>>> NOW, TO A SHOCKING ISSUE AFFECTING BLACK WOMEN ACROSS AMERICA.

NEW RESEARCH REVEALS THAT AFRICAN AMERICAN WOMEN DISPROPORTIONATELY FACE SERIOUS CHALLENGES DURING PREGNANCY AND CHILDBIRTH, REGARDLESS OF THEIR SOCIOECONOMIC BACKGROUND.

AUTHOR AND PROFESSOR KHIARA BRIDGES JOINS MICHELLE MARTIN TO DISCUSS HER NEW BOOK, EXPECTING INEQUITY AND HOW PERSISTENT RACISM HAS CREATED A MATERNAL HEALTH CRISIS.

>> THANKS, PROFESSOR BRIDGES THANKS FOR TALKING WITH US.

>> THANK YOU FOR HAVING ME.

SO BY NOW MANY PEOPLE KNOW THAT BLACK AMERICANS IN THE UNITED STATES ARE THREE TIMES MORE LIKELY THAN WHITE AMERICANS TO DIE FROM PREGNANCY -RELATED CAUSES, OKAY.

BUT WHAT IS SO STRIKING ABOUT YOUR LATEST RESEARCH AND YOUR LATEST BOOK, IT'S NOT JUST THAT THIS GAP DOES NOT CLOSE WITH INCOME OR EDUCATION, AND .

I THINK THAT IS JUST THE KIND OF THING THAT JUST MAKES PEOPLE'S HEAD SPIN.

SO THE FIRST THING I WANTED TO ASK IS, WHEN YOU DUG IN ON THIS PARTICULAR ISSUE, WERE YOU SURPRISED?

>> ABSOLUTELY.

THE STATISTIC THAT YOU JUST MENTIONED IS THE ENGINE BEHIND THIS BOOK.

IT WAS DISCOVERING THAT STATISTIC THAT ACTUALLY ENCOURAGED ME AND PROVOKED ME TO ENGAGE IN TWO YEARS OF RESEARCH THAT CULMINATED IN EXPECTING AN EQUITY.

IT'S NOT ONLY TRUE FOR MATERNAL DEATH BUT ALSO INFANT DEATHS, THE BABIES THAT BLACK PEOPLE HAVE, WHEN THEY ARE AT THE HIGHER END OF THE SOCIOECONOMIC LADDER, THEY MORE FREQUENTLY DIE, THEN THE BABIES THAT POOR BLACK PEOPLE HAVE, SO, THERE WAS SOMETHING THERE, AND I THINK THERE'S A COMMON MISCONCEPTION IN THE UNITED STATES THAT HAVING SOME DEGREE OF CLASS PRIVILEGE, HAVING HIGH INCOME, WEALTH, HAVING A HIGH STATUS JOB, THAT THAT PROTECTS YOU FROM RACIAL DISADVANTAGE, THAT PROTECTS YOU FROM RACISM, AND IT'S TRUE IN A LOT OF RESPECTS, CLASS PRIVILEGE IS PROTECTIVE, HOWEVER, THE FACT THAT BLACK PEOPLE ARE DYING MORE FREQUENTLY THAN THEIR WHITE COUNTERPARTS, WHEN THEY ARE WEALTHIER, IT MEANS THAT CLASS PRIVILEGE ACTUALLY OPENS US UP TO A PARTICULAR TYPE OF VULNERABILITY.

THERE'S A PARTICULAR TYPE OF MARGINALIZATION THAT HAPPENS WHEN ONE HAS WEALTH AND STATUS AND INCOME, SO, THAT IS THE ENGINE BEHIND THIS BOOK AND I SOUGHT TO INTERROGATE THAT A LITTLE BIT MORE AS WELL AS DISCOVER WHAT BLACK PEOPLE WERE DOING IN LIGHT OF THAT REALLY UNIQUE AND UNEXPECTED MARGINALIZATION.

>> YOU WRITE THE HIGHER RATES OF BLACK MATERNAL DEATHS IN THE UNITED STATES ARE NOT BECAUSE BLACK PEOPLE THIS PROPORTIONALLY BEAR THE BURDENS OF PROPERTY, BLACK PEOPLE HAVE HIGHER RATES OF MATERNAL DEATHS THAN WHITE PEOPLE ACROSS ALL INCOME LEVELS, RACIAL DISPARITIES AND MATERNAL MORTALITY ARE NOT A PROBLEM OF CLASS, THEY ARE A PROBLEM OF RACE, OF RACISM, TO BE PRECISE.

