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ON BEHALF OF TP NIH AND THE 

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DEPARTMENT OF HEALTH AND HUMAN 

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SERVICES AND INDIAN HEALTH 

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SERVICES I WOULD LIKE TO INVITE 

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EVERYONE FOR JOINING US WITH THE

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RIVETING PANEL DISCUSSION, 

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HEALTH AND REPRODUCTIVE EQUITY 

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FOR ALL, TO DOULA OR NOT TO 

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DOULA.

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THIS PANEL DISCUSSION LAUNCHES 

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THE EDI SERIES WHICH WILL 

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FEATURE ANNUAL WEBINARS FOCUSING

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ON CHALLENGES FACING NATIVE 

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AMERICAN COMMUNITIES IN MATERNAL

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AND CHILD HEALTH.

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THE PURPOSE IS TO BRING 

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AWARENESS TO NATIVE AMERICAN 

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BIRTHING PEOPLE, CLINICAL 

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PROFESSIONALS IN TERMS OF CHILD 

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MORBIDITY.

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HERE AT NIH, THE EUNICE KENNEDY 

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SHRIVER INSTITUTE OF HUMAN 

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DEVELOPMENT DEFINES MATERNAL 

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MORBIDITY ARE ANY SHORT-TERM OR 

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LONG-TERM PROBLEMS FROM BEING 

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PREGNANT AND GIVING BIRTH.

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MATERNAL MORTALITY IS THE DEATH 

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OF A WOMAN FROM COMPLICATIONS OF

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CHILDBIRTH THAT OCCUR WITHIN SIX

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WEEKS AFTER THE PREGNANCY EARNS.

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WE WILL DEFINE IT AS SIX WEEKS 

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TO ONE YEAR AFTER PREGNANCY 

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ENDS.

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I WOULD LIKE TO INTRODUCE OUR 

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DISTINGUISHED PANELISTS WHO ARE 

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LEADING THIS PANEL ON THIS 

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SERIOUS HUMAN HEALTH CRISIS THAT

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AFFECTS FUTURE GENERATIONS.

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THE ORDER OF THE AGENDA TODAY 

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WILL CARRY ON THE DISCUSSION 

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ABOUT THEIR PROFESSION, THE 

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IMPORTANT WORK THAT THEY DO AND 

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WILL ENGAGE IN QUESTION AND 

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ANSWERS AT THREE DIFFERENT 

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POINTS THROUGHOUT THIS 

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PRESENTATION WITHIN THIS PANEL 

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DISCUSSION.

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SO NEXT PLEASE JOIN ME IN 

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WELCOMING A TRAIL BLAZING 

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ENTREPRENEUR, ADVOCATE AND THE 

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FOUNDING EXECUTIVE DIRECTOR OF 

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HUMMINGBIRD INDIGENOUS FAMILY 

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SERVICES, DIRECTOR CAMIE 

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GOLDHAMMER.

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THANK YOU FOR COMING.

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NEXT JOIN ME IN WELCOMING A 

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PHYSICIAN SCIENTIST SPECIALIZING

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IN OBSTETRICS AND GYNECOLOGICAL 

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CARE FOR ADOLESCENTS AND 

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BIRTHING PEOPLE THROUGH ALL 

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THEIR LIFE STAGES, DR. REIESHA 

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GRAHAM.

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THANK YOU BOTH FOR JOINING US 

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TODAY.

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BEFORE WE BEGIN WITH THE 

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QUESTIONS FOR TODAY, I WOULD 

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LIKE TO ASK EACH OF OUR 

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PANELISTS TO TELL US MORE ABOUT 

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YOURSELVES AND YOUR PROFESSION.

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WE'LL START WITH DIRECTOR 

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GOLDHAMMER.

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PLEASE TELL US ALL MORE ABOUT 

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WHAT YOU DO AND HOW YOUR COMPANY

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GOT STARTED.

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>> YES.

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THANK YOU SO MUCH, CLARISSA, FOR

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HAVING ME.

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[ SPEAKING NATIVE LANGUAGE ]

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CAMIE GOLDHAMMER.

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SO GOOD MORNING, RELATIVES, GOOD

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DAY RELATIVES FOR THOSE OF YOU 

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ON THE EAST COAST.

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MY NAME IS A CAMIE GOLDHAMMER.

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I AM A DAKOTA WOMAN, I USE 

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SHE/HER PRONOUNS.

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MY TRIBE IS SISSETON-WAHPETON 

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OYATE.

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I'M GLAD TO LIVE IN THE HOME OF 

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THE DUWAMISH PEOPLE IN SEATTLE.

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I'M A FULL SPECTRUM DOULA AND 

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LACTATION CONSULTANT.

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I AM -- I HAVE SPENT NEARLY 20 

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YEARS WORKING IN MATERNAL CHILD 

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HEALTH IN THE NATIVE COMMUNITY 

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WITH THE LAST 15 OR SO DEVOTED 

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TO THE RECLAMATION AND 

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REMATRIATION OF OUR BIRTH AND 

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BREAST FEEDING PRACTICES.

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I'M VERY HAPPY TO BE HERE ON DAY

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TWO OF INDIGENOUS MEDICINE WEEK 

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IN ADDITION TO INDIGENOUS 

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PEOPLE'S DAY.

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HUMMINGBIRD INDIGENOUS FAMILY 

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SERVICES, THE NONPROFIT I RUN IN

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SEATTLE, WE SUPPORT NATIVE MOMS 

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AND THEIR FAMILIES.

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WI BELIEVE THE BEST THING FOR A 

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NATIVE BABY IS TO LOVE AND TAKE 

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CARE OF THEIR NATIVE MOTHER AND 

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LIFE GIVER AND WE HAVE COMMITTED

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TO DO THAT AND WE DO THAT 

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THROUGH SEVERAL PROGRAMS, 

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INCLUDING HOME VISITING, A 

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GUARANTEED BASIC INCOME PROGRAM 

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WHICH GIVES NATIVE MOMS $1250 NO

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STRINGS ATTACHED CASH ONCE A 

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MONTH THROUGH THREE YEARS.

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WE ARE DOULAS.

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ALL OF THE PROGRAMS STAND ON THE

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FOUNDATION OF THE DOULA PROGRAM.

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I HAVE BEEN A DOULA FOR ALMOST 

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15 YEARS, STILL ATTEND BIRTHS.

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JUST HAD A TALK LAST NIGHT ABOUT

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HOW I'M GOING TO BE ON CALL THIS

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WEEKEND FOR BIRTHS BECAUSE ALL 

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OF OUR DOULAS ARE DOING AMAZING 

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THINGS.

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I'M SURE OTHERS MIGHT BE 

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FAMILIAR WITH BABY BOOMS, BUT WE

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HAVE A LOT OF BIRTHS HAPPENING 

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RIGHT NOW.

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WE ARE REALLY LUCKY TO BE 

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TRUSTED BY THE LOCAL URBAN 

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NATIVE AMERICAN COMMUNITY.

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WE SERVE NATIVE HAWAIIAN AND 

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PACIFIC ISLANDER MOMS AND THEIR 

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FAMILIES, TOO.

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I'M GRATEFUL FOR THIS 

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OPPORTUNITY AND TIME TO BE WITH 

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YOU ALL TO TALK MORE ABOUT WHAT 

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WE DO AS DOULAS.

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>> THANK YOU SO MUCH.

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AND DR. GRAHAM, PLEASE DO TELL 

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US MORE ABOUT YOUR PROFESSION 

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AND WHY YOU STARTED SPECIFICALLY

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HAVING AN INTEREST IN THIS TYPE 

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OF MEDICINE, THIS PARTICULAR 

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SPECIALIZATION.

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>> GOOD MORNING.

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THANK YOU SO MUCH FOR HAVING ME.

151
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I AM DR. REIESHA GRAHAM.

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I HAVE BOTH AN M.D. AND PH.D.

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AND I AM A BOARD CERTIFIED 

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OB/GYN HERE WORKING IN MY HOME 

155
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STATE OF DELAWARE WHERE I AM 

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PART OF THE NANAKOKE TRIBE HERE 

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IN DELAWARE.

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GROWING UP, YOU KNOW, BEING A 

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TRIBAL WOMAN, WE PUT AN EMPHASIS

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ON THE WOMEN OF OUR COMMUNITY, 

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THE LIFE GIVERS IN OUR 

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COMMUNITY.

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AND CARING FOR THEM HAS JUST 

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BEEN A HUGE PART OF MY LIFE 

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GROWING UP.

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AND SO IT ONLY SEEMED NATURAL TO

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BECOME AN 

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OBSTETRICIAN/GYNECOLOGIST TO 

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CONTINUE TO CARE FOR WOMEN ALL 

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STAGES OF THEIR LIVES IN MY 

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PROFESSIONAL REALM AS WELL.

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SO I DO FULL SCOPE OB/GYN.

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I ALSO AM TRAINED IN LACTATION 

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AS WELL.

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I SERVE MOST OF OUR LACTATION 

176
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NEEDS FROM A PRACTICE 

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STANDPOINT.

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WE ALSO PARTNER WITH LACTATION 

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CONSULTANTS WITH OUR PRACTICE, 

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IN OUR HOSPITAL SYSTEM.

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I'M HAPPY TO BE THAT RESOURCE 

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FOR OUR PATIENTS.

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FOCUSING ON PATIENT CENTERED 

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CARE FOR OUR PATIENTS BECAUSE 

185
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THAT MEANS THE MOST TO THEM.

186
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>> EXCELLENT.

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I CAN'T HELP BUT NOTICE THE 

188
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CROSSOVER AND SIMILARITIES 

189
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BETWEEN THE WORK YOU DO, HOW IT 

190
00:08:45,038 --> 00:08:46,673
LAYERS INTO ONE ANOTHER.

191
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DIRECTOR GOLDHAMMER, CAN YOU 

192
00:08:48,908 --> 00:08:50,710
EXPLAIN MORE ABOUT WHAT A 

193
00:08:50,710 --> 00:08:56,482
LACTATION COUNSELOR OR LACTATION

194
00:08:56,482 --> 00:08:58,685
CONSULTANT IS AND WHAT THEY DO 

195
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AND EXPLAIN MORE ABOUT WHAT 

196
00:09:00,119 --> 00:09:06,526
DOULA SERVICES ENTAIL?

197
00:09:06,526 --> 00:09:08,995
>> I WOULD BE HAPPY TO.

198
00:09:08,995 --> 00:09:11,898
SO THE BEST WAY THAT I DESCRIBE 

199
00:09:11,898 --> 00:09:14,834
A DOULA IS SPECIFICALLY AN 

200
00:09:14,834 --> 00:09:15,868
INDIGENOUS DOULA, WE GET ASKED 

201
00:09:15,868 --> 00:09:18,404
THAT A LOT, WHAT MAKES YOU 

202
00:09:18,404 --> 00:09:19,872
DIFFERENT THAN OTHER DOULAS.

203
00:09:19,872 --> 00:09:23,176
THE SIMPLEST WAY I PUT IT IS WE 

204
00:09:23,176 --> 00:09:25,545
FULFILL THAT TRADITIONAL ROLE OF

205
00:09:25,545 --> 00:09:28,548
AN AUNTIE.

206
00:09:28,548 --> 00:09:32,518
WHEN WE LOOK AT COMMUNITIES 

207
00:09:32,518 --> 00:09:35,888
PRECONTACT OR PRECOLONIZATION 

208
00:09:35,888 --> 00:09:43,096
AND MAKE GUESSES AND LOOK AT 

209
00:09:43,096 --> 00:09:46,132
ANTHROPOLOGICAL STUDIES AND WHAT

210
00:09:46,132 --> 00:09:48,201
LIFE WAS LIKE FOR BIRTHING 

211
00:09:48,201 --> 00:09:49,702
PEOPLE PRIOR TO CONTACT WHAT WE 

212
00:09:49,702 --> 00:09:51,871
KNOW IS THEY WERE CARED FOR BY 

213
00:09:51,871 --> 00:09:52,872
THE COMMUNITY.

214
00:09:52,872 --> 00:09:55,408
AND THEY DIDN'T NECESSARILY HAVE

215
00:09:55,408 --> 00:09:58,344
DOULAS OR LACTATION CONSULTANTS 

216
00:09:58,344 --> 00:10:00,146
OR COUNSELORS, BUT THEY HAD 

217
00:10:00,146 --> 00:10:02,315
AUNTIES AND THEY HAD MOMS AND 

218
00:10:02,315 --> 00:10:05,451
THEY HAD GRANDMAS AND THEY HAD A

219
00:10:05,451 --> 00:10:08,221
FORCE OF PEOPLE WHO HAD CULTURAL

220
00:10:08,221 --> 00:10:12,959
KNOWLEDGE OF HOW TO SUPPORT 

221
00:10:12,959 --> 00:10:18,097
PEOPLE AFTER OR DURING THE PERE 

222
00:10:18,097 --> 00:10:18,998
NATAL PERIOD.

223
00:10:18,998 --> 00:10:20,600
AS DOULAS, THAT IS WHAT WE ARE 

224
00:10:20,600 --> 00:10:21,367
DOING.

225
00:10:21,367 --> 00:10:23,469
WE ARE FULL SPECTRUM DOULAS, 

226
00:10:23,469 --> 00:10:24,637
WHICH MEANS WE SUPPORT PEOPLE 

227
00:10:24,637 --> 00:10:25,938
REGARDLESS OF THE OUTCOME OF 

228
00:10:25,938 --> 00:10:28,708
THEIR PREGNANCIES.

229
00:10:28,708 --> 00:10:30,677
WE SUPPORT PEOPLE EXERCISING 

230
00:10:30,677 --> 00:10:32,779
THEIR RIGHT TO TERMINATE THEIR 

231
00:10:32,779 --> 00:10:34,414
PREGNANCIES, EXPERIENCING OTHER 

232
00:10:34,414 --> 00:10:36,849
TYPES OF PREGNANCY LOSS.

233
00:10:36,849 --> 00:10:38,785
BUT THE OVERWHELMING FAMILIES 

234
00:10:38,785 --> 00:10:40,420
WHO COME TO US ARE HOPING TO 

235
00:10:40,420 --> 00:10:41,487
PARENT AND PLANNING TO PARENT 

236
00:10:41,487 --> 00:10:43,723
THEIR CHILDREN.

237
00:10:43,723 --> 00:10:47,894
WE KNOW A FEW THINGS ABOUT 

238
00:10:47,894 --> 00:10:49,295
PREGNANCY AND CHILDBIRTH SO WE 

239
00:10:49,295 --> 00:10:51,464
CAN GIVE THAT ADDITIONAL 

240
00:10:51,464 --> 00:10:52,699
KNOWLEDGE, HELP TRANSLATE SOME 

241
00:10:52,699 --> 00:10:54,367
OF THE INFORMATION THEY LEARN AT

242
00:10:54,367 --> 00:10:58,071
MEDICAL APPOINTMENTS, THINGS 

243
00:10:58,071 --> 00:10:59,472
LIKE THAT.

244
00:10:59,472 --> 00:11:00,606
BE SOMEONE TO PROVIDE 

245
00:11:00,606 --> 00:11:02,408
INFORMATION SO THEY CAN BE 

246
00:11:02,408 --> 00:11:03,776
EMPOWERED TO MAKE A DECISION 

247
00:11:03,776 --> 00:11:05,578
BASED ON WHAT IS BEST FOR THEIR 

248
00:11:05,578 --> 00:11:06,112
FAMILY.

