing that I wanted to touch on here was, you know, we see a ton of factors that you spoke to in the beginning. You know, it's not just access to, you know, physical health care. You have the ability to go to clinic. It's not just access to insurance things of that nature. What are some of the most significant factors that you see contributing to the high rates of maternal mortality, specifically amongst black women in the United States?

Bayo: 25:43

I would say, you know, when we think of bias, um, whether it's due to your thoughts of what pain should look like, what your thoughts of someone. What someone should get as far as care. Those are really important pieces that are adding to this crisis, because when you look at some of the studies that have shown it spans across all social economics. So this is really a, an issue of course, racism and bias, but that those two pieces, I think we're missing the boat. I do think of course, dualism midwives are helpful and they're a part of it, But if that bias still exists, and this is something I often say, if that clinician isn't listening to the patient, what's going to change for them to listen to that doula, that midwife and so forth. If we haven't invested in the bias piece or the imagery piece of what you think should be going forward, for someone to get help during their pregnancy, or when they're coming to you saying, I have this certain concern. Those are the parts. And then literacy, health literacy, the more you're informed, the more you can really say, you know, I don't feel right in my pregnancy. And this is the reason why. And I know These things could be due to preeclampsia, other factors, or a big piece that I often I've done multiple videos on this, we forget that during pregnancy, if you've had any complications, it actually increases your risk for heart disease down the road. So if you are facing, you face an issue and maybe your doctor, not because of malice or ill intent and so forth, just didn't share that with you that, Hey, you should get your heart checked out. One month, three months, six months, or just keep an eye. If you have any of these issues, that could be a sign of heart failure. Imagine by sharing that with that patient, how informed that they can be with their health. So there's many elements to this crises and the parts that we're missing is really embracing all of those areas and highlighting our voices. Those of us who are seeing patients, those of us, you and I that are advocating, we are. Practicing physicians, we are people who are seeing the underserved and I, I actually am very careful with that word. Historically excluded populations that deserve to know more information about their health.

Chris: 28:20

yeah. And no more information in a way that is palatable to, like you said, breaking that down, you know, just speaking at people as we've seen historically doesn't work. Right? Like, if you're, if you're speaking, you know, medical at people, no one knows what you're talking about in these situations. So, breaking it down in a way that is acceptable, breaking it down in a way that's palatable is, is, is important. It's going to be the only way that folks are going to know those complication risks, and they're going to return, you know, before things get too bad.

Bayo: 28:48

And a good example of that is when I was approached to do the Ted, the TEDx talk, I thought we often hear this, this, this statistic, um, but people don't really have someone that they can connect to. And I think stories are so powerful. And I thought to myself, if I can share my story, even though it's painful, it will allow someone to think that way. Deeper about that statistic that they see. Think of like their approach, all of the things that they associate with it. And then I knew I needed to make sure that I delivered the speech, in a very disarming manner, because if you come at. Come at it attacking or saying, well, this and this is happening. And this is why without inviting people in to share the information and tell your story, you're going to miss the boat and you're not going to make progress. And that's why I did it. And, um, I, I get messages every day of black and brown women saying, thank you so much for sharing your story. I feel empowered. During my pregnancy or I feel empowered now after and that's what it's about.

Chris: 29:59

Absolutely. We talked about, um, some things that medical providers can help to, can do to help support black mothers during before and after childbirth. Do you think there's any interventions that we can do specifically at the medical training level to help address those implicit biases and ensure better outcomes for black women?

Bayo: 30:19

Yes First I start with diversity, of course, and we know that in representation But when I mentioned stories, there's a reason why if your class is diverse imagine the color all of the the things that you're going to have and added to your education from the friendships, the acquaintances, all the people that you meet will shape how you deliver your health care for future patients. And so I think that part is a very important piece. And then when it comes to bias, being able to Really have situations where people can share. These are the bias that I have and not feel like they're, they're bad people. And there's a part of my talk that I talk about. We all have unconscious bias and it doesn't mean it's a bad thing. It's something that we all have. And I highlight it's something the way how people look, talk and behave. And I use those examples because I think when you do that, everybody can reflect on that. It doesn't mean that they were. You know, coming from a bad place. It's just these things that pop in our mind, but it's what you do with that. So once you can acknowledge it, then the work starts to be able to reshape it or think about where did that come from? And that allows you to build that. That kind of pipeline to share, Oh, this was not what I thought it was, and this is why I thought, and then share that amongst others. So I think that's a powerful piece that we need to bring in and have those stories, have patient stories, have people come in and highlight what has happened during their pregnancy, because if you can have that connection, it brings it into a different perspective.