BUT IF IT'S NOT POVERTY, IF IT'S NOT THAT, WHAT ARE SOME OF THE THINGS THAT ARE HAPPENING TO BLACK PEOPLE, BLACK PATIENTS, EVEN IN WELL RESOURCED SETTINGS ARE LEADING TO THE OUTCOMES.

>> SOME OF THE FACTORS THAT ARE CONTRIBUTING TO THE HIGHER RATES OF DEATH AND SEVERE INJURIES AMONG PREGNANT FOLKS, EVEN AT THE HIGHER ENDS OF THE SOCIOECONOMIC LADDER, IT'S MANY DIFFERENT CONTRIBUTORS.

BEING A PERSON OF COLOR UNITED STATES, BEING A BLACK PERSON IN THE UNITED STATES, IT'S STRESSFUL AND THERE'S REAMS OF RESEARCH AT THIS POINT, THAT DEMONSTRATES, IT'S CALLED WEATHERING, THERE WAS A PUBLIC HEALTH RESEARCHER THAT HAS DEVOID --DEVOTED HER LIFE JUST HOW CHRONIC STRESS WEATHERS PEOPLE'S BODIES.

I ALSO TALK ABOUT EPIGENETICS, THAT IS A TOUCHY SUBJECT TO TALK ABOUT BECAUSE IT'S SO EASILY MISUNDERSTOOD AS GENETICS .

NO ONE IS MAKING THE ARGUMENT THAT BLACK PEOPLE HAVE SOME RACE SPECIFIC GENETIC VARIATION THAT CAUSES US TO DIE MORE FREQUENTLY THAN THEIR WHITE COUNTERPARTS INSTEAD IT REFERS TO THE EXPRESSION OF THE GENES.

IN THE GENES ARE EXPRESSED IN PARTICULAR WAYS ACCORDING TO THEIR ENVIRONMENT.

SO, IF YOU LIVE IN A HOSTILE ENVIRONMENT, YOUR GENES WILL BE EXPRESSED IN A WAY THAT IS INCONSISTENT OR CONTRARY TO LIFE AND HEALTH.

AND I TOLD THE STORY IN THE BOOK, MY MOTHER, MY MATERNAL GRANDMOTHER WAS A MADE IN THE JIM CROW SOUTH, SHE CLEANED WHITE PEOPLE'S HOUSES HER ENTIRE LIFE.

SHE DIED PREMATURELY, AND I THINK IT WOULD BE FANTASTICAL TO BELIEVE THAT HER JEANS WERE NOT EXPRESSED IN A WAY THAT LED TO HER PREMATURE DEATH MOREOVER, SHE PASSED THAT GENETIC EXPRESSION DOWN TO A MOTHER, I LIKELY INHERITED THAT FROM MY MOTHER SO EVEN THOUGH I HAVE ALL THIS PRIVILEGE AND ALL THIS YOU KNOW, ELITE STATUS, I'M JUST TWO GENERATIONS OUT OF JIM CROW.

SO IT WOULD BE SURPRISING IF I HAVE NOT INHERITED THOSE EXPRESSION OF THE GENES THAT WOULD COMPROMISE MY HEALTH AND THAT MIGHT LEAD TO THE PREGNANCY COMPLICATIONS PERIOD ONE OF THE DATA POINTS YOU CITED IS THAT AFRICAN IMMIGRANTS WHO COME FROM MAJORITY BLACK COUNTRIES WITHIN A GENERATION OR TWO, THEIR BIRTH OUTCOMES DETERIORATE WHEREAS WHITE IMMIGRANTS WHO COME FROM LESS AFFLUENT OR RESOURCED COUNTRIES, THERE BIRTH OUTCOMES IMPROVE.

THAT IS AN INTERESTING POINT.

WHAT ARE SOME OF THE OTHER FACTORS?