249
00:11:06,112 --> 00:11:08,281
WE KNOW THE BIRTH COMMUNITY SO 

250
00:11:08,281 --> 00:11:13,119
WE ABSOLUTELY WILL SAY DON'T GO 

251
00:11:13,119 --> 00:11:13,786
TO THAT HOSPITAL.

252
00:11:13,786 --> 00:11:14,921
DON'T USE THAT DOCTOR.

253
00:11:14,921 --> 00:11:21,994
OR THIS IS A MIDWIFE WE TRUST OR

254
00:11:21,994 --> 00:11:24,263
A PROVIDER THAT WILL TREAT OUR 

255
00:11:24,263 --> 00:11:24,764
FAMILIES WELL.

256
00:11:24,764 --> 00:11:26,566
THOSE KINDS OF THINGS.

257
00:11:26,566 --> 00:11:27,867
POSTPARTUM WE ARE THERE.

258
00:11:27,867 --> 00:11:30,236
WE GENERALLY WILL BE THERE 

259
00:11:30,236 --> 00:11:31,637
BECAUSE MOST OF OUR FAMILIES 

260
00:11:31,637 --> 00:11:34,340
DELIVER IN HOSPITAL SO THEY ARE 

261
00:11:34,340 --> 00:11:35,775
COMING HOME 24 TO 48 HOURS AFTER

262
00:11:35,775 --> 00:11:37,143
THEY HAVE THEIR BABY.

263
00:11:37,143 --> 00:11:39,412
AND WE ARE THERE, HAVE THEIR 

264
00:11:39,412 --> 00:11:43,449
HOUSE WARMED UP, PICKED UP, A 

265
00:11:43,449 --> 00:11:45,385
GOOD TRADITIONAL MEAL OF 

266
00:11:45,385 --> 00:11:47,487
WHATEVER, WHETHER THAT IS 

267
00:11:47,487 --> 00:11:52,592
BUFFALO OR SALMON OR WHATEVER.

268
00:11:52,592 --> 00:11:55,895
WE DO A LOT OF RESEARCH IN WHAT 

269
00:11:55,895 --> 00:11:59,198
MAKES MOST SENSE FOR THE FAMILY.

270
00:11:59,198 --> 00:12:01,434
AND WE JUST HELP THEM REALLY 

271
00:12:01,434 --> 00:12:02,869
TAKE CARE OF THEIR BABIES AND 

272
00:12:02,869 --> 00:12:05,438
ANSWER ANY QUESTIONS AND BE OF A

273
00:12:05,438 --> 00:12:07,039
SUPPORT FOR THEM.

274
00:12:07,039 --> 00:12:11,511
AS LACTATION COUNSELORS OR 

275
00:12:11,511 --> 00:12:14,781
LACTATION CONSULTANTS, I'M A 

276
00:12:14,781 --> 00:12:15,648
CONSULTANT, MY STAFF ARE 

277
00:12:15,648 --> 00:12:18,084
LACTATION COUNSELORS, WE ARE 

278
00:12:18,084 --> 00:12:19,452
PROVIDING SUPPORT TO OUR 

279
00:12:19,452 --> 00:12:20,586
FAMILIES TO MEET THEIR BREAST 

280
00:12:20,586 --> 00:12:22,989
FEEDING GOALS.

281
00:12:22,989 --> 00:12:27,894
WE HAVE 100% BREAST FEEDING 

282
00:12:27,894 --> 00:12:29,295
INITIATION RATE SO 100% OF OUR 

283
00:12:29,295 --> 00:12:30,930
FAMILIES WANT TO BREAST FEED.

284
00:12:30,930 --> 00:12:32,965
AS MANY OF YOU PROBABLY KNOW 

285
00:12:32,965 --> 00:12:35,468
ABOUT 60% OF PEOPLE DON'T 

286
00:12:35,468 --> 00:12:37,437
IMMEDIATE THEIR BREASTFEEDING 

287
00:12:37,437 --> 00:12:38,905
GOALS IN THE UNITED STATES.

288
00:12:38,905 --> 00:12:40,640
WHEN WE BREAK THAT DOWN BY 

289
00:12:40,640 --> 00:12:42,809
COMMUNITIES OF COLORS, 

290
00:12:42,809 --> 00:12:43,743
SPECIFICALLY BLACK AND 

291
00:12:43,743 --> 00:12:45,645
INDIGENOUS COMMUNITIES WE SEE 

292
00:12:45,645 --> 00:12:47,280
EVEN MORE PEOPLE NOT MEETING 

293
00:12:47,280 --> 00:12:47,647
THEIR GOALS.

294
00:12:47,647 --> 00:12:51,217
AND SO A LOT OF WHAT WE DO IS 

295
00:12:51,217 --> 00:12:53,319
PROVIDE SUPPORT, ANSWER FEEDING 

296
00:12:53,319 --> 00:12:56,055
QUESTIONS, ANSWER THOSE CALLS AT

297
00:12:56,055 --> 00:12:58,224
2:00 A.M., WORRIES ABOUT NOT 

298
00:12:58,224 --> 00:13:00,359
MAKING ENOUGH MILK, ALL OF THOSE

299
00:13:00,359 --> 00:13:01,194
KINDS OF THINGS.

300
00:13:01,194 --> 00:13:03,529
AND WHAT THE DOULAS, WHEN IT 

301
00:13:03,529 --> 00:13:06,065
REACHES THE DOULAS SCOPE OR 

302
00:13:06,065 --> 00:13:07,366
THEIR KNOWLEDGE BASE THAT IS 

303
00:13:07,366 --> 00:13:09,001
WHEN THEY REACH OUT TO ME AND 

304
00:13:09,001 --> 00:13:12,939
THAT IS THE MAJORITY OF MY HOME 

305
00:13:12,939 --> 00:13:14,841
VISITS DOING THE MORE COMPLEX 

306
00:13:14,841 --> 00:13:15,441
LACTATION CHALLENGES.

307
00:13:15,441 --> 00:13:19,445
>> IT IS AMAZING THAT WITH
THIS 

308
00:13:19,445 --> 00:13:22,215
TYPE OF IMPORTANT WORK THAT IT 

309
00:13:22,215 --> 00:13:25,918
IS NOT COVERED BY EVERY FORM OF 

310
00:13:25,918 --> 00:13:26,185
INSURANCE.

311
00:13:26,185 --> 00:13:27,887
THERE ARE SOME LAWS AND STATES 

312
00:13:27,887 --> 00:13:30,122
THAT ALLOW FOR THE COVERAGE OF 

313
00:13:30,122 --> 00:13:31,891
DOULA SERVICES AND WE'LL BE 

314
00:13:31,891 --> 00:13:33,559
DISCUSSING A LITTLE MORE ABOUT 

315
00:13:33,559 --> 00:13:34,994
THAT.

316
00:13:34,994 --> 00:13:39,866
I THINK IT IS ALSO IMPORTANT 

317
00:13:39,866 --> 00:13:43,769
THAT WE LEVEL SET AND LET THE 

318
00:13:43,769 --> 00:13:45,538
AUDIENCE KNOW YOU WILL BE ABLE 

319
00:13:45,538 --> 00:13:48,074
TO ASK QUESTIONS AND BOTH 

320
00:13:48,074 --> 00:13:49,742
PANELISTS WILL ANSWER YOUR 

321
00:13:49,742 --> 00:13:50,009
QUESTIONS.

322
00:13:50,009 --> 00:13:52,111
THERE WILL BE THREE POINTS IN 

323
00:13:52,111 --> 00:13:53,312
THIS PANEL DISCUSSION TO ANSWER 

324
00:13:53,312 --> 00:13:55,281
THE QUESTIONS YOU HAVE.

325
00:13:55,281 --> 00:13:56,749
FEEL FREE TO PUT QUESTIONS IN 

326
00:13:56,749 --> 00:13:59,285
THE Q&A BECAUSE THEY WILL BE

327
00:13:59,285 --> 00:13:59,552
ANSWERED.

328
00:13:59,552 --> 00:14:01,954
ADDITIONALLY, I WANT TO MAKE 

329
00:14:01,954 --> 00:14:04,090
SURE EVERYONE UNDERSTANDS THE 

330
00:14:04,090 --> 00:14:08,861
DIFFERENT STAGES OF REPRODUCTIVE

331
00:14:08,861 --> 00:14:09,095
PROCESS.

332
00:14:09,095 --> 00:14:15,868
DR. GRAHAM, CAN YOU PROVIDE A 

333
00:14:15,868 --> 00:14:19,872
LITTLE INFORMATION WHAT IS 

334
00:14:19,872 --> 00:14:21,908
POSTPARTUM, WHAT IS PRENATAL 

335
00:14:21,908 --> 00:14:23,643
PERIOD AND GIVE THEM PERSPECTIVE

336
00:14:23,643 --> 00:14:29,448
ON THAT?

337
00:14:29,448 --> 00:14:30,316
>> YES.

338
00:14:30,316 --> 00:14:34,587
SO AS AN OB/GYN, MY CARE OF 

339
00:14:34,587 --> 00:14:36,756
WOMEN IN GENERAL BUT BIRTHING 

340
00:14:36,756 --> 00:14:39,892
WOMEN OR ASSIGNED WOMEN FEMALE 

341
00:14:39,892 --> 00:14:42,595
AT BIRTH PATIENTS, IT 

342
00:14:42,595 --> 00:14:49,135
ENCOMPASSES THE VERY BEGINNING.

343
00:14:49,135 --> 00:14:50,903
WHEN WE ARE FIRST ENCOUNTERING 

344
00:14:50,903 --> 00:14:54,307
OUR MOON AND COMING ON TO OUR 

345
00:14:54,307 --> 00:14:56,475
CYCLE AND JOURNEY THROUGHOUT 

346
00:14:56,475 --> 00:14:59,045
WOMANHOOD WELL BEFORE WE BECOME 

347
00:14:59,045 --> 00:14:59,946
CONSIDERING FAMILY HAVING.

348
00:14:59,946 --> 00:15:02,848
SO A LOT OF PEOPLE THINK OF 

349
00:15:02,848 --> 00:15:04,116
OB/GYNs IS JUST WHERE YOU GO 

350
00:15:04,116 --> 00:15:05,685
WHEN IT IS TIME TO HAVE 

351
00:15:05,685 --> 00:15:06,018
CHILDREN.

352
00:15:06,018 --> 00:15:07,887
BUT THERE ARE A LOT OF 

353
00:15:07,887 --> 00:15:10,523
VARIATIONS IN OUR GENETICS AND 

354
00:15:10,523 --> 00:15:14,827
OUR DNA, IN OUR CYCLES AND 

355
00:15:14,827 --> 00:15:17,830
THINGS WE ARE THERE TO HELP FOR.

356
00:15:17,830 --> 00:15:20,533
WITH RESPECT TO BIRTHING 

357
00:15:20,533 --> 00:15:22,635
PERSONS, I THINK ALL OB/GYNs, IT

358
00:15:22,635 --> 00:15:25,972
IS OUR HOPE AND GOAL THAT WE CAN

359
00:15:25,972 --> 00:15:29,508
BUILD THOSE RELATIONSHIPS BEFORE

360
00:15:29,508 --> 00:15:31,844
THEY BECOME PREGNANT AND HAVE 

361
00:15:31,844 --> 00:15:33,412
PRENATAL VISITS OR PRECONCEPTION

362
00:15:33,412 --> 00:15:35,014
VISITS TO GET TO KNOW THAT 

363
00:15:35,014 --> 00:15:37,750
FAMILY, TO GET TO KNOW AND 

364
00:15:37,750 --> 00:15:41,153
OPTIMIZE THEIR MEDICAL HEALTH IN

365
00:15:41,153 --> 00:15:42,955
PREPARATION FOR PREGNANCY, 

366
00:15:42,955 --> 00:15:45,625
MAKING SURE THEY ARE INITIATING 

367
00:15:45,625 --> 00:15:47,526
PRENATAL VITAMINS WELL BEFORE 

368
00:15:47,526 --> 00:15:50,963
THEY NEED IT, BEFORE THEY BECOME

369
00:15:50,963 --> 00:15:51,897
PREGNANT AND GET THEM 

370
00:15:51,897 --> 00:15:54,400
ESTABLISHED IN THE CARE NETWORK 

371
00:15:54,400 --> 00:15:56,502
AND SYSTEM AND ATTACHED TO ALL 

372
00:15:56,502 --> 00:15:57,603
THE RESOURCES THAT ARE AVAILABLE

373
00:15:57,603 --> 00:15:59,538
WELL BEFORE THEY FIND OUT THEY 

374
00:15:59,538 --> 00:16:00,473
ARE PREGNANT.

375
00:16:00,473 --> 00:16:01,641
THAT IS OUR IDEAL GOAL.

376
00:16:01,641 --> 00:16:04,143
I KNOW THAT IS NOT THE MOST 

377
00:16:04,143 --> 00:16:04,844
REALISTIC.

378
00:16:04,844 --> 00:16:07,747
SO PATIENTS COME TO US AT VERY 

379
00:16:07,747 --> 00:16:08,814
DIFFERENT POINTS OF THEIR 

380
00:16:08,814 --> 00:16:10,583
JOURNEYS AND CERTAINLY THERE ARE

381
00:16:10,583 --> 00:16:13,619
A LOT OF DIFFERENT HEALTH CRISES

382
00:16:13,619 --> 00:16:17,523
IN AMERICA LIMITING PATIENTS' 

383
00:16:17,523 --> 00:16:21,927
ACCESS TO CARE NATIONWIDE.

384
00:16:21,927 --> 00:16:23,095
UNFORTUNATELY, EVEN THOUGH 

385
00:16:23,095 --> 00:16:24,897
PATIENTS WOULD PREFER TO START 

386
00:16:24,897 --> 00:16:28,668
THAT INTERACTION, AT THE FIRST 

387
00:16:28,668 --> 00:16:29,869
PREGNANCY TEST OR WELL BEFORE 

388
00:16:29,869 --> 00:16:31,704
THAT THERE ARE BARRIERS FOR THEM

389
00:16:31,704 --> 00:16:33,439
BEING ABLE TO DO SO.

390
00:16:33,439 --> 00:16:35,741
SOMETIMES APPOINTMENTS ARE JUST 

391
00:16:35,741 --> 00:16:39,512
NOT AVAILABLE DUE TO A LIMITED 

392
00:16:39,512 --> 00:16:41,547
NUMBER OF, YOU KNOW, BIRTH 

393
00:16:41,547 --> 00:16:46,752
WORKERS, PROVIDERS, PHYSICIANS 

394
00:16:46,752 --> 00:16:47,520
IN THEIR COMMUNITIES.

395
00:16:47,520 --> 00:16:50,256
SO WE TRY TO GET THEM IN AND SEE

396
00:16:50,256 --> 00:16:51,824
THEM AS SOON AS WE CAN.

397
00:16:51,824 --> 00:16:55,728
YOU THEN CARE FOR THAT PATIENT 

398
00:16:55,728 --> 00:16:58,431
THROUGHOUT THEIR PREGNANCY.

