When Brittany Ferrell was a high-risk labor and delivery nurse at a hospital here in St. Louis, a pregnant woman came in with hyperemesis and elevated blood sugar levels. She was sent home without further assessment, only to return a week later in diabetic ketoacidosis. “Her body was super acidic,” Ferrell says, “and they had to make a decision: to save her or to save her baby. … So they did the emergency C-section. They saved the woman’s life, but the baby survived for maybe 20 minutes.” As the woman, whom Ferrell says looked numb, sat there and rocked her child, her family upset and unsure of how things had gotten to this point, Ferrell thought about why no one had intervened earlier.
“What contributed to people not intervening when they realize that her blood sugar was elevated?” Ferrell asked. “Could it have been because she was a black woman?”
Ferrell has since left the medical field in pursuit of making her documentary, working title You Lucky You Got a Mama. She’s hoping to show how the medical care system fails black pregnant women and trans and nonbinary patients, who are three to four more times likely to die after giving birth. Doctors don’t listen to black patients, she says, and she hopes to expose audiences to this issues, as well as humanize the black pregnant experience so that black women and nonbinary and trans people can be shown with full dignity.
For the documentary, Ferrell is hoping to focus on two subjects, at least one from St. Louis. That’s because the city has its own maternal mortality crisis, she says. “Our data is poorly documented in St. Louis, and I think it’s really important for us to ensure that we know that we have a problem right here,” she says. “We’re the home of SSM, BJC, and Washington University, and we should be intervening.”
Below, more about You Lucky You Got a Mama.
What are you most hoping to communicate with this film?
There’s this common narrative that the reason why black pregnant people are dying as a result of childbirth is because of something that we’re doing ourselves—we’re contributing to our own demise. And that is simply not true. And so with You Lucky You Got a Mama, I really want to explore the day-to-day experiences of black pregnancy in America and to humanize black pregnant people.
By doing this, not only will we get to see the day-to-day experiences, whether it’s people just chilling at home with their families, or getting ready for work, or going to the doctor or be well appointments, but we’ll also be able to see how these different societal factors and conditions contribute to a thing called weathering, which plays a huge role in the types of stress and the impact not just on the health of black people, but of black, pregnant people and black women, which oftentimes, compounded with a number of other things, increases maternal mortality rate. Being able to have children, to start a family, it is your birthright. But what does it feel like to have to hold that with the reality of knowing that you’re three to four times more likely to die as a consequence of that?
I also wanted to use this film as an opportunity to explore America’s medical system and the racism that it’s laced with that contributes to maternal mortality. That means interviewing experts, medical providers, and historians so that we can explore the history of the advancement of obstetric practices in this country, and getting real about how all of the advancements that have been made in OB practice have been because of experimentation on black women’s bodies. That type of racism, that type of experimentation, it doesn’t just happen. The racism that fuels it, and the thoughts that black women are somehow inferior, it doesn’t just go away. It’s still very much a part of our medical system. It informs and influences a lot of the thinking around how black people are viewed when they go seek care.
You’re also including nonbinary and trans patients in the documentary.
What I’m hoping to do is to really shift the culture in how we talk about birth, pregnancy, and reproductive health when it comes to nonbinary and trans people. Because all too often, we center reproductive health, pregnancy, and childbirth around cis women, when nonbinary and trans people get pregnant and have babies, too, and they’re at risk for the same disparity that black women are at risk for when it comes to being three to four times more likely to die after having a baby in this country.
And they’re at risk for a number of other things that cis women are at risk for, including different cancers. When we talk about reproductive health, a lot of times, we lock nonbinary and trans people out of that conversation, and we do a disservice to the health and well-being of our community when we do that. And so using this project as a tool to share stories, to break down and deconstruct narratives, and to shift culture, those are three really big goals for me.
For readers who aren’t people of color, can you share what black women’s experiences are like at the OB?
