Podcast Summary: Something Was Wrong
Episode: S23 E14: S23 Roundtable with MAMA Founders Kristen & Markita and Dr. Shannon M. Clark, MD, FACOG
Release Date: May 15, 2025
Introduction
In this special bonus episode of Something Was Wrong, host Tiffany moderates a roundtable discussion featuring survivors Kristen and Markita, the founders of the nonprofit organization Moms Advocating for Moms (MAMA), and Dr. Shannon M. Clark, a renowned obstetrician-gynecologist specializing in maternal-fetal medicine. The conversation delves into the maternal healthcare crisis, the personal experiences of survivors, and the pressing need for systemic changes to improve maternal and infant care.
Participants and Their Roles
- Tiffany: Host of Something Was Wrong.
- Kristen and Markita: Survivors featured in Season 23 and founders of MAMA.
- Dr. Shannon M. Clark, MD, FACOG: A double board-certified OBGYN and maternal-fetal medicine specialist, serving as an expert voice in the discussion.
- Lily Rowe and Amy B. Chesler: Associate producers of the season.
Dr. Shannon Clark's Professional Background
Dr. Clark begins by sharing her extensive experience in maternal-fetal medicine:
“I am a double board certified OBGYN and maternal fetal medicine specialist. ... All my patients are pregnant with either maternal fetal complications or both. I've been faculty ... since 2007.”
[05:13]
She emphasizes her commitment to high-risk pregnancies and her role as an educator and provider in a large academic institution.
Shift Lengths and Impact on Patient Care
The discussion shifts to the demanding nature of medical shifts and their implications for patient care:
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Tiffany: Questions Dr. Clark about managing 24-hour shifts and the potential impacts of longer shifts, such as the 48-hour shifts reported by some midwives.
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Dr. Clark responds candidly:
“48 hours is a lot. ... The most I will do now is probably about 36 hours, and that's very, very rare.”
[07:14]
She highlights the physical and emotional toll of extended shifts and the challenges they pose to maintaining high-quality patient care.
Impact of Birth Center Shifts vs. Hospital Shifts
The conversation explores the differences between working in birth centers versus hospitals:
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Dr. Clark discusses the higher risks associated with birth centers for compensating complications:
“With a couple of these stories, I saw red flags in their antenatal care ... They are delivering in a birth center setting. I wish that some things had been picked up earlier ...”
[09:36] -
Kristin adds her perspective on the lack of comprehensive information provided to patients in birth centers:
“We are not given all of the information that is needed ... What they're not saying is 1 in 200 women have a rupture.”
[11:48]
The need for transparency and informed consent in choosing birth settings is emphasized.
Survivors' Perspectives and Experiences
Kristen and Markita share their personal experiences and the emotional impact of sharing their stories publicly:
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Kristin reflects on the emotional toll of recounting traumatic experiences:
“This episode actually made me cry ... It just gives me so much hope.”
[41:29] -
Markita discusses the difficulty of reliving painful memories through others' stories:
“Hearing the stories on the podcast was hard. ... it made me think how did this happen?”
[40:58]
Their testimonies highlight the importance of visibility and dialogue in fostering change and providing support to others.
Discussion on Meconium and Its Risks
Dr. Clark provides a medical insight into meconium, a substance found in newborns:
“Meconium is associated with abnormal fetal heart rate tracings, meconium aspiration syndrome, ... It can cause an increased risk of cesarean delivery for the patient.”
[18:35]
She underscores the critical need for protocols in handling meconium to prevent severe complications, especially in non-hospital birth settings.
Introduction to Malik's Law and MAMA Nonprofit
The founders of MAMA, Kristen and Markita, introduce Malik's Law (House Bill 4553) aimed at improving data reporting for midwives in Texas:
“Malik's law requires midwives to report outcomes related to transfer, mortality, morbidity rates ... It leaves birthing centers to create their own statistics.”
[21:46]
They explain how the law seeks to enhance transparency and provide consumers with vital information to make informed decisions regarding their care.
Changing Medical Records and Ethical Issues
The group discusses the ethical concerns surrounding the alteration of medical records:
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Dr. Clark explains the stringent protocols in hospitals to prevent unauthorized changes:
“EPIC logs every edit. ... It happens, but it's grounds for dismissal.”