399
00:16:58,431 --> 00:17:00,299
PRENATAL VISITS IN THE BEGINNING

400
00:17:00,299 --> 00:17:03,803
ARE USUALLY MONTHLY AND AS YOU 

401
00:17:03,803 --> 00:17:06,806
TRANSITION THROUGH THE DIFFERENT

402
00:17:06,806 --> 00:17:08,040
TRIMESTERS OF PREGNANCY THEY 

403
00:17:08,040 --> 00:17:09,141
BECOME MORE FREQUENT TOWARDS THE

404
00:17:09,141 --> 00:17:11,544
END, YOU ARE SEEING THEM EVERY 

405
00:17:11,544 --> 00:17:13,879
TWO WEEKS OR WEEKLY, SOMETIMES 

406
00:17:13,879 --> 00:17:17,116
TWICE WEEKLY IF THEY HAVE OTHER 

407
00:17:17,116 --> 00:17:19,685
MEDICAL CO-MORBIDITIES OR 

408
00:17:19,685 --> 00:17:22,254
CONDITIONS YOU ARE CONCURRENTLY 

409
00:17:22,254 --> 00:17:22,988
MANAGING.

410
00:17:22,988 --> 00:17:25,257
THE POSTPARTUM PERIOD IS 

411
00:17:25,257 --> 00:17:26,258
TRADITIONALLY DETERMINED TO BE 

412
00:17:26,258 --> 00:17:29,562
THE SIX WEEKS FOLLOWING 

413
00:17:29,562 --> 00:17:30,763
PREGNANCY.

414
00:17:30,763 --> 00:17:32,498
HISTORICALLY WE'VE ONLY SEEN 

415
00:17:32,498 --> 00:17:35,000
PATIENTS AT THAT SIX-WEEK VISIT,

416
00:17:35,000 --> 00:17:37,970
BUT I THINK SCIENCE AND DATA AND

417
00:17:37,970 --> 00:17:39,271
HEALTH OUTCOMES HAVE SHOWN THAT 

418
00:17:39,271 --> 00:17:40,940
IS JUST NOT EFFICIENT.

419
00:17:40,940 --> 00:17:43,809
PATIENTS ARE EXTREMELY 

420
00:17:43,809 --> 00:17:45,678
VULNERABLE IN THOSE FIRST FEW 

421
00:17:45,678 --> 00:17:46,912
DAYS TO WEEKS.

422
00:17:46,912 --> 00:17:49,315
AND SO THE AMERICAN COLLEGE OF 

423
00:17:49,315 --> 00:17:53,285
OB/GYN IS PUSHING FORWARD TO 

424
00:17:53,285 --> 00:17:55,988
HAVE AT LEAST ONE TO TWO WEEK 

425
00:17:55,988 --> 00:17:57,623
VISIT WITH ALL WOMEN, REGARDLESS

426
00:17:57,623 --> 00:18:00,292
OF THEIR HEALTH STATUS.

427
00:18:00,292 --> 00:18:02,394
JUST TO CHECK IN, TO BE THERE 

428
00:18:02,394 --> 00:18:04,764
FOR THEM, TO HELP THEM NAVIGATE 

429
00:18:04,764 --> 00:18:14,173
THE CHANGES IN THEIR BODY, 

430
00:18:14,173 --> 00:18:15,007
PHYSIOLOGICALLY AND CHALLENGES 

431
00:18:15,007 --> 00:18:15,875
FOR THAT PATIENT.

432
00:18:15,875 --> 00:18:17,376
UNFORTUNATELY, A LOT OF THE 

433
00:18:17,376 --> 00:18:21,580
SYMPTOMS OF COMPLICATIONS OF 

434
00:18:21,580 --> 00:18:27,887
PREGNANCY, LIKE PRECLAMSIA, 

435
00:18:27,887 --> 00:18:30,055
THINGS THAT ARE KILLING OUR 

436
00:18:30,055 --> 00:18:32,458
PATIENTS AT RECORD RATES ARE 

437
00:18:32,458 --> 00:18:34,727
VERY SUBTLE.

438
00:18:34,727 --> 00:18:36,328
SOMETIMES THAT PATIENT BEING IN 

439
00:18:36,328 --> 00:18:40,633
THE THROES OF MOTHERHOOD AND 

440
00:18:40,633 --> 00:18:41,734
FOCUSING ON CARING FOR HER BABY,

441
00:18:41,734 --> 00:18:43,869
THE SIGNS ARE NOT RECOGNIZED BY 

442
00:18:43,869 --> 00:18:45,838
THE PATIENT, SOMETIMES NOT EVEN 

443
00:18:45,838 --> 00:18:47,106
BY THE FAMILY.

444
00:18:47,106 --> 00:18:48,674
IF YOU HAVE BEEN ABLE TO 

445
00:18:48,674 --> 00:18:49,742
ESTABLISH A RELATIONSHIP WITH 

446
00:18:49,742 --> 00:18:51,877
THAT PATIENT, THEN YOU KNOW WHEN

447
00:18:51,877 --> 00:18:53,546
THINGS ARE DIFFERENT FOR THAT 

448
00:18:53,546 --> 00:18:54,580
PATIENT.

449
00:18:54,580 --> 00:18:57,349
I THINK THAT IS WHAT DOULA 

450
00:18:57,349 --> 00:18:59,785
SUPPORT SERVICES AND MIDWIFERY 

451
00:18:59,785 --> 00:19:01,587
CARE ARE SO IMPORTANT BECAUSE 

452
00:19:01,587 --> 00:19:03,889
THEY CAN ACTUALLY BE THE EYES 

453
00:19:03,889 --> 00:19:06,659
AND EARS ON THAT PATIENT TO 

454
00:19:06,659 --> 00:19:09,228
BUILD THOSE RELATIONSHIPS AND BE

455
00:19:09,228 --> 00:19:11,030
PHYSICALLY PRESENT AND ADVOCATE 

456
00:19:11,030 --> 00:19:12,665
FOR THAT PATIENT ESPECIALLY WHEN

457
00:19:12,665 --> 00:19:14,667
THEY DON'T EVEN KNOW THEY NEED 

458
00:19:14,667 --> 00:19:15,034
TO.

459
00:19:15,034 --> 00:19:17,269
EVEN IF THEY ARE HAVING SYMPTOMS

460
00:19:17,269 --> 00:19:20,272
THEY DON'T RECOGNIZE AS BEING 

461
00:19:20,272 --> 00:19:21,173
CONCERNING.

462
00:19:21,173 --> 00:19:24,610
BUT TRULY TRADITIONALLY, THE 

463
00:19:24,610 --> 00:19:26,579
BIRTHING TIME PERIOD REALLY 

464
00:19:26,579 --> 00:19:29,615
EXTENDS FAR BEYOND THAT SIX 

465
00:19:29,615 --> 00:19:30,783
WEEKS.

466
00:19:30,783 --> 00:19:34,920
WE THINK ABOUT LACTATION AND 

467
00:19:34,920 --> 00:19:35,721
SPECIFICALLY THE WORLD HEALTH 

468
00:19:35,721 --> 00:19:37,122
ORGANIZATION SUPPORTS LACTATION 

469
00:19:37,122 --> 00:19:40,459
UP TO YEAR TWO OF LIFE.

470
00:19:40,459 --> 00:19:42,828
AND SO WE CAN'T JUST FORGET 

471
00:19:42,828 --> 00:19:44,496
ABOUT THESE PATIENTS AND TURN 

472
00:19:44,496 --> 00:19:45,798
OUR BACK ON THEM AT THE SIX-WEEK

473
00:19:45,798 --> 00:19:51,570
VISIT.

474
00:19:51,570 --> 00:19:54,506
THEY ARE HAVING NUANCED 

475
00:19:54,506 --> 00:19:55,741
DIFFERENCES IN THEIR HEALTH UP 

476
00:19:55,741 --> 00:20:00,579
TO ONE TO TWO YEARS AFTER CHILD 

477
00:20:00,579 --> 00:20:00,946
BEARING.

478
00:20:00,946 --> 00:20:02,514
>> I THINK THAT IS A
REALLY 

479
00:20:02,514 --> 00:20:05,384
STRONG POINT AND I WANTED TO 

480
00:20:05,384 --> 00:20:11,857
PRESENT A QUESTION TO DIRECTOR 

481
00:20:11,857 --> 00:20:14,560
GOLDHAMMER BECAUSE SHE'S IN THE 

482
00:20:14,560 --> 00:20:15,895
COMMUNITY AND LIKE YOU 

483
00:20:15,895 --> 00:20:16,996
MENTIONED, DOULA SERVICES ARE 

484
00:20:16,996 --> 00:20:19,632
ABLE TO BE THERE AND BE PRESENT 

485
00:20:19,632 --> 00:20:22,067
WHERE IT IS NOT FEASIBLE FOR THE

486
00:20:22,067 --> 00:20:23,168
CLINICAL PROFESSIONAL TO 

487
00:20:23,168 --> 00:20:24,436
CONTINUE ON WITH CARE.

488
00:20:24,436 --> 00:20:26,805
THAT CARE HAS SHOWN TO HAVE 

489
00:20:26,805 --> 00:20:31,744
INCREASED POSITIVE OUTCOMES AND 

490
00:20:31,744 --> 00:20:33,946
REDUCED THE NEGATIVE 

491
00:20:33,946 --> 00:20:35,547
CO-MORBIDITIES AND MORTALITY 

492
00:20:35,547 --> 00:20:35,748
RATES.

493
00:20:35,748 --> 00:20:39,885
SO MY QUESTION STEMS FROM IN 

494
00:20:39,885 --> 00:20:41,086
2019 THE WORLD HEALTH 

495
00:20:41,086 --> 00:20:43,589
ORGANIZATION IN COLLABORATION 

496
00:20:43,589 --> 00:20:47,626
WITH THE UNITED NATIONS 

497
00:20:47,626 --> 00:20:51,864
POPULATIONS DIVISION, UNICEF 

498
00:20:51,864 --> 00:20:56,602
PUBLISHED A REPORT CALLED TRENDS

499
00:20:56,602 --> 00:20:57,770
IN 2000 TO 2017.

500
00:20:57,770 --> 00:21:03,876
EVEN THOUGH THERE WAS A 

501
00:21:03,876 --> 00:21:06,078
WORLDWIDE DECREASE OF MATERNAL 

502
00:21:06,078 --> 00:21:07,880
MORTALITY RATE, THE UNITED 

503
00:21:07,880 --> 00:21:10,249
STATES WAS ONE OF TWO THAT 

504
00:21:10,249 --> 00:21:12,051
REPORTED AN INCREASE OF 

505
00:21:12,051 --> 00:21:13,152
PROPORTION OF PREGNANCIES THAT 

506
00:21:13,152 --> 00:21:16,121
RESULT IN DEATH OF THE BIRTHING 

507
00:21:16,121 --> 00:21:17,556
PERSON.

508
00:21:17,556 --> 00:21:22,227
IN A DATA BRIEF PUBLISHED BY 

509
00:21:22,227 --> 00:21:22,995
COMMONWEALTH.ORG IN DECEMBER 

510
00:21:22,995 --> 00:21:26,165
2020 REPORTED RACE AND ETHNICITY

511
00:21:26,165 --> 00:21:28,467
WAS TIED TO THE DIFFERENT CAUSES

512
00:21:28,467 --> 00:21:31,003
OF DEATH AND THE PAPER STATED 

513
00:21:31,003 --> 00:21:33,172
THAT BLACK WOMEN AND NATIVE 

514
00:21:33,172 --> 00:21:34,773
AMERICAN WOMEN AND BIRTHING 

515
00:21:34,773 --> 00:21:38,811
PEOPLE HAVE A MARKEDLY HIGHER 

516
00:21:38,811 --> 00:21:39,878
MATERNAL MORTALITY RATE THAN 

517
00:21:39,878 --> 00:21:41,780
WOMEN OF ANY OTHER RACES.

518
00:21:41,780 --> 00:21:47,586
I JUST WANTED TO ASK YOU, 

519
00:21:47,586 --> 00:21:48,854
DIRECTOR GOLDHAMMER, WHAT ARE 

520
00:21:48,854 --> 00:21:53,625
YOUR THOUGHTS ON THAT FROM YOUR 

521
00:21:53,625 --> 00:21:53,959
PERSPECTIVE?

522
00:21:53,959 --> 00:21:55,694
WHAT DO YOU THINK IS THE 

523
00:21:55,694 --> 00:21:56,328
CONTRIBUTING FACTOR TO THIS HIGH

524
00:21:56,328 --> 00:22:00,032
NUMBER?

525
00:22:00,032 --> 00:22:00,566
>> YEAH.

526
00:22:00,566 --> 00:22:06,605
THANK YOU FOR THAT QUESTION.

527
00:22:06,605 --> 00:22:08,974
I THINK IT'S -- THERE ARE SO 

528
00:22:08,974 --> 00:22:09,808
MANY DIFFERENT THINGS.

529
00:22:09,808 --> 00:22:11,643
I SAID THIS IN OUR PRETALK THAT 

530
00:22:11,643 --> 00:22:15,180
I ALWAYS JUST WANT TO 

531
00:22:15,180 --> 00:22:16,148
ACKNOWLEDGE MY PRIVILEGE AS 

532
00:22:16,148 --> 00:22:19,551
SOMEONE WHO IS NOT ACTUALLY 

533
00:22:19,551 --> 00:22:20,452
RESPONSIBLE FOR SOMEONE'S LIFE 

534
00:22:20,452 --> 00:22:25,691
AS A PROVIDER IS.

535
00:22:25,691 --> 00:22:30,596
I RECOGNIZE IT IS EASY FOR ME AS

536
00:22:30,596 --> 00:22:32,531
SOMEONE OUT OF A HOSPITAL TO SAY

537
00:22:32,531 --> 00:22:34,233
ALL THE THINGS THAT ARE GOING 

538
00:22:34,233 --> 00:22:34,433
WRONG.

539
00:22:34,433 --> 00:22:38,137
WITH THAT BEING SAID, I HAVE 

540
00:22:38,137 --> 00:22:39,505
SERVED THOUSANDS OF PREGNANT AND

541
00:22:39,505 --> 00:22:42,174
PARENTS FAMILIES AND I HAVE A 

542
00:22:42,174 --> 00:22:43,876
LOT OF EXPERIENCE -- AND ALL OF 

543
00:22:43,876 --> 00:22:46,678
THEM HAVE BE NATIVE.

544
00:22:46,678 --> 00:22:48,781
100% OF THE PEOPLE I SERVE ARE 

545
00:22:48,781 --> 00:22:50,115
NATIVE OVER MY CAREER.

546
00:22:50,115 --> 00:22:51,884
WHILE THERE'S MANY THINGS THAT 

547
00:22:51,884 --> 00:22:55,220
MIGHT BE CONTRIBUTING TO IT AND 

548
00:22:55,220 --> 00:22:57,589
I WILL ADDRESS THOSE, I THINK 

549
00:22:57,589 --> 00:22:59,858
WHAT I THINK IS REALLY IMPORTANT

550
00:22:59,858 --> 00:23:03,495
TO ACKNOWLEDGE WHAT IS NOT 

551
00:23:03,495 --> 00:23:05,330
CONTRIBUTING TO IT IS NATIVE 

552
00:23:05,330 --> 00:23:11,170
PEOPLE IN OUR COMMUNITY AND OUR 

553
00:23:11,170 --> 00:23:11,503
BODIES.

