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♪ Thelisha Eaddy> The United States is facing a maternal health crisis.

The country's maternal mortality rate is higher than that of many other high income countries.

And in the U.S., Black women experience significantly higher rates of maternal mortality compared to White women.

South Carolina ranks eighth nationally for maternal mortality.

These deaths can result from complications related to pregnancy or its management.

And recent data reveals nearly 95% of all maternal deaths in South Carolina could have been prevented.

Tonight, mothers, health care professionals and policymakers discuss the complex factors impacting maternal health.

This is Palmetto Perspectives: Saving Mom.

Good evening and thank you for joining us.

I'm Thelisha Eaddy.

5.4 million people call South Carolina home.

Many of them are probably right now having conversations about starting a family or expanding their family.

And it's an exciting time.

There are conversations filled with the talks about babies' names and the colors for the nursery and whose mom is going to temporarily move in first.

But unfortunately, making its way into those conversations are concerns and fears about the health of the baby or babies, but also about the mother's health and ultimately her life.

We heard the stats just a moment ago, and to help make sense of why we are seeing these numbers and how we can all play a role in getting to different numbers are our panelists tonight.

First, we have Maya Pack, She is the executive director of the South Carolina Institute of Medicine and Public Health.

Rhonda Sims is Program Manager for MoMMA's Voices and founder of the Black Maternal Health Collective.

Representative Sylleste Davis could not join us this evening, so helping to advance tonight's conversation is Kristen Shealy, Deputy Director of Maternal and Child Health at the Department of Public Health.

And rounding out our esteemed panelist for tonight is Dr. Lisa Waddell, former Chief Medical Officer for the CDC Foundation and founder and CEO of LFW Public Health Connections.

Good evening.

Thank you all for joining me.

I'm excited about tonight's conversation.

I'm really excited about being able to take your expertise and of the knowledge about what we have here into the homes and living rooms across South Carolina.

Preparing for this...program.

I was shocked to learn that when we talk about maternal mortality, we're talking about the deaths of women, of course, during their pregnancy, but also within 42 days after the pregnancy.

I was really shocked.

That's over a month.

How was that so?

And I want to, we're just going to go around, around the room.

That was shocking to me when I shared it with family members and with friends.

That was also shocking.

We...have this nine month, usually nine month journey, and then we think all is well and good, but what's been found to be the leading factors for these deaths?

Maya?

Maya Pack> So one of the contributing factors there is that not all new moms are able to get themselves to the health care appointments.

And we know in the first few weeks of life it's particularly important for newborns to see their pediatricians.

Sometimes that means that mom de-prioritizes her own health in order to get her baby to the doctor.

And so, the Institute of Medicine and Public Health is in the final stages of convening a task force to look at the... to look at the issue of access to health care in the most rural parts of our state, where there's really a lack of services.

And in order to be healthy, both the mom and the baby, need to have, a physician and other members of the workforce, to help take care of them.

Thelisha> Each of you have served on that task force.

And it recently convened.

What were some of the takeaways that the, the information that you learned and was able to discuss that really stood out to you and has stayed with you?

Dr. Waddell?

Dr. Lisa Waddell> Sure.

Thank you so much for having all of us here tonight.

And, the issue of maternal mortality, is very troubling.

And it should not be an issue, here in our state and across the country.

We have, far too many mothers who are dying as a result of childbirth, as a result of being pregnant.

And when you talked about up to 42 days, actually, when you look at pregnancy related mortality, that's up to 365 days.

So that full year, after the delivery and many of the deaths actually happen in that latter part.

So about 50, over about 50% of the deaths actually happened, after the first 42 days.

So therefore, the issue is important for the mothers, the spouses, those who care about moms to pay attention to them for that full year, at least.

And why is that happening?

Well, as Maya indicated, we often hug on the babies and, you know, and pay attention to the little ones, as we should.

But mom may be continuing to have issues related to her blood pressure that she may have had during pregnancy.

She may have had pre-eclampsia, where that blood pressure has gotten really high and eclampsia where its even higher.

And that may continue in that postpartum period.

So it's important for a mom and family to know what the urgent warning signs are, and maybe we can talk about that a little bit later.

Thelisha> We hear that term a lot.

What is pre-eclampsia?

Dr. Waddell> So pre-eclampsia is when you actually may have blood pressure, high blood pressure before pregnancy, but after 20 weeks of pregnancy, your blood pressure can potentially really go up very high and you may start to spill some protein in your urine.

And so that's called pre-eclampsia.

If it really shoots up then that's called eclampsia.

And this is serious.

It's very serious and women can die from it.

So it's really this exceptionally serious high blood pressures.

Thelisha> You mentioned, access to care, in our rural health and a large portion swaths of South Carolina is rural.

But I'm going to read this because I want to make sure I get it right.

But just this morning, South Carolina Public Radio reported the annual survey of health in U.S. counties in U.S....counties shows almost a quarter of counties here in South Carolina are ranked low, with two of them, Marion and Dillon counties are among the least healthiest in the country.

So kind of bridge these two stats for us.

We have this information from the county reports and then our stats with South Carolina ranking eighth highest when it comes to maternal mortality.

Where...how do they connect?

