Hot Comb Survivors
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Hot Comb Survivors
Hot Comb & Hospital Gowns: Confronting Racial Disparities in the Delivery Room
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When Dr. Mackenzie Boyce—a physician herself—was nearly discharged from the hospital with undiagnosed preeclampsia just four days after giving birth, she realized a terrifying truth: medical training and knowledge couldn't protect her from a healthcare system that routinely fails Black women.
The Hot Comb Survivors gather with two medical professionals to unpack the crisis of Black maternal health in America. Dr. Paige Long-Sharps, an OBGYN with decades of clinical experience, doesn't mince words about what's driving maternal mortality rates that are three times higher for Black women: "Absolute racism in this country. There's no ifs, ands, or buts about it."
Through Mackenzie's harrowing personal story, we witness how racial bias manifests in real-time—delayed care, dismissed symptoms, and dangerous discharge decisions that could have cost her life. Her experience confirms what statistics have long shown: being educated, affluent, or even medically trained doesn't shield Black women from the devastating impacts of healthcare bias.
The conversation moves beyond problems to solutions, exploring how advocacy, better mental health support, and consumer power can create change. Mental health emerges as a surprising leading cause of maternal mortality, with women often left without support during the critical weeks after birth. The group proposes revolutionary ideas like postpartum mental health check-ins within days of delivery and developing an app to help women navigate maternal healthcare.
Most powerfully, they remind us that economic pressure works. "We have to believe in our consumer power," one panelist notes, encouraging Black women to research hospital statistics, build relationships with providers who listen, and share information about their experiences—because hitting healthcare systems in their pocketbooks may be the most effective path to transformation.
Join this essential conversation about truth, trash, and transformation in maternal healthcare—where acknowledging hard truths leads to life-saving action for Black mothers and their babies.
Meet the Hot Comb Survivors
Speaker 1Hello , I'm Denise .
Speaker 2I'm Lisa , I'm Takisha and I'm Laverne .
Speaker 1And we're the . Hot Comb Survivors .
Speaker 3Come join us . It's an opportunity where women of a certain age will talk truth , trash and transformation . Today's guest is Dr Paige .
Speaker 4Long-Sharps Talked about it before , it's a real informal space Just really want to have the opportunity to capitalize on your presence and expertise . We know that you are one of us , a hot comb survivor , so we appreciate that perspective sister girl , sorority , all the things . So I think just having you in this space to have this dialogue is so important and we appreciate that . Just want to share with our listening audience a couple of things about you that I think are important for them to recognize that the value that you bring to this conversation . So Dr Long-Sharp is a certified OBGYN with decades-long firsthand clinical experience working with patients in large hospital systems like Montefiore here in New York . During her time in a clinical setting , she served as both a physician advisor and a medical director . Paige has always been very vocal about the need for doctors to be trained on or to be made aware of unconscious biases and how those biases impact patient care in particular . I know that after leaving the clinical setting , you spent some time teaching at Page University and that gave you the opportunity right to catch students in the education phase and share the importance of kind of raising awareness and themselves being aware of how bias impacts patient care . And I know that currently and the reason that we're focused here on this conversation . We know that you're a strong advocate and voice for the education on Black maternal health , so we're excited that you are able to join us today . I would also be remiss if I didn't mention that Paige is my SORROR , a member of the fabulous Alpha Kappa Alpha Sorority Incorporated , the Pi Iota Omega chapter in White Plains , and to make us all aware that the sorority is also very active in the discussion on Black maternal health . So definitely want to give you your props where they're due . I appreciate you being here . Thank you for having me . Just to introduce our next guest .
Speaker 4We have an additional guest here as well Mackenzie Boyce . I do not have Mackenzie's bio in front of me so I may have to wing it a little bit , but Mackenzie Boyce is first and foremost my daughter . She is a graduate of Downstate Medical School . She is currently finishing her last year in residency , where she serves as the chief resident . She has worked as a psychiatrist in some of the most difficult places in the New York area . Her resume includes places like Kings County and Jamaica Hospital . She is also very passionate about the education of doctors and the issues around bias . She has herself had that experience as a medical student and is looking for opportunities to assure that generations of doctors going forward have the opportunity to be engaged in the discussion . She has a host of extracurricular activities as well the mother to my amazing grandson Kai , mother to Bea . She also serves on the charity , she sits on the West Ham Junior Board , and so she is passionate about giving back to community as well .
Speaker 4So glad to have you here as well , mackenzie , excited to hear your story , and it's just really nice to have you and your mentor in the same space . I mean perspectives as someone who's budding in the career and someone who's a little more seasoned in their career . So we'll have both ends of that conversation today , so I'm just going to open it up . I'm just kind of a broad question . I think we have all heard the statistics , right , about Black maternal health and they're startling , right , and so I think the one that's probably most publicized is that the rate of Black maternal morbidity is three times that of white women , right , and that's nationally . And then there are some spaces where it's much higher , right , so certain hospitals and in certain demographics it's even higher than that . I guess my first question is why ? What is driving that level of disparity ?
Speaker 2Want me to answer first what I think about that . When I think about how it's popular now and we're saying the numbers are high , I think our social media , our artificial intelligence , our data recording indices , so to speak , have become more sophisticated , that we're now capturing numbers more adequately . So I wouldn't necessarily say , oh , this is something new . It's new that now we have social media , we're able to now record in labor rooms . We are hearing stories of patients and their family members saying that different things go on . So I think we're hearing about it a lot more .
Speaker 2With that said , what is the reason why ? And absolute racism in this country ? There's no ifs , ands or buts about it . That is the bottom truth of why . And then , when you think of racism , we can break that down even further . We have just systemic racism , just overall .
Speaker 2And then , when you break that down further , you have structural racism . You can break that down even further . You have institutional racism , then you have state racism and then you have organizational racism . So that's it . On a structural basis , you have individual racism , and so we have our own innate racism that we internalize from our own experiences . And then we have interpersonal racism that people have shown us more personally and directly , but that is the bottom line of why these numbers are the way they are .
