[Music]
[Music] [Applause]
hello welcome my name is Shannon I’ll be
hello welcome my name is Shannon I’ll be talking about maternal health last
talking about maternal health last
talking about maternal health last summer
summer
summer I walked into a hospital room not
I walked into a hospital room not
I walked into a hospital room not knowing that what I would see that day
knowing that what I would see that day
knowing that what I would see that day would completely transform my life I was
would completely transform my life I was
would completely transform my life I was a research assistant at the pediatric
a research assistant at the pediatric
a research assistant at the pediatric newborn medicine division at Brigham and
newborn medicine division at Brigham and
newborn medicine division at Brigham and Women’s Hospital in Boston and there I
Women’s Hospital in Boston and there I
Women’s Hospital in Boston and there I said the effects of preterm birth I
said the effects of preterm birth I
said the effects of preterm birth I followed doctors who cared for the
followed doctors who cared for the
followed doctors who cared for the smallest and most precious patients in a
smallest and most precious patients in a
smallest and most precious patients in a neonatal ICU one day the doctor was
neonatal ICU one day the doctor was
neonatal ICU one day the doctor was paged down to a c-section and I
paged down to a c-section and I
paged down to a c-section and I witnessed my first live birth we welcome
witnessed my first live birth we welcome
witnessed my first live birth we welcome to a happy healthy baby girl into the
to a happy healthy baby girl into the
to a happy healthy baby girl into the world with no birth complications
world with no birth complications
world with no birth complications I left the oor with a huge smile on my
I left the oor with a huge smile on my
I left the oor with a huge smile on my face but when I got back to the NICU
face but when I got back to the NICU
face but when I got back to the NICU floor the air was still and quiet and I
floor the air was still and quiet and I
floor the air was still and quiet and I could tell that something was wrong the
could tell that something was wrong the
could tell that something was wrong the night before a mother had given birth to
night before a mother had given birth to
night before a mother had given birth to two twins both born extremely premature
two twins both born extremely premature
two twins both born extremely premature at 28 weeks and Y was very sick I
at 28 weeks and Y was very sick I
at 28 weeks and Y was very sick I remember waiting outside the hospital
remember waiting outside the hospital
remember waiting outside the hospital room well the doctors huddled and
room well the doctors huddled and
room well the doctors huddled and murmured to themselves and I watched as
murmured to themselves and I watched as
murmured to themselves and I watched as the doctors confronted the mom and
the doctors confronted the mom and
the doctors confronted the mom and confessed that there was nothing that
confessed that there was nothing that
confessed that there was nothing that they could do to save her son an hour
they could do to save her son an hour
they could do to save her son an hour later he died in the same hour I had
later he died in the same hour I had
later he died in the same hour I had seen a child both enter and leave this
seen a child both enter and leave this
seen a child both enter and leave this world and both mothers had the same
world and both mothers had the same
world and both mothers had the same expectations a safe birth and a healthy
expectations a safe birth and a healthy
expectations a safe birth and a healthy child but instead one mom was left
child but instead one mom was left
child but instead one mom was left saying goodbye to her son she had met
saying goodbye to her son she had met
saying goodbye to her son she had met only a few hours ago how could such joy
only a few hours ago how could such joy
only a few hours ago how could such joy and grief exists in the same moment I
and grief exists in the same moment I
and grief exists in the same moment I began asking myself how maternal and
began asking myself how maternal and
began asking myself how maternal and child health were intertwined because we
child health were intertwined because we
child health were intertwined because we know that the relationship between a
know that the relationship between a
know that the relationship between a mother and her child is like that of no
mother and her child is like that of no
mother and her child is like that of no other just ask your mom so that
so this powerful connection means that
so this powerful connection means that the health of the mother reflects the
the health of the mother reflects the
the health of the mother reflects the health of her child so rather than
health of her child so rather than
health of her child so rather than focusing on poured newborn health
focusing on poured newborn health
focusing on poured newborn health outcomes and it was already too late I
outcomes and it was already too late I
outcomes and it was already too late I decided to trace back my steps and look
decided to trace back my steps and look
decided to trace back my steps and look at where it all began
at where it all began
at where it all began maternal health globally three hundred
maternal health globally three hundred
maternal health globally three hundred and three thousand women die every year
and three thousand women die every year
and three thousand women die every year in childbirth how many of these deaths
in childbirth how many of these deaths
in childbirth how many of these deaths do you think to be prevented the answer
do you think to be prevented the answer
do you think to be prevented the answer ninety-eight percent so why are there so
