Racism and Medicine
Racism and Medicine
This is a jam packed episode of Wine, Women, and Revolution. We are doing a deep dive into the very real and significant effects that racial bias in medicine can have from emergency, to trauma medicine, to obstetrics. November is also Premature Birth Awareness Month and women of color have a far statistically higher rate of premature births and deaths from childbirth related complications. The March of Dimes just released their annual report card and in 2019 NJ got a C. The US is among the most dangerous developed nations to give birth in. On average 2 babies die every hour across the country, and every 12 hours a woman dies from pregnancy complications.
We start the conversation with DeShanna Uneal who had a very real and life altering experience with medical racism. Her story is chilling and heartbreaking because so much of the damage could have been easily prevented. Then we are joined by author and expert Dana-Ain Davis who talks about some of the history of racism and medicine and then explains what she discovered writing her book ” Reproductive Injustice: Racism, Pregnancy, and Premature Birth.
She did no other tests that my doctor went just basic vital check, and then had me walk without my walker, which I could barely do. And I kept grabbing on to things and she recorded it and the jokes. It was a joke, quote unquote joke where she said, Don’t worry, I wont to share this on social media.
Heather Warburton 0:31
This is Wine, Women and Revolution with your host Heather Warburton coming at you here on New Jersey Revolution Radio. Hi and welcome to Wine Women and Revolution. I’m your host Heather Warburton coming at you here on New Jersey revolution radio. You can find us online at www.njrevolutionradio.com, follow us on all the social medias and get us Wherever you get your podcasts from. Today, I’m going to be tackling a pretty significant and tough issue. And that’s of racial bias in medicine. We see stories, even celebrities like Serena Williams, we see what happened to her when she went into the hospital to have her child and nearly died. Because they weren’t listening to her. They weren’t hearing her story. So even beingwealthy and you know, a higher stratus of class doesn’t protect you from things like this. And it’s especially bad for women of color. Black women, I think probably face the most discrimination since women are not listened to generally, anyway. So adding that extra layer on there really can be, you know, can end someone’s life. So this is an issue that we need to really dive into. I’m breaking my usual format but I want to start off with someone local here in New Jersey telling their stories of what happened to them. So I’d like I like to first introduce my guests to DeShanna Uneal, and welcome to the show to DeShanna.
Thank you. Thank you for having me.
Heather Warburton 2:08
So when I said I was looking for someone who was willing to share their story, a few people told me to reach out to you and that you also have experienced racial bias and medicine.
Yeah, um, I was tagged quite a few times to reach out and when I saw that you were doing an episode on racial bias and medicine I you know, as an advocate, I knew I needed to speak out as well. I don’t have Serena Williams money. If she is willing to give me some I will always have my wallet open for it.
But I honestly it was a it was.. I’m just slowly getting to the place where I can talk about it without just feeling a sense of anger and a sense of disbelief. And, you know, I was very vocal about it on my social media about what was happening to me. So I was really glad to see you know, someone tackling this, it’s very important and we need to start discussing it because it is life or death in a you know, it just we aren’t heard often. So thank you.
Heather Warburton 3:33
So are you comfortable sharing your story now telling us a little background of what happened and how medicine let you down?
Um, yeah, so I will preempt it with it took almost a full year for me to come up with the team that I currently have now that is working so hard to help me and I’m grateful for them.
But before that, I am a pretty active person. I have four kids. I kind of need to be running everywhere and there’s not enough of me. I’m also a public figure and LGBTQ activist and advocate. So I did a lot of public speaking. And then I created a festival. And I was like, doing everything. I was everywhere. Most people called me a super person. And I was like, No, really, it’s just Margarita. And I you know, but I did things my got things done. And then I, the first I would say really the first issue kind of happened on the day of my festival. I had noticed I forgot my agenda. The actual agenda I put together, I forgot. Like I kept thinking, Okay, who’s going on next? Oh, no, I don’t remember this. So I actually had to get someone to give me a copy of my own schedule.
Heather Warburton 5:16
And that’s out of your normal. You’re normally that wouldn’t be something that happened to you.
Exactly. I mean, I was a home schooler remembering things and organization is, you know, something I was good at. And I kind of chalked it up to just the excitement of a first festival being successful and I was just really like, oh, my goodness, this is actually working. A few days later, I needed to get a procedure done just a outpatient procedure, called a spinal ablation. It was the second one I had had within a year. They take a year they wear off after a year. And pretty much what they do is they inject The needle into between my vertebrae and inject a solution that burns the nerves so that you don’t feel pain. And I had had this done before, so I wasn’t really worried about it. Um, the only difference this time was I wasn’t fully under when they injected the first needle, and I flinched. And I recall it like everyone, like don’t move, don’t move. And then I finally went under, and they did what the rest of what they had to do. So I was like, Well, that was different, but whatever.
And then about a few days later, I still had a massive headache. And my skin was burning all over my body. And I couldn’t figure out what was going on with me. They called just to check in on me and I was like, well, I still have a headache. And my skin kind of burns. Like it’s got frostbite all over it. I’m also numb from the middle of my skull down to them center my back. Is that normal?