Where's the connection?

Maya> There's so many connections there, Thelisha, and the Institute of Medicine and Public Health is the lead dissemination agent for the county health rankings.

So every year we take a, serious look at that data.

Unfortunately, our state ranks poorly among states.

And then within our state, there's areas, that are faring far worse than others.

And the reason that we chose to focus on rural communities in South Carolina is because the differences in outcomes between the rural and urban communities in our state are significant.

And one of the reasons for that, there are many reasons.

But one of the reasons for that is, the number of counties where there are no obstetric, obstetric services whatsoever.

And some women are having to travel really far distances for their prenatal and postpartum care, but also for their birthing care.

And, it's shown that when women have to drive a significant amount of time, that the outcomes suffer as a result.

And so, the reasons for the poor health outcomes are myriad and they're complicated, and a lot of them are connected to, the existing health of the mom at the time of conception, as well as the social and environmental factors in the community where she lives and works.

And if you add on other, demographic factors like access to insurance and employment, you can see the statistics suffer in different categories.

And so creating solutions that are comprehensive, but then also targeting communities for intervention and support and new services that are really, the most in need right now.

Thelisha> You know, there is another statistic, that on the surface level, it's, it's jarring, as well, that at least 95% of the deaths here in South Carolina could have been preventable.

But if you kind of think about it and dig a little bit deeper, there is a silver lining.

Is that it's preventable.

There's something we can do about it.

Kristen, I want to come back to you.

What steps and what initiatives is the state currently doing to kind of bridge the gap, get the education out to people so that we can start working on these preventable steps?

Kristen> Absolutely.

Thank you for that question.

We are, we're, we're doing, we're doing many things.

We really want to make a difference and want to make an impact.

D.P.H., Department of Public Health is a partnering organization for the South Carolina Morbidity and Mortality Review Committee, and the committee is charged with reviewing all of the deaths that occur to women while they're pregnant, and then up to one year after the end of that pregnancy.

And so we are looking to see if they're pregnancy related and if so, are they preventable?

And the committee is also charged with coming up with recommendations at various levels the facility level, the hospital level, the provider level, the community level, the patient level, those recommendations to really help eliminate or prevent those...maternal deaths, and education really is key, like Maya said, with, with, you know, the health of the mom before getting pregnant.

That's, that's very important.

And we know that it's important to seek preventive care, especially when there are underlying conditions, such as, high blood pressure or diabetes, and mental health conditions, as well.

So it really is important if a mom is struggling with some of those conditions, to really seek the care and make sure that those are well managed, hopefully prior to getting pregnant, but during the pregnancy, absolutely.

And then the urgent maternal warning signs that we've mentioned before, you know, making sure that the mom after, after the end of her pregnancy does follow up with, with the postpartum care.

That's, that's really essential for the provider to be able to...really assess the mom and look into those conditions such as, mental health concerns, substance use, and some of those early warning signs too, such as dizziness, headache that won't go away, fever, swelling in the face, in the hands, chest pain, difficulty breathing.

Those are really, really important signs.

And if the mom notices those or her caregivers or her support system notices those, it's really imperative that she get to, to care immediately.

Thelisha> Rhonda, I want to come to you because, Maya mentioned connections and support and community.

And I want you to share a little bit about the steps that happened in your life that led you to create your organization.

Rhonda> Sure.

So, I was a mentor at the University of South Carolina, had a mentee there who attended.

So, she later in the years got pregnant and married and was a very, much so, health care advocate.

She was actually a pharmacist and she was, well, much so, well versed with the health care system.

And, she went into labor and delivery at one of our local hospitals here, and she was birthing her twin boys, and she died immediately after preg... after her delivery.

So her, her, story was really a life changing, point in my life to really consider, questioning whether to have more kids.

For my community, it took a, a very toll on us to make that decision to, to really examine if it's worth it, whether we would die during pregnancy, you know, whether it be to survive pregnancy, if we were able to take that step forward.

So it really kicked me to really start having the conversation within the community to discuss what are the issues, what things are happening that, that are causing these issues.

We were hearing them.

But when it happens in your community and it happens on a personal level, it strikes you in a much difficult way.

So a lot of the organizations that were here doing work, connected with some midwives here, some doulas, advocates who were doing research and really just had safe conversation on what do we do as a community to bring education and awareness to the ground.

So that's pretty much how the Black Maternal Health Collective was formed.

Our intention is to amplify voices, to continuously be at the table of change, to ensure that the patient voices are heard, which is a lot of the work I do at MoMMA's Voices, because if the lived experience is not at the table, then we're absolutely not serving anybody well.

So we represent them in everything that we do, and we ensure their voices are heard.

Thelisha> You know, you mentioned something that I actually experienced, saying to someone in a, in a group, you know, and I want to ask the audience by show of hands, how many of you had the thought or found yourself sharing with someone?

I probably wouldn't have a child right now.

The stats are too jarring, and it's, it's jarring and it's scary.

It's downright scary.

You know, a few years ago, there was a TV judge who shared her family's story.

And I think that helped amplify, this topic a little bit more.

But when you hear things like that, you know, it's, there are no rights given to us, but it seems like we should all have the right and the freedom and the comfort to want to do what, what we were kind of created to do.