Speaker 2That is the bottom line of why these numbers are the way they are and , interestingly , the CDC has just come out and said that the numbers actually have dropped . So you had , I believe , say , over 800 deaths in 2022 . They're not dropping drastically , but a drop is a start and it's maybe 600 and so in 2023 . However , guess what segment rose ? Wow , non-hispanic Black women . And so that is sad , that , although the numbers have come down overall ,
Understanding Black Maternal Health Disparities
Speaker 2we are continuing to rise and that's just not good . So I'll leave it there . In terms of the why is basically racism . But then you can throw in our health care systems , the inequity . You might have an excellent health care system in New York State . You have rural areas where hospitals have closed , where women are driving two hours to even get adequate care . You have , yes , the decrease in doctors going into particular fields , be it OB , everyone wants a certain lifestyle now .
Speaker 2They don't want to be on call , they don't want to go spend all night watching a patient went to labor and monitoring and all of that . We have also women of color . They get more C-sections because doctors are rushing out . They want to go play golf , they want to go do whatever . They have their own lifestyles . These are just some real things that we , even as the medical community , need to acknowledge , need to address and need to work on and try to rectify and correct . But those are some of the just broad reasons why these inequities are continuing , especially in women of color .
Speaker 4Wow , that's startling , right when you hear something like oh , people are having C-sections because doctors have T-times , right . So . And I think , as we try to kind of push past the numbers because I think folks hear the numbers and I'm not sure how that gets processed , but I think even as impactful as the numbers are the stories , right . So what's actually happening behind these closed doors in these labor and delivery rooms ? We can say that it's racism , but what does it look like in the room , right ? And so how do you identify what way something is kind of amiss here and I don't know .
Speaker 4Kinsey , if you want to jump in at this point , kind of give some sense of your experience so we can frame it around that , how it played out . And here's a situation where she's giving birth , a medical professional herself . I'm in the room with her . She chose a midwife because she felt like she would have better outcomes if there was a midwife . We had checked the many of the boxes and still things really went left really , really quickly . And in processing that back , mackenzie , maybe you want to share , and then we can kind of dissect where the racism happens in that situation .
Speaker 2Yeah , before you answer that , mackenzie , it brings me back to my own training . I'm a woman of color , but I was taught , for example , hispanics their pain tolerance is way up here . So pull back and giving them pain medication , pull back and giving them every dose when you think back . But when you're being told this , I'm a woman of color , I'm not even really institutionalizing that in my head , that this is racism . It's wrong , wrong . But these are things that you're even in your training , that you're taught in terms of how to even manage different patients . So go ahead and answer . But when you said that , it just brought to my attention that these are things that even talk to physicians of color and we don don't even say wait a minute something's wrong with that .
Speaker 2Hopefully they are now , but back 30 years ago not necessarily .
Speaker 6And even today , I remember sitting in a lecture and we were addressing Black maternal health , which may not have even been the case in trainings past , but they actually went through the PowerPoint and when the numbers slide came up , the presenter said and we're going to skip this one because it's too morbid , right ? So ? And this is a room full of training doctors , eventually going out into the field and treating hundreds and thousands of patients over the course of their career , and you won't even show us the numbers in an effort to protect the organization , the career , the title , and I remember that being startling to me as well as a woman of color and as a doctor . Teach me what the numbers are so that we can do something about it . I mean , it seems like things may be better , but they're not where they should be . So , but I can now , mommy , if it's okay to talk about went on with my particular situation .
Speaker 6So I went to work , worked from home on August 16 , went into labor didn't really know what that felt like , because it was my first baby Promptly did what most physicians do I went to my mother to ask her exactly what I was supposed to be feeling .
Speaker 6Is this normal ? Very calmly just started timing the contractions , seeing if it was time to go . I called the midwife , let her know what was going on . She told me to wait it out a little bit . Eventually we got to the point where they were coming a little bit more consistently . We drove to the hospital . Once we got to the hospital they checked me three centimeters dilated , 90% of face , I was admitted . Things seemed like they were headed in the right direction according to my lovely , well thought out birth plan . Anesthesiologist was there . I got the epidural in time . Things looked like they were headed for smooth delivery .
Speaker 6I labored without pain for about 24 hours or so and then
Dr. Paige on Racism in Healthcare
Speaker 6was fully dilated and it was time to push . Pushed for about three hours and that's kind of where things started to kind of break down a little bit . Felt very fatigued , felt very nauseous , very dizzy and really felt like I was losing consciousness . They brought in alcohol swabs to kind of bring me back to during the process because I really really was not wanting to be cut open . That was something I was really adamant about . But where things kind of went left is I had become fatigued , but Kai was too far or too low for a C-section at that point , but I couldn't myself deliver him , where I think things also kind of went left . We asked for a physician at this point . We begged for a physician at this point and we're told that they couldn't come , that they weren't in the hospital , they weren't in the building and if it had not been for advocacy from my mother at that point saying listen , this is really going bad and that's my child like laying on that hospital bed , they would not have had her come in . She finally after I would say maybe and you can correct me , mommy , because my timeline at that point off maybe 45 minutes to an hour or so she came in and promptly asked me if I wanted to do vacuum , which at this point I had no choice because I had no more energy . The stores were completely empty . She agreed to do the vacuum . I gave it one last push and he delivered and things again looked like they were okay . They wheeled me to postpartum and I was on the road to recovery , went home about maybe two days after delivery and then kind of just started the transition into motherhood .
Speaker 6On day four post his birth I woke up and felt like couldn't breathe , like something was kind of sitting on my chest . But again , I'm a new mom , so I really don't know what I'm looking for . I don't know what is normal . I don't know what is normal . Postpartum Again , asked my mother what is this ? I can't catch my breath . Is this because I had been pushing for so long ? Maybe I'm just tired ? She urged me to go to urgent care .
Speaker 6I went to urgent care and I think about this physician often because if it had not been for him , I do not know how this would have played out . He did my pulse ox and it was 97 percent , which for most physicians wouldn't trigger much because it's pretty high , it's a pretty solid oxygen . But something about it and my situation didn't sit right with him and he said listen , given your age and your health , I think just go to the hospital . I'm not totally comfortable with this situation . Go to the hospital . Went to the hospital . My dad drove me thank God for him drove me to the hospital . They hooked me up to a blood pressure monitor . The blood pressure was 140 over 80 . Again , for most people they wouldn't be triggered too much by 140 over 80 . But for me my blood pressure is always normal , so I knew instantly something was not right . But again , maybe it was the stress of the day . I hadn't slept in days so it could have been anything .