>> WELL, THERE'S ALSO SEGREGATION, GOOD OLD-FASHIONED HEALTHCARE SEGREGATION, AND THE FACT THAT THERE ARE SOME HOSPITALS THAT CARE FOR MORE PEOPLE OF COLOR THAN OTHER HOSPITALS WHICH PREDOMINATELY CARE FOR WHITE PEOPLE AND I THINK A LOT OF PEOPLE BELIEVE YOU HAVE STATUS, YOU HAVE SOME WEALTH, AS A BLACK PERSON YOU CAN MOVE INTO A MORE AFFLUENT NEIGHBORHOOD BUT STUDIES OVER THE GENERATIONS HAVE DEMONSTRATED IT'S REALLY HARD FOR BLACK PEOPLE TO LIVE IN INTEGRATED NEIGHBORHOODS BECAUSE WHEN A CRITICAL MASS OF BLACK PEOPLE MOVE INTO THOSE NEIGHBORHOODS, WE EXPERIENCE WHITE FLIGHT AND THE WHITE FAMILIES LEAVE AND THE RESOURCES LEAVE, THE VALUES DECREASE, AND THEN WE ARE DEALING WITH UNDER RESOURCED COMMUNITIES RELATIVE TO THEIR WHITE COUNTERPARTS.

SO THE HOSPITALS AND HEALTHCARE SYSTEMS THAT BLACK PEOPLE ARE RELYING ON FOR THEIR HEALTHCARE, JUST TEND NOT TO BE AS WELL RESOURCED AS THE HOSPITALS AND HEALTH SYSTEMS THAT THEIR CAN GO TO IN THEIR NEIGHBORHOOD.

>> WHAT ABOUT WHAT HAPPENS IN THE EXAM ROOM.

YOU SAY THERE ARE SYSTEM ISSUES BUT ALSO THESE INDIVIDUAL INTERACTIONS.

I THINK IT'S STANDARD OR AT LEAST IT WAS UNTIL THE CURRENT ERA, TO HAVE IMPLICIT BIAS TRAINING, DOES YOUR RESEARCH INDICATE THAT THERE ARE STILL ONE-ON-ONE PATIENTS AND IT CONTRIBUTES TO MORE NEGATIVE OUTCOMES WITH BLACK PATIENTS.

>> I DON'T DENY THAT IMPLICIT BIAS IS A FACTOR TOWARDS THE INFERIOR HEALTHCARE THAT BLACK PEOPLE RECEIVED FROM THEIR PROVIDERS.

MY PROBLEM WITH IMPLICIT BIAS AS AN EXPLANATION IS THAT IT HAS BEEN A TOTAL EXPLANATION OF ALL MATTER OF RACIAL INEQUITIES AND RACIAL DISPARITIES.

AND THAT'S WHAT MEDICAL SCHOOLS AND NURSING SCHOOLS HAVE BEEN DOING.

THEY'VE BEEN TRYING TO FIX THE PROBLEM OF RACIAL DISPARITIES IN HEALTH AND MATERNAL MORTALITY AND MORBIDITY BY HAVE THESE IMPLICIT BIASES AGAINST THEIR BLACK PATIENTS.

AGAIN, INCREDIBLY LAUDABLE BUT THERE'S SO MUCH MORE THAT WE CAN DO ESPECIALLY WHEN YOU ARE A PERSON LIKE ME AND YOU BELIEVE THAT STRUCTURAL CONTRIBUTORS ARE WHAT ARE DOING THE HEAVY LIFTING WHEN IT COMES TO KILLING BLACK PEOPLE AND SHORTENING THEIR LIVES AND MAKING THEM SICK THEN IMPLICIT BIAS SEEMS LIKE AN EASY FIX.

IT SEEMS LIKE SOMETHING WHERE YOU CAN MAINTAIN THE STATUS QUO WHILE PROFESSING TO ACTUALLY BE DOING SOMETHING TO SOLVE THE PROBLEM.

>> TELL US ABOUT ANNETTE AND HER EXPERIENCE.

WHAT DOES ANNETTE'S STORY TELL US ABOUT THE LIMITS OF CLASS PRIVILEGE .