[26:44] -
Kristin highlights the lack of oversight in midwifery practices, leading to potential ethical breaches:
“These professionals being in these groups ... there's nothing to stop them from doing that.”
[59:52]
This segment emphasizes the importance of accountability and integrity in medical documentation.
Root Causes of the Maternal Healthcare Crisis
Dr. Clark identifies several factors contributing to the rising maternal mortality rates in the U.S.:
“Racial disparities ... limited access to care ... social determinants of health ... missed or delayed diagnoses ...”
[28:39]
She points out that systemic issues, including racism and inadequate healthcare infrastructure, are exacerbating the crisis, particularly affecting Black patients.
Proposed Solutions to the Crisis
Addressing the crisis, Dr. Clark suggests several actionable solutions:
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Health Equity Over Equality:
“Health equity means allocating resources to those who need it the most.”
[31:47] -
Enhanced Research and Data Collection:
“We need to continue research and data collection ...”
[31:47] -
Acknowledging and Addressing Racism in Healthcare:
“We have to acknowledge that racism and obstetrical care is an issue.”
[31:47]
These recommendations aim to create a more equitable and informed healthcare system that prioritizes the needs of marginalized communities.
Nonprofit's Future Plans and Advocacy Efforts
Kristen and Markita outline the ongoing and future initiatives of MAMA:
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Education and Awareness:
“Making sure that we give foundational education ...”
[34:20] -
Support Groups and Mental Health Resources:
“We're hoping to host some support groups ... help with the mental aspect as well.”
[37:00] -
Legislative Advocacy:
“Creating bills like Malik's Law ...”
[20:42]
Their comprehensive approach focuses on empowering mothers through education, support, and legislative change.
Reflections on Sharing Stories and Their Impact
The survivors express the profound personal and communal impact of sharing their narratives on the podcast:
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Kristin:
“This podcast is a dream come true. ... Maybe this sparks conversation to make changes.”
[43:55] -
Markita:
“It was really an eye opener ... the facade that they put on for people.”
[41:46]
Dr. Clark commends their bravery:
“You are going to change somebody's life ...”
[44:10]
Their testimonies underscore the transformative power of sharing experiences to drive societal and systemic change.
Social Media Ethics in Patient-Provider Relationships
A critical discussion emerges around the boundaries between patients and medical professionals on social media:
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Dr. Clark advises against maintaining personal connections:
“You will lose your objectivity ... It's not appropriate.”
[57:18]
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Kristin shares concerns about professionals intruding into private support groups:
“There's a lot of crossing in ethical patient provider relationships.”
[59:52]
This segment highlights the necessity for clear ethical guidelines to protect both patients and providers in digital communications.
Conclusion and Resources
The episode concludes with acknowledgments and reminders for listeners to support MAMA and advocate for Malik's Law. Tiffany encourages the audience to engage with the resources provided in the episode notes, including petitions, website links, and social media platforms for further involvement and support.
Notable Quotes
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Dr. Shannon Clark:
“Everyone deserves to know all of those stats. We have to have transparency.”
[24:26] -
Kristin:
“Our stories are so important if we are going to start making change.”
[41:29] -
Markita:
“We are really hoping to host events, provide more resources, more education.”
[37:00]
Key Takeaways
- Transparency and Data Reporting: The necessity for comprehensive data collection and reporting in midwifery to ensure informed patient choices and accountability.
- Systemic Racism and Health Disparities: Addressing how racial inequalities contribute significantly to the maternal healthcare crisis.
- Ethical Boundaries in Healthcare Communication: Maintaining professional boundaries to preserve objectivity and trust in patient-provider relationships.
- Empowerment Through Education and Support: The role of organizations like MAMA in providing vital resources, support networks, and advocacy for mothers and infants.
- Impact of Shared Narratives: The powerful influence of survivors sharing their experiences to foster awareness and drive meaningful change in healthcare practices.
This episode serves as a poignant exploration of the multifaceted issues within maternal healthcare, blending expert insights with personal narratives to highlight the urgent need for reform and support systems for mothers and their babies.