Speaker 6They brought me into the emergency room , they hooked me up to IV and I had gone in now for chest pain and shortness of breath . It took them three hours three hours to wheel me to CT and the concern at this time was that I had a clot somewhere in my lung right and that's what the urgent care doctor was concerned about at the time . But it took them three hours to get the CAT scan for me Finally got the CAT scan no clot , thank God , but fluid in both of my lungs , which would explain the shortness of breath and the pain that I was having on both of my sides . He told me then that he was going to draw some labs . They drew CBC , cmv , the whole panel . They did it all . It took a very long time for those to result and when they resulted he didn't tell me what the results were .
Speaker 6He brought over my discharge paperwork and said you probably have postpartum cardiomyopathy . You can follow up with your cardiologist outpatient . Me as a new mom . My instinct , my want and desire is to immediately go home . All I want to do at this point is be with my baby . So these discharge paperwork this was golden . This was gold to me . I got up with the paperwork in my hand but God stopped me in my tracks and basically said you know better , you know better than them . So I opened the paperwork myself and I read my labs . Immediately I could tell I had preeclampsia Immediately . So I turned to the nurse and I said can you just do me a favor and check my blood pressure one more time ? 160 over 110 . Sky high . I've never seen numbers like before on me . So I was shook .
Speaker 2They called the doctor . I don't want to interrupt . You keep going on , but I'm sitting here saying is this a hospital . I mean , I know it's in New York , so I know that's the answer yeah , but I just cannot believe this .
Speaker 6I cannot believe this Wild ? Absolutely bonkers . I had the paperwork in my hand . I opened the lab work immediately knew what I had I had preeclampsia . I asked him hey , do you mind considering this diagnosis ? Because I never wanted to step on , particularly as a resident . We're trained to not step on an attending's toes .
Speaker 4I wanted to step on somebody's toe .
Speaker 6This is the place that we go to . I just want to be clear not to interrupt her story .
Speaker 4She was very accommodating throughout this whole process and I think that's also something we need to discuss how Black women are raised up to be accommodating . So even in situations where we should be more outspoken , she was very kind to this doctor . She was like , considering that there are multiple organs involved in this , shouldn't we check this ? And then , ultimately , ultimately , when he was advised , he took the discharge papers back right away . Right , it was a red flag for me , because now clearly you're concerned about it , but not to cut you off , kim , sorry .
Speaker 6Yeah , so I read the labs preeclampsia . He took the papers back from me which at the time I'm so fatigued I don't really have them , just get me well , was my only concern at this time and called OB . This is the first time that he had called OB , since I had been in that hospital for almost 10 hours at this point and I am four days postpartum . This is the first time he had called them ,
Mackenzie's Dangerous Birth Experience
Speaker 6called them on the phone . I could see his face as the woman on the other end talked to him , and then he walked back over and said yeah , you're going to need admission to the ICU , which she must have on the other end , and , like you , could not possibly think that you were sending her home with these numbers .
Speaker 2I'm sure she was screaming at him .
Speaker 6Yeah .
Speaker 2This is why I'm sitting here Like I mean , I know this story that's happened to my cousin in the South and not to knock hospitals in the South , but I cannot believe I'm hearing this in a New York City state hospital .
Speaker 4And a hospital that's well regarded . This is a hospital that's well regarded and we did follow up . I did follow up on expressing my concerns and I definitely want you all to kind of jump in here . But here are some places and Paige you correct me if I'm wrong because my question was really like where is the racism ? Where do you see it ?
Speaker 4And one of the things that was often said is that they don't listen to us , like they don't take us into account and that , like you've been trained that Black women don't feel pain or Hispanic women don't feel pain , or that we're aggressive or that we whine , and you bring all that into the room . So when these things happen , so when she was delivering and I have no medical knowledge when it became clear to me in the room that one , there's a problem that's outside of this midwife's capabilities , she leaned her head on Mackenzie's bed like I don't know what to do here , and at one point she got up and left the room with didn't say anything , just left . What to do here ? And at one point she got up and left the room with didn't say anything , just left .
Speaker 2And so now I'm asking who's in charge here , what's going on , and I'm still even confused . I don't know any hospitals where you're saying the attending , there is no attending . This is what I was in a hospital that has a labor and delivery , correct ?
Speaker 4And then when ? I went out they told me only the midwife can ask for the doctor . You can't ask and I was like I need a doctor , not like your midwife has to call the doctor . You can't call a doctor and then I'm like so can one of you call for a doctor ?
Speaker 2Midwives are supervised is the word by doctors . You can't have a midwife in a hospital acting in an autonomous way . Mds are always supervising doctors Doctors , I mean . There's zillions of times where I'm looking at a tracing that a midwife may be taking care of and I'll pull her aside . What do you think about this ? The more you have a relationship with them , you could say look , it's time to do whatever call quits , or midwives should always be collaborating with the md . There's this so much loopholes in this story . That's mind-boggling in 2023 .
Speaker 223 it's insane because this is insane because we don't know , if you told me this 15 years maybe . I just don't understand it , particularly when I it's such a big thing now to have all these physicians go through all this unbiased training and I know that a lot of them are probably not even really watching , not paying attention , they're just checking boxes . But at the same time any woman postpartum walking into an ER I mean in my facility they got sent straight to labor and delivery . Er docs don't even want to touch you . So I cannot understand this .
Speaker 4That's why I think it's so important for us and sorry , ladies , please jump in , I want to monopolize the conversation but I think this is why it's so important for us to be having this conversation , because there's so much that , even in this 20 minute conversation , that we didn't know , I didn't know at the time that there had to be an attendant that's monitoring . Or because you're telling me you can't get a doctor , only your midwife can get , I literally went outside and said either produce a doctor for me , I'm calling 911 . Because essentially , what you're telling me is you don't have medical staff on this facility to help my child .
Speaker 2Where was the nurse advocating , you're the nurse's patient . You don't have any time nurses tell us , as doctors , what to do , especially when we're training . Nurse knows 10 times more than me .
Speaker 4Where's your nurse advocating for you ? But the nurse was telling Mackenzie you need to tell your mother to calm down . So that's what they do . As a black woman , when we start to flex a little bit , then it's we're aggressive , then they start treating us based on the bias that they've heard , then they stop listening to us and then that's when bias kicks in and they disregard . So I had to show my whole behind in order to get some attention and to have the situation resolved .