ninety-eight percent so why are there so
ninety-eight percent so why are there so many preventable maternal deaths
many preventable maternal deaths
many preventable maternal deaths occurring around the world in order to
occurring around the world in order to
occurring around the world in order to answer that question we need to ask
answer that question we need to ask
answer that question we need to ask ourselves a different question where are
ourselves a different question where are
ourselves a different question where are these deaths occurring this graph the
these deaths occurring this graph the
these deaths occurring this graph the World Health Organization demonstrates
World Health Organization demonstrates
World Health Organization demonstrates maternal mortality around the globe and
maternal mortality around the globe and
maternal mortality around the globe and it’s concentrated in low and middle
it’s concentrated in low and middle
it’s concentrated in low and middle income countries especially sub-saharan
income countries especially sub-saharan
income countries especially sub-saharan Africa this next graph from the World
Africa this next graph from the World
Africa this next graph from the World Bank demonstrates neonatal mortality
Bank demonstrates neonatal mortality
Bank demonstrates neonatal mortality around the globe and it’s no coincidence
around the globe and it’s no coincidence
around the globe and it’s no coincidence that the disparity is in the same exact
that the disparity is in the same exact
that the disparity is in the same exact areas it turns out that where you live
areas it turns out that where you live
areas it turns out that where you live is the best indication of whether or not
is the best indication of whether or not
is the best indication of whether or not you and your child will survive birth
you and your child will survive birth
you and your child will survive birth 99% of maternal deaths are occurring
99% of maternal deaths are occurring
99% of maternal deaths are occurring outside of our borders in low and middle
outside of our borders in low and middle
outside of our borders in low and middle income countries because of the lack of
income countries because of the lack of
income countries because of the lack of basic health services that you and I
basic health services that you and I
basic health services that you and I take for granted every day so what
take for granted every day so what
take for granted every day so what exactly is causing maternal mortality
exactly is causing maternal mortality
exactly is causing maternal mortality medically it’s things like hemorrhage
medically it’s things like hemorrhage
medically it’s things like hemorrhage sepsis obstructed labor and other direct
sepsis obstructed labor and other direct
sepsis obstructed labor and other direct causes but I’m more interested in the
causes but I’m more interested in the
causes but I’m more interested in the true causes and return of mortality
true causes and return of mortality
true causes and return of mortality which like deep and factors we call
which like deep and factors we call
which like deep and factors we call social determinants these are things
social determinants these are things
social determinants these are things that you can’t control like your age
that you can’t control like your age
that you can’t control like your age your race your gender where you live how
your race your gender where you live how
your race your gender where you live how educated you are and how much money you
educated you are and how much money you
educated you are and how much money you have these factors hinder mother’s long
have these factors hinder mother’s long
have these factors hinder mother’s long before they even become pregnant if a
before they even become pregnant if a
before they even become pregnant if a pregnant mother and rural Cameroon lives
pregnant mother and rural Cameroon lives
pregnant mother and rural Cameroon lives 300 kilometers away from the nearest
300 kilometers away from the nearest
300 kilometers away from the nearest health clinic she’s unlikely to make it
health clinic she’s unlikely to make it
health clinic she’s unlikely to make it there for a safe and supervised birth
there for a safe and supervised birth
there for a safe and supervised birth because she lives in a rural area there
because she lives in a rural area there
because she lives in a rural area there is little transportation to the clinic
is little transportation to the clinic
is little transportation to the clinic and even if she were able to call a taxi
and even if she were able to call a taxi
and even if she were able to call a taxi there’s no money to pay for it and even
there’s no money to pay for it and even
there’s no money to pay for it and even if she were able to call a taxi and had
if she were able to call a taxi and had
if she were able to call a taxi and had the money to pay for it her inferior
the money to pay for it her inferior
the money to pay for it her inferior status as a woman and at patriarchal
status as a woman and at patriarchal
status as a woman and at patriarchal society means she she may not have
society means she she may not have
society means she she may not have financial independence from her husband
financial independence from her husband
financial independence from her husband so even if she had the taxi the money
so even if she had the taxi the money
so even if she had the taxi the money and the means to decide to go she’s
and the means to decide to go she’s
and the means to decide to go she’s likely uneducated which means that she
likely uneducated which means that she
likely uneducated which means that she has no idea how important it is to seek
has no idea how important it is to seek
has no idea how important it is to seek antenatal care in the first place mom
