Birth Equity in Community

Everyone has a birth story.  A warrior for sexual and reproductive health, Carmen Green, Vice President of Research & Strategy at National Birth Equity Collaborative (NBEC), is creating solutions to optimize Black maternal and infant health stories through training, research, policy advocacy and community-centered collaboration.  Aurora + Kelly dig deep into her experience in operationalizing anti-racist frameworks and Black feminist theory in healthcare, policy, and culture.  She’s is a writer, reproductive justice activist and doula in training, whose continued commitment is to Black families experiencing wellness and joy and we are here for it.

Season 3 Episode 34 Carmen Green
Released Nov 17, 2020
Hosts:
Aurora Archer
Kelly Croce Sorg
Guest:
Carmen Green
Production:
Rachel Ishikawa
Music:
Jordan McCree
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Season 3 Episode 34 Carmen Green

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Transcript

Aurora Archer
Well, hello everyone. I’m Aurora

Kelly Croce Sorg
And I’m Kelly

Aurora Archer
And you’re listening to the The Opt In. Hey Kelly so I’ve been thinking about this birth and birth stories. And I’m curious, what was your experience the first time you gave birth?

Kelly Croce Sorg
Ah, the first time.

Aurora Archer
So first out of three

Kelly Croce Sorg
Out of… yeah, one out of three. One out of three states. This one was Pennsylvania and it isn’t, you know, the Jewish proverb, man, man plans and God laughs I fancy myself to be a real real bohemian. Hardy-har-har. But um, I was going to a birth center. I wanted a midwife and at the birth center if you were two weeks overdue you had to be induced and go to a hospital and give birth there. So I was 15 days overdue. Ended up at the hospital. Always a good experience. I’ll be it. Very long birth, very long amount of pushing probably I would have if I could estimate I would say 99% of the time would have ended up in the C section. I did have a midwife there that championed for me to have a vacuum suction which at the time sounded like a trip to Cabo was like 10 minutes of hell but it kept me out of having a C section, but did leave some residual physical trauma and alignment that I’m still working on ever since. But I do remember be having sovereignty around my birth and saying, you know, yeah, so in an epidural, yes. You know, when’s the anesthesiologist gonna get here? Yeah, you know, you know, can my partner being here with me, you can like I remember having sovereignty and remember telling other friends, like, ask for what you want. And for the most part, everybody was very reciprocal to what I wanted, and to my comforts, and ended up being a very an experience that I don’t want to say enjoyed, but I felt held I felt some more than I’m here to say it all went a okay for this white woman.

Aurora Archer
Gotcha.

Kelly Croce Sorg
How about you, dear? Your first?

Aurora Archer
Yeah, so my first was my daughter Mila, and like, I had that shit on lockdown. Like,

Kelly Croce Sorg
Where were you? Where in the world were you

Aurora Archer
Where in the world? Houston, Texas. We were living at the time in Houston, Texas. And I just remember that I like I had Oh, yeah, I had sovereignty. Oh, yeah. I had clarity. Oh, yeah. I had cue cards. I had a birth plan

Kelly Croce Sorg
you’re like, here’s your job list. Here’s your job list. Here’s your job list.

Aurora Archer
I have a 50 page PowerPoint. I had everybody’s roles and expectations outline bullet point did underlined with cue cards and color coded for everyone on the team. Oh girl. Yes, this was like when I was at the height of my professionalism

Kelly Croce Sorg
50 page PowerPoint?

Aurora Archer
And, you know, I was just like, you know, again, for me there was just sort of this very natural aspect of it. That became very sterilized in a hospital setting in this protocol,

Kelly Croce Sorg
Oh yes – type A plus plus plus

Aurora Archer
Command and control and …

Kelly Croce Sorg
I’m just picturing everybody like a deer in the headlights.

Aurora Archer
Oh yes. I hired a doula. I was the person who was like I’m having a natural birth. I had a whole birth plan. I had crystals. I had a jukebox. I had my ball. Like, I literally took a U-Haul truck to actually unpack me at the hospital and I and it’s so interesting, because I think to me that it was so clear that that is how I was going to have my birthing experience. And I look back now and think Wow, no wonder everyone was looking at me like I was crying crazy. Yeah. And because I just recognize now how it was out of the norm. That whole model was and I didn’t give. I didn’t give a rat’s. I sure didn’t. And, and I’m like,

Aurora Archer
and I was keen on bringing him as much of that element into what was my thing because I had been the one who had carried this child for 10 months. So I was crystal clear that I was calling the shots of what I wanted that experience to be for me and my child. And either you were on board or you were not and I politely asked you to step aside. And I am very grateful that between my Doula, the support team, my doctor and the nurses, I can honestly say they were all very supportive. They were all very clear. About what I wanted. It was a very long birth because I was

Kelly Croce Sorg
The first?