554
00:23:11,503 --> 00:23:13,272
TOO OFTEN I FIND THAT WHEN IT 

555
00:23:13,272 --> 00:23:17,342
COMES TO MATERNAL MORTALITY, 

556
00:23:17,342 --> 00:23:18,644
MAINSTREAM KIND OF SOCIETY 

557
00:23:18,644 --> 00:23:22,481
REALLY WANTS TO BLAME IT ON 

558
00:23:22,481 --> 00:23:24,583
NATIVE MOMS BEING TOO FAT, TOO 

559
00:23:24,583 --> 00:23:27,886
UNHEALTHY, TOO ADDICTED, TOO, 

560
00:23:27,886 --> 00:23:31,790
TOO, TOO.

561
00:23:31,790 --> 00:23:32,057
RIGHT?

562
00:23:32,057 --> 00:23:34,159
AND THAT IS SIMPLY JUST NOT THE 

563
00:23:34,159 --> 00:23:34,460
CASE.

564
00:23:34,460 --> 00:23:41,333
WE WANT TO SEE THE DISPARITIES 

565
00:23:41,333 --> 00:23:45,671
THAT WE DO AND IT REALLY IS 

566
00:23:45,671 --> 00:23:48,607
COMPLEX STRESS AND TRAUMA, 

567
00:23:48,607 --> 00:23:49,608
SYSTEMIC RACISM AND OPPRESSION 

568
00:23:49,608 --> 00:23:51,410
THAT IS CONTRIBUTING TO IT AND 

569
00:23:51,410 --> 00:23:55,481
HOW WE KNOW THAT IS THE 80% OF 

570
00:23:55,481 --> 00:24:03,355
MATERNAL DEATHS ARE PREVENTABLE.

571
00:24:03,355 --> 00:24:05,657
THE FACT THEY ARE PREVENTABLE, 

572
00:24:05,657 --> 00:24:09,161
AS DEPRESSING AS THAT STAT MAY 

573
00:24:09,161 --> 00:24:11,063
BE, I'M A GLASS HALF FULL 

574
00:24:11,063 --> 00:24:12,598
OPTIMIST, MAN, WE CAN ONLY GO UP

575
00:24:12,598 --> 00:24:13,732
FROM THERE.

576
00:24:13,732 --> 00:24:15,868
AND HOW INCREDIBLE IS IT THAT WE

577
00:24:15,868 --> 00:24:17,569
HAVE WITHIN OUR GRASP THE 

578
00:24:17,569 --> 00:24:20,539
ABILITY TO PREVENT THE DEATHS, 

579
00:24:20,539 --> 00:24:21,840
80% OF DEATHS, RIGHT?

580
00:24:21,840 --> 00:24:24,476
THOSE ARE STATS THAT MOST 

581
00:24:24,476 --> 00:24:26,245
PROVIDERS WOULD LOVE TO BE ABLE 

582
00:24:26,245 --> 00:24:36,788
TO BE ABLE TO HAVE AN IMPACT ON.

583
00:24:37,055 --> 00:24:39,625
I SIT ON THE MATERNAL REVIEW 

584
00:24:39,625 --> 00:24:41,160
PANEL FOR WASHINGTON STATE, HAVE

585
00:24:41,160 --> 00:24:42,761
FOR SEVERAL YEARS.

586
00:24:42,761 --> 00:24:45,764
WHEN WE MAKE OUR RECOMMENDATIONS

587
00:24:45,764 --> 00:24:48,867
TO OUR STATE LEGISLATURE ABOUT 

588
00:24:48,867 --> 00:24:51,236
WHAT WE CAN DO TO PREVENT DEATH,

589
00:24:51,236 --> 00:24:55,140
IT IS ADDRESSING SYSTEMIC RACISM

590
00:24:55,140 --> 00:24:57,843
AND OPPRESSION, PROVIDING BASIC 

591
00:24:57,843 --> 00:24:58,410
NEEDS TO FAMILY.

592
00:24:58,410 --> 00:25:00,579
THE FINANCIAL STRESS FOR MANY OF

593
00:25:00,579 --> 00:25:02,714
OUR FAMILIES AND THE INABILITY 

594
00:25:02,714 --> 00:25:05,350
TO ACCESS THEIR BASIC NEEDS 

595
00:25:05,350 --> 00:25:08,020
REALLY CONTRIBUTES TO A LOT OF 

596
00:25:08,020 --> 00:25:10,255
THIS STRESS AND MENTAL HEALTH 

597
00:25:10,255 --> 00:25:16,662
CHALLENGES THAT NATIVE FAMILIES 

598
00:25:16,662 --> 00:25:18,497
ARE EXPERIENCING.

599
00:25:18,497 --> 00:25:22,167
THIS IS SOMETHING WHEN I THINK 

600
00:25:22,167 --> 00:25:26,271
ABOUT MATERNAL MORTALITY AND 

601
00:25:26,271 --> 00:25:29,208
INFANT MORTALITY THAT ARE SO 

602
00:25:29,208 --> 00:25:31,009
CLOSELY TIED BECAUSE BLACK AND 

603
00:25:31,009 --> 00:25:33,879
NATIVE BABIES HAVE HIGH INFANT 

604
00:25:33,879 --> 00:25:35,180
MORTALITY IN OUR COUNTRY AS 

605
00:25:35,180 --> 00:25:35,380
WELL.

606
00:25:35,380 --> 00:25:38,283
I BELIEVE IT IS NOT OUR FAULT AS

607
00:25:38,283 --> 00:25:39,885
NATIVE MOMS AND FAMILIES AND 

608
00:25:39,885 --> 00:25:40,986
COMMUNITY.

609
00:25:40,986 --> 00:25:41,253
RIGHT?

610
00:25:41,253 --> 00:25:43,188
WE DIDN'T CREATE THIS PROBLEM 

611
00:25:43,188 --> 00:25:44,790
BUT WE CERTAINLY HAVE THE 

612
00:25:44,790 --> 00:25:46,091
ANSWERS.

613
00:25:46,091 --> 00:25:49,494
AND IT IS REALLY IMPORTANT THAT,

614
00:25:49,494 --> 00:25:54,933
I THINK, HEALTH CARE PROVIDERS, 

615
00:25:54,933 --> 00:25:57,102
POLICY MAKERS, FOLKS THAT ARE 

616
00:25:57,102 --> 00:25:58,971
PROBABLY HERE TODAY LISTENING TO

617
00:25:58,971 --> 00:26:00,939
US UNDERSTAND THAT THE ANSWER IS

618
00:26:00,939 --> 00:26:03,342
IN THE COMMUNITY AND WE HAVE 

619
00:26:03,342 --> 00:26:06,845
PRETTY INCREDIBLE OUTCOMES WHEN 

620
00:26:06,845 --> 00:26:09,982
WE ARE GIVEN THE FREEDOM TO LOVE

621
00:26:09,982 --> 00:26:11,683
OUR COMMUNITY UNCONDITIONALLY 

622
00:26:11,683 --> 00:26:15,454
AND PROVIDE THEM WITH WHAT THEY 

623
00:26:15,454 --> 00:26:15,887
NEED.

624
00:26:15,887 --> 00:26:18,423
>> I ABSOLUTELY AGREE
WITHOUT A 

625
00:26:18,423 --> 00:26:19,891
DOUBT.

626
00:26:19,891 --> 00:26:26,999
THAT BRINGS ME TO ANOTHER 

627
00:26:26,999 --> 00:26:27,266
QUESTION.

628
00:26:27,266 --> 00:26:31,303
IN A PAPER THAT WAS PUBLISHED IN

629
00:26:31,303 --> 00:26:33,472
2021, IT WAS DISCUSSING HOW 

630
00:26:33,472 --> 00:26:35,674
HISTORICAL TRAUMA IS CONSIDERED 

631
00:26:35,674 --> 00:26:39,678
TO BE A SIGNIFICANT SOCIAL 

632
00:26:39,678 --> 00:26:41,546
DETERMINANT OF HEALTH FOR NATIVE

633
00:26:41,546 --> 00:26:43,148
AMERICAN BIRTHING PEOPLE.

634
00:26:43,148 --> 00:26:46,918
PER THE PAPER IT STATED THAT 

635
00:26:46,918 --> 00:26:49,354
HISTORICAL TRAUMA MANIFESTED 

636
00:26:49,354 --> 00:26:50,856
ITSELF IN SUBSEQUENT GENERATIONS

637
00:26:50,856 --> 00:26:54,793
AS CO-MORBIDITIES, SUCH AS 

638
00:26:54,793 --> 00:26:57,229
MENTAL HEALTH ISSUES, 

639
00:26:57,229 --> 00:27:01,166
DEPRESSION, SUBSTANCE USE, 

640
00:27:01,166 --> 00:27:02,434
INTIMATE PARTNER VIOLENCE, 

641
00:27:02,434 --> 00:27:04,803
DIABETES AND OTHER ADVERSITIES 

642
00:27:04,803 --> 00:27:05,671
THAT DAMAGE THE SOCIAL 

643
00:27:05,671 --> 00:27:07,406
DETERMINANTS OF HEALTH.

644
00:27:07,406 --> 00:27:10,609
MY QUESTION WOULD BE TO DR. 

645
00:27:10,609 --> 00:27:10,842
GRAHAM.

646
00:27:10,842 --> 00:27:15,480
AS WE STATED THIS IS A 

647
00:27:15,480 --> 00:27:17,249
COMMUNITY-BASED ISSUE, IT HAS 

648
00:27:17,249 --> 00:27:19,718
HAD A GLOBAL IMPACT, RIGHT?

649
00:27:19,718 --> 00:27:22,154
HOW CAN CLINICAL PROFESSIONALS 

650
00:27:22,154 --> 00:27:28,560
AND DOULAS WORK TOGETHER TO COME

651
00:27:28,560 --> 00:27:31,897
PAT THESE SOCIAL DETERMINANTS 

652
00:27:31,897 --> 00:27:32,464
THAT IMPACT NATIVE AMERICAN 

653
00:27:32,464 --> 00:27:37,169
BIRTHING PEOPLE.

654
00:27:37,169 --> 00:27:42,274
>> I FULLY AGREE WITH
DIRECTOR 

655
00:27:42,274 --> 00:27:42,674
CAMIE GOLDHAMMER.

656
00:27:42,674 --> 00:27:45,677
IT IS ABOUT KNOWING YOUR 

657
00:27:45,677 --> 00:27:47,312
COMMUNITY, KNOWING THESE WOMEN, 

658
00:27:47,312 --> 00:27:48,847
GETTING TO KNOW THEM AS PEOPLE, 

659
00:27:48,847 --> 00:27:51,483
NOT JUST A NUMBER, NOT JUST A 

660
00:27:51,483 --> 00:27:53,352
PATIENT, BUT UNDERSTANDING EVERY

661
00:27:53,352 --> 00:27:55,887
ASPECT OF THEIR LIVES AND 

662
00:27:55,887 --> 00:27:57,089
EVERYTHING THAT IS GOING INTO 

663
00:27:57,089 --> 00:28:07,532
MAKING THEM WHO THEY ARE.

664
00:28:07,933 --> 00:28:10,836
IT IS BUILDING RELATIONSHIPS AND

665
00:28:10,836 --> 00:28:12,371
TRUST, THAT YOU HAVE THE SAME 

666
00:28:12,371 --> 00:28:13,171
GOAL AT HAND.

667
00:28:13,171 --> 00:28:15,841
THAT IS ABSOLUTELY FUNDAMENTALLY

668
00:28:15,841 --> 00:28:17,175
CRITICAL FOR MAKING ANY 

669
00:28:17,175 --> 00:28:17,776
DIFFERENCE, RIGHT?

670
00:28:17,776 --> 00:28:22,481
WE HAVE SEEN THIS HISTORICALLY 

671
00:28:22,481 --> 00:28:23,682
THROUGHOUT THE DECADES THROUGH 

672
00:28:23,682 --> 00:28:27,219
OUR HISTORICAL TRAUMA IN OUR 

673
00:28:27,219 --> 00:28:27,886
NATIVE COMMUNITIES.

674
00:28:27,886 --> 00:28:33,925
THE UTTER LACK OF TRUST BECAUSE 

675
00:28:33,925 --> 00:28:35,894
HOBBLE THINGS HAVE HAPPENED TO 

676
00:28:35,894 --> 00:28:36,795
BIRTHING WOMEN.

677
00:28:36,795 --> 00:28:39,030
WE HAVE THOUSANDS UPON THOUSANDS

678
00:28:39,030 --> 00:28:41,266
OF MISSING INDIGENOUS WOMEN AND 

679
00:28:41,266 --> 00:28:44,202
CHILDREN ACROSS THIS NATION, 

680
00:28:44,202 --> 00:28:46,872
WOMEN THAT ARE INVISIBLE, THAT 

681
00:28:46,872 --> 00:28:52,711
ARE DISAPPEARING AT 

682
00:28:52,711 --> 00:28:53,678
UNPRECEDENTED RATES.

683
00:28:53,678 --> 00:28:54,813
AND NO ONE IS DOING ANYTHING 

684
00:28:54,813 --> 00:28:55,781
ABOUT IT.

685
00:28:55,781 --> 00:28:59,651
WE HAVE WOMEN THAT ARE RAPED AND

686
00:28:59,651 --> 00:29:03,321
MOLESTED AND VICTIMIZED AND NO 

687
00:29:03,321 --> 00:29:12,097
ONE IS DOING ANYTHING ABOUT IT.

688
00:29:12,097 --> 00:29:22,574
WE HAVE TAKEN SYSTEMICALLY, 

689
00:29:23,575 --> 00:29:27,879
SANCTIFIED BY OUR FEDERAL 

690
00:29:27,879 --> 00:29:29,748
GOVERNMENT TAKING FAMILIES FROM 

691
00:29:29,748 --> 00:29:31,616
INDIGENOUS NATIVE LANDS THAT 

692
00:29:31,616 --> 00:29:34,152
WERE FRUITFUL AND THEY CAN 

693
00:29:34,152 --> 00:29:36,087
THRIVE AND GROW AND RELOCATE 

694
00:29:36,087 --> 00:29:37,889
THEM TO BARREN LANDS THEY CAN'T 

695
00:29:37,889 --> 00:29:38,790
GROW ANYTHING ON.

696
00:29:38,790 --> 00:29:41,660
SO I THINK EVEN WHEN WE LOOK 

697
00:29:41,660 --> 00:29:44,329
BACK AT SOME OF THE MEDICAL 

698
00:29:44,329 --> 00:29:46,798
CONDITIONS AT HIGHER RATES IN 

699
00:29:46,798 --> 00:29:49,434
OUR COMMUNITIES, BOTH 

700
00:29:49,434 --> 00:29:50,001
AFRICAN-AMERICAN AND NATIVE 

701
00:29:50,001 --> 00:29:51,870
AMERICANS, IT STEMS FROM ALL 

702
00:29:51,870 --> 00:29:53,572
THOSE THINGS, RIGHT?

703
00:29:53,572 --> 00:29:55,874
OUR BODY'S ABILITY TO PROCESS 

704
00:29:55,874 --> 00:29:59,444
SALT IS DIFFERENT FUNDAMENTALLY,

705
00:29:59,444 --> 00:30:00,345
PHYSIOLOGICALLY, IT IS 

706
00:30:00,345 --> 00:30:00,612
DIFFERENT.