Chris: 32:01

Yeah. And, and I feel like a lot of medical schools are starting to go in that direction. We just recently had on, um, one of my good friends, Dr. Nimmer, who spoke to, uh, the program that she's running through the children's hospital, which is a D and I initiative. And it's more so geared towards opening up those doors, taking those objective measures and saying, these are my implicit biases that are going into patient care that are going into my day to day activity. Like you said, there's nothing that. We're looking to penalize anyone for it's nothing that we're looking to, wag our fingers at and say, you know, you're wrong for thinking this way, but more so taking the next step and saying, how can I make these changes in my thought process to prove to prevent, you know, premature closing in a patient diagnosis to kind of shun, you know, that, that, that vital sign abnormality and say, Oh, everything's fine. It'll, it'll be okay. Right? To open yourself up to be that advocate for your patient sitting in front of you.

Bayo: 32:56

Yes. And then also, um, you know, I have students that still rotate with me, medical students and residents. And when they present, I will ask them, so tell me why you said what you said. Tell me why you said the pain doesn't look that bad. And I, And I do it in a very deliberate and an open way that allows them to think about, well, why did I say it like

Chris: 33:21

Yeah. Mm

Bayo: 33:22

And then the unconscious bias comes into play and they're able to see it. So, I think if more medical institutions, of course, that training, all those things that we talked about, but pair them up with preceptors that can allow this delivery of D. E. I. in a way that they can just learn from it and see. See it. I think that's going to be something that could really help change, because we can all read books, we can all do certain things, but if you can have someone that can bring them in and understand it, that's amazing. And I, I get to do that through students and to see that like light click and they do it for me. So it's bidirectional. They're like Dr. BCW. Well why did you say that? I'm like. Oh gosh, I did say that. And you know, and, and, and this part, you'll, you'll resonate. We all, those of us who are still teaching, why do we do it? Because the student keeps us on our toes. They keep us fresh, right? But they can also keep you fresh as well on your bias. So I think that would be an amazing thing if we could do more of that. And that's why I'm like, I'll take as many students as I can, because I love that.

Chris: 34:37

we're all learning from each other and medicine in general is a lifetime learning process, right? It's one of those vocations that you have to always keep, you know, the doors open, always have to be learning and even from an own personal standpoint, right? Like, you need to check yourself and say, like, where, where am I at as a person right now? Where am I at in my emotional intelligence? Right? And so those are things that students and are going to be invaluable with. Providing as you know, we're getting more and more generations of physicians that are going to be coming out.

Bayo: 35:07

I agree. I actually use that often in my, in my speeches. I'm like, you got to check it, check yourself, start with you first. And, um, you know, cause I give talks to amazing organizations and often organizations that are like amazing FQHCs and, you know, their heart is in the right place, but they're often surprised when I'm able to highlight some of the bias that they do have. And again, it's. It's not you. It's just something that happens. But once you can recognize it, and I help you recognize it, it's fantastic.

Chris: 35:39

One of the things that we talk about is kind of that advocacy and that empowerment arm that, that you're so, um, uh, powerful at doing for your patients. What, how important, just in general, as we talked about a little bit before is self advocacy and ensuring better health outcomes. And let's say, you know, you have, a pregnant patient that comes to you. What are some, of the techniques that you will, will sort of teach them to advocate for themselves down the road?