But when you hear and you see that shared experience that people are afraid to, to have to expand their families, what are what are the thoughts that runs through your mind?

Dr. Waddell> I want to speak on that, because I think the work that everyone is doing is so important, and in particular with the Black Maternal Health Collective, because when you look at the data and you see the data, while the state's pregnancy related mortality has been coming down, for Black women, it's been increasing.

And so the gap is widening.

It's getting worse.

And so Black women are 4.2 times more likely to die as a result of pregnancy and pregnancy related issues.

And so we don't want to scare people, but we want people to be informed.

Knowledge is power.

Support is power Advocacy is power.

And so that's part of what we need to be doing is to inform everyone about here's why it's important to be as healthy as possible before pregnancy.

Here's why it's important to ensure that we can get access to all women, particularly in rural communities.

Here's why we have to have policies to ensure that women can access payment for services.

Here's why, we have to have providers who are all respectful and listen.

Many women report not being heard, not being listened to.

So we have to have these conversations so that women and families know that it's okay to ask questions.

I should be able to have access.

We need to address where the gaps are.

That's why some of what the Department of Public Health and the March of Dimes are working on to try to, get, our mobile units are important.

So there's a lot of complexity to this issue.

And so the way to address it, is to have the conversations, peel the onion back and then to, very intentionally address each one of those factors.

Thelisha> What are some of the barriers you encounter, in completing that task through the work, through the lens of your of your work, the work that you do.

What are some of the barriers that you encounter that slows this process of getting the education to people?

I know we have the access to care and, but what are you experiencing as the women with the boots on the ground?

I'll say, for us in particular, it's...access to funding.

And, you're restricted because your organization may not be, be as big or as prominent, but you're, you're doing the work and there's a bunch of organizations.

I have one sitting in front of me right now, like the Bee Collective, and you know, they're doing the work.

They're on the ground, and funding is always an issue.

So being able to really, connect and work with organizations like D.P.H.

who have partnerships, the local H.B.C.U.s who have partnerships to be able to connect with them to ensure that, that's not a barrier.

When we look at some of the organizations in our collective who are teaching childbirth classes, sometimes they're donating childbirth classes so that people have accessibility and access to the information.

So that shouldn't have to happen.

The doulas and the educators should not have to sacrifice what they do for their families professionally in order to bring a service that is so necessary and needed for our community.

So definitely resources.

Resources are one of the main things that we lack much so in community organizations.

Thelisha> Again, many of you served on that task force.

We talked about Maya and Dr. Waddell, You served as a chairwoman of that task force.

How did the task force come to be?

What did you all... what were you able to uncover or to kind of what seeds were you able to plant?

And then what can we expect, out of the work that you all did together?

Maya> So I'll start us off.

If everyone can mark their calendars on April 29th we'll be, right here in this building for a press event to release the report that, resulted from this task force's year long efforts.

And, our goal was to develop consensus based, evidence based recommendations and an action plan for our state for the next ten years to improve maternal and infant health outcomes through increased access to care for rural, residents of our state.

And so we looked at a lot of different factors.

And there are recommendations and action plans related to the delivery of health care, as I've mentioned already.

And then, as others have mentioned, the workforce, the health care workforce, which is made up of many different types of workers that are all very important to the overall health of the mom and her baby.

We also talked a bit about, the non-medical drivers of health, particularly transportation, because transportation is a barrier to accessing services of all sort, but particularly health care services.

And then we also talked a bit about the training and education, required of the workforce to best serve the needs of the moms and babies.

But for the details on those recommendations, stay tuned.

And plan to participate in our press event.

Lisa, is there anything you want to add to that?

Dr. Waddell> We also talked about behavioral health kinds of issues as being really important, and particularly when you look at pregnancy related deaths in the state, one of the leading causes is related to substance use and our mental health.

Many women may experience postpartum depression.

And so that's an important issue to that.

We've also looked at, that would need to be addressed.

Thelisha> If you're just joining the conversation, this is Palmetto Perspective: Saving Mom.

Tonight, we're talking with mothers, health professionals, and we have a live studio audience talking about improving the numbers here in South Carolina when it comes to women and their pregnancy, during their pregnancy and after their pregnancy.

I want to turn to our audience members now because many of you are in the trenches working as well.

And I want to spotlight some of you that are willing to share.

But if I can get someone to tell me who you are, the name of your organization, and how you are working in this space in your neck of the woods, You all look so great out there.

(laughs) And Rhonda you kind of mentioned someone earlier, but that's the exciting part for me, is that there are a lot of entities already in place.

The information is readily available and we just have to connect them.

So I'm really eager to hear about the South Carolinians joining forces with the state to improve the health of moms and babies here in the Palmetto State.

No one.

Okay.

Wait... we have...there we go.

So we have, if we can get a mic to the back.

Yes, ma'am.

>> Good evening.

My name is Tameca Wilson.

I'm with March of Dimes, and it's...

I work with this panel, and they are, you know, they're fantastic in the work that we're doing.

And, some of the things that March of Dimes is doing I really wanted to focus on is advocacy.