707
00:30:00,612 --> 00:30:02,614
IF THE FOODS WE HAVE ACCESS TO 

708
00:30:02,614 --> 00:30:06,384
AT A CHEAPER RATE ARE HIGH IN 

709
00:30:06,384 --> 00:30:09,654
SALT CONTENT, HIGH IN PROCESSED 

710
00:30:09,654 --> 00:30:11,656
FOODS, HIGH IN ALL OF THESE 

711
00:30:11,656 --> 00:30:14,726
THINGS THEN WE DO NOT THRIVE.

712
00:30:14,726 --> 00:30:17,629
IF WE LOOK AT SUGAR AND 

713
00:30:17,629 --> 00:30:18,663
DIABETES, THOSE THINGS ARE HIGH 

714
00:30:18,663 --> 00:30:21,867
IN OUR COMMUNITY, BUT NOT 

715
00:30:21,867 --> 00:30:24,903
BECAUSE INHERENTLY WE HAVE A 

716
00:30:24,903 --> 00:30:25,136
PROBLEM.

717
00:30:25,136 --> 00:30:31,543
IT STEMS DOWN FROM ALL OF THOSE 

718
00:30:31,543 --> 00:30:33,211
YEARS AND OUR CIRCUMSTANCE.

719
00:30:33,211 --> 00:30:35,680
SAME FOR MENTAL HEALTH, 

720
00:30:35,680 --> 00:30:39,150
DEPRESSION, SUBSTANCE ABUSE.

721
00:30:39,150 --> 00:30:42,254
THESE ARE ALL PRODUCTS OF THE 

722
00:30:42,254 --> 00:30:45,090
SYSTEMIC RACISM, THE HISTORIC 

723
00:30:45,090 --> 00:30:46,458
OPPRESSION AND SITUATIONS THAT 

724
00:30:46,458 --> 00:30:50,195
WE HAVE FOUND OURSELVES IN.

725
00:30:50,195 --> 00:30:51,863
YOU KIND OF NAVIGATE THAT 

726
00:30:51,863 --> 00:30:54,065
FURTHER INTO A VERY COMPLEX 

727
00:30:54,065 --> 00:30:55,467
HEALTH CARE SYSTEM THAT MAKES IT

728
00:30:55,467 --> 00:30:58,503
HARD FOR PATIENTS TO ACCESS 

729
00:30:58,503 --> 00:31:00,639
CARE, HARD FOR THEM TO REALLY 

730
00:31:00,639 --> 00:31:02,140
BUILD RELATIONSHIPS.

731
00:31:02,140 --> 00:31:03,875
YOU KNOW, THEY APPROACH THE 

732
00:31:03,875 --> 00:31:06,845
SYSTEM THEN FROM A PLACE OF 

733
00:31:06,845 --> 00:31:11,616
DISTRUST, MISTRUST, OF 

734
00:31:11,616 --> 00:31:13,451
SKEPTICISM, OF FEAR.

735
00:31:13,451 --> 00:31:15,887
AND TRADITIONALLY I THINK WE ARE

736
00:31:15,887 --> 00:31:19,891
ALSO RAISED AND INGRAINED TO 

737
00:31:19,891 --> 00:31:23,461
KIND OF FLY BELOW THE RADAR, NOT

738
00:31:23,461 --> 00:31:25,564
RUFFLE FEATHERS, NOT ASK 

739
00:31:25,564 --> 00:31:25,830
QUESTIONS.

740
00:31:25,830 --> 00:31:26,031
RIGHT?

741
00:31:26,031 --> 00:31:28,333
SO MANY OF THE PATIENTS I SEE, 

742
00:31:28,333 --> 00:31:31,069
MANY OF THE FAMILIES I 

743
00:31:31,069 --> 00:31:33,772
ENCOUNTER, MANY OF MY OWN 

744
00:31:33,772 --> 00:31:35,473
FAMILY, YOU KNOW, THEY WILL GO 

745
00:31:35,473 --> 00:31:37,976
TO THE DOCTOR'S APPOINTMENT, 

746
00:31:37,976 --> 00:31:39,878
THEY WILL GO TO THE VISITS AND 

747
00:31:39,878 --> 00:31:42,647
WILL BE QUOTE-UNQUOTE COMPLIANT 

748
00:31:42,647 --> 00:31:45,283
WITH CARE BUT THEY HAVE NO IDEA 

749
00:31:45,283 --> 00:31:46,851
WHAT HAPPENED BECAUSE THEY 

750
00:31:46,851 --> 00:31:48,853
WEREN'T ACTIVELY PARTICIPATING.

751
00:31:48,853 --> 00:31:49,721
THEY DIDN'T UNDERSTAND WHAT 

752
00:31:49,721 --> 00:31:49,988
HAPPENED.

753
00:31:49,988 --> 00:31:51,890
THEY DID NOT AT THE END OF THE 

754
00:31:51,890 --> 00:31:54,492
DAY FEEL HEARD.

755
00:31:54,492 --> 00:31:55,760
I'M SURE, YOU KNOW, DIRECTOR 

756
00:31:55,760 --> 00:31:56,928
HUMMINGBIRD WILL SAY THE SAME 

757
00:31:56,928 --> 00:31:58,763
THAT HER PATIENTS COME BACK TO 

758
00:31:58,763 --> 00:32:01,666
HER TO SAY, HEY, WHAT HAPPENED?

759
00:32:01,666 --> 00:32:02,834
IS I DON'T EVEN KNOW.

760
00:32:02,834 --> 00:32:06,638
I SEE IT IN MY ASSOCIATE CIRCLES

761
00:32:06,638 --> 00:32:09,341
AND MY INTERACTIONS IN MY 

762
00:32:09,341 --> 00:32:10,942
COMMUNITY WITH FAMILY MEMBERS, 

763
00:32:10,942 --> 00:32:12,577
FRIENDS, COLLEAGUES, THAT ARE 

764
00:32:12,577 --> 00:32:14,379
JUST LIKE, I WENT TO THE DOCTOR,

765
00:32:14,379 --> 00:32:17,682
I HAD ALL THE VISITS AND I HAVE 

766
00:32:17,682 --> 00:32:19,117
NO IDEA WHAT HAPPENED.

767
00:32:19,117 --> 00:32:22,921
I HAVE NO IDEA WHY THEY ARE 

768
00:32:22,921 --> 00:32:23,688
RECOMMENDING THIS TREATMENT, 

769
00:32:23,688 --> 00:32:27,192
THIS EARLY INDUCTION, THIS 

770
00:32:27,192 --> 00:32:34,633
DELIVERY, THIS CAESAREAN WHICH 

771
00:32:34,633 --> 00:32:36,101
IS CRITICAL TO THEIR CARE AND 

772
00:32:36,101 --> 00:32:37,002
THEY JUST DON'T KNOW.

773
00:32:37,002 --> 00:32:39,871
IT IS NOT BECAUSE THEY ARE 

774
00:32:39,871 --> 00:32:40,171
UNEDUCATED.

775
00:32:40,171 --> 00:32:42,273
IT IS NOT BECAUSE -- WE FAILED 

776
00:32:42,273 --> 00:32:44,609
TO BUILD THE RELATIONSHIPS AND 

777
00:32:44,609 --> 00:32:46,378
WE FAILED TO BUILD THE TRUST 

778
00:32:46,378 --> 00:32:49,114
THAT ALLOWS THEM TO OPEN UP TO 

779
00:32:49,114 --> 00:32:50,048
US AS HEALTH CARE PROFESSIONALS 

780
00:32:50,048 --> 00:32:54,753
TO BE ABLE TO HAVE THAT CORE 

781
00:32:54,753 --> 00:32:55,887
FUNDAMENTAL UNDERSTANDING.

782
00:32:55,887 --> 00:32:58,156
TO HAVE THE IMPACT ON HEALTH 

783
00:32:58,156 --> 00:33:00,792
OUTCOMES THAT WE HOPE TO HAVE.

784
00:33:00,792 --> 00:33:01,993
>> ABSOLUTELY.

785
00:33:01,993 --> 00:33:05,697
ONE OF THE THINGS I WANT TO JUST

786
00:33:05,697 --> 00:33:08,933
POINT IN FACT AS A MIXED RACE 

787
00:33:08,933 --> 00:33:14,472
PERSON WHO IS ALSO A NATIVE 

788
00:33:14,472 --> 00:33:17,709
WOMAN, THE WEATHERING HYPOTHESIS

789
00:33:17,709 --> 00:33:19,878
DOES SUGGEST CUMULATIVE STRESS 

790
00:33:19,878 --> 00:33:24,282
OF RACISM, SOCIOECONOMIC 

791
00:33:24,282 --> 00:33:26,751
DISADVANTAGE DOES PRODUCE 

792
00:33:26,751 --> 00:33:30,155
WEATHERING EFFECT AND EXPLAINS 

793
00:33:30,155 --> 00:33:31,890
DISPARITY OUTCOMES ACROSS LIFE 

794
00:33:31,890 --> 00:33:32,457
SPANS.

795
00:33:32,457 --> 00:33:33,925
THIS HAPPENS NOT JUST IN WOMEN 

796
00:33:33,925 --> 00:33:36,628
AND BIRTHING PERSONS THAT MAY 

797
00:33:36,628 --> 00:33:38,363
NOT HAVE GOTTEN PAST HIGH SCHOOL

798
00:33:38,363 --> 00:33:41,199
EDUCATION, BUT THIS IS FOR 

799
00:33:41,199 --> 00:33:45,403
PROFESSIONALS, PEOPLE WHO HAVE 

800
00:33:45,403 --> 00:33:45,937
MARYL

801
00:33:45,937 --> 00:33:47,639
M.D. AND PH.D.s, PEOPLE AT THE 

802
00:33:47,639 --> 00:33:50,208
PINNACLE OF THEIR FIELDS ARE 

803
00:33:50,208 --> 00:33:52,544
SUFFERING AT THE SAME RATES AS 

804
00:33:52,544 --> 00:33:55,880
THOSE WITHOUT EDUCATION OR THOSE

805
00:33:55,880 --> 00:33:58,016
WITH SOCIOECONOMIC HIGHER 

806
00:33:58,016 --> 00:33:58,283
STANDINGS.

807
00:33:58,283 --> 00:34:00,552
SO IT HAS NOTHING TO DO WITH 

808
00:34:00,552 --> 00:34:01,519
EDUCATION, TO BE CLEAR.

809
00:34:01,519 --> 00:34:05,724
AND ALSO TO BE CLEAR, IT IS MORE

810
00:34:05,724 --> 00:34:08,560
THAN JUST A HISTORICAL CONTEXT.

811
00:34:08,560 --> 00:34:10,662
BECAUSE AS RECENT AS 2021, THE 

812
00:34:10,662 --> 00:34:13,631
FIRST PEOPLE OF CANADA ARE STILL

813
00:34:13,631 --> 00:34:14,833
EXPERIENCING THEIR CHILDREN 

814
00:34:14,833 --> 00:34:15,700
BEING TAKEN FROM THEM.

815
00:34:15,700 --> 00:34:17,702
AND THIS IS A FACT.

816
00:34:17,702 --> 00:34:20,071
THIS IS DOCUMENTED IN WHITE 

817
00:34:20,071 --> 00:34:20,338
PAPERS.

818
00:34:20,338 --> 00:34:23,875
AND SO IT'S NOT JUST AN 

819
00:34:23,875 --> 00:34:25,410
UNFOUNDED FEAR.

820
00:34:25,410 --> 00:34:27,278
THIS IS REALISTICALLY SOMETHING 

821
00:34:27,278 --> 00:34:35,720
THAT STILL TAKES PLACE TODAY.

822
00:34:35,720 --> 00:34:39,090
AND PEOPLE WERE SHIPPED TO 

823
00:34:39,090 --> 00:34:41,726
BOARDING SCHOOLS IN RECENT YEARS

824
00:34:41,726 --> 00:34:45,830
IN A GENERATION WHEN WE ARE 

825
00:34:45,830 --> 00:34:47,465
ALIVE, WE WERE HERE WHEN 

826
00:34:47,465 --> 00:34:50,068
BOARDING SCHOOLS WERE OPEN IN 

827
00:34:50,068 --> 00:34:52,437
THE UNITED STATES.

828
00:34:52,437 --> 00:34:55,406
UNDERSTANDING A HISTORICAL 

829
00:34:55,406 --> 00:34:57,308
CONTEXT HAS VALIDITY BUT 

830
00:34:57,308 --> 00:34:59,043
UNDERSTAND FOOD DESERTS ARE 

831
00:34:59,043 --> 00:35:00,111
INTENTIONAL BECAUSE YOU DON'T 

832
00:35:00,111 --> 00:35:03,248
FIND THEM IN WELL-TO-DO 

833
00:35:03,248 --> 00:35:03,581
NEIGHBORHOODS.

834
00:35:03,581 --> 00:35:04,649
YOU DON'T FIND THEM IN PLACES 

835
00:35:04,649 --> 00:35:09,120
WHERE YOU HAVE A REDUCED NUMBER 

836
00:35:09,120 --> 00:35:11,723
OF NATIVE WOMEN OR WOMEN FROM 

837
00:35:11,723 --> 00:35:15,460
OTHER ETHNIC BACKGROUNDS.

838
00:35:15,460 --> 00:35:18,429
SO SOME OF THESE THINGS CAN BE 

839
00:35:18,429 --> 00:35:19,864
ADDRESSED WITH THE SAME 

840
00:35:19,864 --> 00:35:23,468
INTENTIONALITY AS THE SYSTEMIC 

841
00:35:23,468 --> 00:35:26,805
PROCESSES THAT OPPRESS WOMEN OF 

842
00:35:26,805 --> 00:35:28,740
COLOR AND BIRTHING PEOPLE OF 

843
00:35:28,740 --> 00:35:32,911
COLOR OR PEOPLE IN GENERAL THAT 

844
00:35:32,911 --> 00:35:35,713
ARE NOT FROM THE DOMINANT 

845
00:35:35,713 --> 00:35:36,981
CULTURE ACROSS THE GLOBE.

846
00:35:36,981 --> 00:35:40,785
WE CAN DO THINGS TO PREVENT IT.

847
00:35:40,785 --> 00:35:43,588
THAT 80% PREVENTIBLE IS AN 

848
00:35:43,588 --> 00:35:44,889
ATTAINABLE GOAL.

849
00:35:44,889 --> 00:35:47,692
SOMETHING THAT WE NEED TO 

850
00:35:47,692 --> 00:35:51,629
STRONGLY CONSIDER.

851
00:35:51,629 --> 00:35:53,464
AT THIS POINT I WANT TO SEE IF 

852
00:35:53,464 --> 00:35:54,599
THERE ARE ANY QUESTIONS THAT 

853
00:35:54,599 --> 00:35:59,404
HAVE BEEN PRESENTED IN THE CHAT.