Speaker 5I'm so triggered by your story , Mackenzie . This is my first time hearing all this , and to know that you experienced this , I'm really taken aback and really feeling like there has to be some other mechanisms that we put in place . And look , I lost my first child due to preeclampsia . I had no idea what preeclampsia was before it happened , so to know that this is still going on this way , we have all our loved ones at the peril of the medical industry and don't have a pamphlet or just anything to go to in the case of an emergency , I feel like we definitely need to know the things like you're saying , Paige and Mackenzie . We need to be able to call on an attending or call on a nurse or someone else . We need to know do we go in these emergency situations ?
Speaker 3Mackenzie , I think the most important part of your birthing plan was to bring your advocate .
Speaker 6Yeah , and I didn't even know it right . They don't add that as part of the plan in the little paper they give you at your last OB appointment . But having someone because for as much training as I have , in that moment you're weak , right Like I'm lost , I'm scared , my life is changing in seconds . So you do need somebody to kind of step in and like make sure that things are running the way that they should be I would have never considered because I'm in my head , I'm a physician . There is no possible way this happens to me . So I feel to this day stunned that all of this happened to me , which is a little bit crazy .
Speaker 3So what are you going to do differently ? Like what does your birthing plan look now for baby number two ?
Speaker 6Yeah , so I mean , in terms of the logistics of like pain management , all is the same . All of that has remained totally the same .
Speaker 3Let's manage that pain Manage .
Speaker 6That number one . But I do think that one advocacy is a big deal . So mommy will not be watching Kai . Someone else will be watching Kai , because someone will have to be in the room managing me , and that will be her . So that's number one . And then also this time I just feel that I'm a little bit more prepared , I'm a little bit less anxious , I have a little bit better understanding of what things should feel like , all of which were brand new the first time . So pains that seemed out of the ordinary , but also I really don't know . So could be normal . But I think , just this time I'm a little bit more confident in what I know about my body .
Speaker 3Yeah , I don't know if you want to share . Are you going with a midwife again , like what ? If you feel like sharing that with us , okay .
Speaker 6No , I won't , and I appreciate all the work that they bring and all that they bring to the table , and I would love if they could collaborate in some way on a team . But I do think that my story ends differently because a physician stepped in for me . So I think that this time around I would feel more comfortable with the MD .
Speaker 2That hurts me to say that , because I really appreciate what midwives bring to the table and of course in your situation I'd probably be like I am running to the nearest MD . But I think the breakdown in so many of what has happened to you , even during your prenatal care , was there discussion of things . If things went awryry , this doctor is my backup . This doctor is who I call when things go awry or if I don't have a personal doctor , at this particular facility there's a 24-hour attending , always on call , and we have that kind of relationship that they will be the backup . Because a midwife can't do a C-section . So right and listen .
Speaker 2It's hard for me because I'm an OBGYN and I don't want to be knocking any of my colleagues . But , God forbid , you had a late decel , which means your baby would have been really in trouble . You can't tell me they're really saying that somebody is not available for the next hour . I just can't fathom that . In my head there are other people laboring in that labor unit . So if anybody had D-cells , baby crashed and they needed to do a stat C-section . I can't understand . There is no one around to do that , even if it's a chief resident and there's no attending there . So it's so much defects in that story , where I think it started with the midwife and her not setting up adequately with you the plan . That's number one . And I can't see any physician or I don't know if this place had residents that they're not even stepping in and saying , okay , we need to overtake here . So I don't know .
Speaker 5Is there training that we should demand that all people who are in the labor and delivery room have ?
Speaker 2Well , supposedly that's in place . There's all these . American College of Obstetrics and Gynecology has now mandated all these things in place , but I'm glad that I'm hearing this because the next incoming president is a good friend of mine , so I got to tell her that something else needs to really be done . And for me personally , I think people are hit in their pocket . Physicians are just like anybody else . You start hitting these hospitals and these physicians and these labor unions in their pocket bad ratings , bad reviews just like we pick out a restaurant and , oh , they have a terrible review , we're not going there .
Speaker 2That needs to start happening with these hospitals and these doctor's offices . I know it happens with doctor offices , but hospitals as well . I know there's an app out called Earth . I don't know if you all have heard of it or Mackenzie , you've heard of it . It's I-R-T-H , so it's birth without the B , and it's basically an app that you can go on and see if your midwife is on there , if the hospital is on there , and all kinds of reviews and things like that . And the lady who instituted that . She started behind all these stories going on . But this is crazy .
Speaker 1So , mackenzie , I was in the midst of all .
Speaker 6Yeah , you had my little Bambino while I was going through all this . The integral part .
Speaker 1And I'm truly grateful that you and Lisa were able to kind of get through all of that but being women of color , like we're in a catch 22 . This is what I'm looking at , like my beautiful niece here who is a doctor having a baby . She's a woman of color , she's in a medical space where she's kind of familiar with , but she's going through something new . What are we to do ? How can we be best equipped to circumvent all of this ? Because if we are aggressive , then we are looked at in a certain way but we can't be too calm either . Why ? Because then we're overlooked , as you mentioned earlier , paige .
Speaker 1Then you have all of the teachings of we can deal with this , we're okay , but we're not okay and we're either losing babies , losing our lives , or having like terrible , unfortunately , these horrible experiences around childbirth , where it's supposed to be something . Yes , it's not easy , it's extremely difficult , it's already stressful , but it's supposed to be a beautiful experience and we are getting looked over . My question for you , paige , is what can we do , how can we best equip ourselves so that women like Mackenzie don't have to , or what's the best way they can get through this process and not be looked over Like what are some key questions . What are some key things that we can do so that we can be heard ?
Speaker 2I think when it starts in the office , when you're having your prenatal care , like I said , we used to say , those walking in with these birthing plans just go left real quick because you kind of doomed yourself . But you have your plan , you're discussing these things in the office with your provider , whether they be a doctor or a midwife , or now , with a lot of doulas , are coming into the situation as advocates as well . So that's another thing that I promote . I think once you hit the labor and delivery unit , you definitely need an advocate and delivery unit , you definitely need an advocate , be it your mom ,
The Life-Threatening Postpartum Crisis
Speaker 2your husband , a cousin , if you can get somewhat more medically and everybody is not going to have that , obviously , and you yourself were a doctor , but you're the patient now but having an advocate and I think for especially women of color , we maybe need to , not maybe we need to get the word out that when you come to the labor unit , your advocate says hi , I'm such and such .