We recognize that the clinical piece is very important and that access to care is important, but also advocacy, trying to be the voice for our moms and babies out there, advocating with our legislators, putting in front of them the information that is extremely important, for legislation that needs to be passed or budgets that need to be approved so we can continue to do the work that we're doing to provide and improve access within the state.

Thelisha> Thank you for sharing.

Keep the mic right there.

Because the work you're doing is very important.

There is another jarring statistic.

Could you talk a little bit about the March of Dimes' annual report card and the gray that South Carolina has been getting, but...also the work that you all are doing to change that letter, to change that grade.

Tameca> Certainly, So, many of the people in the room are probably aware that last year, March of Dimes received an F on its report card, and it has received an F for the last couple of years, but the trend is moving in the right direction, where we are making some changes and improvements.

What we are doing, like I mentioned, is advocacy really trying to advocate for moms and babies and understanding, one of our missions are access to care and looking at what is happening.

Why aren't women getting to care as early as they need to, showing that, getting into care can make an improvement in their pre-term birth rates.

Also, educating women about the importance of being healthier before pregnancy.

Dr. Waddell mentioned that where if they can improve their, preexisting conditions like diabetes, hypertension, stop smoking, having a healthy weight at the time of pregnancy, that they can make some improvements.

In addition to, again, broken record, advocacy, advocacy, advocacy.

Thelisha> Thank you for that.

Yes.

Right here in the front.

Jennifer Baumstark> Hi.

My name is Jennifer Baumstark, and I'm, I work at the University of South Carolina.

I'm a certified nurse midwife, and I just want to mention that other countries that have had really poor maternal mortality, the way they turned it around is by introducing the midwifery model of care.

So we have 82 certified nurse midwives in the state of South Carolina.

Only half of them are actually working in practice.

We do need to make some changes in our legislation to allow, advanced practice nurses, dental practice authority, and that will make a big difference.

And also we just need to increase the amount of people that recognize the midwifery model of care, which, recognizes a women's body as being able to do, ... be pregnant and have a baby without many interventions.

So I'd like to advocate for that.

Thelisha> Awesome.

Thank you for sharing.

And right here in the red jacket.

Cheryl Myrick> Good evening.

I'm Cheryl Myrick and I have a different perspective.

I don't work for an organization, but I'm a mother and grandmother.

And I... my awareness was heightened of the mortality rate for expectant mothers when my daughter was expecting, and I began to read articles about her chance of having complications that could result in death.

And then I had the experience of my daughter in law in delivering one of my grandchildren to have had a problem postpartum, and there was an issue with the placenta, a part of it being left in place, which almost resulted in her death.

And so I want to echo, I heard someone talk about listening to patients, and I want to say, what kind of training is being given to your health care professionals, your doctors, your nurses, your anesthesiologists who work with patients in their delivery so that they listen to what the patient is saying as to what is happening to them?

And it has... both of my daughters were in, one daughter was in Maryland at a very, high rated hospital.

My other daughter was in Charlotte at a very high rated hospital.

But again, the listening to her talk about the pain she was still experiencing and it was ignored for a while, almost to the point that could have resulted in her mortality.

Thelisha> I'm curious, just by show of hands, how many of you have experienced that or heard someone experience that, just not being heard?

I think that's just about every hand in the room.

I see your hand.

I'm going to come right back to you.

But she brought up, our audience member in the red jacket brought up a really good point.

Is there, a vehicle for training, especially now when we see so many people are having the same shared experience that, you know, of that touches our our physicians so that we can have a better experience?

Kristen> Yeah.

Okay.

I can speak to that.

So with the South Carolina Maternal Health Innovation Collaborative, we are lucky at D.P.H.

that we, we do get to take advantage of federal funding.

And so that has made it possible to form a collaborative where we're looking at ways to really improve maternal health.

One of the aims is around service delivery and workforce development.

So, we are thinking about the training of the providers, the medical professionals that are, at the birthing facilities, but also at the emergency departments for rural hospitals and EMS, we're wanting to incorporate a respectful care model there, in the training that we offer.

And then we also, are able to... we've run a pilot for the CDC Hear Her campaign, in the Pee Dee area of South Carolina, lasts January through March.

And we're gearing up to kick off a statewide campaign.

And that campaign is really successful in being able to increase and improve communication between the pregnant mom or postpartum mom and her provider.

So there are some tools and some guidance that really is available to anyone.

It's all free.

And it can it can really help improve the communication skills, and really help to advocate for, the mom can advocate for herself and make sure that she is heard if she's not feeling that she's being listened to.

There is also a provider component to that as well.

So we're looking into implementing that as well.

Dr. Waddell> So I would also add that, it's important to have support.

And so during pregnancy, and particularly at the time of delivery and leading up to that and postpartum, that's an ideal role for doulas who are there, to provide support.

And data has shown that, there are better outcomes, particularly for women of color, that have doulas or that kind of support.

The March of Dimes, several years ago, when so much more attention, started around this issue, has developed training, around the issues of, listening and, for providers and, cultural competence and health equity, specifically in the maternal and infant health space.

So some of those tools and resources are out there as well.

Rhonda> Just going to mention, I'm a program manager with MoMMA's Voices who's under the Preeclampsia Foundation, but we specifically focus on allowing the patient to come in and share their lived experience to be advocates for themselves.