854
00:35:59,404 --> 00:36:00,805
>> WHILE WE ARE LOOKING AT

855
00:36:00,805 --> 00:36:02,574
QUESTIONS OR WAITING FOR 

856
00:36:02,574 --> 00:36:08,613
QUESTIONS I DO WANT TO SAY ALSO,

857
00:36:08,613 --> 00:36:11,883
CLARISSA, JUST I GUESS ADD ON TO

858
00:36:11,883 --> 00:36:14,886
WHAT YOU SAID AROUND INCOME AND 

859
00:36:14,886 --> 00:36:19,757
EDUCATION BECAUSE I THINK THAT'S

860
00:36:19,757 --> 00:36:21,459
REALLY COMMON MAYBE, I'M NOT 

861
00:36:21,459 --> 00:36:23,194
FULLY SURE ABOUT THE FULL 

862
00:36:23,194 --> 00:36:25,163
AUDIENCE HERE, BUT I THINK IN 

863
00:36:25,163 --> 00:36:27,165
THE GENERAL POPULATION, I SAY 

864
00:36:27,165 --> 00:36:29,367
OUT ON THE STREETS A LOT OF 

865
00:36:29,367 --> 00:36:31,536
PEOPLE WOULD MUCH RATHER TALK 

866
00:36:31,536 --> 00:36:33,004
ABOUT THINGS LIKE POVERTY OR 

867
00:36:33,004 --> 00:36:36,641
LACK OF EDUCATION THAN RACE.

868
00:36:36,641 --> 00:36:36,841
RIGHT?

869
00:36:36,841 --> 00:36:39,878
AND THAT'S OFTEN BROUGHT UP AS 

870
00:36:39,878 --> 00:36:41,279
WELL, IT IS POVERTY THAT IS 

871
00:36:41,279 --> 00:36:41,746
CAUSING THIS.

872
00:36:41,746 --> 00:36:43,314
IT IS LACK OF EDUCATION THAT IS 

873
00:36:43,314 --> 00:36:43,882
CAUSING THIS.

874
00:36:43,882 --> 00:36:44,616
NO, IT'S NOT.

875
00:36:44,616 --> 00:36:46,117
IT'S RACE.

876
00:36:46,117 --> 00:36:52,490
OR RACISM.

877
00:36:52,490 --> 00:36:53,157
RIGHT?

878
00:36:53,157 --> 00:36:54,692
THERE IS NOTHING INHERENT ABOUT 

879
00:36:54,692 --> 00:36:56,427
US THAT MAKES US AT RISK.

880
00:36:56,427 --> 00:36:57,962
IT IS THE WEATHERING, THE 

881
00:36:57,962 --> 00:37:01,966
SOCIETY WE ARE LIVING IN THAT 

882
00:37:01,966 --> 00:37:04,769
HAS QUITE FRANKLY BEEN BUILT FOR

883
00:37:04,769 --> 00:37:07,772
US NOT TO BE HERE, RIGHT?

884
00:37:07,772 --> 00:37:09,540
AND I THINK THAT IS SOMETHING 

885
00:37:09,540 --> 00:37:11,876
THAT IS REALLY IMPORTANT TO 

886
00:37:11,876 --> 00:37:14,212
ADDRESS THAT THERE IS NO 

887
00:37:14,212 --> 00:37:16,314
PROTECTIVE FACTORS WHEN IT COMES

888
00:37:16,314 --> 00:37:19,884
TO MATERNAL MORTALITY WITH 

889
00:37:19,884 --> 00:37:25,857
INCOME AND EDUCATION AND SO AT 

890
00:37:25,857 --> 00:37:28,593
MY ORGANIZATION, WE ARE A SOCIAL

891
00:37:28,593 --> 00:37:29,694
SERVICE AGENCY BUT WE SERVE 

892
00:37:29,694 --> 00:37:31,229
PEOPLE REGARDLESS OF THEIR 

893
00:37:31,229 --> 00:37:32,063
INCOME.

894
00:37:32,063 --> 00:37:33,264
WE KNOW A NATIVE MOM IN 

895
00:37:33,264 --> 00:37:35,166
WASHINGTON STATE WHO IS A LAWYER

896
00:37:35,166 --> 00:37:37,368
OR A DOCTOR, WHICH WE HAVE 

897
00:37:37,368 --> 00:37:41,506
SERVED, RIGHT, IS NOT ANY SAFER 

898
00:37:41,506 --> 00:37:45,543
THAN A HOMELESS NATIVE MOM WHO 

899
00:37:45,543 --> 00:37:51,883
HAS ACCESS TO VERY FEW 

900
00:37:51,883 --> 00:37:52,517
RESOURCES.

901
00:37:52,517 --> 00:37:54,052
AND THAT IS FACT.

902
00:37:54,052 --> 00:37:55,887
IT IS WHAT WE SEE AND WHAT THE 

903
00:37:55,887 --> 00:37:59,123
RESEARCH BACKS UP.

904
00:37:59,123 --> 00:38:00,925
AGAIN, IT IS REALLY IMPORTANT 

905
00:38:00,925 --> 00:38:02,994
FOR FOLKS TO UNDERSTAND THAT 

906
00:38:02,994 --> 00:38:05,263
BECAUSE IT IS OFTEN USED AS A 

907
00:38:05,263 --> 00:38:07,699
WAY TO NOT TALK ABOUT RACE, 

908
00:38:07,699 --> 00:38:07,899
RIGHT?

909
00:38:07,899 --> 00:38:08,599
>> YEAH.

910
00:38:08,599 --> 00:38:12,403
>> TALK ABOUT POVERTY OR
LACK OF

911
00:38:12,403 --> 00:38:12,670
EDUCATION.

912
00:38:12,670 --> 00:38:17,075
IT IS NOT -- IT OFFERS NO 

913
00:38:17,075 --> 00:38:19,877
PROTECTIONS FOR DR. GRAHAM OR I,

914
00:38:19,877 --> 00:38:23,614
WHO HAVE GRADUATE DEGREES, 

915
00:38:23,614 --> 00:38:24,048
RIGHT?

916
00:38:24,048 --> 00:38:26,050
ALL THE KNOWLEDGE, ALL THE 

917
00:38:26,050 --> 00:38:27,952
EXPERIENCE, RIGHT, AND WE'RE 

918
00:38:27,952 --> 00:38:30,822
STILL, IF WE WERE TO HAVE BABIES

919
00:38:30,822 --> 00:38:32,957
TODAY IT WOULD STILL BE AT RISK 

920
00:38:32,957 --> 00:38:35,426
AS ANY OF OUR COUNTERPARTS, 

921
00:38:35,426 --> 00:38:35,626
RIGHT?

922
00:38:35,626 --> 00:38:36,894
>> ABSOLUTELY.

923
00:38:36,894 --> 00:38:38,329
SOME OF THE THINGS THAT HAVE 

924
00:38:38,329 --> 00:38:41,499
BEEN NOTED, I CAN READ IT OFF.

925
00:38:41,499 --> 00:38:43,835
SOCIAL DETERMINANTS ARE CITED AS

926
00:38:43,835 --> 00:38:45,770
CAUSES OF POOR PRENATAL 

927
00:38:45,770 --> 00:38:46,204
OUTCOMES.

928
00:38:46,204 --> 00:38:48,806
AS YOU STATED AS POVERTY, LACK 

929
00:38:48,806 --> 00:38:51,109
OF EDUCATION AND THE 

930
00:38:51,109 --> 00:38:52,777
NEIGHBORHOOD LEVEL FACTORS 

931
00:38:52,777 --> 00:38:54,746
AFFECT THE MATERNAL OUTCOME.

932
00:38:54,746 --> 00:38:57,348
I WOULD LIKE YOU BOTH TO ANSWER 

933
00:38:57,348 --> 00:39:01,753
TO SOME FACTORS UNIQUE TO NATIVE

934
00:39:01,753 --> 00:39:03,154
AMERICAN COMMUNITIES AT THE 

935
00:39:03,154 --> 00:39:05,556
NEIGHBORHOOD LEVEL IN RURAL 

936
00:39:05,556 --> 00:39:07,859
AREAS, WHAT WE WOULD COMMONLY 

937
00:39:07,859 --> 00:39:11,062
CALL INDIAN COUNTRY AND URBAN 

938
00:39:11,062 --> 00:39:15,867
AREAS THAT NEGATIVELY IMPACT 

939
00:39:15,867 --> 00:39:18,136
NATIVE BIRTHING PEOPLES' ACCESS 

940
00:39:18,136 --> 00:39:19,871
TO QUALITY HEALTH CARE BASED ON 

941
00:39:19,871 --> 00:39:25,043
THEIR LOCATION?

942
00:39:25,043 --> 00:39:25,810
DR. GRAHAM?

943
00:39:25,810 --> 00:39:28,046
>> SO THOSE ARE TWO UNIQUE

944
00:39:28,046 --> 00:39:33,518
DIFFERENT CIRCUMSTANCES, RIGHT?

945
00:39:33,518 --> 00:39:35,219
AND BOTH INSTANCES SERVE 

946
00:39:35,219 --> 00:39:37,755
DIFFERENT CHALLENGES THAT ARE 

947
00:39:37,755 --> 00:39:37,989
UNIQUE.

948
00:39:37,989 --> 00:39:42,860
HERE IN DELAWARE THE NANAKOKE 

949
00:39:42,860 --> 00:39:45,897
TRIBE I'M A PART OF, THAT I 

950
00:39:45,897 --> 00:39:48,132
MOVED BACK HOME TO SERVE, WE ARE

951
00:39:48,132 --> 00:39:49,934
URBAN, WE HAVE INTEGRATED INTO 

952
00:39:49,934 --> 00:39:50,568
THE COMMUNITY.

953
00:39:50,568 --> 00:39:52,603
WE STILL MAINTAIN OUR UNIQUE 

954
00:39:52,603 --> 00:39:55,273
TRIBAL CUSTOMS AND TRADITIONS, 

955
00:39:55,273 --> 00:40:02,346
BUT FOR THE MOST PART MANY 

956
00:40:02,346 --> 00:40:03,147
PEOPLE THROUGHOUT THE STATE CAN 

957
00:40:03,147 --> 00:40:05,616
WALK BY ALL OF US AND NOT KNOW 

958
00:40:05,616 --> 00:40:11,722
ANY OF US ARE HERE.

959
00:40:11,722 --> 00:40:13,591
THAT WILLFUL BLIND IGNORANCE, IF

960
00:40:13,591 --> 00:40:15,359
YOU WILL, TO AN ENTIRE EXISTENCE

961
00:40:15,359 --> 00:40:19,864
OF PEOPLE THAT SERVES AS THE 

962
00:40:19,864 --> 00:40:30,308
FOUNDATION OF OPPRESSION.

963
00:40:30,842 --> 00:40:33,144
WE DON'T SEE PEOPLE FOR WHO THEY

964
00:40:33,144 --> 00:40:33,611
ARE.

965
00:40:33,611 --> 00:40:35,713
THERE ARE PEOPLE WHO ARE 

966
00:40:35,713 --> 00:40:37,348
ADVOCATING COLOR BLINDNESS AND 

967
00:40:37,348 --> 00:40:39,417
EQUALITY FOR ALL AND NOT 

968
00:40:39,417 --> 00:40:40,318
IDENTIFYING RACE AT ALL.

969
00:40:40,318 --> 00:40:42,120
I THINK THAT IS A HUGE 

970
00:40:42,120 --> 00:40:47,725
DISSERVICE.

971
00:40:47,725 --> 00:40:51,762
WE ARE UNIQUE IN OUR CUSTOMS AND

972
00:40:51,762 --> 00:40:54,365
TRADITIONS, EVEN AMONG INDIAN 

973
00:40:54,365 --> 00:40:56,801
COUNTRY, EACH TRIBE, SUBGROUP, 

974
00:40:56,801 --> 00:40:58,503
SUB FAMILIES WITHIN TRIBES WE 

975
00:40:58,503 --> 00:41:00,638
HAVE DIFFERENT THINGS THAT ARE 

976
00:41:00,638 --> 00:41:02,039
UNIQUE TO EACH OF US THAT MAKE 

977
00:41:02,039 --> 00:41:03,875
US ALL AMAZING.

978
00:41:03,875 --> 00:41:05,409
WE HAVE TO HONOR AND RECOGNIZE 

979
00:41:05,409 --> 00:41:07,845
EACH AND EVERY ONE OF THOSE 

980
00:41:07,845 --> 00:41:08,079
FACETS.

981
00:41:08,079 --> 00:41:09,947
IN ORDER TO TRULY SERVE THE 

982
00:41:09,947 --> 00:41:18,656
WHOLE PERSON AND TO PROVIDE 

983
00:41:18,656 --> 00:41:19,557
COMPREHENSIVE FULL CARE.

984
00:41:19,557 --> 00:41:23,461
AND THAT IS UNIQUELY DIFFERENT 

985
00:41:23,461 --> 00:41:24,795
THAN ACCESS ISSUES OR OTHER 

986
00:41:24,795 --> 00:41:27,865
ISSUES THAT PEOPLE WHO ARE 

987
00:41:27,865 --> 00:41:31,903
LIVING ON RESERVATIONS OR 

988
00:41:31,903 --> 00:41:35,706
RESERVATION ADJACENT ENCOUNTER.

989
00:41:35,706 --> 00:41:39,343
>> YOUR THOUGHTS AS WELL, 

990
00:41:39,343 --> 00:41:41,712
DIRECTOR GOLDHAMMER.

991
00:41:41,712 --> 00:41:43,481
>> YEAH.

992
00:41:43,481 --> 00:41:45,416
I THINK THERE ARE SO MANY 

993
00:41:45,416 --> 00:41:47,218
CHALLENGES THAT ARE BEING FACED 

994
00:41:47,218 --> 00:41:50,988
THROUGHOUT, YEAH, AS YOU SAID, 

995
00:41:50,988 --> 00:41:54,358
AS WE SAY INDIAN COUNTRY.

996
00:41:54,358 --> 00:41:55,893
DEFINITELY WOULD ECHO WHAT DR. 

997
00:41:55,893 --> 00:41:58,129
GRAHAM SAID AROUND JUST THE 

998
00:41:58,129 --> 00:41:59,564
INVISIBILITY THAT WE EXPERIENCE 

999
00:41:59,564 --> 00:42:02,266
IN URBAN COMMUNITIES 

1000
00:42:02,266 --> 00:42:03,301
SPECIFICALLY, RIGHT?

1001
00:42:03,301 --> 00:42:07,638
ABOUT 75% OF NATIVE PEOPLE LIVE 

1002
00:42:07,638 --> 00:42:09,440
IN, YOU KNOW, OUTSIDE OF RURAL 

1003
00:42:09,440 --> 00:42:10,174
COMMUNITIES.

1004
00:42:10,174 --> 00:42:11,475
OFF RESERVATION.

1005
00:42:11,475 --> 00:42:13,411
A LOT OF PEOPLE THAT LIVE CLOSE 

1006
00:42:13,411 --> 00:42:16,447
TO THE RESERVATION, BUT LARGELY 

1007
00:42:16,447 --> 00:42:18,616
IN URBAN AND SUBURBAN AREAS.

1008
00:42:18,616 --> 00:42:20,518
AND SO THAT INVISIBILITY PIECE 

1009
00:42:20,518 --> 00:42:23,387
IS REALLY, REALLY BIG OF JUST 

1010
00:42:23,387 --> 00:42:25,356
NOT BEING SEEN, NOT BEING 

1011
00:42:25,356 --> 00:42:27,858
RECOGNIZED.

