Dr. Rebecca Dekker – 00:00:00:
Hi everyone, on today’s podcast, we’re going to talk with Dr. Leslie Farrington about how to advocate for yourself during prenatal visits and how obstetricians can reduce harm during care.
Dr. Rebecca Dekker – 00:00:15:
Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Decker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. Hi everyone, and welcome to today’s episode of the Evidence Based Birth® Podcast. I am so excited to introduce to you our honored guest, Dr. Leslie Farrington. Dr. Farrington is a retired and recovering African-American obstetrician, gynecologist, and birth justice activist. Leslie is dedicated to improving perinatal and medical experiences through community-based advocacy, education, and community-based solutions. Inspired by her experience in the grassroots patient safety movement, Leslie co-created the ACTT curriculum and co-founded Black Coalition for Safe Motherhood to promote use of the ACTT advocacy toolkit in Black communities nationwide and beyond. Leslie is here today to talk with us about how you can advocate for yourself during your prenatal visits and also how obstetricians can do their part to reduce harm while providing maternity care. Leslie, welcome to the Evidence Based Birth® Podcast.
Dr. Leslie Farrington – 00:01:46:
Thank you. I’m so excited to be here. Very excited. I love Evidence Based Birth®.
Dr. Rebecca Dekker – 00:01:52:
I was really thrilled to meet you at the Anarcha Lucy Betsy Day of Reckoning in Alabama and just so intrigued and inspired by the work you’re doing. So I’m really excited for our listeners to learn from you. I was wondering if you could just start us off by sharing whatever you want to share about your journey as an obstetrician, because I know you’re retired now. So you could probably talk for years about your experiences, but what would you like our listeners to know about you as an OB/GYN and a retired and recovering OB/GYN?
Dr. Leslie Farrington – 00:02:29:
Okay, so I always introduce myself when I say I’m Black, or if someone introduces me as African-American, I always show a photograph of my parents, especially my father, who’s a dark-skinned man, so that people realize how it is that I identify as Black. And that’s one thing. And the way I became an obstetrician was through midwifery. So when I was 18, I got married. I had a baby nine months later. And in the clinic that I attended as I was an undergraduate at Johns Hopkins University, so I went to Johns Hopkins Hospital. And they had two clinics for Medicaid clients. And I was initially seen in the residence clinic. And I was appalled at being examined by men, especially young men. I think maybe there must have been medical students. But I felt like it was somebody my age and I just wasn’t comfortable. So I noticed that there was a clinic run by women. I didn’t know anything about midwives versus residents, any of that. I was not on any kind of pre-med track in college or anything like that. I just said, I want to go to that clinic. And I switched to the midwife’s clinic. And so the experience of getting birth support with a midwife, apparently she was a midwife in training, was so impactful for me that I said, I want to help mothers. I want to help other women get through birth the way this woman did for me. She was in my face. I mean, I remember her face was like the full, like the filled up the screen in front of me, so to speak, while I was in labor and she was breathing with me.Â
And I don’t remember suffering any pain. I remember there was labor, but I do not remember the pain. And it was really a divine intervention looking back that I had that experience and decided that I’m going to be a midwife. But I didn’t become a midwife because my husband at the time said, you won’t get a job. You won’t get a job. You should become a doctor. I can’t become a doctor. I don’t like science. I don’t like math. You know, I really didn’t know what I was going to do. But eight years later, two more babies. I had, I just, I went into medical school knowing that I was going to be an obstetrician to support women giving birth. That was my intention in going to medical school. But then I went to Howard University and I got the same indoctrination that all doctors get, whether they go to Harvard. Well, maybe not at Harvard. I don’t know what they do now in medical school, maybe different. But I’ve heard that they don’t teach people to be physician supremacists at Harvard. This is what someone told me at one of that, actually at that same conference that I met you at, that they do teach Person-Centered Care there. But in my experience in the 80s, everyone was being indoctrinated with physician supremacy, where you believe that you know so much that you are the knowledge authority and superior to everyone else.Â