antenatal care in the first place mom
antenatal care in the first place mom before she enters the operating room I’m
before she enters the operating room I’m
before she enters the operating room I’m long before she even becomes pregnant
long before she even becomes pregnant
long before she even becomes pregnant the odds are stacked against her so if
the odds are stacked against her so if
the odds are stacked against her so if you were pregnant mother in the United
you were pregnant mother in the United
you were pregnant mother in the United States this is where to be welcoming
States this is where to be welcoming
States this is where to be welcoming your children into the world a highly
your children into the world a highly
your children into the world a highly sterile environment with a half-dozen
sterile environment with a half-dozen
sterile environment with a half-dozen medical professionals ready to intervene
medical professionals ready to intervene
medical professionals ready to intervene should anything go wrong and even if you
should anything go wrong and even if you
should anything go wrong and even if you do have to have a c-section you have
do have to have a c-section you have
do have to have a c-section you have access to the latest surgical
access to the latest surgical
access to the latest surgical technologies to ensure a safe birth the
technologies to ensure a safe birth the
technologies to ensure a safe birth the odds are in your favor despite your risk
odds are in your favor despite your risk
odds are in your favor despite your risk factors you will likely deliver happy
factors you will likely deliver happy
factors you will likely deliver happy and healthy children now imagine you’re
and healthy children now imagine you’re
and healthy children now imagine you’re a 16 year old girl in Sierra Leone the
a 16 year old girl in Sierra Leone the
a 16 year old girl in Sierra Leone the country with the highest maternal
country with the highest maternal
country with the highest maternal mortality and morbidity rates in the
mortality and morbidity rates in the
mortality and morbidity rates in the world you live in a rural area of
world you live in a rural area of
world you live in a rural area of immense poverty this is your Oh our
immense poverty this is your Oh our
immense poverty this is your Oh our there is no doctor no surgical tools and
there is no doctor no surgical tools and
there is no doctor no surgical tools and you’d be lucky if you had a trained
you’d be lucky if you had a trained
you’d be lucky if you had a trained birth attendant by your side you might
birth attendant by your side you might
birth attendant by your side you might develop an infection or have
develop an infection or have
develop an infection or have uncontrolled bleeding and because you’re
uncontrolled bleeding and because you’re
uncontrolled bleeding and because you’re 16 years old your body is not physically
16 years old your body is not physically
16 years old your body is not physically ready to give birth yet which means that
ready to give birth yet which means that
ready to give birth yet which means that you might be stuck in the in labor for
you might be stuck in the in labor for
you might be stuck in the in labor for days this prolonged labor can lead to
days this prolonged labor can lead to
days this prolonged labor can lead to something called obstetric fistula which
something called obstetric fistula which
something called obstetric fistula which causes internal tissues to rot away
causes internal tissues to rot away
causes internal tissues to rot away leaving you incontinent for the rest of
leaving you incontinent for the rest of
leaving you incontinent for the rest of your life giving birth in a low-income
your life giving birth in a low-income
your life giving birth in a low-income environment can be catastrophic but it
environment can be catastrophic but it
environment can be catastrophic but it turns out that you don’t have to travel
turns out that you don’t have to travel
turns out that you don’t have to travel to Sierra Leone or other low and
to Sierra Leone or other low and
to Sierra Leone or other low and middle-income countries to observe poor
middle-income countries to observe poor
middle-income countries to observe poor maternal health outcomes in fact mothers
maternal health outcomes in fact mothers
maternal health outcomes in fact mothers are dying in our own backyards the
are dying in our own backyards the
are dying in our own backyards the United States has the highest maternal
United States has the highest maternal
United States has the highest maternal mortality rate of any developed country
mortality rate of any developed country
mortality rate of any developed country and actually
and actually
and actually it’s on the rise and these risks are
it’s on the rise and these risks are
it’s on the rise and these risks are divided among racial and ethnic lines
divided among racial and ethnic lines
divided among racial and ethnic lines for the last 50 years black women have
for the last 50 years black women have
for the last 50 years black women have been four times more likely to die from
been four times more likely to die from
been four times more likely to die from childbirth complications than white
childbirth complications than white
childbirth complications than white women the interesting thing is that the
women the interesting thing is that the
women the interesting thing is that the biological risk is actually the same for
biological risk is actually the same for
biological risk is actually the same for all these women but the disconnect lies
all these women but the disconnect lies
all these women but the disconnect lies in access to health care this reflects
in access to health care this reflects
in access to health care this reflects the social determinants that mean that