The nurse on the line sounds like oh, umm give it until the weekend and see what happens. So like, Okay, um, becuase you want to trust your doctors, you trust the nurses, you know, I’m not a doctor. I’ve seen them on TV. So, the weekend you know came and went. And not only was the pain still like this achy muscle joint a still present The burning skin still present with the headache. But by this point I had lost the ability to speak coherently.
Heather Warburton 8:07
My voice was slurred. And I couldn’t remember words, I completely forgot things. I couldn’t remember my children’s names.
Heather Warburton 8:22
That must have been terrifying.
I mean, they took it as great, mom can’t yell at us now quick. Let’s go and just do crazy things in the house. But they started to get really scared because at one point, they saw me in the kitchen, standing in front of the microwave, and I was crying because I forgot how to use the microwave. And I didn’t know what was happening to my body. And maybe a day or two after that I still had no speech and I also then developed full body tremors and couldn’t walk without falling. So all of this stuff starts happening to my body.
Heather Warburton 9:09
And this is in like a matter of a week this is all happening to you, right? This is quick.
It was, it was all of a sudden and I didn’t know what to do. So I went to my doctor, and he kind of just looked at me and was like, um, why don’t we wait until your follow up with the next surgeon? See what he says.
Heather Warburton 9:37
I wish people could see the face I’m making right now.
I don’t know what to tell you, go see what the surgeon tells you.
At the follow up even the surgeon was kind of like I don’t know what this is. But I can guarantee you has nothing to do with what I did. That was actually the first thing he said to me. And I was like but I didn’t say you did. I just want to know what’s wrong with me. And he’s like, Well, I mean, my job is done. You might want to just talk to your doctor
Heather Warburton 10:10
Who you’d already talked to and said talk to the surgeon.
So I had to go back to the doctor. By this point, I was using a walker.
And it was right before my 37th birthday. So before my 37th birthday, I couldn’t talk. I can barely walk. I was in excruciating, all over body pain. And I I just didn’t understand what was happening to me. How my doctor prescribed just weird pain medication, and said, You know, it could be stress. This could be because you’re stressed and like I’ve been stressed before, it didn’t do is
Heather Warburton 11:00
Yeah, as an activist stress is kind of your normal state of like existence. You’re used to stress.
Yeah. I’m like I am I, a transgender daughter. I know stress. I don’t understand what you’re telling me. Um, but then he just kept saying I needed to see a neurologist. Sounds like that makes sense. I get into the neurologist and I honestly will say I’ve never been treated with such dismissal as I had with this neurologist.
I thought it was going to go well because she was woman. But she was a white woman. And she looked at me and you could look at me and say, Yes, everything is fine with this person. I couldn’t stop trembling. I couldn’t talk to you. I couldn’t recall words. I was almost like I was just my five year old at one point because those were the basic words I could recall. I couldn’t recall, like the larger words that I usually use when I speak. And I explained to her this wasn’t me, this wasn’t who I was. I was also experiencing extreme fatigue, to the point that I had begun missing meetings at work. She just like kind of looked at my eyes, took my blood pressure. And I kept telling her I have a history of seizures from a head trauma as a child, maybe we need to look into that. And she’s like, No, no, I’m pretty sure that’s not it. And she did no other tests than my doctor would, just basic vital checks. And then had me walk without my walker, which I could barely do. And I kept grabbing on to things and she recorded It and the jokes It was a joke, quote unquote joke where she said, Don’t worry, I won’t share this on social media.
Heather Warburton 13:08
That is I mean, in some way I want to say it’s astounding, but it’s not like I know it. It’s happening to women across the country. It’s infuriating. That’s a word I can use for it.
Yeah, I mean, I was like, why would you joke about it? Is that something you do often? Like, do you share patient videos? I’m kind of concerned about my privacy.
Heather Warburton 13:35
Right? It’s not taking your issues seriously here. Like she should be worried for you not making jokes here.
Yeah. And so I just kind of sat back down and she just said, Well, I can’t find an organic reason to your symptoms. So I think really what’s going on here is that you have conversion disorder. And you just need psychiatric assistance? Here’s some names of different psychiatric facilities that you could possibly check yourself into that will help you with this issue you’re experiencing. And I just, I was like is she’s saying what I think she’s saying that she thinks this is all made up, like why would I make this up? I can make so many other things up like I’m Lord Flanda Myers, an aristocrat, like, why would I make pain up? Like, why would anyone make pain like this? I can’t force my legs to walk like this. And
Heather Warburton 14:46
Yeah, essentially. She’s saying it’s all in your head is what your doctor told you.