So this is the same indoctrination that I believe all physicians tend to get. And I call it physician supremacy. And it’s leads to a power differential that interferes with communication, which is a very dangerous problem and probably one of the roots of the problem in our country of medical error. And I learned about this later in my career about how medical error is preventable. Medical error is the third leading cause of death in our country. So, so when I started to learn about that and I started to see how it showed up, I learned that misdiagnosis occurs 15% of the time. When I realized that, I said, oh, my goodness, I’m wrong 15% of the time. And we don’t know it. Doctors don’t hear about it a lot of the times. They don’t find out that they’ve made a mistake in diagnosing someone. Medication errors are very common. There’s a million healthcare-acquired infections every year, and 90,000 people die from those. There’s hundreds of thousands of people dying every year from preventable medical error. So when I learned that, that’s when I began to learn. I started to take off those rose-colored glasses sort of mid-career. I always took a, I called it a midwife approach to my patients in labor. I thought I had a lower C-section rate.Â
So I was different, but I was like other doctors. I blamed mothers, just like other doctors. Mother blame, obstetricians’ mother blame. And that’s a term that I learned from Dr. McLemore. She’s written a paper that includes that. So I started to learn about the problems with healthcare, the way physicians maintain this power differential and the way patients put them on a pedestal. So I started to look into that. And then while I was doing that, I was invited to the women’s, the Council on Patient Safety and Women’s Healthcare in 2013. They wanted a community voice on their panel of 19 groups and organizations that were working on addressing the maternal health crisis. And I was part of a community-based organization that was educating the public about how to prevent medical errors through self-advocacy and family advocacy.Â
So the Pulse Center for Patient Safety Education and Advocacy was invited to the beginning of the ACOG, American College of OBGYN, addressing our maternal health crisis. And so I started to learn then about racism in medicine and obstetrics, obstetric violence. And that’s where I got the idea that we needed to combine patient safety advocacy education with liberation activism in the Black community. And that’s how we got the ACTT curriculum, by combining, you know, obviously I had to find experts like Mama Shafia Monroe, midwives, had to develop this curriculum, get involved with that. Nubia Earth-Martin, another midwife, birth justice scholars, reproductive justice scholars like Lynn Roberts, who helped develop the New York City standards for respectful care at birth. She was involved. There were a lot of people involved in developing the ACTT curriculum. It was an idea that came to me, and I was encouraged by Lori Zephyrin, she’s another one of the co-founders of Black Coalition for Safe Motherhood, and she’s the vice president at the Commonwealth Fund. So a lot of experts and a lot of activists got involved in the ACTT curriculum. And as I now recognize the roots of obstetric violence, obstetric racism, that’s why I’m recovering.
Dr. Rebecca Dekker – 00:10:04:
So Leslie, as you were talking, it was really making me think because I don’t meet that many obstetricians that are activists, as you describe yourself. And I know sometimes there can be like a negative connotation with the word activist. And I think that there’s probably a sexist or racist reason for that. But I think that it should be a positive connotation. So I was curious, like, what was it that made you more open-minded to learning about the flaws in medicine and kind of gaining that humility and realizing that there is this kind of superiority complex among physicians that you didn’t want to have a part of anymore?
Dr. Leslie Farrington – 00:10:47:
I grew up in a household where there was almost daily experiences of bigotry and discrimination. My parents were an interracial couple in the 50s when that was illegal in many states. And they attracted a lot of attention, even though we lived in New York. So and it was not positive attention. So my father was often angry. He taught me all about racism from an early age. He wanted me to understand it. He wanted me to understand why I was Black, even though I look like my mother, who was white. And he taught us Black history. I read the autobiography of Malcolm X. I learned about power dynamics and I was sensitive to injustice, I would say, from growing up interracial couple as my parents. Once I realized that the bigotry that I had observed amongst some of my colleagues and co-workers while I was on labor and delivery, for example, that that thinly veiled racism and other -isms was actually causing harm. I didn’t realize, you know, that it translated into worse care. Initially, I didn’t realize that. I didn’t realize that we were blaming mothers the way we were. We would say that Black women had more preterm labor because they had infections, and that turned out to not be true. So that’s why I’m more of this. And I like I said before, I was going to be a midwife. So I was not in tune with as much with doctors supremacy and had I had a tendency towards empathy and person-centered care. That was also brought on by working with Pulse Center for Patient Safety, which is a grassroots community based organization. So I wanted to get into social justice and I wound up hooking up with that organization. And it really influenced my path and what I’m doing now quite a bit.