Speaker 2Who is the person that I can talk to on a side , calmly , if things aren't going right ? Who is going to be the point person here If it's not that you have a certain relationship with your doctor that I can talk to , especially if things are not going right , if I feel certain things , and I want to be heard and identify that person before you're in any type of emergency situation . Hopefully some of these labor units will be receptive to that , but a lot of them , because there's no standardized care and that's the problem . There is no standardized care . This hospital can do this one care , this hospital can do this one thing , this hospital can do another thing . They're trying to mandate that everybody is on equal playing fields but , again , if you're not hitting them financially or what have you , they're doing what they want , necessarily . But I think , at least setting up that I will be the spokesperson , especially because she's in pain , she's not , and maybe just confront them and say , listen , we all know what these statistics are . We know what they are .
Speaker 2I am advocating for my loved one who is a woman of color and I want her to leave here alive , healthy and happy with her baby . I want this to be a good experience . The other thing is we used to say a lot of patients , especially the younger , ones you have one of the most helpful things in your possession your phone .
Speaker 2A lot of women come in there , especially younger women . They have no idea about anything . Instead of Googling and on Instagram and all of this stuff about nonsense , investigate and research what is the process , because everything now is on this phone . What's the first stages of labor ? Should I be getting an epidural at two centimeters versus active labor ? All this stuff people can research themselves so that you educate yourself a little bit more . You can't be a doctor , obviously , but have some kind of knowledge of what is going on with your own body , because it's out there to be read . So that's another thing I always say speak to the nursing supervisor , because they will get in positions behind as well . So the attending who's the doctor ? But at some point I can't understand why even the nursing supervisor wasn't brought into that . So that's another should be advocate for your care .
Speaker 4That's how racism played out . I mean , would this be different if Mackenzie were not a woman of color ? Would the request that was made for attention for a doctor ? Is it heard differently because it's coming now from an angry black woman ?
Speaker 2Unfortunately . Yes , it is heard differently and I've seen it . I used to hear other , even people of color , complain about other patients of color and I'm like what are we doing here ? Right , we're so ingrained and that's how we're learning and taught that it's the angry black woman and somebody I'm sure you weren't there cursing and carrying on . So you're an articulate woman , why are you the angry back woman ?
Speaker 4No , and I'm a woman of God , even in these spaces . Exactly , I was walking in that light in that instance . Just quickly , I had a couple of questions . Can you explain the difference between a doula and a midwife , like what's the difference of those roles ?
Speaker 2So both of them are trained Well . A doula can start with you doing your prenatal care , but they also continue with you after you deliver your baby in terms of helping you manage the baby at home and all of those kinds of things , whereas the midwife is strictly doing your prenatal care and is equipped to deliver the baby so to speak , and then they have different training Midwives .
Speaker 2I believe their schooling is a little bit more involved than a doula . Doula , you have some of these programs or what have you . You have to be careful with some of these doulas , because some of them may not be licensed and doing what they need to be doing in terms of really having a safe delivery , so to speak . But a doula , I would say , acts more as an advocate for you , more so than the midwife is actually managing your pregnancy and can manage your whole delivery up to delivering your baby , if you have a normal vaginal delivery .
Speaker 4Do hospitals have policies about whether or not doulas can participate or midwives A lot of them are embracing that now because it helps them with the patient care because we don't have .
Speaker 2there's always a nursing shortage , so it helps them with the patient care and being able to also be that spokesperson , say to the nurse or to the doctor . So there are a lot of hospitals that now are allowing doulas and having that partnership and encouraging that in fact . So that's one of the ways that we can try to also reverse some of these statistics .
Speaker 5Is there an after birth plan that is recommended by the doctors or the nursing staff ?
Speaker 2That's another thing , takesha , that we're finding most of your morbidity and mortality . For Mackenzie it was four days . Sometimes it can be 45 days . Traditionally , postpartum is considered six weeks and then you go about your business . We're finding postpartum is a year that you really need to be monitoring this woman and what's going on with her . Be monitoring this woman and what's going on with her . Do you know , in this morbidity and mortality , the number one reason of mortality ? Do you know what that is ? It's mental health .
Speaker 1I was just going to ask about that . It is mental health . That as well , because you have postpartum depression .
Speaker 2Mental health depression , suicide , drug overdose , all of that . The second one that's coming up outside of like hemorrhage , postpartum hemorrhage , eclampsia , preeclampsia cardiovascular disease is now very much on the rise and that's because you're having younger women with these chronic cardiac problems , hypertension . You weren't seeing a lot of 20 , 30 years olds with hypertension . You have so many younger people now with hypertension . Where does that come from ? Poor diets , poor eating habits not exercising .
Speaker 2Nobody goes out and socialize , nobody walks , nobody runs . Our whole lifestyle has drastically changed . Everything we do is really around a meal . People aren't saying let's go roller skating anymore , let's do things that we used to do actively . All of that has changed . So now that has also leading to more of the morbidity and the mortality . So the stuff has just changed so much that we really have to think about how are we eating , educating , diet , but then you have food deserts in certain areas , it's just crazy .
Speaker 5I'm hearing . Adopting a more active lifestyle is something that we definitely need to give some attention to .
Speaker 3Yeah , this is all good stuff . It's scary . You had mentioned that there isn't any national standard of care , right ? If we get national , we can't even get it across the state . So is there anything in the works administration that isn't so kind ? So in ?
Speaker 22023 , there was another thing is that traditionally , family physicians were able to deliver babies Also . That was part of their training . A lot of them liked OB and they delivered babies . Those numbers of training them have gone down . So there was an initiative in 2023 , like they donated I think it was $11 million to kind of institute more residencies of family practice and training and dedicating certain hospitals and residency programs , particularly in rural areas . Biden also , I think two years ago , came up with this . It was like a billion dollars putting just onto women's health research , addressing this maternal morbidity and mortality . Where's that ? Right now , they're talking about cutting Medicaid and Medicare . 40% of deliveries are from Medicaid .