Aurora Archer
It was the first time I wanted it to be natural. So gratefully, everything went well. And after I think 26 hours we had a beautiful healthy baby girl. And it was all good. And I’m grateful and count my blessings for an experience as a black woman. That was positive, because we all know that that’s not really the case. That’s not really the case. Birth is such a sacred part of life. But it isn’t always treated that way, Kelly

Kelly Croce Sorg
For now, this medical industrial complex we have here puts money over people

Aurora Archer
Every time, exactly. And to be quite frank, our medical system in the US. It’s racist. Listen to this Kelly, black women across the entire income spectrum are dying from preventable pregnancy related complications at three to four times the rate of non Hispanic white women

Kelly Croce Sorg
Dying, not just experiencing that. Dying.

Aurora Archer
Yeah It’s just unacceptable. And you know, and in addition to that, unfortunately and horrifically the death rate for black infants is twice that have infants born to non Hispanic white mothers.

Kelly Croce Sorg
This is unacceptable.

Aurora Archer
And these are simply the facts. They’re the facts of birth in our country in the United States. Not yesteryear, but rather today and to unpack the reality of this and other solutions. Through birth equity. We’re speaking to Carmen Green.

Kelly Croce Sorg
Yes, Carmen green is the vice president of research and strategy at National Birth equity collaborative. It’s an organization that creates solutions optimizing black maternal and infant health, through trainings and policy, advocacy, research and community centered collaboration.

Aurora Archer
So let’s let Carmen green start us off.

Carmen Green
My name is Carmen Green. My pronouns are she her and they. I’m a scholar, activist, and artist being groomed in the black feminist tradition. I am Vice President of Research and Strategy at National Birth Equity Collaborative. I’m a doula in training and a sociology doctoral student at University of California San Francisco School of Nursing. So to this point, I have really hung my hat on this phrase that that my mentor friend, and the President and Founder of National Birth Equity Collaborative, she always says that is racism not race that is killing us. That’s killing black and brown people in this country. And on my journey now, I’ve learned that of all the ways that things impact our lives, that racism is so pervasive and its racial health and health inequities, racial health inequities that bother me the most. And so that’s the thing that I always go after. That is my passion. That’s my work. Some other key points in my journey and said, I’ve always been a warrior for sexual and reproductive health after my own experience of rape as a teenager. And so then shortly thereafter, I got into this program because I’m from North Carolina, you know, I grew up in Saulsbury. And then my family moved to Winston Salem. So I got into this high school program at Wake Forest that allowed students to, you know, be mentored by people in different health professions. I really had this come back to remembrance this morning as really my first public health and memory and thank you to Dr. Tim. Q. But that is when I started to first understand racial health inequities. He was doing a project about breast cancer and teaching me about public health. So then, I had another awakening and undergraduate at Wake Forest University about black birth and equities. And he got me so hard. I was so pissed that health inequities were not just you know, about chronic conditions, but also how we birth and create our families. It was deeply bothersome to me so then pursued public health and graduate school at Tulane, all about maternal and child health. After a few years in that time. In my life experience, my nephew passed away. And that was my sister and my my closest friend she had a pregnancy that the doctors themselves called the most healthy pregnancy they’d ever seen. And in five weeks, my nephew passed away for reasons that no one could explain,

Aurora Archer
Oh, gosh

Carmen Green
After observing her and observing others, and then dealing with my own feelings of wanting to be a mother in a in a bonded relationship one day without the risk and fear at that time, that’s when I met Dr. Julia Crea Perry in New Orleans, because I have a two lane in New Orleans and, you know, met up with her working on different projects and she had already had the vision to create National Birth equity collaborative as this like functional intermediary between communities and policymakers and healthcare systems. So, that is, that is where I have found myself now. I am rooted I have learned I have grown and in really come to love this work that I’m doing and really deeply struggled with the implications of white supremacy and seeing how deep it really is within healthcare.

Kelly Croce Sorg
Wow.

Carmen Green
Well, thank you and you said some points on my journey.