Bayo: 36:08

So first, um, the first thing I tell all my patients, pregnant and non pregnant, don't doubt yourself. Do not doubt yourself. What you feel, what you are concerned about should be honored. Should be trusted by you first, because when you start with that, that helps you then advocate because if you have that self doubt, all of the things that I can teach you won't be able to really flourish without you believing in it. yourself. So that's the part I start with. And then really highlighting different topics, different things that are a part of different diagnoses, whether it's preeclampsia, whether, but in a digestible way. And I, Put the puzzle together in a way of symptoms. And this is related to this, and this is why, and this is why this could be a problem, but I do that in a very condensed manner and a way that lets them know why they should be concerned. And if they see someone who doesn't acknowledge, cause I get this question often, well, I saw somebody and they weren't hearing me, Dr. BCW. They weren't listening to me. What should I do? And so one of the ideas that I have, which often people are like shocked when I say this, I say, ask, tell that clinician that you don't feel like you're being heard because having grace is so powerful because a good example is we've all had a friend where we thought we were helping and then they tell us. Why didn't you help me? And I'm like, I thought I was, and there was just a misstep and that can happen even in those clinical encounters. So if you feel comfortable telling them, saying, I don't feel like you're hearing me because they may be in a space thinking they are hearing you. So those are some of the examples and I have other ones as well that I use to empower patients to be able to ask. Advocate for themselves. And, um, you know, I get to do it in person online. Every medium that I can do, I'm going to tap into it just to try to help people because we all take in information differently.

Chris: 38:19

Yeah, no, absolutely. And you never know, you know, what medium will be the key to get to that, you know, that thought process to get those gears turning as well. It's different for everyone, like you said. And, you know, maybe it's a TikTok video. Maybe it's a short, right? You never know what it is.

Bayo: 38:35

That's exactly why I do all of the different mediums. And I, I love it. I'm like, okay, this one could reach this. And as clinicians, we are taught to really meet the needs of our patient and be malleable to our patient. So I'm just doing that online or in person and being able to connect with people, throughout the world. and It brings my heart so much joy. And, uh, we don't often hear that people are excited to go to work. When I told you I was running late, I will share with everybody because I was seeing patients today, but I love it. Yes. But I get excited, you know, to see patients and, um, yeah, it, it brings my heart joy.

Chris: 39:19

Absolutely. One of the things that we talk about often here on the show is our policy and some systemic changes that need to happen in order to better promote public health. What policy changes, if any, do you feel are necessary to improve maternal health outcomes for black women?

Bayo: 39:39

Invite black women from all professionals to the table. That is a big piece of understanding stories, different things that people have experienced, things that we know, especially those of us on the front line that no haven't worked. And we can share why. The other thing is inviting all specialties. I'm a family medicine doctor, but I've been trained. In OB GYN, I've been trained in pregnancy. I've been trained in preventative, all of those areas. And I think often it's thought that it has to be one specialty, but family medicine doctors. We see anything and everything that comes through our door and we are the anchor. And I think when you think of this crisis, having more family medicine doctors, talk about the things that they're seeing and also more patients, but also patients and physicians that can share that story. And that's why another piece of sharing my story here, I am. I flip, I fit both sides of the coin where I can. Tell you as a doctor, the things that are supposed to do, and then I can tell you, or that we are supposed to do, but then I can tell you what happened to me

Chris: 40:51

Right.

Bayo: 40:52

as a patient. And I think if having more of those stories available, when you're creating policies, think of how much more rich and in depth they will be. If you invite those people to the table.

Chris: 41:10

Yeah, yeah, we often talk about, you know, some of the attacks that we're having now on initiatives at a national level. Um, and we also talk about how having that diversity of perspectives at the table. Will create an environment where we're going to avoid some of the pitfalls that we commonly see. Right because if you have everybody at the table, thinking the same way. Right. We're going to fall into the same traps that we did before, and we're not going to move forward.

Bayo: 41:37

Right. And when we think of all the, the, the data points that we know from the past, when we talk about knowing our history, that's because it wasn't diverse. That's because there was this one thought from one perspective of how things can be. So if you don't really allow the opportunity to diversify the policymakers that you have in place. You're going to just create the same thing and the same thing that we continue to have and continue to say, this is an access issue only.

Chris: 42:11

Absolutely. We talked about, some of our, our, our mutual interests and some of our mutual, uh, programs that we work with. One being vote ER that we had on earlier in the season. Are there any existing programs or initiatives that you can think of that are making positive impacts at putting people in those seats, uh, in order to have that diversity of ideas, and what can be learned from programs like those? Yeah.