the social determinants that mean that
the social determinants that mean that women of color are less likely to have
women of color are less likely to have
women of color are less likely to have access to quality affordable health
access to quality affordable health
access to quality affordable health services leading to this human rights
services leading to this human rights
services leading to this human rights failure so how does it impact you in the
failure so how does it impact you in the
failure so how does it impact you in the United States 17 percent of pregnancies
United States 17 percent of pregnancies
United States 17 percent of pregnancies end in miscarriage which means that 2
end in miscarriage which means that 2
end in miscarriage which means that 2 and 10 moms silently bear the burden of
and 10 moms silently bear the burden of
and 10 moms silently bear the burden of losing a child and one in 10 infants are
losing a child and one in 10 infants are
losing a child and one in 10 infants are born prematurely many of you here in the
born prematurely many of you here in the
born prematurely many of you here in the audience are parents and you felt these
audience are parents and you felt these
audience are parents and you felt these worries flicker crossed your minds and
worries flicker crossed your minds and
worries flicker crossed your minds and even if you’re a college student like me
even if you’re a college student like me
even if you’re a college student like me and kids are a very distant concern you
and kids are a very distant concern you
and kids are a very distant concern you are someone you’re close to
are someone you’re close to
are someone you’re close to we’ll have to deal with the anxieties of
we’ll have to deal with the anxieties of
we’ll have to deal with the anxieties of bringing for safe life and the fact that
bringing for safe life and the fact that
bringing for safe life and the fact that it affects millions of individuals
it affects millions of individuals
it affects millions of individuals around the world to me is reason enough
around the world to me is reason enough
around the world to me is reason enough to care so what do we do I think this
to care so what do we do I think this
to care so what do we do I think this relates back to our TEDx Duke theme
relates back to our TEDx Duke theme
relates back to our TEDx Duke theme writing histories and writing futures we
writing histories and writing futures we
writing histories and writing futures we want sustainable change and in order to
want sustainable change and in order to
want sustainable change and in order to do that we need to attack the root
do that we need to attack the root
do that we need to attack the root causes of these negative health outcomes
causes of these negative health outcomes
causes of these negative health outcomes first we need to expand quality
first we need to expand quality
first we need to expand quality affordable health care to individuals
affordable health care to individuals
affordable health care to individuals across the United States and across the
across the United States and across the
across the United States and across the globe and if health clinics are too far
globe and if health clinics are too far
globe and if health clinics are too far let’s train community health workers to
let’s train community health workers to
let’s train community health workers to bring those health care services to
bring those health care services to
bring those health care services to mothers where they are let’s use
mothers where they are let’s use
mothers where they are let’s use creative inexpensive interventions like
creative inexpensive interventions like
creative inexpensive interventions like on-the-go pregnancy kits with vital
on-the-go pregnancy kits with vital
on-the-go pregnancy kits with vital vaccinations medications and surgical
vaccinations medications and surgical
vaccinations medications and surgical tools for labor support let’s teach
tools for labor support let’s teach
tools for labor support let’s teach girls about reproductive health before
girls about reproductive health before
girls about reproductive health before they get their periods for the first
they get their periods for the first
they get their periods for the first time not when they get the plus sign on
time not when they get the plus sign on
time not when they get the plus sign on the pregnancy stick and above all let’s
the pregnancy stick and above all let’s
the pregnancy stick and above all let’s educate girls so we can destroy the
educate girls so we can destroy the
educate girls so we can destroy the social determinants that prevent them
social determinants that prevent them
social determinants that prevent them from achieving their goals and dreams
from achieving their goals and dreams
from achieving their goals and dreams and create profound change for
and create profound change for
and create profound change for generations to come
generations to come
generations to come because the truth is we’re tonal health
because the truth is we’re tonal health
because the truth is we’re tonal health is not just nine months it’s the entire
is not just nine months it’s the entire
is not just nine months it’s the entire life course and in thinking more
life course and in thinking more
life course and in thinking more critically and creatively we can
critically and creatively we can
critically and creatively we can transform the factors that lead to these
transform the factors that lead to these
transform the factors that lead to these health outcomes and give mothers and
health outcomes and give mothers and
health outcomes and give mothers and their children the best chances at life
their children the best chances at life
their children the best chances at life thank you
thank you
thank you [Applause]
[Music] [Applause]