Aurora Archer
Yes. I want to go back to the point you made when you were I believe you said you were at two lane and you were on you were, you know, discovering and understanding the impact to our health. And you were pissed. I want you to tell us Carmen, tell us why you were pissed. Because part of what I struggle is Why is not everybody pissed. Like I want all not just the Black and Brown mamas to be pissed. I want all the white mamas to be pissed. And I don’t know that they understand why we’re so pissed. So I want you to tell us Carmen, tell us what gets it. Tell us what got you so pissed off and what keeps us pissed off when we understand what is happening to our mothers.

Carmen Green
Thank you Aurora for that question. Well, there are there are three things to be true about this maternal health and equity issue. And one of U.S has the worst outcomes for mothers, white, black, and every other identity has the worst outcomes in the industrialized world. That is racism, not race at the core of this crisis. And that we need a culture of respectful maternity care to change. So the things that I just fundamentally believe for me is that all families and all black families like mine deserve an experience of wellness and joy for free. I believe we should not have to increase any race to do this. We shouldn’t have to step out on a limb to do this. We all deserve wellness and joy, because we’re entitled to it. I also believe that we are the creators of our experience. And so we have to continually push for the things that we want to see some other points about like why it really troubled me so deeply is that I don’t family person you know I am. It’s like one of the greatest joys for me is being near the people who created me who share my same blood and learning about public health. And the imperative for everyone to have a fair shot at helping retinas and then understanding how pervasive racism is and having these experiences with Dr. Julia and NVIC and then having these experiences in policy and advocacy and Louisiana for Reproductive Justice. If we are now accustomed to like this racist structure of white supremacy, and we cannot find a way for all of the racist systems to respect our entire life course to respect us when we’re when we’re babies and then adolescence and respect us when we’re adults. If we can be respected, you know, in the 65 to 90 years, we’re honor. I want to find just what are the opportunities to remain or hold on to something sacred. And so, like, the more I thought about it, and this is like my theorizing a little bit, but there are two doors in our lives that could be considered sacred is the point where we cross into this physical realm and birth and the point where we transition back to the non physical and I’ve learned, like do some global health things that you know, different cultures, they still ritualized, and they make a lot of meaning out of those times in our lives. And where you know, culturally, are we holding on where have we lost it? How would it serve us to get back to making some things sacred? And that’s why you know, in the sociology doctoral program, I just want the facts. I’m trying to get to the meat of the situation and explore these topics. Like where can we be respected? Dang, if it’s not, if it’s not at the store if it’s not, you know, at my school, or if it’s not at the church, can I be respected in the most sensitive time in my life when I’m giving birth? Damn. That’s what pissed me off.

Aurora Archer
Thank you. Thank you for sharing that. You know, for folks who may not be as close to all of your learnings Carmen, the inequities? Right the the health inequities and how they are. First, everyone should be shocked that as you pointed out from a maternal health perspective, as a developed country, our model our standing our resources, our support are subpar. That doesn’t affect us brown and black mamas, that is affecting everyone. And so, you know, let’s talk about you know, how does race and racism play such a horrific role in the outcome of brown and black people, and specifically brown and black mothers? Why do you think that is what what is it that we’re not learning? Understanding are what are we hanging on to? What myths and beliefs are we hanging on to?