And that advocacy work starts with being able to be informed about your own trauma, so that you can take that story and work into improve quality improvement practices when it comes to birthing or anything in the provider space.

But on the flip side, we also do provide training for providers.

through our lived integration training, which allows them to understand how do you work with patients, like how do you talk to them, how do you bring them to the table for quality improvement practices?

And I'll give an example for instance, if we have a NICU mom who came through NICU, and she may have had a very bad experience, how do you bring her into the space to discuss her experience so that the next person that comes in can have a different experience?

So that's how we kind of partner, work together when it comes to the providers and the person who comes in with the lived experience on training.

Thelisha> And my sister in the corner over here.

>> I'm Sabrina Prioleau with the Bee Collective.

I'm here with my colleagues.

We're both prenatal and postpartum doulas, and we serve families in the tri-county area, so Charleston, Berkeley, Dorchester County, and we support our clients by making sure that they have prenatal care, access to childbirth education, lactation, support as well.

But the biggest thing that we do is we advocate for them, we help them understand, the medical system and being there to support them, whether it's at doctors appointments throughout their labor and delivery, but also postpartum, as well.

But we also, provide, ACT training for them.

So that they can advocate for themselves if we are not there, but we try to be there with them and walk with them, every step of the way.

We also support them if they need resources.

We have a lending library, so if there's things that they need for themselves or baby, we support them in that aspect.

But we also partner with other organizations in the area.

We also get referrals from different organizations.

So we really work throughout our community to make sure that, moms feel heard, that they feel seen and that they know that they're valuable and we care about them as well as their babies.

Thelisha> Thank you for sharing.

We've talked about the importance of being healthy before you're pregnant.

And just being healthy.

Is, are there, is there any initiative or programs to really push this component in at a really young at a...really young level in our elementary schools or in our middle schools or in our grade schools?

Is something like that in the works or already exists?

Maya> I think there's lots of programs that exist in different areas of our state, because we've been facing up an epidemic of childhood obesity for about 15 years now in this country.

And, you know, there's a bunch of different policies that can happen at the state level, but also at the school level or school district level to make sure that schools are healthy places, offering nutritious foods and opportunities for physical activity.

There's lots of, communities across our state involved in Healthy People, Healthy Carolinas, which is a, community coalition in about 20 different locations across our state working at the local level to improve access to opportunities to be healthy whether that be physical activity or more nutritious foods.

And so I'd say through, the Department of Public Health and a number of other agencies, as well as nonprofit programs across the state, there are a lot of programs working to help children to make healthy choices.

However, the statistics are not going in a good direction still.

And so we have a lot of work to do as a state.

And, you know, when we think about the life between, you know, elementary school and to, you know, a woman who is thinking about having a baby, there's a lot of opportunities there for intervention and for education.

Her employer could provide, you know, incentives for healthy living.

Her faith community could have a working group.

You know, there's lots of different, small policy interventions and programs that, can exist at all different levels and do in many cases exist at all different levels.

Thelisha> Thank you for that.

One of our audience members brought up, midwives, and it made me think about Maude Callen, and the work that she did years ago, decades ago, down in the Low country providing, that...health care service for so many moms in the Pineville area where there, there wasn't any.

Rhonda, can you talk about some of the groups that you have gathered together to make this collective?

When people step into your space, this network, especially during this, this exciting, but, you know, scary time of their lives, I think people probably Google the most when they're expecting, you know.

But can you talk about some of the groups that make up the collective?

Rhonda> Yeah, so many of our collective members are birth workers, so most of them are doulas.

We have...the Black Doulas of Columbia, DoulaSC, we also have lactation specialists who are a part of our collective, as well.

We have some researchers who are affiliated with the University of South Carolina who comes in and help uplifts.

So we know that data translates to, quality work.

So we know that we have to have the data in place to be able to review and...understand what we're implementing into the community, as well.

We have a midwife who I think she's a, the second midwife in South Carolina, and she actually has been a big part of what we do in the community, a lot of education, because she came from another state and actually came here to plant foot in South Carolina.

So it's actually two of them right now who are, one in certification and one who is a certified midwife.

So we have an array of people who are, who are coming in and who are interested in being a part of the collective.

And when I think about like what we do, our intention first is to educate.

We feel that there's a significant gap in education.

And when you talked about, young kids like, how do we start at the youth level?

One of the biggest things that we have to consider is health literacy.

We have to start early.

The maternal space is not where we have to start.

We have to start with our children.

One of the experiences we always talk about as a collective is we know patients who've been in, obstetric care and, or either care for their kids at the doctor's office.

And health is usually, reproductive health is usually not a conversation of comfortability when it comes to the doctors.

So I think we had to break that stigma of that conversation, being able to have those early conversations, like with my four year old, about what his body parts are, what they do, and understanding as a female, what do your body parts do as a young lady, so that we're not in the maternal stage and we're trying to figure out, well, where does a baby come from?

How do we, you know, where does the baby come out of, how do we make a baby?

So being able to start those conversations early.

So when you talk about nutrition, we also have to consider our food supply is not the best.

We have a lot of processed food, even within our school system.