hello welcome my name is Shannon I’ll be
hello welcome my name is Shannon I’ll be talking about maternal health last
talking about maternal health last
talking about maternal health last summer
summer
summer I walked into a hospital room not
I walked into a hospital room not
I walked into a hospital room not knowing that what I would see that day
knowing that what I would see that day
knowing that what I would see that day would completely transform my life I was
would completely transform my life I was
would completely transform my life I was a research assistant at the pediatric
a research assistant at the pediatric
a research assistant at the pediatric newborn medicine division at Brigham and
newborn medicine division at Brigham and
newborn medicine division at Brigham and Women’s Hospital in Boston and there I
Women’s Hospital in Boston and there I
Women’s Hospital in Boston and there I said the effects of preterm birth I
said the effects of preterm birth I
said the effects of preterm birth I followed doctors who cared for the
followed doctors who cared for the
followed doctors who cared for the smallest and most precious patients in a
smallest and most precious patients in a
smallest and most precious patients in a neonatal ICU one day the doctor was
neonatal ICU one day the doctor was
neonatal ICU one day the doctor was paged down to a c-section and I
paged down to a c-section and I
paged down to a c-section and I witnessed my first live birth we welcome
witnessed my first live birth we welcome
witnessed my first live birth we welcome to a happy healthy baby girl into the
to a happy healthy baby girl into the
to a happy healthy baby girl into the world with no birth complications
world with no birth complications
world with no birth complications I left the oor with a huge smile on my
I left the oor with a huge smile on my
I left the oor with a huge smile on my face but when I got back to the NICU
face but when I got back to the NICU
face but when I got back to the NICU floor the air was still and quiet and I
floor the air was still and quiet and I
floor the air was still and quiet and I could tell that something was wrong the
could tell that something was wrong the
could tell that something was wrong the night before a mother had given birth to
night before a mother had given birth to
night before a mother had given birth to two twins both born extremely premature
two twins both born extremely premature
two twins both born extremely premature at 28 weeks and Y was very sick I
at 28 weeks and Y was very sick I
at 28 weeks and Y was very sick I remember waiting outside the hospital
remember waiting outside the hospital
remember waiting outside the hospital room well the doctors huddled and
room well the doctors huddled and
room well the doctors huddled and murmured to themselves and I watched as
murmured to themselves and I watched as
murmured to themselves and I watched as the doctors confronted the mom and
the doctors confronted the mom and
the doctors confronted the mom and confessed that there was nothing that
confessed that there was nothing that
confessed that there was nothing that they could do to save her son an hour
they could do to save her son an hour
they could do to save her son an hour later he died in the same hour I had
later he died in the same hour I had
later he died in the same hour I had seen a child both enter and leave this
seen a child both enter and leave this
seen a child both enter and leave this world and both mothers had the same
world and both mothers had the same
world and both mothers had the same expectations a safe birth and a healthy
expectations a safe birth and a healthy
expectations a safe birth and a healthy child but instead one mom was left
child but instead one mom was left
child but instead one mom was left saying goodbye to her son she had met
saying goodbye to her son she had met
saying goodbye to her son she had met only a few hours ago how could such joy
only a few hours ago how could such joy
only a few hours ago how could such joy and grief exists in the same moment I
and grief exists in the same moment I
and grief exists in the same moment I began asking myself how maternal and
began asking myself how maternal and
began asking myself how maternal and child health were intertwined because we
child health were intertwined because we
child health were intertwined because we know that the relationship between a
know that the relationship between a
know that the relationship between a mother and her child is like that of no
mother and her child is like that of no
mother and her child is like that of no other just ask your mom so that
so this powerful connection means that
so this powerful connection means that the health of the mother reflects the
the health of the mother reflects the
the health of the mother reflects the health of her child so rather than
health of her child so rather than
health of her child so rather than focusing on poured newborn health
focusing on poured newborn health
focusing on poured newborn health outcomes and it was already too late I
outcomes and it was already too late I
outcomes and it was already too late I decided to trace back my steps and look
decided to trace back my steps and look
decided to trace back my steps and look at where it all began
at where it all began
at where it all began maternal health globally three hundred
maternal health globally three hundred
maternal health globally three hundred and three thousand women die every year
and three thousand women die every year
and three thousand women die every year in childbirth how many of these deaths
in childbirth how many of these deaths
in childbirth how many of these deaths do you think to be prevented the answer
do you think to be prevented the answer
do you think to be prevented the answer ninety-eight percent so why are there so