Speaker 2So what's going to happen ? It can't be all bleak . I still have hope , and I think particularly because we're living in this world of social media and we can get the word out much faster than we could before . But we have to really get to our younger people and women who are pregnant , even mothers and whoever . So keep telling , advocate , learn for yourself what's going on with your body .
Speaker 2Like Takesha said , more active lifestyle , being cognizant , particularly when you're pregnant , what you're eating . It's very scary now . We had this cigarette and then it became you can't smoke inside . Now everybody's does marijuana . And then it became you can't smoke inside . Now everybody does marijuana . And that's scary because this marijuana , the synthetic stuff we're going to find out in five or 10 years what that's causing , because it's not the homegrown , natural marijuana you got from Jamaica or wherever that might have some medicinal purposes . This stuff now made in these factories or whatever , that smells like a skunk . As far as I'm concerned , that's also going to have some impact . So we got to be more mindful , especially as people of color . What are we doing and what part do we have that we can better at least try to take care of ourselves ?
Speaker 5Have you been following this Momney Bus Act and do we know if it's still ?
Speaker 2Well , it's still Sister to Sister , which I'm part of . That organization , they particularly partnered with a hospital and Yonkers , and so their numbers have really , really improved there because they really are instituting the biases , more physicians of color recognizing yeah , we need to listen to women when they're trying to advocate , but how many hospitals are really doing it ? And now , with again funding being the gains that we're making , they may be halted .
Speaker 4I did hear about that in Yonkers that initiative and I saw an interview with Dr Suzanne where she talked about some of the things that have been implemented in the hospital in Yonkers that initiative and I saw an interview with Dr Suzanne where she talked about some of the things that have been implemented in the hospital in Yonkers , one of them being this team approach , where you have everyone in the room in conversation , all hearing the same thing and on the same page . So those kinds of initiatives I think are helpful . She talked about cesarean rates and how they've been able to improve those , which makes me wonder , if someone's about to give birth and they're shopping for a hospital , what kinds of questions or information should they be looking for about their hospitals , be that cesarean rates or what kinds of stuff should they be looking for ?
Speaker 5Right .
Speaker 2What is their cesarean rate ? What is their rate of babies going into the ICU just for a full-term pregnancy ? I'm not talking about preterm deliveries or those kind of more immediate medical issues , but what's their ratio of nurses to patients ? Does one nurse have five patients in labor and delivery ? You can't possibly be taking care of them adequately . Is there a 24-hour anesthesia ? I mean , every hospital should have that , but maybe you need to ask that too . What I'm hearing from Mackenzie about there's no attending here .
Speaker 4I just Are hospitals willing to give this information ? So you go in and ask these questions Is this stuff that they are expected to share with ?
Speaker 2us . Well again , then , that's also tied into who you're seeing during your prenatal , so they should know those numbers as well . Tied into who you're seeing during your prenatal , so they should know those numbers as well , because hopefully that physician is delivering at a hospital . That is desirable . We used to have labor and delivery tours . Were you able to tour your hospital ?
Speaker 6No , I didn't tour that particular hospital this time , though , my tour is scheduled .
Speaker 2Okay . So during the tours you ask all those questions . They show you the room , they give you the numbers rather than the statistics . You meet some of the nurses . You get a feel of yourself Like are the family members standing in the hall looking all disgruntled or whatever ? You get to see all that for yourself , versus people smiling happy . You hear babies being born . So just like you may not stay in the local Motel 6 , same thing with some of these hospitals Go and see if you can ahead of time , for yourself as well .
Creating Change and Patient Advocacy
Speaker 4Just to circle back on the point of Kinsey , I'm just wondering about your ideas around mental health and I know that you and I have had conversation about the gap in care , so you want to share a little bit about your thoughts about that .
Speaker 6Yeah .
Speaker 6So I mean mental health is kind of my passion and definitely now , with my own experience , there is a massive gap and there is need .
Speaker 6I think oftentimes we aren't connected with , or connecting our patients with , therapists or psychiatrists unless they have risk factors for postpartum depression or they take a screening . And all of a sudden this comes up quote , unquote red and now let's find you a psychiatrist or therapist . But even if you don't have those risk factors or if you don't check all of those boxes just thinking back to my own experience , this is totally new to me Like six weeks I've gone through every emotion that possibly exists . By the time I go back to see my doctor for my checkup and nobody calls you , nobody calls you in between or discharged in six weeks to say , hey , just checking in , how are you doing ? Like mentally , where are we at ? Whether or not you have risk factor for postpartum depression , but just to check in , because your life is completely different . So I think a massive gap . I think women are kind of left to fend for themselves and figure it out and I think that that definitely needs to be addressed .
Speaker 4How do we do that Like ? What do you think in terms of an aftercare plan for patients ?
Speaker 6Yeah , so I think and I've had some discussions with colleagues of my own about getting in that gap earlier , so maybe connecting patients with a therapist or an advocate afterwards that they talk to , maybe a week after . If you think about it , babies are given a pediatrician appointment within days of their birth , so why can I just have a virtual therapist or a psychiatrist , not even to prescribe medication or not necessarily to continue therapy , but just to do a check-in ? I wonder how many patients you would even catch prior to postpartum depression if you talk to me a week after . I just changed my entire life .
Speaker 5Yeah , that seems like it makes good sense , right ? I mean six days the baby has to see the pediatrician , so the parents should also need to see somebody .
Speaker 2Right , it comes back to that team approach and I think a lot of doing the prenatal care , you have your provider that you're seeing taking care of your baby Within that office should be social workers , slash , some type of therapist , and I think we need to start instituting the same thing , like you're saying , for babies . There's a six-day check-in . Let's check , have a checklist . We check this mom at a week out or two days out , whatever the statistics for mental health are about , where women start feeling a certain way or what have you ? Have a checklist so that by the time they come to postpartum visit at six weeks or if they had a C-section it's two weeks At least have them had some type of interaction with someone who follows up with their care ? Because I'm thinking when you have , like a cardiac test or anything like that , they call you like the next day , how are you feeling ? Or the next two days , how are you feeling ? We need to institute that with our moms who are having babies as well .
Speaker 1Yeah , and it sounds like that should happen like right before the mother is even discharged , like so you have like all these appointments that you have to make before for your baby , or whatever . It would be a checklist , what that would look like . I'm seeing the pediatrician on this day , oh , I have to schedule in a Zoom call with my therapist so they can check in , or whatever that is , because if you don't do it that way , then stuff falls through the cracks .