So being able to consider where these contributions are coming from, those are things that we really have to look at and dig in as a community.

Thelisha> This is not just a woman's issue.

This is a family issue.

Coming up in just a few, few days of couple of weeks, you have an event coming up.

And in that I want you to talk a little bit about that event that's going to happen in the capital city.

But in that event space, you make space for the partners, the dads.

Talk a little bit about that.

Rhonda> I'm going to tell you why I make space for the dads because it's so significant to me.

My husband was very active, like during all of my pregnancies.

And I wanted to do something different.

After experiencing another loss, I really wanted to to have my baby at home.

So I went the midwife route, my mom is out here, so she will tell you her...push back Thelisha> Mom, raise your hand.

for me on... (laughs) There we go.

Rhonda> Her push back from me on like why do you want to do that?

Like nobody does that anymore.

Like, why are we birthing at home?

But I really wanted this experience.

And, my husband was so supportive.

He's like, I'm in support of whatever you do.

So we had a doula and a midwife, and he was, he was my coach, and he supported me throughout my, delivery and pregnancy.

And I feel like that's such a significant foundation for a family is to engage the male in that process.

Oftentimes, they feel left out because of course it is the woman's body, but they're all a part of this journey together.

So it is so significant that their voices are at the table because they get to see the inside of the person and the outside of the person.

So when we talk about mental health and postpartum, they get to recognize the signs and really see the challenges that the birthing woman is having in that journey.

So they're so significant in that process.

So in the coming weeks of April the 5th through the 11th, we have our recognition of National Black Maternal Health Week, which is the following week.

But we do a Columbia Black Maternal Health Week, where we're specifically focused on bringing education and awareness to Black maternal health to increase, to ensure that our community is aware of what's happening in this arena.

So our signature event is the Moms Marketplace, which is a resource vendor space, where we've collaborated with the city of Columbia to just create a very friendly family environment to come to, to be able to access resources.

And in the midst of our vendor space, we do panel discussions kind of like this.

And one of our particular panel discussions is called, Dope Ask Dads.

So you get to ask dads questions about their experiences.

We get to talk to them about what is their role when it comes to supporting the mom, through the birthing process and after the birthing process.

So we have three gentlemen who have volunteered to share their stories and to come up and be able to encourage other fathers to do the same.

I feel like it's so important for them to also lead their father groups, because they're going to be the one who really convert men to say, hey, we need to step up.

We need to be a part of this conversation.

And we're noticing it now in what we're seeing nationally through fathers who's lost their, their wives.

I think about the Care of Moms movement and how he has actually stepped up significantly and been a voice for her after he lost her, during maternal health and mortality.

So it's just so significant for them to be a part of that conversation.

We have a couple panel discussions about, fertility.

And also, ways to birth, like, we want to give people options and we realize that most people are birthing in the hospital space, but we also want them to understand that they have choices and options for support and advocacy.

So that's a big part of that day, as well.

Thelisha> A question I'd like to ask on this program, because we use this platform to reach all corners of South Carolina to talk about the issues that you're already having at your kitchen tables.

And so a question I like to ask is we have the stats in front of us.

We, you've shared with us how you're working in your space.

Maya, you talked a little bit about what we're going to hear from the task force, coming up in April and how we have a ten year plan.

How optimistic are you that we can change these statistics around here in the Palmetto State?

I'll start with you, Maya?

Maya> Well, I have to be optimistic.

I think that's the only choice.

But we are facing some dire circumstances.

We have the benefit, though, of a lot of very, very committed individuals working in the space.

You know, my organization focuses on one topic at a time, and we run task forces, and we publish a set of recommendations, and then we move on to the next topic.

And so I've worked with health care and public health professionals from a variety of different areas.

And I'll tell you all, you all know it.

That...the group of people working on behalf of our moms and babies are the most passionate, dedicated and just enthusiastic about their work.

And so I think, you know, looking at that workforce and across all generations of that workforce, it's a consistent...theme.

That gives me a lot of optimism.

Thelisha> Rhonda?

Rhonda> I have to be optimistic too, which is by the work, that is the reason why we do the work that we do.

And I really feel like we're heading in the right direction because we're having the conversations.

My desire and dream is to take all the conversations and let's create action towards those conversations.

Let's create this ecosystem of around...care, which includes the communities, the providers, the researchers, everybody who's a part of this conversation and ensure that we're leveraging resources in all of the spaces that are contributing to better outcomes for, for our state, Kristen> Right.

I'm optimistic, as well.

And I do want to say that, in addition to the task force that Maya has formed and they're doing their great work, we've got the Maternal Health Innovation Collaborative.

And I feel like with both of these groups, we've really been intentional about bringing folks to the table that are always in the M.C.H.

space but aren't...always.

I think we, we brought in some new partners, just in the past year or so, and I've, I feel like that's, that's very important to, to get the different perspectives, to make sure that we're pulling in community voices and folks with lived experience.

I think that it is crucial in, in helping us to, to plan our work and to implement our work and to evaluate and to keep going, making sure that we're tweaking it, as we see fit.

Quality improvement is, of course, huge as well.