ninety-eight percent so why are there so
ninety-eight percent so why are there so many preventable maternal deaths
many preventable maternal deaths
many preventable maternal deaths occurring around the world in order to
occurring around the world in order to
occurring around the world in order to answer that question we need to ask
answer that question we need to ask
answer that question we need to ask ourselves a different question where are
ourselves a different question where are
ourselves a different question where are these deaths occurring this graph the
these deaths occurring this graph the
these deaths occurring this graph the World Health Organization demonstrates
World Health Organization demonstrates
World Health Organization demonstrates maternal mortality around the globe and
maternal mortality around the globe and
maternal mortality around the globe and it’s concentrated in low and middle
it’s concentrated in low and middle
it’s concentrated in low and middle income countries especially sub-saharan
income countries especially sub-saharan
income countries especially sub-saharan Africa this next graph from the World
Africa this next graph from the World
Africa this next graph from the World Bank demonstrates neonatal mortality
Bank demonstrates neonatal mortality
Bank demonstrates neonatal mortality around the globe and it’s no coincidence
around the globe and it’s no coincidence
around the globe and it’s no coincidence that the disparity is in the same exact
that the disparity is in the same exact
that the disparity is in the same exact areas it turns out that where you live
areas it turns out that where you live
areas it turns out that where you live is the best indication of whether or not
is the best indication of whether or not
is the best indication of whether or not you and your child will survive birth
you and your child will survive birth
you and your child will survive birth 99% of maternal deaths are occurring
99% of maternal deaths are occurring
99% of maternal deaths are occurring outside of our borders in low and middle
outside of our borders in low and middle
outside of our borders in low and middle income countries because of the lack of
income countries because of the lack of
income countries because of the lack of basic health services that you and I
basic health services that you and I
basic health services that you and I take for granted every day so what
take for granted every day so what
take for granted every day so what exactly is causing maternal mortality
exactly is causing maternal mortality
exactly is causing maternal mortality medically it’s things like hemorrhage
medically it’s things like hemorrhage
medically it’s things like hemorrhage sepsis obstructed labor and other direct
sepsis obstructed labor and other direct
sepsis obstructed labor and other direct causes but I’m more interested in the
causes but I’m more interested in the
causes but I’m more interested in the true causes and return of mortality
true causes and return of mortality
true causes and return of mortality which like deep and factors we call
which like deep and factors we call
which like deep and factors we call social determinants these are things
social determinants these are things
social determinants these are things that you can’t control like your age
that you can’t control like your age
that you can’t control like your age your race your gender where you live how
your race your gender where you live how
your race your gender where you live how educated you are and how much money you
educated you are and how much money you
educated you are and how much money you have these factors hinder mother’s long
have these factors hinder mother’s long
have these factors hinder mother’s long before they even become pregnant if a
before they even become pregnant if a
before they even become pregnant if a pregnant mother and rural Cameroon lives
pregnant mother and rural Cameroon lives
pregnant mother and rural Cameroon lives 300 kilometers away from the nearest
300 kilometers away from the nearest
300 kilometers away from the nearest health clinic she’s unlikely to make it
health clinic she’s unlikely to make it
health clinic she’s unlikely to make it there for a safe and supervised birth
there for a safe and supervised birth
there for a safe and supervised birth because she lives in a rural area there
because she lives in a rural area there
because she lives in a rural area there is little transportation to the clinic
is little transportation to the clinic
is little transportation to the clinic and even if she were able to call a taxi
and even if she were able to call a taxi
and even if she were able to call a taxi there’s no money to pay for it and even
there’s no money to pay for it and even
there’s no money to pay for it and even if she were able to call a taxi and had
if she were able to call a taxi and had
if she were able to call a taxi and had the money to pay for it her inferior
the money to pay for it her inferior
the money to pay for it her inferior status as a woman and at patriarchal
status as a woman and at patriarchal
status as a woman and at patriarchal society means she she may not have
society means she she may not have
society means she she may not have financial independence from her husband
financial independence from her husband
financial independence from her husband so even if she had the taxi the money
so even if she had the taxi the money
so even if she had the taxi the money and the means to decide to go she’s
and the means to decide to go she’s
and the means to decide to go she’s likely uneducated which means that she
likely uneducated which means that she
likely uneducated which means that she has no idea how important it is to seek
has no idea how important it is to seek
has no idea how important it is to seek antenatal care in the first place mom
antenatal care in the first place mom