Carmen Green
I mentioned earlier that the black maternal health inequities are the issue because the US has, as you mentioned, the worst outcomes in the industrialized world. And we know that it’s racism not raised as at the core of this inequity, and that we need a culture of respectful maternity care to change. The issue is that when I’m pregnant, when I become pregnant, instead and into my local hospital to give birth, are more likely to experience disrespect and adverse outcome or some or some complication that can in my life, or in my baby’s life, but let me be clear, that when I keep my life, because the overwhelming majority of black mamas are living and thriving later all with their families. Let me clear when I keep my life, I want to be able to thrive with no preventable complications, no traumatic stress disorder, in no fear about my ability or my provider. My Care team’s ability to come back and have another healthy child. So it’s not only an issue about the mortality, but about the people who continue to live afterwards and go on and take care of their families. But like the whole cocktail of things that comes with it so I’ll give you a couple of the stats that I had to share. The United Nations has actually sanctioned the US for his black maternal mortality rate. Yet our numbers are trending upward and downward. So we need to turn the tide to some solution. But getting to the core of it is addressing racism in a system and doing that in any system is difficult. So black and indigenous women bear the weight of generational reproductive injustice through their birth outcomes. And social science, economics and public health teach us that racism and structures also impacts our individual health. The third thing we’ve learned is that there’s a global anti blackness that shows that racism impacts birth outcomes around the world. You know, wherever there is a country where there’s no racial hierarchy, you’ve got to you know, bet your keister that there are some health inequities and it’s gonna fall on people. darker skin tone is a global anti blackness that’s really interesting. But to change all that we need a culture of respectful maternity care that is a term that is, again in other countries around the world. We’re bringing it to the US. Providers right now. They’re trained and socialized to practice in one way. So there are textbooks and medical schools even as recent as 10 years ago. That are teaching of the biological basis of race. So what I mean is, and my president and founder Dr. Julia, she always uses this example. But in her books, it says there are three races, Mongoloid, Caucasoid, and Negroid and I teach you, all of provider’s this information in the textbooks are saying things like, people of African descent don’t feel pain, the same is incorrect. That’s being taught providers are being taught. Yes. So imagine even if they had changed the books, 10 years ago, all of the providers that are practicing whoever we birth, you know, and help us deliver our babies. They have this mindset running behind their practice. Yes. And so we need to be honest about how that filters out, and how black women are being treated during maternity care. And then example that we know for sure, of the Queen, the high queen, Serena Williams, you know what’s not being listened to and dismissed. So imagine of the that’s got to be the typical experience in our research doing focus groups around the country in depth interviews, I’ve been able to get close to people who have had their own burden variants and are willing to share and I’m very humbled to hear because I haven’t had my own yet. So all of that to say health systems notice, and they’re ready for accountability. And quality improvement measures for racism, starting with maternal and child health. So index respectful maternity care project, we have one funded by Robert Wood Johnson Foundation, helping to create tools to teach what respectful maternity care is at a skills level. So that every individual has an opportunity to receive that hopefully it will become the standard

Aurora Archer
so can you can you tell us like what are the components Carmen because I love this respectful maternity care. I’ve never heard that language. So I love that this is something you and Dr. Joya are bringing to to us here in the United States. What are the components of respectful maternity care?

Carmen Green
The components of respectful maternity care there as the they’re being developed? They’re being developed right now by people in research and practice. There is a model within the literature and sub Saharan African countries, South American countries, like Asian countries, but there’s not there isn’t barely any literature for the United States. And so, in order to create some standard of accountability, we have to first make our claim in defining it. So the project that Ian Beck is working on is defining respectful care from the black mamas experience. So that’s where the focus groups and all the listening came from. We wanted to hear how did you experience respect? What do people do to make you feel respected? Okay, then we’ll How does disrespect feel? What are the actions of disrespect so hoping to create that into a measure of accountability that they have to kind of take account for on quality improvement projects? So every healthcare quality improvement project, you know, you have your benchmarks you have your you know, targets and you have checkboxes that you have to meet? But there’s no checkboxes for any hospital about maternal experience. We really have to start from the ground to make that

Aurora Archer
which is so crazy to me. Right, because to your point, there are two sacred moments in our lives when we enter and then when we leave and you think as a developed nation, that we would have a standard, a standard protocol by which we are shepherding and supporting and educating and resourcing mothers to one of the most incredible moments in their lives that uh, you know, childbearing, of giving birth,

Carmen Green
like the medicalization of the of the birthing process has kind of made it into, you know, come in, get out high turnover. Yeah, it’s not as personal. But I do want to definitely acknowledge the research of projects like listening to mother’s project, and the research at a birthplace lab with Dr. Saraswathi about the mothers on respect index, and they have another index called the maternal autonomy in decision making. So those are great things that hospitals are not reaching out to those tools as something easy to use or integrate into their system. They want something that can get taken up like that. Yeah, so we’re learning so much on this process. And we hope that one of our tools are one of the ones from our colleagues on the west coast with Dr. Karen Scott. We hope that you know, with all the demand in the healthcare system, that one of these tools for anti racist and maternal care is going to be standard.

Aurora Archer
Wow, that would be fantastic.

Carmen Green
Yeah, because Okay, look, imagine all of the people that come in for like a cardiac event, or a or a surgery, you get discharged and then you get a survey. Sometimes it’s paper sometimes to your house, sometimes they’ll call you, but that the answers from that survey, that’s what those targets and measures are made of. But none of the questions on the survey have anything to do with maternal health. They don’t have anything to do with if your culture was was respected or if you feel as though your birth plan was diverted. Or, you know, if if you felt muscled into or pushed into a procedure that you aren’t ready for, but that is the normal everyday experience of like moms

Kelly Croce Sorg
to Carmen what is birth equity?