When black women go to seek care, providers don’t listen to them. In fact, they believe that they can tell black women what is wrong with them, despite a black woman reporting something different. A great example would be Serena Williams, one of the best athletes on this planet. After she had her daughter, she told her nurse that she was having shortness of breath. Her care team told her that she wasn’t. But they found pulmonary embolisms. They did not listen to her, and she could have died. She’s wealthy, she’s famous, she’s one of our greatest athletes. So this goes to show that when black women go to a provider, it doesn’t matter what kind of insurance you have, it doesn’t matter how much money you make, it doesn’t matter what you do for a living. We are not listened to. We are not seen as experts of our own bodies. And it’s killing us.
You worked as a high-risk labor and delivery nurse. Was there anything you saw at work that inspired this project?
Sometimes I would have patients who had heart disease, breast cancer, or fetal demise [stillbirth]. But I would also have folks like a single mom who came into labor and delivery and she brought all of her children with her, like two to three younger children. They’re hungry, they want something to eat, and we had a little kitchenette area on the floor near the nurse’s station. And in that kitchenette, we had graham crackers, Saltine crackers, juices, milk, and popsicles. I would give some of those snacks to the kids to hold them over and hope that someone from my patient’s family could come get the kids so that she can have peace while she labors. My staff members would tell me that those snacks are only for the patient. I would explain to them, she has all of her children here, and they’re hungry. In one instance, I told one of my co-workers after looking at a patient’s file that she comes from the north side of St. Louis, which is one of the largest food deserts in the city. She has all of her children here, and they’re hungry. I’m not going to not give them graham crackers. She asked me, “What is a food desert?” And I thought, “Wow, we have people who are working at this hospital that serves a lot of black and brown people who come from the St. Louis Metropolitan and Eastside area. A lot of the staff came from places like Jefferson County and Troy, Missouri. The only time they ever interact with black people is probably when they come to work.”
It’s kind of like police officers. We often say police officers need to know the communities that they serve, and they should reflect the communities that they serve. Same thing here. I feel like medical providers should know the people that they’re serving, they should know about their experiences and where they’re coming from and what they’re at risk for.
How do we solve this type of problem in the health care system?
It’s something I’ve been thinking about a lot lately. I was at She the People in Houston—it’s a forum with eight different presidential candidates. One of the topics that came up quite a bit at this forum was black maternal mortality. Elizabeth Warren was there, and they asked her, “What are you going to do to address black maternal mortality?” She had a plan that sounded reminiscent of No Child Left Behind, proposing the idea of providing financial incentives for hospitals that are decreasing their maternal mortality and infant mortality rates. Then financially penalizing hospitals who are not changing or who are worsening in their maternal mortality rate.
While I appreciate her proposing a plan in the language that these institutions speak—which is money—I also think that it doesn’t really get at the fundamental issue. The problem, why it’s happening, we have to be very explicit in naming it for what it is: racism. And at what point do we begin to make an investment in black women and black pregnant people beyond using this very corporate model, like incentivizing or penalizing, but really wanting to change the culture?
When I think about how complex this problem is, we need an equally complex solution. … The medical field, the majority of the nursing field, is made up of white middle-class women, and that in itself is a problem. We’re the ones who provide the majority of the care for these patients, and we need our field to reflect the populations of people that we’re serving. Being someone who matriculated through a four-year university to earn my BSN, I know that to get into these programs, oftentimes they’re not convenient for people like me. So we have to begin to revolutionize the way that people access the knowledge and expertise we need to change the field of medicine.
Then there are the policies. One thing that frustrated me as a nurse was that I was able to make an impact on the individual level, but it only went so far. … I realized that there’s only so much that I can do, because the policies that are in place, they don’t take into consideration a person’s race. They don’t take into consideration where people are coming from and how trauma has impacted their lives and how their care should be unique. We have to change the way these rooms look when it comes to policy. There needs to be some type of mandated way to assess risk for different variables, stress levels, trauma levels, where you come from, is it a food desert, income level, just so that we can get a full picture of who it is that we’re treating, and how unique this treatment needs to be.