>> ABSOLUTELY, AND THAT, I BEGIN THE BOOK WITH HER, SHE EARNED HER LAW DEGREE FROM AN ELITE LAW SCHOOL, SHE THE CIVIL RIGHTS ATTORNEY, SHE'S MARRIED, SHE WAS PREGNANT WITH HER FIRST CHILD, SHE WAS HEALTHY AND SHE STARTED TO EXPERIENCE HEARTBEAT TOWARDS THE TAIL END OF HER SECOND TRIMESTER AND SHE WOULD GO TO THE EMERGENCY ROOM WHENEVER THIS HAPPENED IN THE PROVIDERS THERE WOULD TELL HER, NOTHING'S WRONG, IT'S JUST STRESS, YOU KNOW, YOU ARE JUST STRESSED OUT, TRY TO RELAX.

SHE WILL REPORT THE SYMPTOMS TO HER MIDWIVES DURING HER FOLLOW- UP VISITS AND THEY WOULD TELL HER THE SAME THING, JUST RELAX, YOUR BODY DOES WEIRD THINGS WHEN YOU ARE PREGNANT.

JUST TRY TO RELAX, ALSO DURING THE PRESIDENT --PREGNANCY SHE WOULD EXPERIENCE THINGS LIKE ON A SCALE OF 1 TO 10, HOW MUCH PAIN ARE YOU IN, SHE WOULD SAY IT'S A 25, IT'S A 50, SHE WOULD BECOME INCONTINENT, VOMIT, DELIRIUM INDUCING PAIN IN FACT THEY TOLD HER THAT YOU KNOW, YOU SHOULD PROBABLY GET A BETTER BRA THAT SUPPORTS YOUR BREATH BECAUSE IT'S BACK PAIN.

SO, LONG STORY SHORT, IT TURNS OUT THAT HER RAPID HEARTBEAT WAS CAUSED FROM A PREGNANCY INDUCED HEART CONDITION THAT COULD HAVE BEEN LETHAL.

THEY FINALLY DIAGNOSED IT WHEN SHE WAS IN LABOR BECAUSE SHE WAS IN THE HOSPITAL, THEY DID AN EKG ON HER AND DISCOVERED THE HEART CONDITION.

THE DELIRIUM INDUCING PAIN WAS ACTUALLY CAUSED FROM PANCREATITIS, THEY COULD HAVE DISCOVERED THE PANCREATITIS BY A SIMPLE BLOOD TEST AND IT WOULD HAVE REVEALED THAT SHE HAD ELEVATED LEVELS OF ENZYMES.

NOBODY BOTHERED TO DO A WORKUP OF HER TO DISCOVER THE SOURCE OF THE SYMPTOMS IN FACT SHE MIGHT HAVE DIED FROM THE PANCREATITIS.

SHE ENDED UP HAVING EMERGENCY SURGERY TO REMOVE HER PANCREAS.

SO, THIS IS A CLEAR EXAMPLE OF MEDICAL NEGLECT.

IT'S A CLEAR EXAMPLE OF NOT PAYING ATTENTION TO PATIENTS, WHEN THEY REPORT THEIR SYMPTOMS AND IT DID NOT MATTER AT ALL THAT SHE HAD A JD FROM ONE OF THE TOP LAW SCHOOLS IN THE UNITED STATES, IT DIDN'T MATTER THAT SHE WAS MARRIED, THAT HER HUSBAND WAS THERE WITH HER, DIDN'T MATTER, SHE WAS WELL MATTERED.

THEY DID NOT ENCOURAGE HER DOCTORS TO ACTUALLY GIVE HER THE QUALITY OF HEALTHCARE THAT SHE DESERVED.

>> YOU POINT OUT THAT THE U.S.

IS ONE OF ONLY A SMALL NUMBER OF COUNTRIES WHERE MATERNAL MORTALITY IS ACTUALLY INCREASING.

AND THE ONLY INDUSTRIALIZED NATION AMONG THAT SMALL GROUP OF COUNTRIES, SO WHAT IF YOU HAD BLACK PRACTITIONERS, THOUGH, DOES THAT MAKE A DIFFERENCE IN THESE OUTCOMES?