Dr. Rebecca Dekker – 00:12:53:
So Leslie, in your bio that I read, you talked about being a recovering physician. Did you experience in a lot of cognitive dissonance, almost like where you were realizing and learning these things, but then still having to practice in the system that was actively harming, particularly Black mothers?
Dr. Leslie Farrington – 00:13:14:
Oh, by the time I learned about obstetric racism, I had already stopped practicing obstetrics. And I had become a well-women office gynecologist by then. And I say recovering because I would relive some of the problems that I saw when I was in training. And I knew that there was still ongoing obstetric violence happening. So that just strengthened my resolve to put some kind of advocacy toolkit in the hands of the community because I knew what doctors were doing in a lot of cases.
Dr. Rebecca Dekker – 00:13:58:
So with the Black Coalition for Safe Motherhood that was co-founded by you, Dr. Michelle Drew, and Dr. Lori Zephyrin, what are you doing there? And what are some of the ways you’re participating in liberation?
Dr. Leslie Farrington – 00:14:14:
So we developed the ACTT for Safe Motherhood curriculum in 2018, 2019. Our first workshop was led in 2019 before we even formed an organization. I had hoped to find an already established organization that would take the ACTT curriculum and spread it to Black communities nationwide, that we could find a nationally based organization that could do that, but we couldn’t. So this is how we wound up founding Black Coalition for Safe Motherhood expressly to promote, to spread the ACTT curriculum. And our mission is to improve Black maternal health through this health care advocacy, education, and raising awareness of the importance of holistic community support for birthing families. So it’s advocacy is important and also making sure that, we’re wrapping our families in a cocoon of support. That’s because support is healing for the impacts of racism over the life course, which is part of the reason that we’re seeing the poor outcomes as part of the reason. So it’s racism in medicine and racism in society that we recognize as a problem. And we’re using ACTT as one of the solutions by equipping those in the Black community, who are, either giving birth or supporting the folks who are giving birth, the families, the community, anyone who’s educating in a community and supporting can help bring this toolkit, this practice of speaking up for oneself and asserting one’s rights in the healthcare setting or supporting someone else to do so. And this applies to pregnancy and birth, but it also applies to any medical situation that people find themselves in
Dr. Rebecca Dekker – 00:16:15:
So what does ACTT mean? Can you walk our listeners through the steps?
Dr. Leslie Farrington – 00:16:19:
Of course, of course. So ACTT is a self-affirming and potentially life-saving reminder to ask questions. Until you understand the answers. And I would even say, until you’re satisfied with the answers. Until they make sense to you. So that’s the A. Ask questions until you understand the answers. The C is claim your space, both physical and mental. Physical is your bodily autonomy. And mental is your dignity, your self-determination. There are two T’s in ACT. Trust your body and tell your story. So trust your body means don’t dismiss your symptoms just because somebody else is dismissing what you say. And tell your story is to make sure your voice is heard. Get the support you need. Get the help of a friend who can be your advocate, your spouse or your partner, your family member. Make sure that your voice is heard with that support. Because often they’re not listening. Tell your story could also mean sharing what has happened to you. So that you can heal from a traumatic experience. And telling your story could also be to help others learn from what you’ve been through. And I also like to think of telling your story is let the provider know if they’re just saying something disrespectful or they’re dismissive. Telling your story means a lot of different things. So that’s what ACTT stands for.
Dr. Rebecca Dekker – 00:17:55:
That is really helpful. And I was wondering if you could go deeper into claiming your space, physical and mental. So what would that look like in practice in a prenatal visit, for example?