Carmen Green
Birth equity is a call to action worth equity says, When will we agree that racism is real? And what are we going to do to show up for black males? The birth equity is defined as the assurance of the conditions of optimal births and wellbeing for all people with a willingness of systems to address racial and social inequities in a sustained effort. So we say sustained because in Health Care Quality Improvement world, there are short term projects you have two or three years to intensely focus on the issue and you move on. But this is not that racial equity in health care is going to include the abolishment of white supremacy. That’s 100 years long issue. So that is something that we will take the same attitude of sustainability and energy towards, you’re gonna spend just as long building a new system.

Aurora Archer
Hello, everyone, just stepping in here for a second. Our conversation with Carmen Green will continue right after this. Break. You’re listening to The Opt In. Now, more than ever, we need to show up for our communities. And that means we also need to show up for ourselves.

Kelly Croce Sorg
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Aurora Archer
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Kelly Croce Sorg
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Aurora Archer
Welcome back, we’re jumping back in with our conversation with Carmen Green.

Kelly Croce Sorg
So I have a question for you Carmen. You did an amazing job of explaining almost racism from an external standpoint and affecting how just these terrible outcomes that we have here. And I’ve also heard Dr. Joy mentioned racism from an internal perspective, like the ancestral trauma and weathering, and all of the experience of racism of white supremacy culture on the body, and then that contributing to not ideal births or complications, etc. So it’s almost twofold. Is that correct?

Carmen Green
That is correct. And that means there’s a twofold solution. So we’ve got to do institutional like policy changes, and then we have to do the internal work each of us on like breaking down the impacts of white supremacist culture on our brains, you know, I am affected, you are affected or Kelly you are affected, and there and there are overwhelmingly negative effects. On all of us from the stress. What comes out of a white supremacy culture. So, like breaking down the institutional and policy things, it’s definitely imperative, like how do we do like healing from ancestral trauma is that your question?

Kelly Croce Sorg
Yes.

Carmen Green
Yeah. Whoo. That’s a deep question. I love it. So healing from ancestral trauma, but my perspective is everyone has a mama you know, there there is nothing more common than having that bond or that feeling, understanding what it is to have a mom or what it is to be a mom. So everyone who has a moment in this world also has a birthing story behind you. Have you ever asked her mom, what’s your birthing story is?

Aurora Archer
Yes.

Carmen Green
Yeah. I love it. Yes, I asked my mom to. And I always think of how those stories shape our reality in ways that we know and don’t know. So, I’ve learned this to some of my Doula trainings on site. Also, previously, like metaphysical stuff that happens in it’s so beautiful, but one woman in my focus group last year, she said we will always return to our birth stories over and over until we expire and they shape us and if they shape every individual I think that shapes our communities to another point that I wanted to make for the internal thing was not that not only that, like our that our birth stories and how we birth makes such a difference to us. But I learned in one of my Doula trainings that like on a brain level, there are certain like waves sure alpha, beta, gamma, you know, delta wave. And when you’re birthing, and sometime in your adolescence, there were two times where that room is open in your brain. Oh, so beautiful. Yeah, so like, literally there are times where your spirit can open up to like different messages. I’ve been told this is your opportunity for generational healing. So if we are in a birthing experience in a hospital, and we’re receiving racial micro aggression at this moment where your spirit is so open, like all that interference and get back out of here, you know, we have work to do in our communities. And I think that’s where the ancestral healing can happen. If we can harness that energy, but right now, you’re too busy, like having to get a nursing check for talking to us crazy. That’s, that’s where I really think the opportunity is for ancestral healing. And I’ve got another story about internalized racism. That could be relevant.

Kelly Croce Sorg
Yes. Tell us, please.

Carmen Green
Okay, so at National Birth equity collaborative, I helped start the organization with Dr. Julia in 2015. And so the purpose was to really help hospitals and health systems, get some meat on the bones of their equity plans. So all systems have an equity plan or they’re still going to have an equity plan because that’s just the movement of medicine and public health right. Now to eliminate inequities. So they’re all going to have an equity plan. But when you ask them, okay, what’s going to be in quarter one? Okay, then what’s going to happen in quarter two? Okay, what’s the what’s the goal of report? Oh, okay. You know, obviously the report is not going to save my black life or my babies. So we’re trying to get, like more like meaning to intention and actual, like efficacy to the dollars that they’re putting behind these equity plan. So anyway, we go and we want to help the systems. And it’s difficult. A lot of times, the health systems won’t even have a common language that they’re using in the department. We’ve been doing racial equity trainings, implicit bias trainings, birth equity trainings, and they have like, developed honestly as we have grown as an organization, the more we learn, gosh, we intake so much information, we have to share it going into hospitals and even places like WIC, but doing these training. And I’m the facilitator.

