Vice President Kamala Harris: Black women deserve to be heard. Their voices deserve to be respected and like all people, they must be treated with dignity.

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Melissa Harris-Perry: Back with you now on The Takeaway, I'm Melissa Harris-Perry. That was Vice President Kamala Harris speaking at the White House round table on Black maternal health back in April. She convened this gathering of academics, activists, and providers in response to deeply troubling national statistics. According to the CDC, in the year 2020, 861 women died in the US as a result of maternal causes.

That was up from 754 women who perished during or shortly after giving birth the year before. That was an increase compared to the 658 women who lost their lives due to pregnancy and birth complications a year earlier. More women dying each year. In fact, the rate of maternal mortality in the United States has increased in the past three decades during a time when most countries throughout the world have improved outcomes for people giving birth.

Having a baby in this country has become more dangerous and deadly. Bearing the brunt of these brutal statistics are Black women. Earlier this year, Professor Monica McLemore professor at the University of Washington discussed the profound racial disparities in maternal mortality with The Takeaway.

Monica McLemore: Black deaths from pregnancy-related causes in these statistics is now three times higher for Black people. That's why those numbers are so alarming.

Melissa Harris-Perry: For nearly a decade, researchers and reproductive justice advocates have worked to marshal resources to address this crisis but statistics, graphs, and rates per 100,000 can make it difficult to capture the human reality of maternal death. A new documentary film out on Hulu is changing that.

Speaker: My daughter's story is loud, colorful, and artful. She was awake, aware, and active, and yet she still died.

Melissa Harris-Perry: In Aftershock, Tonya Lewis Lee and Paula Eiselt, follow what happens to the families of Amber Rose Isaac, and Shamony Gibson after each woman dies from medical negligence after giving birth. I sat down with the filmmakers this week and Paula Eiselt started by telling me about Amber.

Paula Eiselt: Amber Amber Rose Isaac was a vibrant young woman. She was 26 when she became pregnant with her son Elias. Was a healthy young woman who was very conscious of her prenatal care, very active. Yet when her platelets were dropping and she was complaining of not feeling right, she was ignored. When someone finally did something and diagnosed her with the HELLP syndrome and sent her to the hospital, it was too late. She bled to death from an emergency C-section.

Melissa Harris-Perry: Tonya Lewis Lee told me about Shamony Gibson.

Tonya Lewis Lee: Shamony Gibson is a bright light in her family. She was a woman who had a daughter named Danari. She gave birth to her second child Carrie. Shamony had a C-section. After 13 days after that birth, she died from a pulmonary embolism that would've been preventable if only her doctors had listened to her when she was complaining of chest pain.

Melissa Harris-Perry: Now, Aftershock brings viewers into the lives of those who Shamony and Amber left behind the suddenly motherless infants and grief-stricken fathers left a parent alone.

Speaker: I've never lived in this house without her.

Speaker: You just got to keep pushing forward.

Speaker: I can't let Amber be another statistic.

Melissa Harris-Perry: A fierce mama determined to ensure her daughter's life and loss are not forgotten.

Speaker: When Black mothers die, there's a ripple effect. We called it Aftershock.

Melissa Harris-Perry: Aftershock shows us how ordinary folk are transformed into relentless advocates by the agony of this loss. Shamony Gibson, Amber Rose Isaac, just two out of more than 2,200 women who've lost their lives in this country in just three years due to childbirth. There's no way to watch it without thinking if this is the Aftershock of two, how can we possibly measure what has been lost with more than 2,200?

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When we come back, I sit down with Aftershock filmmakers, Tonya Lewis Lee, and Paula Eiselt.

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Welcome back to The Takeaway. I'm Melissa Harris-Perry. We've been talking about the new Hulu documentary Aftershock. A film about what happens to those left behind, after losing a loved one from complications associated with pregnancy and childbirth. I spoke this week with the film's co-directors and co-producers Paula Eiselt and Tonya Lewis Lee. Tonya talked about why Black women are more than three times as likely as their white counterparts to suffer maternal mortality.