>> SO, I TALK ABOUT IT IN THE BOOK, ABOUT RACIALLY AND COORDINATED CARE AND THEIR STUDIES THAT SHOW THAT BLACK PATIENTS HAVE BETTER OUTCOMES WHEN THEY ARE CARED FOR BY BLACK PROVIDERS, IN SOME CONTEXT, INFANT MORTALITY IS ONE OF THOSE CONTEXT, WE HAVE TO WAIT AND SEE WHETHER MATERNAL MORTALITY AND MORBIDITY, THERE'S DATA COMING OUT TO DEMONSTRATE THAT BUT BLACK PROVIDERS CAN IMPROVE THE OUTCOMES OF THEIR BLACK PATIENTS.

AND PATIENTS I TALKED TO SOUGHT CARE FROM A BLACK PROVIDER BUT IT'S IMPORTANT UNDERSTAND THAT THEY KNEW THERE WERE NO GUARANTEES, THEY KNEW THAT THESE BLACK PROVIDERS WERE NOT LIKE UNICORNS OR MAGICAL CREATURES INSTEAD, THEY WERE JUST PLAYING IN STATISTICS AND LIKELIHOOD, THEIR SENSE WAS THAT THEY WERE MORE LIKELY TO AVOID THAT IMPLICIT BIASES IF THEY ARE BEING CARED FOR BY A BLACK PROVIDER, MORE LIKELY TO HAVE A BLACK PROVIDER WHO WOULD LISTEN TO THEM IF THEY WERE CARED FOR BY A BLACK PROVIDER, SO THESE WERE THE CHANCES THAT MANY BLACK PEOPLE WERE WILLING TO TAKE.

>> YOU COMPARED CARE AND PUBLIC HOSPITALS AND ELITE PRIVATE SETTINGS.

AND YOU FOUND THAT IN FACT, EVEN THOUGH THE KIND OF ACTUAL LOGISTICS OF GETTING CARE FROM ONE OF THESE BUSY PUBLIC HOSPITALS COULD BE REALLY TRAINING, COULD BE CHAOTIC, COULD FEEL DEMEANING.

YOU STILL FOUND SOME OF THE OUTCOMES WERE ACTUALLY BETTER.

SAY MORE ABOUT THAT.

>> ABSOLUTELY, SO, I THINK THAT WE BELIEVE THAT WELL RESOURCED SETTINGS, THE PREDOMINATELY WHITE SETTINGS WILL IMPROVE OUR OUTCOMES AS PEOPLE OF COLOR, YOU KNOW, WHITE FOLKS BELIEVE THAT AS WELL, BUT THERE ARE SOME DATA CHALLENGING THAT.

IT MIGHT SEEM LIKE THE HOSPITAL WITH ALL THE BELLS AND WHISTLES THAT HAS THE GREEN TEA STATION AND THAT HAS THE, IT SMELLS LIKE LEMONGRASS AND LAVENDER WHEN HE WALKED INTO THE WAITING ROOM, IT MAY SEEM LIKE THAT IS THE PLACE WHERE YOU WILL GET THE BEST QUALITY HEALTHCARE BUT MEANWHILE, THE HOSPITAL DOWN THE STREET THAT CARES FOR LOW INCOME PEOPLE, THAT CARES FOR MARGINALIZED PEOPLE WHOSE VERY REASON FOR EXISTENCE IS TO CARE FOR THE REGIONS MARGINALIZED, THAT SPACE MIGHT ACTUALLY BE BETTER FOR YOU BECAUSE IT'S ENTIRE ORIENTATION IS ANTIRACIST, THE ENTIRE ORIENTATION IS TO BE CONSCIOUS OF RACIAL DISADVANTAGE AS WELL AS ALL OF THE OTHER DISADVANTAGES.

THESE ARE HIGHLY REGULATED SPACES, SPACES WHERE PROVIDERS DON'T HAVE THE DISCRETION TO NOT RUN A SCAN BECAUSE OF THE MEDICAID APPARATUS BECAUSE MEDICAID SAYS YOU HAVE TO DO X, Y, AND Z IN ORDER TO RECEIVE MEDICAID REIMBURSEMENT.

SO THE HIGHLY REGULATED ASPECTS OF THE CARE THAT YOU MIGHT RECEIVE AT THE UNDER RESOURCED PLACE AS WELL AS THE FACT THAT THESE PLACES EXIST TO CARE FOR THE MOST MARGINALIZED, IT MIGHT MEAN THAT YOU ARE BETTER OFF, AS A BLACK PERSON GOING TO THESE INSTITUTIONS THAT MANY OTHERS AVOID LIKE THE PLAGUE.

