Birthing Justice, Social Action Doc Ignites Grassroots Movement

• A birth should be a joyful, exciting experience for every family, yet Black women in the United States are three to four times more likely to die during childbirth than white women.
• Black mothers experience stillbirths at double the rate of white mothers, and Black infants die at two to three times the rate of white infants.
• The discrepancies persist regardless of a mother’s socioeconomic status and education, and when Black babies are delivered by Black doctors, their mortality rate is cut in half.

These are the disturbing facts today in America. You will find these statistics on the website for Birthing Justice, a social documentary, which offers data — and solutions — on the maternal healthcare system in this country, and birth stories of Black women. 

Birthing Justice executive producers and co-writers Denise Pines and Jacoba Atlas approached Monique Matthews to direct this film (Matthews also co-wrote the film). Matthews said the social documentary was designed to shift policy but also to amplify and highlight the activists, the birth care professionals and the parents who are actively working to make change. As Matthews said, when you want things done you have to go to the people.

“This is not top-down,” she said. “We don’t want this to be above anyone. We created this from the people to amplify their voices.”

The film focuses on real-life birthing traumas that American Black women have experienced and does not shy away from the main culprit of these traumatic experiences, racism.  Matthews said that before Pines and Atlas approached her to direct Birthing Justice, she didn’t know how bad the situation was. As she dug deeper into the story, she realized that there were women she had known for 20 to 30 years but she didn’t know that they had suffered a traumatic birthing experience, such as preeclampsia. She said people don’t share. 

“It’s horrible,” said Matthews. “I remember  going away to college and hearing later about one of the girls I grew up with who died giving birth.”

Matthews had a cousin who died in a hospital giving birth and a sorority sister who lost a baby who was less than a year old, which is also considered part of maternal mortality. Matthews understood the toll it took on her friend ― a 26-year-old woman, married, with a Ph.D.

“She was everything that you could think [to] be on track to have a successful birth,” Matthews recalled. “I kept seeing these things happen but I didn’t connect the dots … when Jacoba and Denise contacted me and we sat down, I said ‘yes, I want to do this.’” 

Matthews noted that she wanted to affirm it with love because she understood the challenge of providing information in a way that informs, without alarming and terrifying people. 

“Black people deal with enough trauma. I don’t want us to be terrified,” Matthews said. “I want us to have successful lives.”

It’s what drew her to this project and to tell this story in a way that informs yet affirms life. 

“It’s really shocking and that’s one of the reasons we made this film, because it’s hiding in plain sight,” Matthews said. “The stats are so alarming, yet so many women and birthing people who go through this feel ashamed sometimes. And it’s not on them. It’s on our policies, it’s on racism, it’s on so many other things.”

Matthews said we need to say to women, “We want to hear your story.” 

“Every woman deserves a beautiful birth story,” she said. “It’s not something that we need to be ashamed of when there’s trauma attached or things go awry.  

“It’s like Dr. Yolandra Hancock says in the film, ‘I’m a doctor, I’m supposed to know better.’ and it has nothing to do with that,” Matthews said. “Or Allyson Felix, a world-class Olympian and she gets preeclampsia (Felix is also an executive producer on the film). There’s not anything that (pregnant people) can do to make it different. But when things happen, the first thing people, particularly women, seem to do, [is] blame ourselves instead of looking at larger factors. I wanted us to make this film so that we could get it out in the open and talk about it, so we can end this.”

Matthews noted the team behind Birthing Justice actually finished the film ahead of a meeting of the Congressional Black Caucus because it was a very big event and because they consider the film to be a social action documentary — about informing and influencing policy. Its first screening, which was the first 20 minutes of the film, took place at the Congressional Black Caucus, in September. Following that, Matthews said they were fortunate to have Congresswoman Lauren Underwood (IL-14), who is also in the film, host the filmmakers at the Centers for Disease Control or CDC to present the film, which can make an impact in terms of changing policy. 

This was followed by another brief screening at The United Nations, in November in Geneva, Switzerland. The first Los Angeles premiere screening was Jan. 11 and Birthing Justice will be shown at the Pan African Film Festival in February.

On Jan. 22 Matthews was especially excited to attend a screening and panel at Community of Hope, in Washington D.C. The city has the highest infant mortality rate of any city in the United States. Community of Hope supports D.C. families with housing and healthcare in the four quadrants of the city, which was highlighted in the film. 

The film shows two sides of the world of maternal health for Black women. On one hand, too often, Black expectant mothers are not listened to when they approach their healthcare providers with serious concerns or questions on the status of their pregnancy. They are brushed off, told “it’s normal” or are not believed when they report their concerns. Dr. Donna Adams Pickett in Augusta, Georgia said she was dismayed by how easily she is dismissed and women who look like her are dismissed. 

“… We can bring a certain level of gravitas to a situation, of knowledge to a situation and how easily we are minimized,” said Pickett in the film. “Trust me to know what I’m doing. Trust me to take the culmination of all these years of education and experience to know that I am truly making the best decision in the moment. It bothers me that sometimes I have to explain [to her peers] why I am advocating for my patient.”

Dr. Pickett had a patient that she saw was abrupting (when the placenta pulls away from the uterine lining before the time of delivery). Yet, she had to convince the anesthesiologist why they needed to do her Cesarean section, or C-section, emergently, as opposed to urgently. The anesthesiologist walked past Dr. Pickett in the room, and went to the nurse and asked, “why are we doing this emergently?” Dr. Pickett had to go to the fetal tracing monitor, point to the pattern and say, “this is an abruption pattern.” Picket said in the film, it frustrated her that after more than 21 years of practice, she had to justify advocating for her patients.