antenatal care in the first place mom before she enters the operating room I’m
before she enters the operating room I’m
before she enters the operating room I’m long before she even becomes pregnant
long before she even becomes pregnant
long before she even becomes pregnant the odds are stacked against her so if
the odds are stacked against her so if
the odds are stacked against her so if you were pregnant mother in the United
you were pregnant mother in the United
you were pregnant mother in the United States this is where to be welcoming
States this is where to be welcoming
States this is where to be welcoming your children into the world a highly
your children into the world a highly
your children into the world a highly sterile environment with a half-dozen
sterile environment with a half-dozen
sterile environment with a half-dozen medical professionals ready to intervene
medical professionals ready to intervene
medical professionals ready to intervene should anything go wrong and even if you
should anything go wrong and even if you
should anything go wrong and even if you do have to have a c-section you have
do have to have a c-section you have
do have to have a c-section you have access to the latest surgical
access to the latest surgical
access to the latest surgical technologies to ensure a safe birth the
technologies to ensure a safe birth the
technologies to ensure a safe birth the odds are in your favor despite your risk
odds are in your favor despite your risk
odds are in your favor despite your risk factors you will likely deliver happy
factors you will likely deliver happy
factors you will likely deliver happy and healthy children now imagine you’re
and healthy children now imagine you’re
and healthy children now imagine you’re a 16 year old girl in Sierra Leone the
a 16 year old girl in Sierra Leone the
a 16 year old girl in Sierra Leone the country with the highest maternal
country with the highest maternal
country with the highest maternal mortality and morbidity rates in the
mortality and morbidity rates in the
mortality and morbidity rates in the world you live in a rural area of
world you live in a rural area of
world you live in a rural area of immense poverty this is your Oh our
immense poverty this is your Oh our
immense poverty this is your Oh our there is no doctor no surgical tools and
there is no doctor no surgical tools and
there is no doctor no surgical tools and you’d be lucky if you had a trained
you’d be lucky if you had a trained
you’d be lucky if you had a trained birth attendant by your side you might
birth attendant by your side you might
birth attendant by your side you might develop an infection or have
develop an infection or have
develop an infection or have uncontrolled bleeding and because you’re
uncontrolled bleeding and because you’re
uncontrolled bleeding and because you’re 16 years old your body is not physically
16 years old your body is not physically
16 years old your body is not physically ready to give birth yet which means that
ready to give birth yet which means that
ready to give birth yet which means that you might be stuck in the in labor for
you might be stuck in the in labor for
you might be stuck in the in labor for days this prolonged labor can lead to
days this prolonged labor can lead to
days this prolonged labor can lead to something called obstetric fistula which
something called obstetric fistula which
something called obstetric fistula which causes internal tissues to rot away
causes internal tissues to rot away
causes internal tissues to rot away leaving you incontinent for the rest of
leaving you incontinent for the rest of
leaving you incontinent for the rest of your life giving birth in a low-income
your life giving birth in a low-income
your life giving birth in a low-income environment can be catastrophic but it
environment can be catastrophic but it
environment can be catastrophic but it turns out that you don’t have to travel
turns out that you don’t have to travel
turns out that you don’t have to travel to Sierra Leone or other low and
to Sierra Leone or other low and
to Sierra Leone or other low and middle-income countries to observe poor
middle-income countries to observe poor
middle-income countries to observe poor maternal health outcomes in fact mothers
maternal health outcomes in fact mothers
maternal health outcomes in fact mothers are dying in our own backyards the
are dying in our own backyards the
are dying in our own backyards the United States has the highest maternal
United States has the highest maternal
United States has the highest maternal mortality rate of any developed country
mortality rate of any developed country
mortality rate of any developed country and actually
and actually
and actually it’s on the rise and these risks are
it’s on the rise and these risks are
it’s on the rise and these risks are divided among racial and ethnic lines
divided among racial and ethnic lines
divided among racial and ethnic lines for the last 50 years black women have
for the last 50 years black women have
for the last 50 years black women have been four times more likely to die from
been four times more likely to die from
been four times more likely to die from childbirth complications than white
childbirth complications than white
childbirth complications than white women the interesting thing is that the
women the interesting thing is that the
women the interesting thing is that the biological risk is actually the same for
biological risk is actually the same for
biological risk is actually the same for all these women but the disconnect lies
all these women but the disconnect lies
all these women but the disconnect lies in access to health care this reflects
in access to health care this reflects
in access to health care this reflects the social determinants that mean that
the social determinants that mean that