Bayo: 42:37

March for Moms, I think they're fantastic. I've partnered with them in many ways where they really highlight stories, patient stories. They highlight, um, doulas, midwives. All of the pieces that need to be a part of this crises, um, are amazing. Another real change maker that I'm really grateful brought me in because when we talk about this problem, like you mentioned, we have to have someone sometimes because the, the room is filled with some, with people who don't look like us. So if someone who doesn't look like us can invite us into the conversation. That is a way to really, you know, kind of shake things up and be able to produce change. And so Liz Powell with the women's health med pack, which is, nonpartisan or bipartisan movement for women's health. And she reached out and she's like, Dr. BCW, I want you to speak to this room and share. And a lot of them were legislators, policymakers, just everyone and share your story. And I can tell you, Chris, just from that moment, it was amazing. All of the people who came up and were like, I didn't think about it like that. You changed my perspective. And so the work that her and her team are doing for the women's health pack has been fantastic. March for moms as well. Um, those are just a few of the names, that are just doing. And one more, I have to put Stacey Houston. Um, from six degrees, it's a fantastic nonprofit. And when we talk about people being open to cold calls, I reached out to her and I said, you know, Kevin Bacon has this amazing podcast. I would love to bring forward maternal health. And she said, yes. And, uh, was like, let's do this. And. It's amazing because that opened the door. She had just had her child and she's a black woman. And she was like, let's bring this to the forefront. And here you have a platform that's doing great things and isn't traditionally in the maternal health space or health space, but accepted it and said, let's do this. And we did a, you know, a podcast with that. And we have some other things that we're going to be doing as well. So those are just some of the, some of the things, but invite people that you wouldn't normally invite. To the table, because you see the same people often at big conferences or different things. Imagine if you just kind of disrupted it a little bit and invited someone non traditional to that space, that would be really powerful and helping people reshape policies.

Chris: 45:20

Yeah. And any, any policymaking. It's been my experience that being uncomfortable is a good thing. If that's okay. Right. If you have that diversity of thought and diversity of ideas and diversity representation of different communities of interest. Whatever it, it's going to get you to a point where you find out how some of the ideas that you're having, how that could fault over across the scenes right across the board. So, like, you're saying, you know, having that community, having that support, having everyone there at the table to have a seat and to make inferences on what can be done and why certain things can't work is the way to go.

Bayo: 46:01

Yes, that's the starting point. If you can go from there, imagine versus just resharing all the things that we already know. But if you can really disrupt by sharing those stories, those things that are not working well, but providing solutions. And I think that's the biggest thing because we hear people raising awareness. But for me, I want to help somebody at the bedside who needs. Tangible ways to say, this is how I need to stand up for myself. This is what I need to know about this diagnosis in a very bite sized manner. That's my jam. That is my, in all areas of health. Like that's what I love to do. Um, it feeds my soul.

Chris: 46:44

Yeah. One thing that we spoke to is the power of having a community and the power of having a support system. In a lot of cases, as I'm sure you see as well in your practice, there are a lot of mothers who are kind of walking this journey of maternity by themselves. What are some things that you see that communities can do to better support black mothers throughout their pregnancy and especially during their postpartum periods? Because a lot of folks don't understand, you know, that postpartum period, you need equally, if not more support than you did during the pregnancy itself.

Bayo: 47:21

I would say investing the same investment that you have from the beginning, have it to the end and increase it because there's this thought of mom and baby, but we also need to look at often. It's heavily baby focused, but we need to make sure mom is. A part of it as well. And so when we think of the many checkups that we have for to check on the baby, we need to have those same checkups for the mom moving forward as well. And that should tap into your mental, your physical health, your social health, All of those pieces are what we need. And when we look at those who are, um, pregnant and, and may not have a partner or have a circumstance because they do not want to partner, which we need to honor as well, thinking about. The bias that you associate with why they don't have a partner or what social economics they may have pulling back from that and finding ways to think about how can I help this person as an individual, how can I help them through their health? That part, I think, is what healthcare systems need to look at when we talk about unwrapping, uncoupling, that is a way to really make that person first and foremost be seen, be heard through their individual situation, because all things aren't what they seem, and if you approach it in that manner, You will miss the boat and not help that person as well as you could have.