Dr. Leslie Farrington – 00:18:08:
Okay, so in a prenatal visit, it would be saying, I have some questions. I have some concerns. Here’s my list. I’d like you to answer them. And this is especially important in the setting where you don’t usually rushed. There are even some doctors who will say, I only have time for blah, blah, blah. There are people who have told me that a doctor has said to them, you only get two questions. I can’t, I don’t have time for more than that. So we, that’s why we put that in there. It could be saying, I know I’m late for this visit, but I can’t reschedule. I must be seen now. Because whatever. And if you have a problem with that, I’d like to speak to the person in charge. So claiming your space is going further than people often do when they are, they get pushback in the healthcare system.
Dr. Rebecca Dekker – 00:19:06:
And I wanted to say, if you go to www.blackcoalitionforsafemotherhood.org, there’s a tab at the top that says how to act. And underneath that you can click on be heard. And you have a whole bunch of like scripts, almost like. Tips of what to say. Like for example, if the doctor says, I don’t have time to answer all your questions and you have on there, I know you’re pressed for time, but my health is important to me. I don’t feel safe because I feel like you’re not listening to me. I think these are really clear and concise ways of talking with your provider. Are there any other tips you have for questions to ask or ways to advocate for yourself in a prenatal visit? Well, I think one really important point to make is that it really helps to have someone with you. Someone on the phone. They could be on the phone on speaker. They could be someone whose name you mentioned.Â
So you can say, my husband wants me to ask you this or my primary care physician encouraged me to ask you these questions that I need answered, saying I would like to be informed and involved in all decisions about me and my baby. And I hope you can be comfortable with that. Or are you comfortable with me having a doula? So there’s a lot of things. It’s really up to you. What is on your mind that you feel that you need to address with the provider? And just being, saying, this is really important to me. And then diving into empathy if needed. When you talked earlier about physician supremacy or superiority, it makes me think that if you go into an appointment. And it’s just one-on-one you and a physician, there’s automatically a power imbalance there because the physician has been trained to see themselves as the authority. And especially if you’re in a group that is stigmatized or experiences racism or any other kind of marginalization. It’s interesting that you say bring someone with you because that helps level the playing field a little bit. And I love your suggestion about having someone on speakerphone because that’s what I did recently for a family member who’s going through cancer and their spouse could not be with them at an appointment. So I said, bring me with you on speakerphone because when the physician knows there’s another person in the room, it changes how they address you.
Dr. Leslie Farrington – 00:21:46:
It’s an amazing thing to me. That’s the power dynamic, right? And we’re intimidated. Most people are fearful or intimidated in the health care settings. But we need to realize that they are there in service to us. That they’re supposed to serve the patients that they’re caring for, caring for in quotes, and to heal. Most of the time, doctors are not healers. They’re more like putting you on edge or, you know, that’s not a good place to be. So that’s not helping. And we say first do no harm, right? But a big part of this problem is there’s a lot of time pressure, production pressure. I experienced this. That’s why I stopped practicing obstetrics early because I was under so much production pressure in the health system where I was working. And I rebelled against that. And that’s why I wound up setting up an office in my home and spending a half an hour, 45 minutes with each patient. I wanted to make sure that we were partners in the care and that would reduce the likelihood that I would make a mistake and miss something. I allowed more time for visits when I had my own practice.
Dr. Rebecca Dekker – 00:23:02:
Leslie, so you talked about parents feeling intimidated by medical professionals. What strategies can you suggest to help someone build confidence if they know they need to advocate for themselves, but they’re just so afraid to open their mouth and say something?
Dr. Leslie Farrington – 00:23:19:
So I would first learn everything you can. First, you need to be knowledgeable about pregnancy, prenatal care and birth. Knowledge builds power. And you can’t advocate for yourself if you don’t know what you want or prefer. Once you have learned what kind of birth you want, whether or not you want all the tests or if you’d like to have less tests or less intervention. Once you know all of those things, then you can tailor your questions. Otherwise, you don’t know what you don’t know and you don’t know what to ask. Once you know what you want, you can practice asking for it with friends and family. You can tell them what your ideas are. Start to flesh out your ideas. And I think that childbirth education helps that way. Having a doula, a birth companion works that way. And then writing what you want to ask down. Having someone with you, even if it’s on the phone, and writing it down. You can practice by asking your questions or telling what you want to tell to the doctor’s assistant when they bring you in the room. And they do your weight and blood pressure. Ask them the same questions. Make the same statements that you’re going to give to the provider. Say it to them. And like I said, bring someone. And mention names. Mention names.