>> BEFORE WE LET YOU GO, YOU KNOW, THERE WAS A VIRAL MOMENT IN WASHINGTON RECENTLY WHICH REPRESENTATIVES SOME REALLY A BLACK DEMOCRATIC CONGRESSMAN CONFRONTED HEALTH SECRETARY ROBERT F KENNEDY JR.

OVER THE DEI CUTS AMONG OTHERS, SHE ARGUED THE CUTS INTERFERED WITH IMPORTANT RESEARCH INTO LOWERING MORTALITY RATES FOR BLACK WOMEN AND ASKED, HOW CAN MATERNAL MORALITY, IF WE CAN'T -- CERTAIN INSTITUTIONS DISRUPTED, CANCELED, TERMINATED, ET CETERA, FOR A VARIETY OF REASONS.

WHAT IS AN AVENUE TO ADDRESS THESE ISSUES THAT YOU RAISE, I THINK THE FEDERAL GOVERNMENT IS THE PRIMARY FUNDER OF BASIC RESEARCH, WHAT CAN PEOPLE DO?

>> RIGHT, I KNOW, I WROTE THE LAST CHAPTER IN THE BOOK IS THE SOLUTIONS CHAPTER.

I WAS WRITING IT IN JANUARY 2025, RIGHT WHEN TRUMP ASSUMES OFFICE FOR THE SECOND TIME, RIGHT WHEN IT BECAME JUST OBVIOUS THAT HE WAS MORE ORGANIZED THAN HE WAS THE FIRST TIME AROUND, THAT THESE CAMPAIGN PROMISES ABOUT ATTACKING EVERYTHING THAT IS IMPORTANT TO ME, THEY WEREN'T JUST CAMPAIGN PROMISES, INSTEAD, THEY WERE GOING TO BE A PROGRAM OF ACTION FOR THE NEXT FOUR YEARS.

SO, WHAT CAN WE DO IN LIGHT OF THE FACT THAT WE CAN'T EVEN SAY RACE, CERTAINLY CAN'T SAY BLACK, WE CAN COUNT THE NEEDLESS DEATHS THAT ARE GOING TO HAPPEN, WE CAN COUNT THE PREVENTABLE DEATHS THAT WILL INEVITABLY OCCUR THROUGH OUR STEADY DETERMINATION, NOT TO PAY ATTENTION TO RACE, AND WE CAN LEARN, WE CAN LEARN FROM WHAT HAPPENS WHEN AN ADMINISTRATION, WHEN A GOVERNMENT AS POWERFUL AS THE UNITED STATES IS, IS -BENT ON IGNORING WHAT IS UNDENIABLY TRUE THAT RACISM PERSISTS AND THAT'S KILLING US.

WE CAN LEARN IN THE NEXT THREE YEARS, AND WE CAN DO WHAT NEEDS TO BE DONE, AND THAT MEANS MAKING SURE THAT BLACK PATIENTS CAN BE CARED FOR BY BLACK PROVIDERS AND WHAT THAT'S GOING TO MEAN IS WE NEED TO INCREASE THE NUMBER OF BLACK PEOPLE IN MEDICAL SCHOOLS AND NURSING SCHOOLS AND MIDWIFERY SCHOOLS AND NEED TO START FUNDING DOULAS, WE NEED TO TACKLE RESIDENTIAL SEGREGATION, WE NEED TO GET RID OF HEALTHCARE SEGREGATION WHERE THERE SOME HOSPITALS THAT WE KNOW PROVIDE INFERIOR COMPARE WHILE OTHER HOSPITALS PROVIDE BETTER CARE.

WE CAN LEARN IN THE NEXT COUPLE OF YEARS ABOUT WHAT NEGLIGENCE AND APATHY AND VIOLENCE LOOKS LIKE AND THEN WE CAN ACTUALLY DO SOMETHING ABOUT IT WHEN WE HAVE AN ADMINISTRATION THAT CARES.

>> PROFESSOR KHIARA BRIDGES , THANK YOU FOR TALKING WITH ME.

>> THANK YOU FOR HAVING ME.