Chris: 48:58

Absolutely. One of the big things that we are dealing with here in the state of Wisconsin, um, is one of the pieces that we talked about, you know, it's not everything, but it is one of the pieces and that's access to health care postpartum. One of the things that we're seeing is the failure of expansion of Medicaid here. We call it BadgerCare in the state of Wisconsin for postpartum women at this point in time. That coverage is only extended to 60 days postpartum as compared to the other, you know, states. We are, you know, a couple of the states here in the, in the, in the, in the union that don't have that expansion to 12 months. And so, you know, initiatives like that are gonna be important to cover women. It needs, like you said, not only, uh, from a physical standpoint, but from a mental health standpoint. There are a lot of things that are going on from a social standpoint as well to help promote. Not only the health of that baby, but also to focus it on the mother too, because as we saw before, as you spoke to in your own testimony, even in the best of circumstances, things can go wrong and they happen often. And if that happens, you know, if you don't have access to care, if you don't have access to insurance, a lot of times folks will come to the urgent care centers or they'll go to the emergency department. And unfortunately it's too late at that time sometimes. Right. And so we want to make sure that we're, Putting our money where our mouth is in those initiatives and making sure that we are continuing to reach out to people who are legislators who are, you know, not as medically versed, but sitting at that table and making those decisions.

Bayo: 50:23

It's so true. Um, you know, I work in an urgent care as well, multiple jobs. And I see women who come in postpartum and have these ailments and things that have been going on. And the, one of the things that I often hear is I thought this was supposed to be, I thought this was normal. I thought this is what I'm supposed to, or I just thought it's not that bad. And they have this. Self talk of like dampering their own symptoms. And that leads to a longer, uh, delay and actually being seen. And again, those complications then are just festering and it. Could have been dealt with sooner, but then there's this, you know, concern. I didn't want, I often hear, I didn't want to waste anybody's time. And I say, it's your time. You're not wasting anyone's time. This is your health. And those are the pieces that we have to, um, really look at if we want to make a change. And then also think about what do, what is the term access? And again, I like to kind of unroof things. So when we talk about policymakers, you know, of course people having access, but what is your definition of access? Is it a building? Who is in the building? Whoever's in the building? Are they trained in DEI? Are they trained in bias training? So there's so many pieces that we have to uncover to really know what access is and to deliver it in the right way.

Chris: 51:57

Let's look towards the future. Looking ahead, what are your hopes for the future of maternal health care for black women specifically?

Bayo: 52:05

First, my hope is that that statistic isn't a statistic. That's what I hope for. I hope for that black women can really have a pregnancy like other people have where it's not this thought when I get pregnant, truly could I die? Will I have a bad outcome? Will I be able to find a doctor that will listen to me? My hope is I'm pregnant. And I get to just have my journey like others and really being able to remove those pieces that are a part of that black woman's pregnancy journey and that those stressors add to increased heart rate. They add to mental stressors, all the things that we know can add to your overall health. And that's my hope because if we can tap into those things, imagine how much healthier mom and baby can be if we focus on those pieces. And that's my hope that when you get pregnant as a black and brown woman, that you're, you're, you get to relish in those pieces because the healthcare system has been able to take care of those parts that we are not able to do. Get at this point.

Chris: 53:30

Absolutely. We talked about a couple projects that you're currently involved with initiatives to help address these issues. Is there anything else that you would like to share with our listeners about black maternal mortality or your personal journey? Anything that you want to leave our listeners with? Absolutely.

Bayo: 53:50

you know, really think of this is this statistic. I can't say that word is it's actual people individualize it. So when you see numbers, when you see data points, think of me, when you think of maternal health. And when I say that it's a powerful thing for me to say, because my hope is the story that I just took the time to share my birth story. That that will live with you when you hear about this crisis, and you will see that this is affecting black and brown women across the world. And think about one thing that you can do, and that can even start with checking your own biases. Thinking about, why is this happening? And what can I do, even if it's just one thing, to make a difference? And that's what I hope for Chris, that more people can, can think about that and also invest in health literacy, invest in different ways that your organization healthcare system is delivering that literacy and look at how currently your outcomes could be better. If you just reshaped it, if you tapped into people who could actually meet those people where they are in different mediums. So that's my hope that people remember what I shared and, and make a difference. That's all that I asked for. And I'm grateful, so grateful to be on the show.