the social determinants that mean that women of color are less likely to have
women of color are less likely to have
women of color are less likely to have access to quality affordable health
access to quality affordable health
access to quality affordable health services leading to this human rights
services leading to this human rights
services leading to this human rights failure so how does it impact you in the
failure so how does it impact you in the
failure so how does it impact you in the United States 17 percent of pregnancies
United States 17 percent of pregnancies
United States 17 percent of pregnancies end in miscarriage which means that 2
end in miscarriage which means that 2
end in miscarriage which means that 2 and 10 moms silently bear the burden of
and 10 moms silently bear the burden of
and 10 moms silently bear the burden of losing a child and one in 10 infants are
losing a child and one in 10 infants are
losing a child and one in 10 infants are born prematurely many of you here in the
born prematurely many of you here in the
born prematurely many of you here in the audience are parents and you felt these
audience are parents and you felt these
audience are parents and you felt these worries flicker crossed your minds and
worries flicker crossed your minds and
worries flicker crossed your minds and even if you’re a college student like me
even if you’re a college student like me
even if you’re a college student like me and kids are a very distant concern you
and kids are a very distant concern you
and kids are a very distant concern you are someone you’re close to
are someone you’re close to
are someone you’re close to we’ll have to deal with the anxieties of
we’ll have to deal with the anxieties of
we’ll have to deal with the anxieties of bringing for safe life and the fact that
bringing for safe life and the fact that
bringing for safe life and the fact that it affects millions of individuals
it affects millions of individuals
it affects millions of individuals around the world to me is reason enough
around the world to me is reason enough
around the world to me is reason enough to care so what do we do I think this
to care so what do we do I think this
to care so what do we do I think this relates back to our TEDx Duke theme
relates back to our TEDx Duke theme
relates back to our TEDx Duke theme writing histories and writing futures we
writing histories and writing futures we
writing histories and writing futures we want sustainable change and in order to
want sustainable change and in order to
want sustainable change and in order to do that we need to attack the root
do that we need to attack the root
do that we need to attack the root causes of these negative health outcomes
causes of these negative health outcomes
causes of these negative health outcomes first we need to expand quality
first we need to expand quality
first we need to expand quality affordable health care to individuals
affordable health care to individuals
affordable health care to individuals across the United States and across the
across the United States and across the
across the United States and across the globe and if health clinics are too far
globe and if health clinics are too far
globe and if health clinics are too far let’s train community health workers to
let’s train community health workers to
let’s train community health workers to bring those health care services to
bring those health care services to
bring those health care services to mothers where they are let’s use
mothers where they are let’s use
mothers where they are let’s use creative inexpensive interventions like
creative inexpensive interventions like
creative inexpensive interventions like on-the-go pregnancy kits with vital
on-the-go pregnancy kits with vital
on-the-go pregnancy kits with vital vaccinations medications and surgical
vaccinations medications and surgical
vaccinations medications and surgical tools for labor support let’s teach
tools for labor support let’s teach
tools for labor support let’s teach girls about reproductive health before
girls about reproductive health before
girls about reproductive health before they get their periods for the first
they get their periods for the first
they get their periods for the first time not when they get the plus sign on
time not when they get the plus sign on
time not when they get the plus sign on the pregnancy stick and above all let’s
the pregnancy stick and above all let’s
the pregnancy stick and above all let’s educate girls so we can destroy the
educate girls so we can destroy the
educate girls so we can destroy the social determinants that prevent them
social determinants that prevent them
social determinants that prevent them from achieving their goals and dreams
from achieving their goals and dreams
from achieving their goals and dreams and create profound change for
and create profound change for
and create profound change for generations to come
generations to come
generations to come because the truth is we’re tonal health
because the truth is we’re tonal health
because the truth is we’re tonal health is not just nine months it’s the entire
is not just nine months it’s the entire
is not just nine months it’s the entire life course and in thinking more
life course and in thinking more
life course and in thinking more critically and creatively we can
critically and creatively we can
critically and creatively we can transform the factors that lead to these
transform the factors that lead to these
transform the factors that lead to these health outcomes and give mothers and
health outcomes and give mothers and
health outcomes and give mothers and their children the best chances at life
their children the best chances at life
their children the best chances at life thank you
thank you
thank you [Applause]
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