Yeah, she marked it down his conversion disorder. She did to be I guess a doctor do blood work, she had me get some blood work, but that was about it. And she said she didn’t need to see me anymore. She sent the information to my doctor. I followed up with him and he’s like I believe her I think it’s just, you know, you know, something that requires some psychiatric assistance, cognitive behavioral assistance, and I’m like, but I already see a therapist. I already I’ve been going to therapy for years. And his response was, oh, wow, usually black people don’t see therapists. And I was like, Oh, okay. I do. So I don’t understand what that has to do with anything but thank you for that fun fact, I guess. Its kind of hurtful and harmful to the community but awesome. Um, and so my blood work did come back that I have my inflammatory markers were elevated and I had to see a rheumatologist. I pretty much, then sat back and said I was never gonna see a doctor. I would just live like this until I couldn’t. And it got to a point where I just considered like, I guess I’m gonna have to give my kids to their dad and just get rid of myself because I can’t stay this way. And they deserve a mom who can be a mom and I can’t be a mom anymore. And it just I am like, and no one believes me. So maybe it is in my head. Like I started truly thinking maybe there’s something wrong with me. And if there’s something that mentally wrong with me, I guess maybe I should just get rid of me. And don’t leave it on my kids.
Heather Warburton 16:50
Like they gas lighted you to the point you were thinking about suicide. That’s what
Yeah, pretty much. Like Okay, I guess that’s it for me now. The End. Finale. But then a wonderful group of friends. Because I have been also documenting this on social media and a wonderful group of friends are like, no, we’re not letting someone who’s done so much for our community be treated this way. So they began looking for doctors. And my rheumatologist was the first one I found and she is a woman of color. I went and saw her and I was already pretty, like, she’ll say, nothing is wrong. Like I was already at that point. She looked over everything. She looked at me. She looked at my blood work, and she’s like, well, it’s definitely not Lyme. And it’s not lupus. I checked for that. And like, I can tell you the numbness and I had neuropathy by this point as well. My fingers and toes. Like this is Fibromyalgia you do have that, she’s like, but I’m kind of worried about this inflammatory marker situation. I want to do a repeat blood sample in a few weeks and see if it goes down. So we did that. And it actually went up more. So that explained that some for some reason my immune system was attacking my body.
Heather Warburton 18:33
Right your body was clearly in distress.
And there was no infection to state why that was. So it was definitely autoimmune. And I looked at her when she was telling me this I’m like, so you’re telling me my brain is making my immune system do things? She’s like, no, this isn’t in your head. This is real. And in the hearing that kind of for the first time I can’t even explain what that felt like. And then I ended up getting a new PCP who is a black woman. And she took everything I said seriously. And she worked so hard to try to get an MRI because that’s what we really needed. We needed to see what was happening with my brain and my nervous system. And she, my insurance kept denying her and denying her and denying her, and she wouldn’t give up, which I loved. And meanwhile, she was finding different medications to help with my numbness and my pain, and working alongside with my rheumatologist. And they kind of tag team like, we have to figure this out.
Heather Warburton 19:52
So did your doctors eventually find the cause of this or do you just have a good team that’s helping you treat the symptoms
They couldn’t. It was the neurologist I did find. And I still to this day I’m shocked about her. She’s almost a unicorn because she is a black woman and she is a neurologist and I think she’s probably the only black female neurologist I’ve ever seen in my entire life. She pretty much said there’s no way your doctor will ever get insurance to approve an MRI, but I can get it approved. And so she did and she got approved. And we found out that I have a very rare chronic migraine variant.
Um, I have a migraine called basilar artery migraine. And these are migraines that start in the brainstem.
Heather Warburton 20:58
Wow. So it affects Everything,
Everything and it causes inflammation, which then restricts blood flow and compresses the nerves within the brain stem. She pretty much saved my life. She kind of you know, she’s like this is what you have. It’s unfortunately incurable. There’s nothing we can do. We can treat it, but you will always have it. And when it’s really bad, that’s when I lose my speech in my ability to walk because our brain stem houses, everything and she managed she’s she is getting me to getting me a lumbar MRI. She wants to make sure there’s nothing else going on through the rest of the spine. But she knows for a fact Just from the MRI I have a lot of inflammation around my brain and specifically focused in my brain stem. So I’m on medication that helps. It doesn’t get rid of it but it it helps. She just had me do a sleep study and we found out that what I have also messes with my breathing. So I will have a C-pap machine soon. And she’s she saved my life. I just experienced something called a hemiplegic migraine and it mimics a stroke. But it’s a migraine that just causes weakness and paralysis on one side of the body. So she gave me a medication to stop it. And within two days it was gone. So yeah.
Heather Warburton 22:57
As scary as all this is and sounds it must have been such a relief to finally have a diagnosis.
Yeah, yeah. Yeah. To know what it was. To know I had an answer. To know it wasn’t in my head. Well, kind of it was literally in my head not figuratively in my head. And she did explain what made actually even more difficult to get the MRI was because the first neurologist had down conversion disorder.
Heather Warburton 23:33
But if you’d never found this team of black women doctors
I would still be I probably even wouldn’t be here. I was that close. I I just kept thinking it. I don’t think I can do this anymore. And then of course, Darn Facebook memories popped up and I saw a picture of me right before the festival. You know, getting ready and I was like smiling and I was up and I was like, look at who I was. And I was saying, you know, now I don’t have work I I’m on TANF. I’m barely supporting my kids.