Dr. Rebecca Dekker – 00:24:42:
Okay, so name dropping, practicing, having somebody with you, having it written down so it’s right there. You can kind of like hold it up and be like, I have this question. If you get pushback from your provider and they seem to dismiss your concerns, you talk about in the ACTT program, you know, about claiming your space and not letting somebody dismiss you. But how do you do that? Say you disagree with your provider and you can tell they’re trying to pressure you into something or they’re neglecting to address a concern that you have. How do you push back against that when there’s that power differential?
Dr. Leslie Farrington – 00:25:21:
You would ask, I would say, what would you want to do if it was you? I’ve had people ask me this and nobody taught them. People have said, well, what would you do if it was you, Dr. Farrington? Or what if it was your sister or mother? What would you do in that case? Can you put yourself in my shoes and try to explain your perspective? That’s the best thing to do. Try to get them to be empathic with you. If you can’t, if they can’t empathize. And that goes along with the T, the tell your story. Yes. Telling your story. Yes. Got to get them to empathize. If they don’t empathize with you, it’s not a good place to be. You’re not in the right setting. Unfortunately, a lot of people can’t leave the doctor they’re with, but I would definitely start to look for other people in the institution that maybe have some pull with that doctor to help you make sure that you’re getting the care that everyone deserves and build a relationship, building a relationship.
Dr. Rebecca Dekker – 00:26:23:
So how can you build that relationship with the provider so that you do have that sense of trust and safety with them and openness?
Dr. Leslie Farrington – 00:26:32:
So talk to them about very basic things that everyone needs. For example, how do you reach the doctor on call or the midwife on call off hours? I’m really concerned that I’m able to get in touch with somebody. So you’re starting to get them to respond that way. You can also share some advocacy tools. I do recommend looking at what they have on the website of Birth Monopoly, Evidence Based Birth®, respectful maternity care information, the Hear Her campaign. You can ask the provider, have you heard about the Hear Her campaign? And maybe share some of those materials. There’s a bill of rights for every hospital. You can share that with the provider so that you can become like partners. There’s the Partner to Decide website where they have the decision aid for deciding between induction of labor for no medical reason versus spontaneous waiting for spontaneous labor. So there are many different things that you could be educating yourself with, and you can start sharing them with the provider and almost educating them as to what there is out there that can improve your communication, get them more involved with you the way you want to be more involved and informed in your care. So it’s becoming like partners. It’s starting that partnership so that you have a better chance of getting what you want. We know that you can advocate for yourself and still not be heard, but we’ve got to do the best we can. And sometimes that means leveraging what we can learn about the system that that doctor is working in.
Dr. Rebecca Dekker – 00:28:17:
Yeah, talk more about that. So how does understanding the system and understanding the pressures that the OB/GYN is facing, how can that help you negotiate with them?
Dr. Leslie Farrington – 00:28:30:
Well, like we said before, you can say, I know you’re pressed for time and I know you have certain ideas about this, but I have certain preferences and I understand from the American College of OB/GYN that there’s a right of refusal of recommended treatment. A statement from the American College of OB/GYN’s Committee on Ethics has that statement. And we provide links to the things that we suggest people use in our workshop packages. So a link to that statement is in there. You could print that up. That’s just one example. The Black Birthing Bill of Rights, you could print that up from National Association for the Advancement of Black Birth. And so there’s certain things that you can bring in. You can learn the hierarchy at the hospital. You can learn, do they have a quality improvement committee? Do they have people in charge whose names you could learn and talk about, drop those names of who’s the doctor in charge of maternal fetal medicine? Who is the department chairman? You can learn more about where do you go to for problems if you’re a patient. For example, there’s usually a patient advocate, patient representative. There’s often a patient advisory council. So learning more about the hospital and how that hospital works is very important to be prepared for some of the obstacles and to find out where you can go to if you need support for addressing any issues you have with your provider.