1012
00:42:27,858 --> 00:42:29,827
A LOT OF PEOPLE HAVE STEREOTYPES

1013
00:42:29,827 --> 00:42:31,696
OF WHAT THEY THINK A NATIVE 

1014
00:42:31,696 --> 00:42:33,998
PERSON SHOULD LOOK LIKE, SHOULD 

1015
00:42:33,998 --> 00:42:37,034
ACT LIKE SO IF SOMEONE COMES IN 

1016
00:42:37,034 --> 00:42:38,336
WHO DOESN'T MEET THAT STEREOTYPE

1017
00:42:38,336 --> 00:42:40,171
THEY ARE NOT SEEN AS A NATIVE 

1018
00:42:40,171 --> 00:42:41,772
PERSON, RIGHT, AND NOT CARED FOR

1019
00:42:41,772 --> 00:42:43,274
IN THAT WAY.

1020
00:42:43,274 --> 00:42:47,778
SOME OF THE OTHER THINGS THAT WE

1021
00:42:47,778 --> 00:42:50,348
SEE SPECIFICALLY, AND I CAN 

1022
00:42:50,348 --> 00:42:51,949
SPEAK TO TRIBAL COMMUNITIES.

1023
00:42:51,949 --> 00:42:55,886
THE INDIAN HEALTH SERVICE IS 

1024
00:42:55,886 --> 00:42:58,990
SEVERELY UNDERFUNDED, HAS NEVER 

1025
00:42:58,990 --> 00:43:02,426
BEEN, YOU KNOW, OUR TREATIES 

1026
00:43:02,426 --> 00:43:05,329
THAT GAVE US ACCESS TO HEALTH 

1027
00:43:05,329 --> 00:43:07,698
CARE, EDUCATION, AND WHAT NOT 

1028
00:43:07,698 --> 00:43:11,002
HAVE NEVER BEEN FULFILLED.

1029
00:43:11,002 --> 00:43:14,338
THE INDIAN HEALTH SERVICES IS 

1030
00:43:14,338 --> 00:43:16,173
CONSISTENTLY UNDERFUNDED BY THE 

1031
00:43:16,173 --> 00:43:17,208
FEDERAL GOVERNMENT, HAS NEVER 

1032
00:43:17,208 --> 00:43:19,777
BEEN FULLY FUNDED, RIGHT?

1033
00:43:19,777 --> 00:43:22,546
AND WITHIN THAT, WE KNOW THAT 

1034
00:43:22,546 --> 00:43:24,749
MATERNITY CARE IS ALSO REALLY 

1035
00:43:24,749 --> 00:43:27,118
UNDERFUNDED WITHIN IN IHS SYSTEM

1036
00:43:27,118 --> 00:43:28,419
BECAUSE THERE ARE SO MANY OTHER 

1037
00:43:28,419 --> 00:43:29,553
FIRES GOING ON, RIGHT?

1038
00:43:29,553 --> 00:43:34,158
SO IT IS ONE OF THE AREAS OF 

1039
00:43:34,158 --> 00:43:35,793
PRACTICE THAT HAVE LARGELY BEEN 

1040
00:43:35,793 --> 00:43:38,696
ABANDONED BY IHS.

1041
00:43:38,696 --> 00:43:43,901
SO MOST OF OUR NATIVE FAMILIES 

1042
00:43:43,901 --> 00:43:46,537
ARE GOING TO THEIR TRIBAL CLINIC

1043
00:43:46,537 --> 00:43:47,772
FOR THEIR PREGNANCY TEST AND 

1044
00:43:47,772 --> 00:43:49,807
THEY ARE SENT AWAY UNTIL AFTER 

1045
00:43:49,807 --> 00:43:51,876
THEIR BABY COMES, YOU KNOW, IS 

1046
00:43:51,876 --> 00:43:57,548
DELIVERED.

1047
00:43:57,548 --> 00:44:01,218
THEY ARE SENT TO BORDER TOWNS OR

1048
00:44:01,218 --> 00:44:03,888
AREAS THAT ARE THE MOST 

1049
00:44:03,888 --> 00:44:05,823
DANGEROUS OR RACIST OR UNSAFE 

1050
00:44:05,823 --> 00:44:07,892
PLACES FOR NATIVE PEOPLE TO BE 

1051
00:44:07,892 --> 00:44:08,626
IN.

1052
00:44:08,626 --> 00:44:11,329
THERE'S A LOT OF HISTORY THERE 

1053
00:44:11,329 --> 00:44:12,563
BETWEEN RESERVATIONS AND BORDER 

1054
00:44:12,563 --> 00:44:14,131
TOWNS AND THAT IS WHERE WE ARE 

1055
00:44:14,131 --> 00:44:17,134
SENDING OUR NATIVE MOMS TO BE 

1056
00:44:17,134 --> 00:44:18,569
CARED FOR, RIGHT?

1057
00:44:18,569 --> 00:44:21,339
BY THE PEOPLE IN THOSE 

1058
00:44:21,339 --> 00:44:21,639
COMMUNITIES.

1059
00:44:21,639 --> 00:44:27,912
AND SO THE TRAUMA THAT OUR MAMAS

1060
00:44:27,912 --> 00:44:30,147
ARE EXPERIENCE IS REALLY A HUGE,

1061
00:44:30,147 --> 00:44:33,451
I THINK A CONTRIBUTING FACTOR TO

1062
00:44:33,451 --> 00:44:33,651
THIS.

1063
00:44:33,651 --> 00:44:37,688
JUST NOT BEING ABLE TO ACCESS 

1064
00:44:37,688 --> 00:44:41,158
HIGH QUALITY, LOVING, SAFE 

1065
00:44:41,158 --> 00:44:47,765
MATERNITY CARE IN OUR HOME 

1066
00:44:47,765 --> 00:44:51,869
COMMUNITIES IS -- IS A LOSS THAT

1067
00:44:51,869 --> 00:44:54,105
CAN MAKE ME CRY WHEN WE THINK 

1068
00:44:54,105 --> 00:44:55,740
ABOUT IT AND WHEN WE THINK ABOUT

1069
00:44:55,740 --> 00:44:57,308
OUR CULTURE AND WHAT IT MEANS, 

1070
00:44:57,308 --> 00:45:01,212
WHAT IT MEANS FOR ME AS A DAKOTA

1071
00:45:01,212 --> 00:45:03,414
WOMAN, I CAN'T EVEN IMAGINE WHAT

1072
00:45:03,414 --> 00:45:05,816
IT WOULD BE LIKE TO DELIVER A 

1073
00:45:05,816 --> 00:45:09,420
BABY IN THE BLACK HILLS, IN OUR 

1074
00:45:09,420 --> 00:45:11,789
TRIBAL LANDS WHERE OUR BABIES 

1075
00:45:11,789 --> 00:45:15,359
ARE SUPPOSED TO BE BORN, RIGHT?

1076
00:45:15,359 --> 00:45:17,061
THAT TIES THEM TO THEIR LAND AND

1077
00:45:17,061 --> 00:45:18,529
STORIES AS DAKOTA PEOPLE.

1078
00:45:18,529 --> 00:45:21,098
WHEN WE ARE REMOVED FROM THAT OR

1079
00:45:21,098 --> 00:45:22,533
HAVE TO LEAVE OUR HOMELAND, 

1080
00:45:22,533 --> 00:45:24,802
THERE IS SO MUCH THAT IS LOST, 

1081
00:45:24,802 --> 00:45:25,002
RIGHT?

1082
00:45:25,002 --> 00:45:30,374
SO MUCH THAT IS LOST IN THAT.

1083
00:45:30,374 --> 00:45:31,909
WITHIN THE INDIAN HEALTH SERVICE

1084
00:45:31,909 --> 00:45:34,278
THERE USED TO BE ABOUT 13 

1085
00:45:34,278 --> 00:45:36,781
HOSPITALS THAT DELIVERED BABIES 

1086
00:45:36,781 --> 00:45:39,884
IN THE INDIAN HEALTH SERVICES.

1087
00:45:39,884 --> 00:45:43,120
HALF OF THOSE WERE IN NAVAJO 

1088
00:45:43,120 --> 00:45:43,354
NATION.

1089
00:45:43,354 --> 00:45:44,488
SEVERAL HAVE CLOSED WITHIN THE 

1090
00:45:44,488 --> 00:45:46,590
LAST FEW YEARS SO I THINK WE ARE

1091
00:45:46,590 --> 00:45:48,125
DOWN TO NINE OR 10.

1092
00:45:48,125 --> 00:45:50,261
AND THAT IS JUST, YEAH, REALLY 

1093
00:45:50,261 --> 00:45:51,562
HIGHLY PROBLEMATIC.

1094
00:45:51,562 --> 00:45:56,734
WE HAVE NATIVE MOMS TRAVELING 

1095
00:45:56,734 --> 00:45:58,536
HOURS FOR HEALTH CARE.

1096
00:45:58,536 --> 00:46:01,372
AND THAT HEALTH CARE THEY ARE 

1097
00:46:01,372 --> 00:46:02,239
RECEIVING IS SUB PAR.

1098
00:46:02,239 --> 00:46:05,109
I JUST WANT TO ADDRESS LIKE 

1099
00:46:05,109 --> 00:46:08,245
ANOTHER ELEPHANT IN THE ROOM, 

1100
00:46:08,245 --> 00:46:11,148
TOO, IS WE HAVE SOME JUST 

1101
00:46:11,148 --> 00:46:13,651
REALLY, REALLY INCREDIBLE 

1102
00:46:13,651 --> 00:46:15,152
PROVIDERS THAT SERVE RURAL 

1103
00:46:15,152 --> 00:46:16,987
COMMUNITIES THAT ARE VERY 

1104
00:46:16,987 --> 00:46:22,526
COMMITTED TO SERVING RURAL 

1105
00:46:22,526 --> 00:46:23,694
COMMUNITIES AND ALSO THAT IS 

1106
00:46:23,694 --> 00:46:25,463
WHERE WE MAY NOT HAVE THE 

1107
00:46:25,463 --> 00:46:29,867
HIGHEST QUALITY PROVIDERS, TOO, 

1108
00:46:29,867 --> 00:46:31,068
RIGHT?

1109
00:46:31,068 --> 00:46:33,103
AND WE'VE -- WITHIN INDIAN 

1110
00:46:33,103 --> 00:46:34,572
COUNTRY WE'VE SEEN THAT.

1111
00:46:34,572 --> 00:46:37,842
WE SAW THAT WITH BOARDING 

1112
00:46:37,842 --> 00:46:38,442
SCHOOLS.

1113
00:46:38,442 --> 00:46:40,478
THE MOST TROUBLING PRIESTS WERE 

1114
00:46:40,478 --> 00:46:42,146
THE ONES WHO WERE SENT TO INDIAN

1115
00:46:42,146 --> 00:46:44,281
COUNTRY TO WORK WITH A 

1116
00:46:44,281 --> 00:46:45,149
POPULATION THAT COULDN'T SPEAK 

1117
00:46:45,149 --> 00:46:48,586
UP FOR THEMSELVES, THAT HAD NO 

1118
00:46:48,586 --> 00:46:49,019
VOICE.

1119
00:46:49,019 --> 00:46:50,421
UNFORTUNATELY, WE SEE SOME OF 

1120
00:46:50,421 --> 00:46:51,956
THAT WITHIN THE HEALTH CARE 

1121
00:46:51,956 --> 00:46:52,189
SYSTEM.

1122
00:46:52,189 --> 00:46:55,559
I JUST WANT TO ACKNOWLEDGE, IT 

1123
00:46:55,559 --> 00:46:56,227
IS NOT EVERYBODY.

1124
00:46:56,227 --> 00:46:58,762
I HAVE MET SOME OF THE MOST 

1125
00:46:58,762 --> 00:47:01,165
INCREDIBLE PROVIDERS THAT HAVE 

1126
00:47:01,165 --> 00:47:02,800
REALLY COMMITTED TO SERVING 

1127
00:47:02,800 --> 00:47:07,838
NATIVE PEOPLE FROM INSIDE AND 

1128
00:47:07,838 --> 00:47:08,606
OUTSIDE THE COMMUNITY.

1129
00:47:08,606 --> 00:47:11,509
AND ALSO THERE ARE A LOT OF 

1130
00:47:11,509 --> 00:47:12,943
PROVIDERS THAT JUST AREN'T THAT 

1131
00:47:12,943 --> 00:47:15,880
GOLD STANDARD OF CARE THAT WE 

1132
00:47:15,880 --> 00:47:16,547
DESERVE.

1133
00:47:16,547 --> 00:47:19,583
THAT WE DESERVE AS NATIVE 

1134
00:47:19,583 --> 00:47:19,817
PEOPLE.

1135
00:47:19,817 --> 00:47:21,819
>> EVERYONE DESERVES THE
RIGHT 

1136
00:47:21,819 --> 00:47:22,753
TO PROPER HEALTH CARE AND 

1137
00:47:22,753 --> 00:47:24,455
ACCESS, BUT IT IS A KNOWN FACT 

1138
00:47:24,455 --> 00:47:26,390
THAT IS NOT ALWAYS THE CASE, 

1139
00:47:26,390 --> 00:47:27,892
EVEN THOUGH THAT IS A PRINCIPLE,

1140
00:47:27,892 --> 00:47:30,828
IT IS NOT A PRINCIPLE THAT IS 

1141
00:47:30,828 --> 00:47:31,061
APPLIED.

1142
00:47:31,061 --> 00:47:35,633
ONE OF THE FACTORS THAT PLAYS 

1143
00:47:35,633 --> 00:47:38,702
INTO THIS IS, YOU KNOW, 

1144
00:47:38,702 --> 00:47:40,371
PERCEPTION BECOMES THE 

1145
00:47:40,371 --> 00:47:41,872
INDIVIDUAL'S REALITY.

1146
00:47:41,872 --> 00:47:47,878
THESE IMPLICIT BIASES DO PLAY A 

1147
00:47:47,878 --> 00:47:50,781
FACTOR IN HOW CARE IS OFFERED.

1148
00:47:50,781 --> 00:47:52,750
SO SOME THINGS MAY TAKE 

1149
00:47:52,750 --> 00:47:53,884
SELF-REFLECTION AND DIFFERENT 

1150
00:47:53,884 --> 00:47:57,888
TRAINING MODULES WITHIN MEDICAL 

1151
00:47:57,888 --> 00:48:00,457
SCHOOLS, WITHIN BIRTHING WORKER 

1152
00:48:00,457 --> 00:48:02,159
PRACTICES, REGULARLY INTEGRATED.

1153
00:48:02,159 --> 00:48:04,028
BUT IT IS GOING TO TAKE A STEP 

1154
00:48:04,028 --> 00:48:05,863
FURTHER FOR THAT TO CONTINUE TO 

1155
00:48:05,863 --> 00:48:10,267
BE IMPLEMENTED.

1156
00:48:10,267 --> 00:48:12,369
THE QUESTIONS ARE WITH THE 

1157
00:48:12,369 --> 00:48:14,805
INADEQUATE NUMBER OF PROVIDERS 

1158
00:48:14,805 --> 00:48:17,341
AND DWINDLING NUMBER OF 

1159
00:48:17,341 --> 00:48:18,943
HOSPITALS AS A RESULT THESE 

1160
00:48:18,943 --> 00:48:21,178
FACILITIES ARE AGING OUT OF THE 

1161
00:48:21,178 --> 00:48:21,946
SYSTEM, RIGHT?

1162
00:48:21,946 --> 00:48:23,247
THAT IS WHY THEY ARE BEING 

1163
00:48:23,247 --> 00:48:25,983
CLOSED AND IT IS AFFECTING 

1164
00:48:25,983 --> 00:48:27,017
PREGNANCY OUTCOMES.