And I, you know, I kind of deal with that stress, which does not help migraines, by the way. It’s a daily struggle, but I do thank them every time I see my doctors like thank you for believing me, because I was so close to taking my own life and then I actually found out from my new doctor, because I told her I was like, I almost wanted to end it and she’s like, well, it would have been either you ending it or your body, but as sometimes hard as it is now, when I know my body can’t do what it used to do, realizing the fact that I was not heard and the whole “Well black women, blah, blah, blah, don’t go to therapy.” And that wasn’t even the worst comment.
That was what I can handle. Being in that situation could have killed me. And I don’t think then it would have been like, Oh, well, maybe she should have told us more about her symptoms. I feel like that’s how it would have ended like, Well, you know, we tried but she was not cooperative very much. And I do also… one of the harder comments before I found my new team, from my doctor was “Have you considered HIV because you are a black woman who’s almost in her 40s and it is very common” I was like, What? Is that how we do medicine now just like well, this does this book I read that one day says this like maybe.
Heather Warburton 26:18
Yeah, that’s it.. It really is. I understand why so many people tagged you when I was said I was looking for an example of racial bias and medicine because I certainly can’t see this as anything other than just not listening to black women. 100% pure and simple. Doctors not caring and not willing to fight for a black woman.
And I mean, yes, I am truly grateful that I have a diagnosis but the now.. the lingering, it was hard and the lingering damage from not getting answers. It took nine months. For me to find my team and get my diagnosis, so this diagnosis is actually very recent. It’s not like it’s very recent. And unfortunately I have now I’m going to try not to cry here because I’m still kind of living with that part. I have a lot of lingering permanent damage from not being believed. I have a lot of things that could have been prevented. And I love my doctors because they’re so honest with me now, and they have honestly said this all could have been prevented by the most simplest thing. If my doctor while they were trying to figure out what was happening, had just given me steroids. It would have decreased the inflammation Instead of letting it get worse and worse and cause irreparable damage to my nervous system, as my doctor said, had they just given me a dose of Prednisone this could have actually been bypassed. I would still have some symptoms, but not to the extent I do now.
Yeah, yeah. So, that’s why a lot of people tag me. Like you, you’ve been through everything. And like have I? Okay.
Heather Warburton 28:42
I’ve just really want to thank you for sharing the story with us that this is a glaring example of exactly what needs to be addressed. And really, doctors don’t seem to be interested in hearing it. even hear it There’s a racial bias and medicine that admitting to it I mean, I guess you see that reflected in every aspect and when you say hey, there’s racial bias here, people knee jerk and don’t agree in to see it, but this definitely this, this has a body count. And you know, you could have been one of those people that died and you suffered severe damage because of that. So I thank you for sharing your story and thank you for everything you’re doing.
Well, thank you again for letting me share it and hopefully, more people you know, who are like I don’t, I just want to give up I’m never going to get an answer. You will get your answer. Find the doctors who do believe good, it might take longer than you want. But I say trust black women. I love my doctor. They are amazing. Because I’m not just a patient. I am a person when they see me because we’re looking, this could have been them. And, you know, I just want people not to give up just yet. I didn’t. I almost did. But I also have a great support system. So that’s also another thing, have your friends like we’re not going to let you give up. And you know, just keep it up until you get something. I mean, now I’m in my master’s program, I am stuck beyond all paperwork, just all the paperwork in the world. But, you know, what if I hadn’t just kept going, and I guess I’m stubborn too, but had not found my team. I wouldn’t be able to do this. Do my master program and I think my kids also took from this, you know, one, they’ve learned how to care. They took care of me quite a bit. Even the five year old made me delicious bowls of soup made from Hot Wheels from the kitchen said it was it was my favorite dish. Oh, I love it tastes like lead.
And you know, but they they’ve learned to also advocate for their health. And I love watching them at the doctor appointments I take them to it they’re like “Well actually, I was coughing since Thursday”. As you can see, I know nothing the child was coughing since Thursday. Don’t listen to me. Who am I, mom, whatever.
You know, I do want to again, thank you for bringing up this very needed discussion. And we need more doctors to start listening to us. You know, we do have value. And we’re not just people who can handle it and we’re not just people who are stressed. We’re People who get sick. And that’s, you know, you need to treat us like that.
Heather Warburton 32:06
All right, thank you so much for being here. Now I’m going to go to my next guest, who’s an expert in the field after a quick break, and we will see you after the break.
Hi and welcome back to Wine Women and Revolution. We’re just coming out of the break now we heard that gut wrenching story of an actual real person experience of racism in medicine and how really life it could be. It could end your life if something isn’t dealt with. So now I wanted to come back with my expert on the subject and I’ve really looking forward to this interview ever since I reached out to her I have Miss Dana-Ain Davis with me. She’s the author of the book “Reproductive Injustice, Racism, Pregnancy and Premature Birth”. Welcome to the show.
Dana Davis 33:05
Thank you so much for having me.
Heather Warburton 33:08
So I’d like to start off a little bit with the history of why you decided to write this book. What were you seeing that really made you feel like this is something I need to address?