Aurora Archer
Yes.

Carmen Green
So we work people through what it means to change your mind. What is a worldview? You know, what are your identities? How might your identity be impacting your actions, you know, in your, in your setting? So I’ll tell the story when we’re breaking down the levels of racism, about internalized racism, interpersonal racism, and institutional. So my internalized story is that, you know, growing up in Saulsbury, my parents were in the suburbs, so I grew up around white people. I had white friends that do my oldest friends are white women, and I have white God babies. So I grew up with them. And when I would go visit my cousins, we go to this little black kids everywhere we run into you know, having fun on the block. So, I was always around my boy cousin, and they would always protect me always, you know, show me things and help me out or just, you know, being great cousins. But sometimes I would feel like this anxiety when I was over there. And in class, in third grade class, I’m asking my teacher, you know, what is it? What does it mean? You know, when I feel this way around, black people don’t feel this way around my white friend . And my third grade teacher didn’t have the language to tell me that I had internalized racism that because I had heard so many stories about little black boys and black men or whatever. When I go over here with my cousins, I’m anxious for what? They’re my cousins. They protect me they helped me but even at that young age, like everybody is changed by white supremacy, by these things that we hear, and we internalize. So now like we have to, in the black community, we have to know that we deserve wellness. We deserve joy. No, we don’t have to act in accordance to this system. And that’s another part of the internal that we have to shape up individually. Well, y’all got me talking with the training the providers in the trainings a lot of folks are being mandated to go to implicit bias training. And this is just like a point on the internal work that we have to do. Me sometimes facilitating those birth equity and implicit bias trainings. Like I’m a student of sociology so I understand power dynamics in the room. I’m looking at, you know, how people show up and back off, like understanding the flow of conversation, when you know, people have higher economic status or one of the department chairs, you know, was responding to a nurse. I’m looking at all of that. And I also look at the people who are mentally checked out and sitting in the back, and that is why we provide coloring sheets and some of our seminars because we don’t want them to be off the deep end. We have to give some people something to do. So yeah. As people with who are at highest risk for adverse birth outcomes, we have to do work and you know, know, our joy and our standpoint, and our advocacy for ourselves. But we also need every provider who is any part of our lives to do the internal work to .

Aurora Archer
Yes What do you find Carmen is the hardest part. I do find in this in the me because I think all of it’s difficult, right? You’re trying to break down so many systems, you’re trying to break down a system that is policy. You’ve got the provider component of it. You have the hospital systems of it, you’ve got the insurance component of it, and then you have as individuals right who are who are walking in with our own sub standard expectation of others in the medical profession or in the place of authority, because of this white you know, supremacy conditioning that has affected all of us. Like where do you see the biggest challenge? There’s so many pieces.

Carmen Green
Yeah,but I think that that also means that there’s a place for everyone is what I’m saying, because we get in so many situations with systems and with people in power to make change in if you’re paralyzed. But there are so many things to do. How could you be paralyzed? We’ll give you a menu that’s how I feel a lot of times so it’s just like choosing one and enacting in earnest towards it we we know that everyone doing their part is going to create outcomes that we spend a lot of time on mostly still breaking down the history behind it. Breaking down the why and how we got here. breaking down what is racism, but it feels like 2020 This could be a different shift. I’m really hoping and praying. I see that in 2021. Our trainings might take a shift because people understand just the state of the US and the racial equity to be a household topic of conversation. We think that that race that raised awareness across all of society is going to you know, make a kinda different landscape for how we all learn about this.

Kelly Croce Sorg
Yeah, it’s amazing like you’re you’re teaching racial literacy and and helping people get their racial identity at the same time that they have to be in the medical field and do their practice or be a mother and give birth, whatever it may be. So to your point, what’s the menu and how can we Opt In? Where I am? Where somebody may be as a health care worker? How can we Opt In and choose from the menu?