So I feel like we've got great dedicated folks in the state, at the Department of Public Health that really are passionate about improving the, the health of moms and babies and birth outcomes.

Thelisha> And Dr. Waddell, Dr. Waddell> Anybody that knows me knows that I...

The glass is always half full.

Thelisha> You're an optimistic... Dr. Waddell> And, so I'm absolutely optimistic and I'm optimistic because we've got a system in place where we're looking at data, and the data is telling us 94% of these are preventable.

And so it takes the patient, it takes providers, it takes the payers, and it takes our policymakers, and it takes a focus on prevention.

And we can address all of those.

It takes a collective team.

It takes different types of providers working together.

And there are things that work.

There are things that we can do.

We just have to make sure that the resources are in place to support all of these efforts, and that, that action is being consistently implemented.

If we think about the postpartum period, for example, when mom is tired, mom is busy.

Thank goodness some do have that, that spouse or significant partner to help?

But let's not forget about the power of digital, and, the use of telehealth and remote monitoring and some of those tools.

So these are all kinds of tools and resources that are out there that we've got to make sure everyone is aware of.

So I am optimistic because there's so much that we can do both for mom and for babies.

And we didn't talk much about the babies tonight.

But when we talk about the infant mortality rate still in the state and there are clear things that can be done to address birth defects as well as unsafe sleep that will save babies lives in this state.

And, so there's a lot of work that is being done, a whole lot more that needs to be done.

Thelisha> I asked you earlier if you felt the sense of fear or if you, you shared with someone, I wouldn't have a baby right now, how optimistic are you?

Yes, ma'am.

Michelle Flanagan> Hi, I'm Michelle Flanagan.

And I am working with the M.H.I grant, and I also work, with our South Carolina Birth Outcomes Initiative.

And, our aim work that we do in the state.

And I'm optimistic for a lot of things I have we have a lot of things coming that will work on different, health issues, and education that we're working with, specifically.

But when you think about maternal mortality, one of the leading causes of maternal mortality worldwide has always been obstetric hemorrhage.

And if you look at our obstetric hemorrhage, it's still there.

It's still in the top ten but it has come down.

And that's because of the work that we've done with the bundles and making sure that, hospitals know what to do.

They're ready.

They're prepared, they recognize and they act.

And so we have switched over to a severe hypertension bundle now.

And I feel like we're at the beginning of this, but we have such a great opportunity to continue to get that information out there, not just for the providers, but also for our patients.

And so I'm very optimistic and excited about that work.

Thelisha> Thank you for sharing that.

And right next to you You had a hand up.

Yes, ma'am.

Marlena Clary> Hi.

My name is Marlena Clary, and I am one of the nurse abstractors that reviews maternal deaths along with my coworker here.

And we are also labor and delivery nurses.

We've been in the field for over 30 years.

And one thing when you ask that question, I think it's so interesting because, yes, if I, I'm too old to have a child, but I have, you know, children who would be having children.

And I think the most important thing is, is the people, the deaths that we review, we try to reach the families and do an informative interview, and every single family I've ever talked to always says, I never knew anybody, you know, we didn't know, we didn't know, We didn't know anybody died from, you know, these things now in this country.

And I'm like, Dr. Waddell said almost 60% of them are, you know, not during pregnancy, not right after.

They're seven days to the 365.

So educated people should be afraid based on these statistics.

But the people that this is happening to don't have the information.

And it's like almost any tragedy that you don't think it's going to happen to you.

You don't.

So, not that we want to put the fear into them, but we want them to understand that this can happen to you.

Look, this happened to her, and she's just like you.

And I think that's one of the most important things.

We have all the statistics.

We have the numbers.

We have the things, we know, the things we need to do.

But we also have to make sure that all the people that are impacted and this could happen to, know that this is them, this potentially could be them.

And until we really, really get that point across, I think... all the work we do isn't going to really be effective, because they need to realize they need to advocate for themselves.

They need to know they need to speak up.

They need to ask.

They need to talk.

Thelisha> Thank you for sharing.

One topic we really didn't broach too much was the economic impact that this topic has on, of course, families, but also the state.

Can you talk a little bit about that, Maya?

Maya> Sure.

So anytime there are poor health outcomes, there's an equally important negative impact to our economy because our economy is made up of the workforce and we need healthy members of our workforce to make a healthy economy for our state.

And so when it comes to issues around maternal health and maternal, morbidity and mortality, it can have a significant impact, on our economy with the, you know, time away from work or time, that is not fully at work presentism and absenteeism.

And there's estimates that, that alone is costing our state over $100 million a year.

And so looking at the, the health issue from an economic lens can give us another set of reasons that we really need to make improvements.

Thelisha> I'm excited.

When you are, when you're armed with the tools that you have or when you know you have the pieces on the table, you just have to find a way to arrange it and so that you can work with it.

So the information is out there.

Yes, the statistics are jarring, but I'm excited about the work that you're doing through, in each of your areas.

And what's to come.

Closing remarks.

What do you want to share with our listeners across the state on this topic?

For those who have already had their kids, for those in the process right now, and for those, and the younger ones, listening right now.

Dr. Waddell> I'd like to say that this is an issue that impacts all of us.

It impacts, you know, our sisters, aunts, you know, brothers, fathers.