Dana Davis 33:17
Okay. Well, the reason that I wrote the book was not necessarily because of what I was seeing it, it got written in part because a young woman came up to me after I started after I’d concluded giving a talk about neonatal intensive care units. My original project was going to be about neonatal intensive care units. I had no intention of talking to parents. And this young woman came up to me after one of my talks and said, both of my children were born prematurely and I would like to talk about it. So I had to change my research project to accommodate yeah To accommodate this, my interview with her, and I then started exploring the issue of prematurity and race. And lo and behold, not surprisingly, I discovered that black women’s rate of premature birth nationally can be as much as two to three times higher than white women. So I was really just simply intrigued by what I saw as the tension between the fact that we had so much technology to address premature births, but not an equal amount of focus on preventing premature births.
Heather Warburton 34:55
And I heard a statistic, if this is an accurate you can correct me if I’m wrong, that black Women are three times more likely to die in childbirth and white women is that an accurate statistic?
Dana Davis 35:05
We are three to four times more likely to die as a result of childbirth related causes. So not in childbirth, but it can be something related to childbirth. And so yes, and in some places, it’s higher. In fact, if I am not mistaken, I recently heard that in the UK, black women were five times more likely to die as a result of childbirth related causes.
Heather Warburton 35:36
And so I mean, in a way that shouldn’t be shocking, because we see how white supremacy causes across the spectrum of everything to be impacted. But there’s a long history of racism in medicine in this country, but I would also say probably around the world, can you touch on a little bit of that history that you’ve uncovered during your research?
Dana Davis 35:58
So I would. So first I would say that, you know, historians have done a far better job of uncovering the history of race, racism and medicine than I, and one of those people, wrote the book “Medical Bondage”. It was written by Deirdre Cooper Owens, who is an historian. And she specifically focuses on the issue of gynecology and the way in which the discipline of gynecology and to some degree, some aspects of Obstetrics was choreographed on the bodies of black women, black and Irish women. In my research, what I did was, I discovered the kinds of conversations that doctors would have about black bodies in particular that led me to analyze, sort of black bodies and black people and black reproduction in relationship to the kind of practices and ideologies that existed around around those bodies.
So anyone can take a look at, you know, medical journals over time. And see, what doctors used to do is they would write case studies that would be printed in the journals. And you could see when they talked about Negro patients, or enslaved women, the way they view them. In my book, one of the things that I talk about is the story of a doctor who came upon a young girl, a very young girl who had a protruding stomach. And the presumption was that she was pregnant, which in and of itself is a sort of horrific kind of presumption. And they tried to examine her and was were unable to do so. To make a much longer story short, they assumed that she was pregnant and it turned out that she had a tumor, and later she died. Well, what we see embedded in that case, is the way that presumptions about blackness and fecundity and reproduction trumps all other possibilities about what could have been wrong with her. And this is of course during the time of enslavement.
So I think a lot of people know about J. Marion Sims, the doctor who conducted extensive surgeries on enslaved women, in an effort to figure out a way to repair vesco vaginal fistula and he did so honestly women without the use of anesthesia. Although some people have argued that anesthesia was not available in the form that we know it. The fact that they may not have been available doesn’t. It doesn’t excuse the reality that he actually thought that black women had a higher pain threshold than white women, which is was a very common belief, and in many ways still is.
Heather Warburton 39:24
Yeah, that is one of the many list of things that I’ve seen, you know, these racial biases that still maybe even be appearing in medical journals to these days, like discussions about bone thickness, pain tolerance, and especially a very horrible discussion about compliance, that doctors are much more likely to just automatically believe a person of color won’t comply with their orders or their directions. And these are things that are still showing up in medical journals these days, maybe not as often but it’s still out there. Right?
Dana Davis 40:00
I think so I have not done an extensive search on medical journal contemporary medical journals. But we do know based on surveys that have been conducted by people within the medical field, that many of these ideas still circulate. I think one of the things is it’s not necessarily only in a journal, I think we also need to take a look at what happens in the training environment. What are the ways in which ideas about the differentialy racialized bodies get talked about when a person is a resident when a person right is in the, in an operating room or etc. And I have heard, for example, from some of my colleagues who are in the struggle to end all kinds of racism and oppression, who are also in the medical field. Talk about being in a room where one doctor will say something like, they’ll talk about the wimpy white boy syndrome, which is the which is called a syndrome whereby young, white infants are believed to be more fragile. And if you believe that, then you’re going to believe the opposite. Right?
Heather Warburton 41:21
Dana Davis 41:23
So these are the kinds of concerns I think that many people have about not just the history of medical, medical education, but these contemporary practices that have bled into our contemporary moment. I think we see lots of examples and heard of lots of examples of doctors who think that certain groups of women are hardier, much more capable, right, of giving birth and they do so with less duress than other people. Now that’s not going to necessarily be written in a textbook. Right.
Heather Warburton 42:01
Dana Davis 42:02
But these ideas certainly circulate in, right. And we know this right from some of the surveys that have just described the way that many doctors believe that black people have different pain thresholds as just as one example. So, in many ways, what we see is the kind of shrinkage of a sort of time collapse, where similar ideas of the past have, you know, made their way into the present moment. But not always in a book because some of what happens, I think, and circulates is, you know, knowledge gets passed down, right? Not only in books, but in conversation.