Carmen Green
Yes, I was thinking before today are one of our what are our calls to action for folks outside of health and medicine. So I think just at the bare bones of it is Opt In having difficult conversations in our own houses and challenging ourselves to wake up and use different language. What I’ve learned as a birth equity trainer is that even my own skills do not always translate. So I, as a facilitator, have to constantly push myself to use the right language, or to ask you know, certain questions or to put myself out there when I don’t understand something about someone’s culture. It is uncomfortable to ask them questions, but we need to get there. And we’ve got to make a practice of it so that we’re comfortable bringing it into work. Work is going to be the last place we’re comfortable doing something you’ve got to be really secure in what you’re doing and what you learned to bring it to work in many cases because people want to be on their, on their P’s and Q’s people want to do right, and especially healthcare providers. It’s frustrating the SE in our trainings that is frustrating when some providers that step out and do something good for health equity, but then they didn’t say the right words or they were talked to afterwards and then they got discouraged in their walk towards equity. But that same person, the second time they address an issue on their like department or in their ward is going to be more comfortable. So we just have to kind of just brush the dust off of our communication skills. Yeah, that’s the one another one is just everyone sharing your birth stories. It was really encouraging to hear you too had asked your mom’s about your birthing story. So that’s not common either.

Aurora Archer
Well, you know, as you said that I was like, Oh, I don’t know that I shared the birthing story with each of my children, and they should know their birthing story. So you’ve just given me a to do list. I’m going to make sure that both of my children are very aware of their birthing stories, because both of them were very different.

Carmen Green
So I’ve learned that even in the focus groups that were doing, that we were doing around the country, there would be people that you know, shared something about their about their postpartum experience or something that happened at the hospital and they will say wow, you know, I’ve actually I’ve never told anybody that and I get it. You know, right after you have a baby people come in to see your baby. You have so many other things to talk about. But did did mama really download does she put a cap on her experience? Does she feel holder she needs to do one little other thing to round it out. And a lot of moments don’t. So hey, let’s talk about it. And then it just builds community to stories. Yeah, yeah. And the third one that is going to be for? Well, here there are 149 health professionals is continuing to support legislation for reproductive health care access and reproductive justice legislation is going to be under attack, as usual, but probably more so. Now, until, you know, gosh, until there’s another shift in the Supreme Court, we really don’t know what’s going to happen. So everyone just just have your ear to the ground. On you know if there’s a senator you can call or if there’s any action that you could take, please do. Then another way to Opt In, will say a way to Opt In for healthcare professionals. Is that when you are mandated to go to some anti racism implicit bias training, genuinely participate. It is is difficult on both sides as a facilitator, and as a black woman facilitator, doing this reproductive justice work. Your facilitators feel that so deeply Yes. And they want to understand your perspective. So even if you have something crazy to say, that would help us, let’s be transparent, now’s the time to be transparent with each other. There is a there is a liberation happening. You know, there is a revolution happening. So the quicker we get things on the table, the quicker we can find more solutions for racial equity.

Kelly Croce Sorg
And what does community mean to you and how does birth equity play into that?

Carmen Green
community, to me, means the places where I can be my most authentic self and be cared for. I’ve never felt more in community than I do in New Orleans. Favorite city that is where I live for a while and those people, they care for me, they taught me how to connect spiritually in ways that work for me. I learned how to be strangers, you know, and wherever I go, I know whatever systems work, whatever research work I’m doing. There’s gonna be one foot in the brainiac, pot and then another foot in the community. But I know that I’ve always been near and around birth workers and healthcare professionals. Because I believe they’re the people who helped that, you know, transition. And within Beck, at the heart of it is just protecting the right for black families and all families to parent the children that they have safely and sustainably. And so I know that’s the priority for me and community. So, how does birth equity relate to community? One is based in reproductive justice, which is a black feminist theory and movement is also based in human rights. And that’s a global standard on human entitlements that the US didn’t ratify, and are not adhering to. So birth equity is about securing a standard of safety, care and joy for growing black families. And when we think about it, that has never been promised to black families in this country. So imagine not having to worry, Wow, that really is a luxury when you think of our history. And there is such thing as a community effect. You know, when a whole population is traumatized by an event, and so I think about it in those terms. So living in New Orleans. I learned quickly that I was in a hurricane zone. So I got there in 2012. And that was seven years after the devastation of Hurricane Katrina. But I quickly learned that during that hurricane season, when there’s something big coming, you protect yourself, you know, you move you learn from your past experiences and you adapt to protect yourself because that’s a natural response. But it’s gonna work the same way, like as other traumas in our collective community. So, like a community can be defined as people in a geographic location, or just people who have similar values, similar interests, so I can have my my Oakland Community in California or I can have the community of gamers all that to say, like collectively in the black community. In the US, we have this prevailing narrative like that has gone on for decades and decades. Black women are three to four times as likely to die in childbirth. Black women are not listened to. If you’re a black woman, you’re going to have them have a baby, you’re going to have a terrible experience. Like those are the messages that are seeping into our brains and into our communities. That’s where they internalize things starts to come in and that is not good. You know it has begun to instill fear in the hearts of people who would otherwise become mothers, and our mothers are our community creators. And so it’s, I believe the spirit of fear and trepidation as a tool of the devil in general. And it’s one of those messages that that perpetuates racialized inferiority. It perpetuates racial hierarchies. And if we if we turn the tide on this part of our community, like everything, equalizes wellness is, I believe, just like our natural state, as humans, if we can just allow ourselves and resource ourselves to be well, I believe, like, that’s one one part of community building that index is committed to

