According to the State Department of Public Health, South Carolina ranks the 8th highest in the U.S. for maternal mortality. To address this tragic statistic, and to help improve future maternal outcomes, the state established the South Carolina Maternal Morbidity and Mortality Review Committee (SCMMMRC) in 2016.
As a member of the SCMMMRC, Dr. Kari-Claudia Allen Harrington recently joined the executive director of the Good Samaritan Clinic, Mike Young, at SC Public Radio’s studios to discuss the causes of maternal mortality, improving maternal health outcomes, and eliminating preventable maternal deaths. This conversation is part of the South Carolina statewide initiative, Voices|Voces, which aims to understand the experiences and perspectives of maternity care patients throughout pregnancy, birth, and postpartum and to bring their voices directly into policy and practice discussions. Voices|Voces is housed at the University of South Carolina’s Institute for Families in Society and supported by the Center for Rural and Primary Healthcare (USC School of Medicine).
TRANSCRIPT:
Harrington: I sit on the South Carolina Maternal Morbidity and Mortality Review Committee, which is a legislative appointed body that I am very grateful that South Carolina determined to be necessary and we review every death that is either pregnancy related or pregnancy associated in the state. One of the checkboxes that we have to check as we're reviewing the death is is, “it preventable or not?” And “preventable” does not mean “did the doctor mess up?” Preventable means “if she had had childcare to keep her children and go to her doctor's appointments, they could have caught this earlier.” Preventable means “if we had a criminal justice system that arrested her domestic abuse partner, then she may still be alive today.” Preventable means “if we had had mental health providers in her area, that she may not have seen suicide as the only option for her.” If you take a heat map (heat maps, I think, tell a lot of stories and there's one when I'm presenting on the maternal mortality research), if you take a heat map of the most concentrated areas that we see the highest maternal morbidity and death, and then you superimpose that with the heat map of the lowest incomes area in our state, and then you superimpose that with the highest concentration of fast food restaurants, and then you superimpose that with education, all of those heat maps look identical.
Young: Mm-hmm.
Harrington: In defense of doctors, not that they need a whole lot of defending, but the healthcare system is not set up to have meaningful, heartfelt conversations.
Young: Yeah.
Harrington: You know, a lot of times we're anxious because we're already running late. By the time we see you, we’re 40 minutes after your appointment time, and we know we only have seven minutes to give you, and we want to squeeze the best care out of the lemon, but there's no more juice in the lemon, right? And so, we don't always get it right.
Young: You have to listen, you have to hear their stories, you have to know what they're going through. And that equity, that individualized care is going to come from hearing and connecting. And you know, it could be a hug, it could be a conversation, it could be silence. I want to tell you about this. This is a, it's called the Hunab Ku. It's part of a poem called “In Lak’ech.” What that is, it's “Tú eres mi otro yo (You are my other me).” What I do to you, I do to myself, you know, And I feel like that's really getting to the heart of how we're gonna make the more beautiful world is that we see each other as the universe, having a human experience, right, in our individual vessels, and just knowing how to change your approach based on everybody's individual experience.
Harrington: Yeah, that's what it goes back to for me. Listening as if you are the one wanting to be heard.
Young: That's a skill, that's a magic that you have, as an amazing provider, and I love to see people that do it. I'm in the clouds thinking about things a lot, but you're actually, like, touching lives and generations and changing the future. And I'm just so honored to work with you and collaborate with you. It's such an honor, to be in this with you.
Harrington: Thank you.
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