Heather Warburton 42:45
Right, that it’s just so pervasive in the culture, that it’s getting passed down through generations of doctors and no one’s really calling it out and saying, why do we believe this bullshit? Like, no ones really like hey? I meannow? Maybe? Some doctors are but like, throughout history,
Dana Davis 43:03
I think that there are an increasing number of medical professionals who really do question not only the training, but also the kind of background or foreground impetus that facilitates viewing bodies differentially. And some people, you know, I was just met a doctor recently in the state of Missouri who made a comment that one of the reasons that there’s such a disparate racial disparity is that it’s driven by driven by capitalism, it’s driven by insurance. And if people weren’t getting paid, and if they weren’t, if insurance wasn’t the negotiator, then people would probably be in the profession in a much more caring way. And I said, So who’s not going to want to paid, you know. And her comment was that it’s not it’s not so much that people don’t want to get paid, but rather that there needs to be a different structure of the provision of care so that it can equalize out how we at least deliver the care. It’s not going to necessarily change what people perceive about other groups of people. Right, but we might have a decrease the lower disparity.
Heather Warburton 44:25
Yeah, well, we are an anti capitalist show here in New Jersey Revolution Radio, we definitely want to seek the intersection of how capitalism and racism and feminism everything comes together into the larger big picture. So I would have tended to agree with your colleague that says there is a capitalistic element. I mean, historically, just to exploiting black bodies, there’s a capitalistic element.
Dana Davis 44:50
I mean, and I think that there are there are ways in which, you know, capitalism and care are sort of contradictory. Definitely. Right, yeah. And when you have developed a strategy that can help bolster the financial base of a system like the medical institution, which is through the provision of a certain series of interventions, but which there is a relatively reasonably high reimbursement rate, then you’re going to, you know, gesture and, and, and, and lean your hospital toward that or lean your medical system toward that kind of care. Right.
But I do think it’s very interesting to speaking of capitalism and care. I think it’s very interesting that premature infants have I would love to be able to spend some time to cost out all of the ways in which premature birth have attached to an ancillary cash generating domains like micro clothing and micro Pampers and all of these kinds of things, which I don’t think anybody’s done a sort of cost analysis of.
Heather Warburton 46:10
No, that would be an interesting subject matter, maybe a matter for a new book for you. And if you do publish it, you’re welcome to come back. So I wanted to dig a little more into your specific book, you talk about something called radical caring. I’ve seen this topic, you know that the phrase, can you talk a little bit about what radical caring is what something like that would look like?
Dana Davis 46:39
So, I was trying to think about what was it about these radical birth workers that I had interviewed? What was it that they were doing, that seems so extraordinary, that, you know, states, local, state governments were interested in, you know, integrating doulas and maybe even being more open to midwives, in their caregiving projects. And I was thinking that some of it had to do with this idea of radical caring. And what I mean by that is, we need to, I think I want to start with the fact that things are usually only radical when there is an extraordinary absence of something. So if there is an extraordinary absence of caring in an environment where we have numerical evidence that there’s a problem, then almost anything that one does that even looks like caring is going to be viewed as radical.
But when I take a look at the ways that various birth workers engage in the issue or try to address the issue of of black women’s higher rates of mortality and premature birth etc. What I walk away with is people who are willing to listen. People who are so right listening doesn’t seem so radical, but it is in an in an environment where the temporality of the inter exchange with the medical professional is really truncated. So, listening, being available, understanding that, that not every pregnancy needs to be viewed as a medical event. That you take the time to use the knowledge that you have about medicine in this case, and not take that knowledge to oppress people not take that knowledge to dominate people not take that knowledge to assert one’s expertise, but rather to use that knowledge in a way that’s going to be beneficial for the person for whom you are caring, that one should be doing in partnership. So I’d like to give you If I may an example of what radical caring looks like, in my opinion.
Heather Warburton 49:18
Dana Davis 49:19
There was, and this person is not in my book. There is a woman that I know in Philadelphia, who was a doula, a midwife. I’m sorry, a doula, a nurse and a midwife. And that’s the order in which she got trained first she was a doula and she became a nurse and she became a midwife. And she told me this story about a young woman who’d had four, well she was on her fourth pregnancy and came into her hospital. And when she got to the hospital, she was concerned because her pregnancies had been very fast, very easy. And she was concerned that this one wasn’t going so fast. So she thought that she was in labor. And it turns out, based on her examination with the resident that she was not in labor. And the residents suggested that she go home, rightfully so.
But in the interim, this woman became very upset, and really didn’t want to leave the hospital, and maybe even raised her voice at a pitch that was probably not presumed to be appropriate in a hospital setting. And this friend of mine, who was on that particular day, thought to herself, you know, something’s not right like this. She’s not just angry, right? There’s something going on. So she sat down to talk with the woman, and she discovered that the woman’s sister that the woman had come to the hospital, and this particular hospital was out of range from where she lived, the hospital that was in range of where she lived was the same hospital that her sister had given birth in. And the birth was horrific. And that woman did not want to go there. So she spent her last bit of money coming to this hospital hoping that she would be admitted so that she could give birth in a safer environment.