Kelly Croce Sorg
you make that sound like a wonderful place to be. I don’t know why we wouldn’t want to be there. I enjoy and respect and care and community. It’s like a big hug, Carmen.

Carmen Green
It is and Kelly, you know, people are running away from the universe’s hug.

Aurora Archer
Well, this has been absolutely a delight. Thank you for giving us so much context and data around a critical issue for all women, but specifically for black mamas. What’s next, Miss Carmen? What’s next for the coalition? What’s next for you? And Dr. Joya, what should we be looking out for?

Carmen Green
All right, thank you both for having me. Wow. This is one of the first opportunities I’ve had to to really share and connect these big ideas about wellness and joy from black families and how we get there with birth equity. So what’s next for National Birth equity collaborative is continuing to support our programs like MTAP. The MTAP project is really addressing one of the social determinants we know impacts black maternal health, and that’s just fundamental access, our access to information, access to quality health care. And when the COVID 19 pandemic began, one of the things that we learned was a lot more prevalent in black mamas experiences was just their ability to reach providers. And so, at the same time, many foundations and in the federal government were investing and like telehealth opportunities, they knew that broadband and you know, internet access, that’s going to be one of the number one drivers for people to take care of the circumstances of life and small work, health care. So in back was really grateful to be part of that project. And then re grant funds to think 15 Different organizations around the country. And for myself, I’m just going to try to keep my head on straight and complete this doctoral program because I just started and just started so hopefully you’ll see a doctor Green at National Red equity collaborative

Aurora Archer
we love you. So just keep going. Keep going. Keep pushing. Thank you

Kelly Croce Sorg
Thank you so much.

Carmen Green
Love you both. Thank you so much.

Aurora Archer
Thank you, Okay, wow. So much going through my mind at this moment. What are you thinking about?

Kelly Croce Sorg
I mean, we just keep coming back. I just keep coming back to this idea. Of how we settle we settle for a lot less than what could be we as white people settle for levels of health care, and levels of leadership and

Aurora Archer
And I feel that I feel that brown and black people settle because we are left with no other choice. Right. We are quickly dismissed. We are quickly chastised for asking for what we believe is a basic right. I mean, I navigated a black father, a Mexican handicapped, broken immigrant speaking mother, to biracial children through a health care system, and quite frankly, it was pretty atrocious. And so as much as you may articulate that you settle, there is almost an expectation that we as bipoc Don’t demand or expect much of the system. And quite frankly, the system is gives us very little in return with regards to seeing us. You know, I walk into hospitals and I like who created this it’s so horrible. Yeah. And it’s like I know who created it. The white male created it. And you can see it. There’s nothing creative about it. There’s nothing communal about it. There’s nothing joyous about it. It’s all Stark, sterile.

Kelly Croce Sorg
Yeah. A lot of health care workers out there that really do the best they can with the tools that they’re given. But man, their lives, their jobs would be made a lot easier and their lives lot more uplifting if it was centered around if health care and the system was centered around care and respect and community.

Aurora Archer
We do not have a health care system that is focused on wellness. We have a health care system that’s focused on sickness illness. Yeah, totally. It’s not it’s not it’s sickness, like you’re sick. And the more you are sick, the more I profit from you being sick. So I’m actually not focused on your well being. We have a system that is operating exactly the way it was intended. To operate. So something is broken. Thank you all for listening. Find us on Twitter, Facebook, and Instagram at The Opt In.

Kelly Croce Sorg
Music for this episode is by Jordan McRae and The Opt In is produced by Rachel Ishikawa. See you next week everyone. Buh bye. Stay safe. Stay

Aurora Archer
say yes, we love you. We need to change and that’s why you’re here. That’s why you stick through these conversations as hard as they may be, and continue to challenge your communities to think bigger. We’re here for liberation. We know you know how important this work is, and we want to keep doing it. However, we need your support, you can pledge your contribution to our Patreon Venmo PayPal, all the links are at our website.

Kelly Croce Sorg
theopt-in.com

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