Dr. Pickett’s patient, Erin Johnson, discussed how she experienced bleeding during her first pregnancy. She went to the emergency room, where the doctor told her that she could “just stop coming because there’s nothing wrong.” He said it’s very common for a woman to bleed up until they are six months pregnant. Surprised, she said “I didn’t know that. I didn’t think that was true but, okay.” A couple weeks later, when she was 10 weeks pregnant, she miscarried at home. Johnson said she was too scared and traumatized to go back because the doctor said it was okay. “And I lost my first baby from listening to this doctor who completely ignored me,” said Johnson.

Framing the solution 

The film highlights how it helps Black women when they seek midwives and doulas for their maternal care and delivery — which contributes to successful birth outcomes — and it cites the dramatic differences in the care they receive through conventional maternal healthcare. The Birthing Justice team has taken a grassroots approach to this crisis. By hosting small screenings and panels all across the nation and by facilitating home screenings — with support via questionnaires, discussion topics and how to host a panel discussion — they aim to activate a movement. 

There’s an 11 bill legislative package making its way through congress called the Black Maternal Health Momnibus Act ― a package spearheaded by the congressional Black Maternal Health Caucus that includes policy proposals to address the racism and inequities at the root of the Black maternal health crisis in the U.S. The Protecting Moms Who Served Act became the first of the Black Maternal Health Momnibus Act bills that passed in November 2021. Nine of the remaining eleven Momnibus bills were included in the text of the Build Back Better Act which passed the House in November 2021. The Build Back Better Act is currently stalled in the Senate amidst ongoing negotiations. While it remains the most likely legislative act through which much of the Momnibus could pass, this grassroots effort is what can make that happen.

Matthews said solving this crisis takes a multipronged approach. Highlighting exciting progress on the Black maternal healthcare front, Birthing Justice focused on the complete turn-around of Los Angeles’ Martin Luther King Jr. Community Hospital or MLKCH.

“We focused specifically on Martin Luther King Jr. Hospital,” Matthews said. “It’s a midwife led labor and delivery with M.D.’s. We wanted to show a model of what works.”

Built in 1972, in the aftermath of the Watts riots, MLK served the poorest residents of South Los Angeles. After acquiring the nickname killer king, the hospital eventually closed in 2007, when regulators found it was unable to meet minimum standards for patient care. In 2015, the new, smaller hospital, MLKCH, reopened. Designed as the hub of a network of clinics, it aims to provide the day-to-day care residents need, while the hospital itself focuses on acute-care and specialized services for patients. Its new vision is to improve the lives and protect the health of its residents by taking much more responsibility for dealing with the social determinants of health.

[MLKCH] is now one of the [most] successful birthing hospitals in the country,” Matthews said.  “It has a distinguished award (California Distinguished babies Hospital) , a very hard designation to get and it’s a model for how we can turn this around in a hospital setting.” 

Matthews cited a few of the answers; listen to Black women. One of the things her team finds consistently is that women are not being listened to. They’re saying what the problem is and are not being heard. Also, it’s not just about writing bills. Matthews stressed there are specific, practical solutions, including case models of what those solutions look like throughout the country.

“We want to encourage people to see [the film] and call their representative because it’s important to them,” she said. “If we don’t then the reality is the majority of the bills may die. One of the things we want to get across is what Dr. Kanika Harris said, “there’s nothing that Black women are doing  that is so different than what other women are doing. [What] I want to make clear is that [this] is not an individualized problem, it’s systemic so, we want to address it systemically.

“We want to shift the narrative. It’s not one of doom and gloom but [its] the proactive policies and procedures we can make to shift this narrative forward to make sure every woman has a successful birth story.”

Birthing Justice highlighted the Missouri Bootheel Regional Consortium or MBRC, an organization that works with residents, providing resources, transportation and education to the community, which is home to the largest rural Black population in the state.

MBRC sends its staff out to network on the ground, directly to community members. Focusing on one particular family, the mother, with high blood pressure, also suffered from preeclampsia. The husband said he watched his wife go through emergency surgery, he even cut the baby’s umbilical cord. You could see his pride when he stood up and shared how he learned so much through that experience and afterward by taking classes on how to parent and to be a better, supportive husband and dad. 

Matthews said that’s another way we end maternal and infant deaths. This issue affects the whole family and we have to treat the whole family. 

“Momnibus helps address systemic issues of Black maternal health care,” Matthews said. “Maternal health care in this country is awful. It’s just more impacted in the Black community. When you help Black women, you help the entire country because if it’s affecting us on a more impacted level, that means helping us will help the other mothers who are still having difficulty giving birth.

“We hear the stories about lower life expectancy among Black Americans — of about six years. It happens so much we don’t think in terms of practically walking that out. No, it’s as much of a health hazard as diabetes, and it does contribute to diabetes or heart disease or maternal health. Racism is what’s killing us.”

While Momnibus is a policy, Birthing Justice shows models of success. It highlights organizations and two birthing centers, one black owned and the other, Community of Hope, in Washington D.C. 

“And we show a hospital in LA (MLKCH) that is winning. Everything we showed is an example of what can work.”

Birthing Justice screenings are taking place across the country. For more information or to find out how to host a screening, visit https://www.birthingjustice.com/ to complete and submit a request form.

Time: 5:30 to 9:30 p.m., Jan. 27
Cost: Free
Details: https://www.birthingjustice.com
Venue: The Miracle Theater, 226 S Market St., Inglewood