So in 15 minutes, this doula nurse midwife found out that what this woman was actually doing was being proactive and trying to figure out how to give birth in a place that she thought was a safe, safest environment for her. And quickly they came up with a plan, which was that she was going to borrow $20 from a family member and that she was going to have another family member who had a car available to her so that in the event that she didn’t get the 20 dollars, that she would be able to get to this particular hospital. To me, that’s an example of radical carrying.
Because what the nurse recognized was that this individuals not being aggressive, was not being non compliant was not being all of the things that people like to talk about when they think about black women that are upset, calling them angry black women, but rather that they was really concerned about how and where she was going to give birth. And I’ve always and I use that example, regularly. It’s not the only one, but it’s the most profound one because it takes place in a hospital setting where she just tried to renegotiate the terms of understanding between this is, as a person who’s in a hospital, she’s trying to negotiate the terms of renegotiate the terms of understanding between the system and this client.
So I see radical caring as those kind of simple acts in which somebody’s needs get met. And when somebody gets heard, and when somebody doesn’t feel afraid. I think that everybody is capable of doing that. And so that, you know, that’s exactly what I mean. But I also want to say that the people that I identify, in my book as radical birth workers are people who have a really intense knowledge of the history of obstetrics, gynecology and reproduction across different groups of people. And that they take that knowledge with them, as well as their knowledge of systems and utilize that and offer sort of comprehensive approach to caring for the people that they assist in birth, and this kind of caring, although in the book, I talked about it in terms of reproductive justice advocates, midwives and doulas. It can also apply to as in this case, a nurse. It can also apply to a doctor because I’ve seen it. So, that’s what I mean.
Heather Warburton 54:02
I mean, it sounds a lot like just realizing that the person in front of you is a human being who has experiences and thoughts and emotions, and maybe those are significant and the doctor should pay some attention to them like, this doesn’t seem that it’s called radical just because of the complete lack of it, like you said in the very beginning, but these are’t difficult or challenging concepts you wouldn’t think
Dana Davis 54:23
I think that they’re not but I think when a system is not orchestrated on on that philosophy, but rather it may be you know, it’s orchestrated on profit, it’s orchestrated on bottom line, it’s orchestrated on dominance, because even if it wasn’t about necessarily about money doctors have historically, you know, doctors healers, shaman. They’re people who have a particular knowledge base, and they are to be revered, and in that process of reverence, I think we’ve moved toward a more of an almost irrational reverence. Because it’s like whatever a doctor says goes, or whatever a medical professional says goes and they can be intimidating. And you know what, they are intimidating. I have actually heard about medical professionals who have threatened black women with having their children removed, or calling, you know, administration for Children’s Services, because they’re not going to do what they want them to do. And that is clearly an indication of the kind of dominant subordinate relationship that I think the medical, many in the medical profession expect. Again, I do not I think this is the case with all of them. I still I know, I know doctors who believe it or not still make house calls with a certain group of their clients, their patients. I know doctors who do sit down and listen, I know doctors who want to train other doctors to do better, you know. But, yeah, it’s
Heather Warburton 56:25
Yeah, that doesn’t mean that there’s not a systemic problem that needs to be absolutely addressed. And
Dana Davis 56:33
There are these ranges of incidents and feelings that pop up for people. And they really impact people’s even interest in reproducing. And there was a study in Italy that showed that the prevalence of obstetric violence so I call obstetric violence in a US context obstetric racism, but they called it obstetric violence, the prevalence of obstetric violence, which included: not being listened to, being coerced into into doing some having some kind of procedure, this is around pregnancy, having some kind of procedure that they didn’t want, being treated as if they were stupid, being forced to wait to see a doctor, all of this kind of thing has resulted in a relatively high percentage of Italian women saying that they will never give birth again. Now, Italy already has a very low replacement rate. And as a result of this study, there is a major concern about the issue of replacement because women get treated so badly.
Now, if we calculate if we try to address that in terms of race in Italy, or race in Spain, or race in France, know all of which are countries that don’t even collect data by race, we will probably find that those grades would be even higher. Because right those countries all have histories of colonialism and oppression. And so you can imagine that people migrating there from the south, the southern hemisphere experience similar, if not worse kinds of interactions with medical professionals. But the I just I just think that the egregiousness is on a continuum. The egregiousness is not only death, the egregiousness, is for example, having a doctor or a nurse, give your child formula when you really wanted to give your child only breast milk and them not calling you, the egregiousness happens when you tell a doctor that you’re concerned, and they don’t listen, the egregiousness happens when you or your partner or your family are made to feel like you’re less than. And that’s why I think the focus of my book on prematurity gives us another space on that continuum. That’s its not only about death, because then people also live with the kind of medical encounter that they had, and fear and fear. And very recently, I was in a, doing a childbirth training with a woman with a group of women and people were asking, we were asking people, what’s your vision for your childbirth, and this woman said, I hope I give birth in a cab or in a car or at my job, I just don’t want to go to the hospital that’s in my community, and she must have said that like six times over the course of the childbirth education class.