Dr. Rebecca Dekker – 00:30:13:
That’s really interesting advice. I think also going back to what you said earlier about … not just name dropping, but dropping resources. So sharing, hey, I’ve been learning about the Black Birthing Bill of Rights from the National Association to Advance Black Birth. Have you heard of it? I’d love to share their materials with you. Or like you said, I’ve been reading up on Group B Strep at Evidence Based Birth® and I was wondering if you’d heard of their article on that topic and just kind of presenting yourself as more of an equal, like because you are the expert on your own body and you’re bringing your expertise in your body to the meeting and they’re bringing their medical school training and experience to the meeting and seeing yourself more as partners. I like that perspective shift. It also seems like some of what you’re suggesting is something that a doula could do at a prenatal visit with you. If you brought your doula with you.
Dr. Leslie Farrington – 00:31:15:
Definitely, definitely. A lot of the participants in our ACTT Workshops are birth companions, doulas. So yes, because they need these extra tips and tools and they can use them more effectively because they’re in the hospital all the time. So they can pass these tips on to their clients. So yeah, so this is something that we can, especially is needed in the Black community. When I was a kid, my father, would use the fact that his brother was one of the few Black police officers in the New York City Police Department. If he got pulled over, he would bring up my uncle’s name. So it’s the same thing as when you’re running into the police. If you’re in an encounter with police as a Black person, you know what to do. If you are a Black person going into the health care system, you need to know about the ACTT curriculum. And it’s the same kind of thing and the same risk of death, as a matter of fact.
Dr. Rebecca Dekker – 00:32:16:
Speaking from the obstetrician’s perspective, I was at the Integrative Obstetrics Conference in Kansas City this year, and one of the OBs actually stood up and said, because it was an inter-professional group, I would love to see more doulas at prenatal visits because then I could get to know them better. As a retired obstetrician, how did you feel when there was an advocate or somebody else in the room with the patient? How did it change the visit for you?Â
Dr. Leslie Farrington – 00:34:02:
Oh, the more the merrier. If there’s no ego issues, you should be welcoming any support the person brings with them.Â
Dr. Rebecca Dekker – 00:34:10
So speaking of OBs again, what are some ways that current OBs who are out there practicing right now could improve their practices to reduce harm and ensure safer care for their clients, especially for African American clients?
Dr. Leslie Farrington – 00:33:06:
Well, first of all, the signage, signage and employees. If I go to an office and I see that all the employees, and I live in Alabama now, if all the employees are blonde, white women, I feel uncomfortable in that place. So signage and who you employ makes a difference. If you’re serving a Black community, some of the people in your office should be Black. The artwork on the wall should reflect the cultural background of the people that you’re serving. Of course, good customer service is important. There’s too many doctor’s offices where the receptionists and the nurses wield that same power differential that doctors do. So we want to have good customer service. And if the perinatal providers do not understand racism, classism and paternalism, they’re going to continue to be complicit in the harms that those -isms cause. And they can never be culturally competent in a society that’s so entrenched in white supremacy culture unless they continue to work at it, to remain humble, sensitive to the individuals that they intend to serve. So they can do this by practicing mindfulness, learning about nonviolent communication so that they’re using empathy more of the time. And learn about person-centered care. And the principles of person-centered care. Saying to their clients, and this is a patient safety movement term or thing to say, ask people when you’re seeing a patient or a client. What matters to you? Not what’s the matter with you? What matters to you? So that you can say to each person. So these are some of the things that a doctor can do to do a better job. Get on that anti-racism path.
Dr. Rebecca Dekker – 00:35:02:
That’s incredible advice, Leslie. And are there any groups of physicians you see working on these issues together or places they’re gathering? Or does each physician just kind of seem to be more in a silo working on their own if they’re working on anti-racism at all?