Chris: 55:26

And we are so grateful to have you here, Dr. BCW. I want to thank you so much for sharing your story, sharing your powerful testimony and all of the advice that you were able to give to our listeners. And, you know, we, we, we hope to have you on again. I'm looking forward to see everything that you are going to accomplish and we'll definitely link all those resources that you gave to us and, um, you know, beyond clinical walls, we're going to shout it from the rooftop. So,

Bayo: 55:53

Thank you. And the TEDx, I tell everyone to share it, you know, TED is nonprofit, but every time if you can share that story and share the, the talk, it's a mad, it's amazing what, you know, you can do to save a life from just those. Little 12 minutes.

Chris: 56:10

Yeah, absolutely. Absolutely. Well, thank you so much. Hope you uh, enjoy your your day. I hope you get some days off coming up here. So

Bayo: 56:17

Oh, I'm going back to work after this.

Chris: 56:19

Oh gosh, okay. Well Enjoy the work All right, my friend, There was a recent article. That was published by Wisconsin public radio. Back in December of 2023, that highlighted some of the work of the states, maternal mortality review team. And they studied the 55 maternal deaths that happened in 2021. And in that work, they found that more than 90% of those deaths were preventable. One of the members of the team highlighted. That many deaths in Wisconsin are happening after the child is born. When people stop receiving the care that they need. From their obstetricians or from follow-up care. As mentioned in the interview. A lot of this is due to the lack of insurance or the lack to access of care. Here in the state of Wisconsin, we have, what's known as BadgerCare or Medicaid that is provided to mothers who are postpartum. Unfortunately in the state. That has kept it around 60 days. So that means that. A mother will lose the access to healthcare insurance. Coverage. After 60 days postpartum but you compare this to other states in the union and we see that. That is extended to about 12 months with Medicaid expansion. And so that's why on this show and you'll see me doing, uh, interviews and commercials and promos that are going to be coming up. That highlights the need for us to expand Medicaid here in the state of Wisconsin. As we are only in a handful of states that have not done. So. It's going to be a tremendous. Benefit for people who don't have access to care. And it's going to reduce maternal mortality. It's going to reduce mortality for patients that have a number of elements around the state. Getting back to maternal mortality. Oftentimes, it's not only due to the physical health of the mother, some types of students with mental health. Sometimes due to addictions as well. But all those things again, will be covered. If we have better access to care. And if we address these racial disparities, We can reduce. Pregnancy related deaths. One thing that this article mentioned was while black people represent about 10% of the state's births annually. They represent about 21%. Of pregnancy related deaths each year. Now as always. Especially as we're getting closer and closer to national elections. There are a lot of sentiments on both sides of the Al. That. Make statements like this. More provocative and difficult to discuss. However, as we sit before being uncomfortable is, okay, we need to discuss racial disparities in healthcare. We need to discuss ways that we can improve the health outcomes for folks who historically have been affected disproportionately by racial disparities. And the way that we do that is to be upfront. Is to. Lean into the science and the statistics that we have available. And also have folks at the table. Like Dr. BCW. Who have experienced. Racial disparities. Firsthand. Again, I'll link this article to. This podcast I'll link. Dr. BCWS. Information to this as well to her website. As well as to her podcast, she also has a podcast in addition to all the other amazing things that she's doing. And we're hoping to have her on again, just to touch base and to. Keep us up to date with. The things that she's doing and the things that we can hopefully in the future, collaborate on. To help bring you more information and to help. Less than the divided. That is created by these racial disparities in healthcare. As always. I want to thank you all. For joining us here today. Again, this has been an amazing first season. I want to think. Everyone who has subscribed when I think everyone who has provided. Um, commentary and, their questions, these things are going to be super helpful in going forward. Looking forward to season two, we're going to continue to touch on some of these hard hitting healthcare topics that affect your health every day. And we're going to continue to bring you. That transparency because as Dr. BCW talked about. Our goal. Is to be advocates for our community. We're looking to provide you with the truth and what. We see as deficiencies in healthcare. And to provide that bridge to folks who may have a hard time understanding. Why they're on these medications and historically may have some mistrust in the healthcare system with, again, Is well-rooted and there are good reasons for it. So we're hoping to lessen that. Load for folks. And we're looking to continue to, again, bridge that gap. So again, too. All out there. I want to thank you. Enjoy the rest of your summer. We'll see you in a few weeks. When we start off with season two. And as always. Take care of yourselves. Take care of each other. And if you need me. Come and see me.