Heather Warburton 1:00:07
Yeah, that is so indicative that there’s something very wrong going on. Right. So I guess that brings me to kind of where my last question is, is, what kind of things would you suggest or have you thought of that might actually help address these inequities and this lack of caring in what’s supposed to be a caregiving profession.
Dana Davis 1:00:30
So, it’s not it’s not so much the profession. I’m interested in the profession, the medical profession and the medical system, adjusting its practices. But I’m also interested in there being more information given to people as they make decisions about what their reproductive experiences and lives are going to be like. And so one of the things that I have done personally, is started a childbirth education class in Yonkers, New York with a woman named Nubia Earth Martin. And we do it in a in a community that has a very high rate, a very high C section rate, and basically one hospital. And part of what we’re trying to get people to understand is it, the more they know, the better they can advocate for themselves, the better they can challenge if they need to. But we also want people to know that there are options and this is where I would offer a prescriptive. I think that what we need to have is both, you know, we need hospitals for you know, emergencies that there are a group of people who are going to need to have medical intervention, always. Probably the natural, this I don’t know how to describe this well, but I think there might be a natural rate at which people might need to have an intervention and that natural rate might be about four to 5%. Okay.
In addition to that, I think we need to have and support midwifery. And that I think, for a non complicated birth, there should be a midwife who gets paid at the equal rate of a doctor for a hospital birth. And then the third thing and this is not in order, right, because the third thing is what I think should be the first Well, it’s the fourth is the third thing is, I think that we need to have birthing centersas an option. And I think that there needs to be reimbursement for those home birth midwives who do home births, and home birth midwives, hospital based midwives, and birthing center midwives. As well as home home birth, doulas hospital based doulas, and birthing center doulas. They should they should be reimbursed at a rate that is the equivalent of a of a doctors medical intervention. And what that that opens up the scope of options. And it equalizes pay.
And I think that that the kind of care that people get in environments, not always with midwives, because you know, a hospital based midwife often works with a hospital. Although in other countries, midwife, some other countries, midwives are allowed to just reserve a room. It’s like a community space. And I think that those kinds of interventions or those kinds of practices, would yield us a far better set of outcomes. In addition to the medical profession, not being so quick to make decisions about C sections, there’s a, the C section rate is, I think completely out of control. And I would argue that it’s increasing internationally and, you know, in places like Europe as well. But oftentimes, it’s the inability to wait for a person’s body to go through a natural progression to have a baby that causes the utilization of C section.
Heather Warburton 1:04:42
Yeah, I think those are amazing suggestions. And it really, we talk so much about grassroots activism. This is like grassroots medicine that kind of that we’re talking about here that empowering local women, especially women of color, into positions where they’re controlling outcomes.
Dana Davis 1:05:01
Exactly, And I think that’s part of what I think I’m trying to get at, at least in my book is say that, that that the movement, the reproductive justice movement is comprised of people who are trying to lift up the importance of local responses, right, to the to the problem, as well as localized versions and versions of care. You know, I did have a I did have a gynecologist and I’m sorry, an obstetrician and OB GYN say to me, you know, there’s no reason for a person to go to a hospital, even for you know, regular gynecological checkups. You can use a nurse practitioner or midwife for that, like, so you could talk yourself out of a job and she said, I’m all right with that, you know,
Heather Warburton 1:06:04
Well, this has been a great conversation, it’s really kind of opened up my eyes to some reproductive options that maybe aren’t being talked about. So that’s great. I wanted to give you the chance for a last word and a closing word before we wrap it up today.
Dana Davis 1:06:20
The one thing that I would say that I might want to say is that I’m so deeply proud of the fact that I get to stand with a group of amazing human beings who are doing care work in the most phenomenal way. And while I also became a doula in the process of writing the book, I don’t do it as I probably do, maybe two or three births a year. But to be a part of this kin group is just an extraordinary, extraordinary feeling. And I really believe that the kind of justice that we need around reproduction rests in the hands of these amazing people. And I’m proud to, to know them and be working with them.
Heather Warburton 1:07:17
Thank you so much for being here today. It’s really been great talking to you.
Dana Davis 1:07:20
Heather Warburton 1:07:23
To my listeners, thank you for joining us today. I hope this episode kind of opened up your eyes to everything that’s happening as far as medicine and racism and reproductive justice. We sort of often when we talk about reproductive justice, we’re talking about the right not to have a child. But the other half of that conversation that we’re not talking about is the right to have a child safely under your control in a way that feels natural for you. So there’s layers upon layers of this conversation to be had. And I thank you so much for joining us today. We are trying to be the voice of under served communities the voice of stories that aren’t being talked about enough a voice for anti capitalism that you’re not seeing in the mainstream media, because this is not a profit-y discussion, nobody’s going to be lining up to give money to talk about these kinds of things. So that’s what we’re here for. And that’s why we always have to ask you if at all possible to click on our website, www.njrevolutionradio.com and click on that Donate button even if it’s only a couple of dollars a month. It really helps keeps us keep us going here at NJRR. The Future Is Yours to create, go out there and create it.