Dr. Leslie Farrington – 00:35:20:
I don’t know that. If anything, there’s pushback. There’s anti-DEI movement amongst physicians. So it doesn’t look good. There was even an article in, I think it was the gray journal, from some prominent OBGYNs saying that obstetric violence is a misnomer. And pushing back against the concept that they’re perpetrating any harm. So we have a problem. We’re not going to fix the maternal health crisis until doctors recognize it for what it really is, which is, and this is my opinion, an epidemic of obstetric harm and obstetric violence. So that’s something that because they’re not recognizing, they won’t acknowledge the history of the profession. They won’t acknowledge that they pushed midwives out and took over something that should be a sacred rite of passage that builds a woman’s power and doesn’t pathologize her, make her a medical condition. So that’s a problem for, like I said, this physician supremacy issue is really one of the causes of our maternal health so-called crisis. And so. We need a consumer movement. And I see Black women leading this consumer movement with the Irth App®, with the PREM-OB scale, measuring racism from Dr. Karen A. Scott.Â
Most of the leaders in this movement to, I would say, decolonize birth, reclaim it as a, like I said, a sacred rite of passage. That’s something that doctors don’t know anything about. They aren’t recognizing. They don’t see how it was with the history. Of obstetrics has done to birth and look we’re the only country that has predominantly doctors. 90% of births are managed by doctors, managed delivers, as you say, babies are not pizzas. So until doctors learn the babies are not pizzas, we’ve got to be having a consumer movement going on. And it’s especially important for the Black community because as you know, from the The Giving Voice to Mothers study, at least one in six women are experiencing this treatment. And for Black women and women of color that’s at least twice as many, so that’s why speaking up, and learning how to leverage how to work the system so it doesn’t work you — work that system so that it’s working for you, and not just the medical industrial complex. So, learning the system is helpful, and we practice doing that in our ACTT workshops.Â
Dr. Rebecca Dekker – 00:38:04:
So Leslie, you know, so many resources, especially Black-led grassroots community initiatives are coming from outside the field of physicians. And I think that is important that we’re following their lead. And then it also seems important, like you point out, there is a need for physicians to gather and start putting their efforts together because they are isolated. When I do meet an obstetrician like you, there are several others out there that I can think of off the top of my head. They often confide in me that they feel alone, you know, because they’re not with a group of physicians. Often they’re the only physician at a birth justice event or at a training. And if we only had more of them kind of gathering together, but I know the career itself does not lend itself to activism because if you speak up, you could be ostracized. And then also because the hours are so intense. The lifestyle of a doctor is, you know, kind of like nonstop work is what I’ve seen and people I’ve known who are doctors. So I think you raise a good point in that we need more physician community around this topic.
Dr. Leslie Farrington – 00:39:19:
One of the things I’d like to do is to get the ACOG, the American College of OB/GYN, to be more aware of some of the tools that we’re using in the Black community. I would like to see them have Kimberly Seals-Allers speak at their next year’s annual meeting. That’s my that’s my goal for the next coming months. I’m on her advisory council for the Irth App®. We need more reviews. So if we get hundreds of thousands of reviews of births of Black and Brown people, reviews of the care that they received at the hospitals, then that information can be shared with those hospitals so that they can do better. So that’s an example of a consumer movement on a grand scale that we can make bigger that can really influence hospitals. If they really want to do better, they can use the information from that. They can start measuring racism. It should be a never event for Black women to be experiencing discrimination and disrespect in healthcare settings. That should be a never event. They have found, I don’t know if you’ve heard of the latest data from the CDC and even from New York, that the review committees reviewing maternal deaths have found that nationally, 30% of the deaths are related to discrimination.Â
So they’re finding that racism is a cause of death at a rate of 30% in the 38 states that they got data from the review committees. And in New York state, that review committee found that 46% of the deaths were contributed to by discrimination. So this issue of racism in healthcare, we need to pay more attention to that and hopefully more Black doctors, there are a lot of Black doctors who are involved in these review committees and other aspects, and they’re recognizing, they’re calling the leadership of ACOG’s attention to this issue of racism impacting the care. And so we need to have the rank and file OBGYNs wake up to that.