Speaker 2Yeah , as I'm sitting here , thinking also because people need jobs and I'm sure , just how you have visiting nurses for other issues , because maybe the mom can't come in or maybe you can't capture everything via Zoom , sometimes Maybe you need to come into the house and see what the dynamics is . What's going on ? Is she trying to take care of herself and another kid ? And this is a recipe for a disaster . So I think , maybe also instituting a visit , a home visit . I know there are programs like that , but we need to start standardizing these things so that it's across the board .
Speaker 4And it would give us the opportunity to assess for resources . So you have a mom who's food insecure , who's concerned about eviction , who is in an abusive situation . But it gives us an opportunity because I definitely can't take care of me and baby if I can't feed either of us or I'm breastfeeding baby but I also have to be nourished and well enough so that I can breastfeed properly . And food insecurity is a real issue and not just for folks who we think are like homeless or who you traditionally think of as food insecure . You've got a lot of people who are working middle class level kinds of households that are also suffering . So just kind of to connect to mental support , emotional support and actual resources , I think being able to close that loop as well as just having someone .
Speaker 6If I think back , if someone had called me , I could say hey , my lungs don't feel so great . Just someone to say something to , Because at four days postpartum , my only concern is Kai . That is all I am worried about . Oh , I can't breathe . Well , that must be normal . On to the next thing . But if someone is making me take a moment to think about what I'm feeling in that moment hey , what are you going through ? I could have easily said hey , I've noticed like for the last few days , my chest has been kind of tight , and they could have advised hey , you probably need to go do this , this and this .
Speaker 2Or upon discharge , and I think everyone should be discharged with someone else in the room , because you may not have heard but maybe probably mom , friend , cousin , whoever when a nurse says if you feel in a certain way short of breath , if your legs are cramping , if you have headaches , if you feel you're not urinating , all these things that we could tell patients upon discharge especially something as common as preeclampsia that you almost got discharged from . Not good , yeah . So thank God , thank God .
Speaker 1I'm just sitting here saying to myself , though how can we challenge the OBGYN or just physicians in general about these biases that are going on with people and women of color , Like it boggles my mind that we're fighting this , Like we're still being like dehumanized . How can we bridge this gap ? Because it's just not . It's not just OBGYN .
Speaker 2I think , making them more aware . Because I find , particularly now that I have older parents and older aunts and uncles and I feel like I'm just constantly confronting other physicians about their biases and I tell them we just have to start confronting them . I feel more comfortable doing it because I am a physician , but we're going to have to start saying are you hearing me , or maybe you're not , I don't know .
Speaker 5Are those exams mandated ? For the physicians to have to take those bias testing at certain times , I think it seems like they should be having them more often .
Speaker 2Maybe people forget If you make me take a course and I took the course and I checked the box that I took the course . If I'm still innately racist , it doesn't matter how many courses I took .
Speaker 3To Paige's earlier point , you got to hit them in the pocketbook , so it's the pocketbook that will make them fake the funk .
Speaker 3then if they really aren't changing , Because oftentimes you get your customer service experience survey before you get your lab results , right . Right , the whole medical industry is now and I've been in pharmaceuticals for a number of years so it's so consumer-driven . Now , where you have the whole marketing landscape has changed , you can get Keytruda Travolta whatever you want , they're coming directly at us . So I think that , and given the situation that we're in now , that gives us more of a right , a more direct pathway to hit those pocketbooks , because I think that , and given the situation that we're in now , that gives us more of a right , a more direct pathway to hit those pocketbooks , because I think that- .
Speaker 2I mean , just take example how Target has been affected just from December . We have to start speaking among each other . Don't go to that hospital .
Speaker 3Yeah , I think we also have to believe in our own consumer economic impact . Right , we're so used to like , oh , we don't have any money , we don't do this , we're not fast growing . But I think we need to up our confidence and I think the target is a perfect example that we do have that power . Yes , you can do that for target candles , but you can also do that for your medical treatment as well . I think getting confident to do that and really just making sure that birth plan has the right people in the room .
Speaker 4We should do that , Like if you begin to create a medical green
Mental Health After Childbirth
Speaker 4book , like the green travel book , I like it . So when Black women are looking for hospitals this hospital consistently popping up , like I don't go we start to targetize them . I'm going to make that a word .
Speaker 1Didn't you say there's an app page ? Didn't you say there's an ?
Speaker 6app page that does exactly that right .
Speaker 2The I page ?
Speaker 4didn't you say , yes , yeah , that's exactly that right , the , if I'm sorry , birth I r t ? H , so birth without the b . Yeah , we need to begin to socialize that . This site , the high cone survivors we should begin to let's publicize that so individuals will know that that exists . But , yeah , some sort of I just sent the app . We can definitely thank you . We can do that as a resource . We can do that as our resources .
Speaker 4I think this conversation has been wonderful and I think what's great is just in the time that we've had conversation , I've had a number of points right . So I move into this advocacy role again in October for McKinsey do beforehand what to expect on the tours . Identify myself as advocate . Find out beforehand who should be contacted should things go left . I heard you say somebody should be in the room with you when you're being discharged . So it's just like a number of pointers that you've given us . Is there a way we can develop that into a resource guide ? Obgyn offices are handing folks as they come in and they get these information packages , that that information , particularly these information packages . That that information , particularly women of color , that that information is also in it . These are the questions . Ask about nerves to patient ratio . Ask about C-section . Ask about how a doula is in midwives . All of those questions in one place .
Speaker 1But maybe we need to develop an app for it , because when you get all of that paperwork , a lot of people don't read right . A lot of people . They have a lot of things going on in their lives .
Speaker 4They're not because I think people learn differently , like I know that if I'm a new mother , I have a packet full of stuff and I've got to fill out this and fill out that . I might look at that , I might whatever whereas if I have a link and I have to go to an app , I I may or may not .
Speaker 3Yeah .
Speaker 2But I'm thinking for the majority of people , and particularly in this . We're talking about mostly younger women who are attached to this phone , even women who are still in their 47 babies . I think if we make an app to Denise's point , anybody who's successful is because there was a need , and there is absolutely . I'm hearing a story unbelievable to my ears .