Tonya Lewis Lee: The issue really is that we intervene in birthing of 500% more than we used to. The outcomes are not better. The C-section rate has gone up over the last 25, 30 years, and the maternal mortality and morbidity rate, as you referenced, Melissa, has gone up with that rate. That's not to say C-sections are not important. That's not to say that they aren't necessary, but that we are intervening too soon, too much.

We are seeing poor outcomes from that intervention. Also, the United States is the only industrialized nation that does not have midwifery care integrated into women's healthcare.

Those other nations have better birth outcomes than we do. I really think what we're seeing is number one, women are not being seen and heard. Number two, we are over-medicalizing in a lot of cases, a birthing process, women are not sick.

Birthing is not a pathology. It is a natural process. I think we need to go back a little bit like we did with food back to that Farm to Table a little bit with the technology that advances, I think we need to pull back a little bit and go back to what was working.

Melissa Harris-Perry: Paula, talk to me about a phrase that both of you have surfaced several times here, which is they weren't listened to. They weren't heard they were talking, but no one listened. How is that failure to listen showing up in these situations?

Paula Eiselt: In mainly hospital systems where the goal is in all parts of medicine to fill the beds in hospitals and move everyone along. That's the goal here. Women and birthing people are not being seen and heard, which is, as Tonya mentioned, causing more interventions or on the other hand, just completely ignoring women like Shamony Gibson, Amber Rose Isaac, who were saying, we feel there's something wrong and they're told that, "No, you're fine." Dr. Shaw says in our film, seeing and hearing someone is not a luxury. Dignified care will get you to better outcomes.

That is evidence-based that when patients are part of their care, they do better. Because 85%-plus women are low risk and pregnancy is not inherently dangerous to them, you need to listen because their body's doing what it's supposed to be doing and they know best. Being not seen and heard is something that is directly correlated with poor outcomes. Especially for Black women who are not seen and heard at greater rates than white women, because of the racism that they experience in the hospital system.

Melissa Harris-Perry: The documentary's title Aftershock, it emerges in part because of the approach that you all take in this documentary, walking us through the aftershock that the partners that the families are feeling. Paula, talk to me a bit about Omari and Bruce. You captured some really extraordinary scenes with the two of them.

Paula Eiselt: Thank you. I'm so glad you mentioned our title Atershock and then, and then Omari and Bruce with that because Shawn when she created the event called Aftershock, that celebrates Shamony's life. It was two months after she had passed away. That's in fact where we met Shawn and Omari. The point of that word is that when a mother dies, there's a ripple effect. It affects her family, her community, and the whole nation.

Of course, the first people that are going to be most affected are the family members and are the partners, the fathers. Omari and Bruce, they're the ones that were directly left behind to raise the children after their partners had passed and it's just really beautiful in this unfortunate, horrific way that this brotherhood was formed and that these men could be there for each other support each other bring in other men, Omar creates art of other women who have died. As you've seen, the film delivers that art to Sam in Texas and he has done that all over the country and really bringing men into the conversation because maternal health and maternal mortality is not a women's issue it's a family issue, it's a national issue and we need to treat it as such.

Melissa Harris-Perry: These families are both the generation of the partners, the generation forward, the children who are left but also Tonya, you all as Paul was just telling us you begin with Shamony, you begin with mama who's lost her daughter. Can you tell us a little bit about her?

Tonya Lewis Lee: Shamony is an amazing force, an amazing human being. She is the one who we started with with this film when Shamony passed away, Shamony wanted to have as Paula mentioned the celebration of her life, but it was also a conversation with the community about what was happening around Black maternal health. The thing about it is that Shamony was a reproductive or is a reproductive rights advocate and that's the work that she does in many ways.

She's known in New York City, amongst the Department of Health. She's known just in this country in terms of the reproductive rights people on the ground. I think for her, as she says in the film, knowing the issues around Black maternal health and still having to suffer the loss of her daughter was obviously terribly difficult, but it also inspires her even more. Shamony's an artist as well, she does a lot of work through her art, through dance, through performance.