Dr. Rebecca Dekker – 00:41:31:
I love it. Thank you for that call to action. And you’ve mentioned the ACTT Workshops a bunch of times. So before you go, I was wondering if you could tell people how they can attend one, because I think people hear the word workshop and they think it’s something they have to pay for. But you have a free workshop that people can attend. Can you tell us a little bit about that and maybe share a story from a workshop where that resulted in a positive impact?
Dr. Leslie Farrington – 00:42:00:
Oh, sure. The ACTT Workshops that the Black Coalition for Safe Motherhood® offers are free. They’re virtual once a month on the last Wednesday evening. We are devoted to improving advocacy skills in the Black community. Anyone who’s supporting Black birthing people is welcome to come. And of course, anyone in the Black community who wants to improve health outcomes and advocacy skills in their community is invited to come and welcome. And we also, we have a training program for those who want to offer these workshops in their community. So that’s a really important thing for everyone to know that you can sign up for a workshop. On our website or go to our link tree or what have you. But we also, if you want to be someone who’s offering ACTT Workshops in your community. Please do our ACTT for Safe Motherhood workshop facilitator training. It’s online. It’s on demand. We have a dynamic instructor, Porsche Holland-Otunba, who’s also Evidence Based Birth® instructor as well.
Dr. Rebecca Dekker – 00:43:17:
That’s right.
Dr. Leslie Farrington – 00:43:18:
Yeah. And she’s our instructor. She trains our ACTT facilitators. And we have ACTT facilitators all over the country. You can look at our facilitator list and you can ask them, those who are listed on our website, the ACTT facilitator listing, you can see if they are offering workshops and they’re in your community, because it’s great to have someone in the community who’s offering the workshops. So, oh, and we’re going to be taking this training on the road. Porsche can bring a two-day training to your group, your birth workers, community health workers, and you can do it as a group. So. That’s all about how we’re getting the ACTT shared in Black communities nationwide and beyond. We’ve had requests for the the UK as well.
Dr. Rebecca Dekker – 00:44:04:
Wow. That’s amazing that the workshops are free and that, you know, the facilitator training is low cost and you’re, so you’re training facilitators right now. Anybody can apply to become a facilitator? Anyone can enroll. That’s incredible. Anyone can enroll.
Dr. Leslie Farrington – 00:44:23:
Right. If you need a scholarship, you need to get in touch with me. Okay. It’s $250 for a very comprehensive training that has eight continuing education credits approved by Lamaze and International Childbirth Education Association and DONA. And so you can get credits and you can gain skills and you can share them with your community.
Dr. Rebecca Dekker – 00:44:49:
That’s incredible. And there is a directory on the Black Coalition for Safe Motherhood website. We’ll link to all of these in the show notes where you can find people who are already trained as facilitators in your state if you want an in-person or locally led group. And then at their website, you can also find the link to attend one of the free monthly workshops that’s virtual. So, Leslie, thank you so much for sharing with us your passion and your commitment. And we’re just really grateful for the work that you’re doing. And to have you as an activist in this space is just so important and impactful.
Dr. Leslie Farrington – 00:45:31:
Thank you for everything you’re doing as well.
Dr. Rebecca Dekker – 00:45:34:
All right, everyone, thank you so much for listening to this interview with Dr. Leslie Farrington. And I hope you go check out the many resources that she mentioned. We’ll make sure to create a comprehensive list of everything she mentioned. And we are so excited that Leslie came on today to share all this information. Thanks, everyone. And I’ll see you next week.
Dr. Rebecca Dekker – 00:45:54:
Bye. Today’s podcast episode was brought to you by the online workshops for birth professionals taught by Evidence Based Birth® instructors. We have an amazing group of EBB instructors from around the world who can provide you with live, interactive, continuing education workshops that are fully online. We designed Savvy Birth Pro workshops to help birth professionals who are feeling stressed by the limitations of the health care system. Our instructors also teach the popular Comfort Measures for Birth Professionals and Labor and Delivery Nurses workshop. If you are a nurse or birth professional who wants instruction in massage, upright birthing positions, acupressure for pain relief, and more, you will love the Comfort Measures workshop. Visit ebbirth.com slash events to find a list of upcoming online workshops.