Speaker 2What happened to Mackenzie . I mean , I remember Lisa telling me she ended up with preeclampsia , but I didn't know how she got there . It was crazy . There's a need . So we make the app , just like this earth lady made her app . We make the app because it's definitely needed .
Speaker 4I definitely think that we should take responsibility maybe just birthed out of this conversation that we take responsibility for putting that together and offering that and also getting it into be promoted through OBGYN offices right so even if you give me a flyer with a QR code where I can write to the QR .
Speaker 1That's what I was going to say , yeah .
Speaker 6I think that's the most , because , even thinking back to my last doctor's appointment , the way my tour got scheduled is because there was a QR code in my office while I waited 15 minutes for the doctor .
Speaker 4Yeah , we produce it in the offices . You can go , here's what you need to know and it comes up for you . I think that's definitely . We always talk about truth , trash and transformation as a buzzword . I think that's an opportunity for transformation .
Speaker 1And there was another point I wanted to just point out is that you were saying something about Paige . You were saying that getting all this information about prenatal care , and you were saying that the women need the information , but it's hard when you don't have a relationship . And actually , the high-cost survivors we were talking about being able to even trust our doctors and trust our GYNs and what they say , because , yes , you have the degree and we should be able to trust you , but we can't trust you because of our experiences . So , like it's a catch 22 and how can we continue to bridge that gap ? I know we want to bring it together , but I wanted to ask that question Well , how do you think we can do that ?
Speaker 2Well , it comes back to relationships . So I mean , for most pregnant women they should have been seeing their provider for at least six months , have been seeing their provider for at least six months . And I just know , for me , when I was practicing , most of my patients were like my family , like they could trust me , because I treated them like they were my sister or cousin or whoever . So I mean , these conversations should be had in the office and after two or three visits you know whether this is just not going to work . I don't feel your relationship with your doctor should almost be kind of like how you , picking out your best friend , your husband , whoever Are y'all vibing Because it's okay , she might be the smartest person , but your personalities or whatever , just don't mix . Now the situation when I was diagnosed in cancer and I was sent patients to this particular college , I said he's not warm and fuzzy , but you're not going to him for that . His hands are the best to cure your cancer . So I would tell them that at any time , because I'm warm and fuzzy . You don't need that right now , but for pregnancy you may be the one . Every woman doesn't need warm and fuzzy , but for pregnancy you might be the one . Every woman doesn't eat warm and fuzzy , but most would like that .
Speaker 2If that person isn't fitting your personality , drop around to the next person . You have to be stuck with them so that when you get in that labor room there wasn't a patient who didn't know I was going to have their back . I would curse at an anesthesiologist for I'm not cursed , but they knew that they had nothing to worry about me , that they were coming home with a live baby . As far as humanly possible could do that , because that's just the relationship we had and they can trust me . So if you don't have that kind of relationship with your provider , shout for the next one . Thank you , you should be able to say anything to them . Don't feel timid or what have you ? This is somebody who you're entrusting . We have to take care of two lives , yours and your baby's .
Speaker 4Yes .
Speaker 5I think that's the most transformational right About this whole evening knowing that we can rely on the information
Economic Power and Transformative Action
Speaker 5we know about our providers .
Speaker 2Yeah , you may feel more comfortable with somebody of color , but there are a lot of others who are not of color who will still be concerned about you and advocate for you . I have lots of colleagues who are not of color who I would trust to go to . But you got to shop around and don't just pick anybody from , let's say , under your plan . And the same with women who may be on Medicaid or what have you . Medicaid pays big bucks . They don't have to be stuck with the clinic doctor . You don't like them , go somewhere else . You got to start hitting people in their pocket .
Speaker 1It's true , yep Money talks . I say that all the time . So what would be our truth , ladies ?
Speaker 4So , paige , just so you're aware we've held you probably longer than we should have , so , but you've been so informative for us . This has been so helpful . Awesome your time , you two , mackenzie the ability to have both of you has been wonderful . And , typically , I know you are all avid listeners to our podcasts , so you know that we end all of our podcast sessions by sharing what our truth , our trash and our transformation was as part of the conversation we just had . So we're going to invite you both to share with us what you experienced in this conversation as truth , what you experienced as trash us , what you experienced in this conversation as truth , what you experienced as trash , what you experienced transformation Truth trash transformation .
Speaker 6And I'm new to this , but for me , in this particular realm , I think the truth and the trash are the same . The numbers are what they are , right . It's . A hard truth is we're dying , people are really , really sick , and that is trash . Yeah , transformation I think this is transformative . I think having these discussions that people are not really having this this is where transformation happens , even discussions around making an app this is how change is made . So we are transforming by just having these discussions , so , so we are transforming by just having these discussions .
Speaker 2So yeah , I would agree with that . I would say for me , the truth is , it's startling for me to hear your story in this day and age in New York City . I'm astounded . And so that is trash as well . Numbers are trash , but the transformation is , I think , where there is a need , you make transformative decisions and measures , and here comes our app .
Speaker 4Ladies , you want to add your truth trash transformation . They said it all .
Speaker 3Yeah , yeah , I would agree , but I would say that we really have to believe in our consumerism or not , economic weight and really have the same approach when it comes to have the same stringent process what sneakers we buy or what things we buy and have that same stringent , even more so when it comes to the medical services . I think we're just still not used to shopping like we're going online , up in network , that's it and we're done . The transformation piece is getting people to really understand that . I think once we unlock that , that's going to make such a huge impact for us .
Speaker 4I agree . I agree that the truth and the trash are the numbers , are the fact that it's being driven by racism . I think the transformation is the opportunity to get the information into the hands of the folks that need them , and that we have identified that gap and that need and that we are committed to changing that , and I think that that's transformative and the fact that the Knicks are currently winning .
Speaker 5That is absolutely transformational .
Speaker 3That is true . They probably feel that way too .
Speaker 1You know it's been 25 years , like we . What , yeah , my God , my God .
Speaker 5I have to absolutely agree that creating an app to benefit the masses of the folks out there is truly transformational . So I'm very excited about that . These conversations are leading to that type of transformational work .
Speaker 4All right , ladies and that's a wrap .
Speaker 3Thank you so much thank you so much for being here , paige . Thank you I know it's .
Speaker 4The lights are on . If I might be home , I wouldn't be here .