It impacts all of us.

And it doesn't have to be.

We're living in the United States of America.

And we should not have mothers and babies dying at the rate that they are.

So it's something that we should all be informed about, our places to work hopefully, have policies in place that are supportive of expectant mothers.

And, for families after they deliver.

And if not, ask about those policies in your places of work and businesses.

And be that advocate for yourself.

Be that advocate for your family members and those that you care about, because, no one should be dying as a result of childbirth, and our infants should not be dying, in the state at the rate that they are.

Thelisha> Kristen.

Kristen> We focused today, on mortality for the most part.

But, you know, morbidity is also just as concerning.

And that, I think, is something that, you know, if we make an impact to reduce the deaths, we should be making an impact to reduce the morbidity, as well.

But, you know, those are lasting conditions.

It can you know, be much more expensive and costly down, down the road, in the long term.

So, you know, I really do think that the education and, and being able to provide the education in ways that are appealing, especially to our youth, that's really important, you know, with the use of social media and, you know, that no one looks at printed materials that much anymore.

So I think, I think, you know, making sure that with, with, innovation, we can really get this information out and in an appealing way and, and in an appropriate way to using appropriate language and making sure that we're culturally competent.

Thelisha> Thank you.

Rhonda.

Rhonda> I would say stand in the gap for those who are, discussing pregnancy and looking at expanding family.

Instead of having baby showers, let's have educational showers.

Thelisha> Oh, that's good.

Rhonda> Let's educate the families about, how do we support them?

How do we show up for them?

I think about postpartum as such as, it's such an untapped conversation.

And especially in this, in the community of Black women, It is, it's definitely a place where a lot of my friends who are very highly educated and they do well and they struggle.

And it is, it is not.

It is...

It does not miss anyone.

So just stand in the gap for families who are looking to expand.

Support them outside of the norm.

Show up for them outside of just, at their baby shower.

Call them and check on them Make sure they're okay, mentally.

Support them in ways that are unexpected.

So just, just fill the gap for your community.

We have to get back to community.

I think as we grow older, we're like, we want to move away from family, but let's get back to family and community and ensure that we're supporting those who are around us.

Thelisha> I am writing that down.

I love that idea.

You're so right.

We have the showers or at work, we have the baby sprinklings, but this.

(laughs) But we've dedicated an entire hour to this conversation.

I love the idea of having that be a part of the showers, because you most definitely need the information when baby gets here.

You do most definitely need that network when baby gets here.

Maya.

Maya> So during the course of our task force, I learned a lot about the differences and outcomes and resources across our urban and rural areas in our state.

And, because the outcomes are so, different.

That's what led us to really focus on rural areas of our state.

Now, the population density isn't always there to support a hospital system or the infrastructure that's been there in the past.

So I think it calls for a lot of creative solutions and a lot of partnerships of different organizations that all need to come together to be able to provide the services that each community needs.

And so thinking about, women and pregnant women living in a rural area that don't have a personal vehicle, that rely on others to get a ride to work or to their doctor appointments, what are the things that are going to benefit that woman and then her baby?

And it's things around the social and environmental factors.

It's things like making sure she has access to healthy foods, making sure she has a ride to, see the doctor and to see her infant's doctor, making sure she has a family friendly workplace to return to after her maternity leave.

So I think it's, you know, upon us to really think creatively about the solutions and think about how new and different kinds of partnerships are necessary, to really meet, meet the needs that are there today.

Thelisha> Creative solutions.

I like that.

One more time again, what's happening in April?

And.

Maya> Oh, yeah!

Thelisha> I'm excited about April.

I'm excited about the work, hearing about the work that you all have worked, have been plowing through in this task force.

What's happening in April?

Maya> So on April 29th at 10 a.m., we'll be back here at SCETV to host a press conference.

Dr. Waddell and I will be representing, the task force and releasing the full report, along with some executive summaries, to communicate the findings that this task force developed over the past year.

And, there's some, there's some things you would expect and there's some things you might not expect.

So I think everybody will be interested to take a look at that piece.

And if you want to get an invitation, just sign up for our newsletter at our website, imph.org We'll send you an invitation to the press event.

Thelisha> All right.

And Rhonda, also in April, big event happening in the capital city.

Rhonda> Yeah.

So Columbia Black Maternal Health Week 2025 April the 5th through the 11th.

You can visit our website at www.colabmhweek.com Thelisha> Thank you very much.

That is about our time for this evening.

Let's give our panelists and yourself a round of applause.

Thank you so much.

This was informative.

Like I said I feel extremely excited and empowered.

But thank you for the conversation and thank you for the work that you are doing in your communities across South Carolina.

But the conversation can continue.

We have resources and information on our show's webpage.

Just head over to our website at scetv.org, click on Palmetto Perspectives.

You will see our panelists here, links to their organizations and programs, along with some video clips that we talked with you a little while ago.

But thank you very much.

Don't forget, start your Friday morning with South Carolina Public Radio for statewide news and weather.

I'll meet you right there at 6:04 a.m..

I'm Thelisha Eaddy.

For all of us here at South Carolina ETV and Public Radio, thank you very much.

Have a great night And thank you all again.

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