She continues to be out there pounding the pavement, demanding accountability for the death of not just Shamony, but for all of the women who are dying or nearly dying from preventable childbirth complications. I think we, we should all be grateful that Shamony has the voice that she has and that she continues to do the work that she's doing for all of us.

Melissa Harris-Perry: Tonya, as you make that point again, beautifully about that it's not simply death as horrifying is that it's not simply the mortality. It's not simply the morbidity it is also the preventability the fact that these are deaths and illnesses that don't have to happen. Part of what you all address in the film is this notion of monetary incentives, fiscal incentives that hospitals face for C-sections over vaginal births. Can you connect that back to your earlier point around intervention?

Tonya Lewis Lee: Unfortunately what has happened is, as I mentioned earlier, the C-section rate has gone up in the last 25, 30 years. C-Sections require less time and less money than a natural spontaneous vaginal birth because vaginal birth takes time. It's a process that takes time. Often when we have C-sections or we're intervening, we put people on Pitocin that costs money.

We put them into the ICU. We operate on them and like I said, it's cheaper, but insurance companies reimburse hospitals more for C-sections than they do for vaginal and birth. There is this incentive in a way that's set up for whether healthcare providers intended or not that put us in a position where we have more C-sections than necessary and when it comes to Black women unfortunately again, what happens is now we are looked at as a vulnerable population. People want to intervene even more when maybe the aggressive intervention while it may be well meaning is actually causing more harm than good.

Melissa Harris-Perry: Paula, what does any of this have to do with the Dobbs decision?

Paula Eiselt: Maternal mortality and maternal health has a lot to do with the dob's decision because it's all one conversation abortion care is maternal healthcare is healthcare and we need to talk about full spectrum, reproductive rights like that. It's all one conversation we're seeing miscarriages be criminalized and women nearly dying already since post row and this adopt decision came about.

It really is one conversation in the same way that it's a human right to choose whether or not to carry a pregnancy, if a woman chooses to carry that pregnancy. It's her human rights, not only survive that birth but have a dignified and safe birth. This is all about choice. It's the same conversation. Unfortunately, there are studies coming out that they're predicting that maternal mortality rate can go up 21% post row and for the general national population and then specifically for Black women, 33%. It's horrific to have forced birth in a country that has the worst maternal mortality rate in the developed world, we need to talk about this together.

Melissa Harris-Perry: I want to also give you both an opportunity to weigh in on the Momnibus. It's something we'd been covering here on this show and trying to track as it had gone in and out of the real possibility of becoming law. I wonder if either one of you or both of you would like to speak on the MOMMA's Act of 2021 and the ways that it could potentially make a difference.

Paula Eiselt: It's great that I know Congresswoman Lauren Underwood introduced this recent iteration of the bill of the Momnibus bills and they really can have an impact. One of the big things about that is postpartum care that Medicaid would cover postpartum for a year. Again, as we've said that a lot of these deaths happen postpartum and often women who do get Medicaid get kicked off very soon after giving birth so we need to keep them covered so they keep getting care. There are bills there that can help bring cover doulas, cover midwives. I think that it's the Momnibus bills could have a tremendous impact.

Tonya Lewis Lee: I'll just add to that. Another facet of these bills is increasing the perinatal workforce to include midwives. We didn't touch it here in this conversation, but the US is the only industrialized country that does not have integrated midwifery care. It's proven that when you have midwives in care there are fewer interventions. Back to our discussion on C-sections there are way fewer of them with midwives and less intervention and better outcomes.

Those bills would increase access to midwifery care especially in communities of color and make sure that women and birthing people have cultured congruent care. That's just another really big part of this too.

Melissa Harris-Perry: Paula Eiselt and Tonya Lewis Lee are Co-Directors and Co-Producers of the documentary Aftershock. Thank you both for taking the time to talk with us.

Paula Eiselt: Thank you, Melissa.

Tonya Lewis Lee: Thank you for having us.

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