1165
00:48:27,017 --> 00:48:28,886
WHAT ARE YOUR THOUGHTS ON HOW 

1166
00:48:28,886 --> 00:48:32,756
THIS IS IMPACTING INADEQUATE 

1167
00:48:32,756 --> 00:48:33,290
PRENATAL CARE?

1168
00:48:33,290 --> 00:48:35,859
ONE OF THE FACTORS IS RESEARCH 

1169
00:48:35,859 --> 00:48:38,462
SHOWS THAT IF YOU HAVE PROVIDERS

1170
00:48:38,462 --> 00:48:41,865
THAT FEEL THEY LOOK LIKE YOU OR 

1171
00:48:41,865 --> 00:48:44,735
CULTURALLY AWARE OF WHAT IS 

1172
00:48:44,735 --> 00:48:47,838
APPROPRIATE AND WHAT MAY BE 

1173
00:48:47,838 --> 00:48:50,774
CONSIDERED INAPPROPRIATE OR RUDE

1174
00:48:50,774 --> 00:48:54,311
OR OFFENSIVE, YOU'RE MORE LIKELY

1175
00:48:54,311 --> 00:48:59,883
TO BUILD A RAPPORT WITH THOSE 

1176
00:48:59,883 --> 00:49:02,386
PATIENTS.

1177
00:49:02,386 --> 00:49:04,321
AND THE FACT IS NATIVE AMERICAN 

1178
00:49:04,321 --> 00:49:06,757
PEOPLE ARE NOT ALWAYS IN REGALIA

1179
00:49:06,757 --> 00:49:09,026
IN THE CONCEPT OF WHAT THEY 

1180
00:49:09,026 --> 00:49:12,062
THINK A NATIVE PERSON LOOKS LIKE

1181
00:49:12,062 --> 00:49:14,031
MAY BE VERY FARFETCHED FROM THE 

1182
00:49:14,031 --> 00:49:14,231
TRUTH.

1183
00:49:14,231 --> 00:49:16,467
OUR FACES ALL LOOK DIFFERENT.

1184
00:49:16,467 --> 00:49:18,268
YOU CAN'T JUST HAVE ONE STAMP 

1185
00:49:18,268 --> 00:49:20,704
AND SAY THAT IS WHAT A NATIVE 

1186
00:49:20,704 --> 00:49:23,040
PERSON IS OR LOOKS LIKE BECAUSE 

1187
00:49:23,040 --> 00:49:26,543
EVERY INDIVIDUAL IS UNIQUE, DOWN

1188
00:49:26,543 --> 00:49:31,882
TO THEIR BASIC GENETIC MAKEUP.

1189
00:49:31,882 --> 00:49:34,151
EVERYONE IS UNIQUE.

1190
00:49:34,151 --> 00:49:36,587
EVEN IN THE CASE OF IDENTICAL 

1191
00:49:36,587 --> 00:49:40,491
TWINS WHO SHARE THE SAME GENETIC

1192
00:49:40,491 --> 00:49:41,892
MAKEUP, THEY HAVE THEIR 

1193
00:49:41,892 --> 00:49:42,660
DIFFERENCES.

1194
00:49:42,660 --> 00:49:47,698
THERE ARE 574 TRIBES THAT ARE 

1195
00:49:47,698 --> 00:49:49,199
FEDERALLY RECOGNIZED, BUT 

1196
00:49:49,199 --> 00:49:50,334
COUNTLESS TRIBES THAT ARE NOT 

1197
00:49:50,334 --> 00:49:50,834
FEDERALLY RECOGNIZED.

1198
00:49:50,834 --> 00:49:53,337
THERE ARE TRIBES THAT ARE NOT 

1199
00:49:53,337 --> 00:49:54,538
STATE RECOGNIZED.

1200
00:49:54,538 --> 00:49:55,639
THEY ARE STRUGGLING.

1201
00:49:55,639 --> 00:49:58,042
AT THE END OF THE DAY WE ARE ALL

1202
00:49:58,042 --> 00:49:58,275
NATIVE.

1203
00:49:58,275 --> 00:50:01,045
WHAT ARE YOUR THOUGHTS ON HOW 

1204
00:50:01,045 --> 00:50:03,313
THAT IMPACTS INADEQUATE PRENATAL

1205
00:50:03,313 --> 00:50:11,221
CARE AND HOW THAT MAY IMPACT 

1206
00:50:11,221 --> 00:50:11,722
POSTPARTUM CARE AS WELL?

1207
00:50:11,722 --> 00:50:14,992
>> SO THAT'S ABSOLUTELY
TRUE.

1208
00:50:14,992 --> 00:50:19,863
THE INVISIBILITY IS HUGE.

1209
00:50:19,863 --> 00:50:23,400
AND THERE IS COUNTLESS RESEARCH 

1210
00:50:23,400 --> 00:50:24,802
EVEN WITHIN DIVERSITY, EQUITY 

1211
00:50:24,802 --> 00:50:31,275
AND INCLUSION SPACES, BUT EVEN 

1212
00:50:31,275 --> 00:50:33,243
BEFORE THAT MEDICAL CARE 

1213
00:50:33,243 --> 00:50:35,379
PROVIDED BY FEMALE PHYSICIANS, 

1214
00:50:35,379 --> 00:50:37,848
PATIENTS TEND TO HAVE BETTER 

1215
00:50:37,848 --> 00:50:39,049
OUTCOMES, THEY CONNECT BETTER 

1216
00:50:39,049 --> 00:50:40,517
THAN MALE PHYSICIANS.

1217
00:50:40,517 --> 00:50:44,088
YOU CAN ARGUE, RIGHT, ABOUT THE 

1218
00:50:44,088 --> 00:50:46,957
VALIDITY OF SOME OF THESE 

1219
00:50:46,957 --> 00:50:48,092
STUDIES OR, YOU KNOW, OUTSIDE 

1220
00:50:48,092 --> 00:50:50,194
POTENTIAL CO-FOUNDING FACTORS, 

1221
00:50:50,194 --> 00:50:51,495
BUT THE DATA IS THERE.

1222
00:50:51,495 --> 00:50:53,664
THE ARTICLES ARE THERE.

1223
00:50:53,664 --> 00:50:55,265
AND THERE'S ABSOLUTELY DATA TO 

1224
00:50:55,265 --> 00:50:57,301
SHOW THAT WHEN YOUR DOCTOR IS OF

1225
00:50:57,301 --> 00:50:59,303
THE SAME ETHNIC BACKGROUND, WHEN

1226
00:50:59,303 --> 00:51:01,105
THE DOCTOR LOOKS LIKE YOU, WHEN 

1227
00:51:01,105 --> 00:51:03,874
YOU ARE THE SAME, YOU KNOW, 

1228
00:51:03,874 --> 00:51:05,576
OUTCOMES ARE BETTER FOR THESE 

1229
00:51:05,576 --> 00:51:06,043
PATIENTS.

1230
00:51:06,043 --> 00:51:08,679
I THINK THE HARD PART IS THAT WE

1231
00:51:08,679 --> 00:51:10,581
HAVE TO GET MORE DOCTORS IN 

1232
00:51:10,581 --> 00:51:12,382
THESE SPACES, MORE BIRTH 

1233
00:51:12,382 --> 00:51:15,886
WORKERS, MORE DOULAS, MORE MID 

1234
00:51:15,886 --> 00:51:18,989
WIVES THAT ARE COMING FROM THESE

1235
00:51:18,989 --> 00:51:19,289
COMMUNITIES.

1236
00:51:19,289 --> 00:51:20,891
I GRADUATED FROM THE UNIVERSITY 

1237
00:51:20,891 --> 00:51:22,159
OF VIRGINIA.

1238
00:51:22,159 --> 00:51:24,661
I REMEMBER BEING SO EXCITED AND 

1239
00:51:24,661 --> 00:51:27,064
HAVING A HUGE MEDICAL CLASS OF 

1240
00:51:27,064 --> 00:51:27,798
SEVEN HUNDRED.

1241
00:51:27,798 --> 00:51:29,900
THERE WERE 10 ETHNIC MINORITIES 

1242
00:51:29,900 --> 00:51:31,435
IN THAT CLASS.

1243
00:51:31,435 --> 00:51:33,670
I WAS THE ONLY NATIVE.

1244
00:51:33,670 --> 00:51:35,873
AFTER BEING THERE FOR MY M.D. 

1245
00:51:35,873 --> 00:51:38,675
PH.D. FOR 10 YEARS, THERE WAS 

1246
00:51:38,675 --> 00:51:39,476
ONLY ONE OTHER NATIVE THAT CAME 

1247
00:51:39,476 --> 00:51:42,880
THROUGH, RIGHT?

1248
00:51:42,880 --> 00:51:47,885
AND SO FINDING US IS HARD, 

1249
00:51:47,885 --> 00:51:49,353
RIGHT?

1250
00:51:49,353 --> 00:51:50,287
BUILDING COMMUNITY AMONGST 

1251
00:51:50,287 --> 00:51:53,891
OURSELVES AND FINDING US CAN BE 

1252
00:51:53,891 --> 00:51:54,992
HARD.

1253
00:51:54,992 --> 00:51:55,893
HELPING TO CULTIVATE INTEREST IN

1254
00:51:55,893 --> 00:51:58,962
THE LIFE SCIENCES, INTEREST IN 

1255
00:51:58,962 --> 00:51:59,630
MEDICINE, INTEREST IN HEALTH 

1256
00:51:59,630 --> 00:52:02,833
CARE WORK IN THE CHILDREN OF OUR

1257
00:52:02,833 --> 00:52:05,035
COMMUNITIES TO HELP CREATE THE 

1258
00:52:05,035 --> 00:52:07,871
PIPELINE TO HAVE A FUTURE OF 

1259
00:52:07,871 --> 00:52:09,840
BIRTH WORKERS, OF HEALTH CARE 

1260
00:52:09,840 --> 00:52:13,010
PROVIDERS, OF PHYSICIANS, OF 

1261
00:52:13,010 --> 00:52:15,112
DOULAS, OF MIDWIVES, OF NURSES 

1262
00:52:15,112 --> 00:52:17,080
THAT ARE COMING FROM OUR 

1263
00:52:17,080 --> 00:52:19,750
COMMUNITIES TO SERVE OUR 

1264
00:52:19,750 --> 00:52:22,653
COMMUNITIES IS PARAMOUNT.

1265
00:52:22,653 --> 00:52:23,620
THERE ARE SEVERAL DIFFERENT 

1266
00:52:23,620 --> 00:52:25,289
ORGANIZATIONS THAT ARE TRYING TO

1267
00:52:25,289 --> 00:52:28,158
SERVE THOSE PIPELINES AND TO, 

1268
00:52:28,158 --> 00:52:31,595
YOU KNOW, TO DO THAT BECAUSE IT 

1269
00:52:31,595 --> 00:52:37,968
TAKES DECADES TO PROVIDE THESE 

1270
00:52:37,968 --> 00:52:38,302
REPLACEMENTS.

1271
00:52:38,302 --> 00:52:43,440
SO WHEN 10 PHYSICIANS RETIRE, 

1272
00:52:43,440 --> 00:52:45,309
YOU MAY BE ONLY REPLACING ONE OR

1273
00:52:45,309 --> 00:52:45,576
TWO.

1274
00:52:45,576 --> 00:52:51,415
I THINK THAT GETS BACK DOWN TO 

1275
00:52:51,415 --> 00:52:53,917
WHAT DIRECTOR HUMMINGBIRD SAID 

1276
00:52:53,917 --> 00:52:56,486
IS WE HAVE TO PRIORITIZE THESE 

1277
00:52:56,486 --> 00:52:56,787
EFFORTS.

1278
00:52:56,787 --> 00:52:58,789
WE HAVE TO FUND THEM.

1279
00:52:58,789 --> 00:53:06,763
WE HAVE TO FUND THESE PROGRAMS.

1280
00:53:06,763 --> 00:53:09,199
WE HAVE TO BUILD THESE PIPELINES

1281
00:53:09,199 --> 00:53:11,235
AND INVEST IN THESE COMMUNITIES,

1282
00:53:11,235 --> 00:53:12,436
INVEST IN THIS WORK.

1283
00:53:12,436 --> 00:53:14,838
OTHERWISE IT IS NOT GOING TO 

1284
00:53:14,838 --> 00:53:16,840
HAPPEN, RIGHT?

1285
00:53:16,840 --> 00:53:22,212
I THINK WE ARE BOTH 

1286
00:53:22,212 --> 00:53:22,746
AFRICAN-AMERICANS, NATIVE 

1287
00:53:22,746 --> 00:53:24,414
AMERICANS, INDIGENOUS PEOPLE, WE

1288
00:53:24,414 --> 00:53:25,349
ARE RESOURCEFUL PEOPLES.

1289
00:53:25,349 --> 00:53:26,717
WE ARE SURVIVORS.

1290
00:53:26,717 --> 00:53:29,519
WE HAVE BEEN THROUGH A LOT AND 

1291
00:53:29,519 --> 00:53:32,789
WE KNOW HOW TO WORK IN OUR 

1292
00:53:32,789 --> 00:53:34,524
COMMUNITIES TO THRIVE.

1293
00:53:34,524 --> 00:53:37,494
AND SO WE SEEK OUT 

1294
00:53:37,494 --> 00:53:37,995
OPPORTUNITIES.

1295
00:53:37,995 --> 00:53:39,930
WE SEEK OUT ONE ANOTHER, RIGHT?

1296
00:53:39,930 --> 00:53:43,533
SO EVEN THOUGH I AM NOT FORWARD 

1297
00:53:43,533 --> 00:53:46,703
FACING EVERY DAY AS A NATIVE 

1298
00:53:46,703 --> 00:53:48,038
WOMAN, PATIENTS MAY ENCOUNTER ME

1299
00:53:48,038 --> 00:53:49,573
EVERY DAY AND NOT EVEN THINK 

1300
00:53:49,573 --> 00:53:53,110
TWICE TO THINK THAT I COULD BE A

1301
00:53:53,110 --> 00:53:54,778
PART OF OUR TRIBE, OTHER NATIVE 

1302
00:53:54,778 --> 00:53:58,282
WOMEN WHO ARE COMING TO SEE ME 

1303
00:53:58,282 --> 00:54:01,218
KNOW EXACTLY THAT THEY ARE.

1304
00:54:01,218 --> 00:54:03,020
THAT IS NOT JUST UNIQUE TO ME 

1305
00:54:03,020 --> 00:54:05,355
LIVING AND WORKING IN MY OWN 

1306
00:54:05,355 --> 00:54:06,857
COMMUNITY AT HOME.

1307
00:54:06,857 --> 00:54:11,395
I WAS VERY EXCITED AS A MEDICAL 

1308
00:54:11,395 --> 00:54:12,696
STUDENT AT THE UNIVERSITY OF 

1309
00:54:12,696 --> 00:54:14,932
VIRGINIA WHEN WE WERE ON OUR 

1310
00:54:14,932 --> 00:54:16,800
ROTATIONS AND GOING THROUGH -- I

1311
00:54:16,800 --> 00:54:19,036
WAS IN THE, YOU KNOW, GENERAL 

1312
00:54:19,036 --> 00:54:25,075
MEDICINE CLINIC AND A LAKOTA MAN

1313
00:54:25,075 --> 00:54:26,476
CAME AND HE WAS ON HIS 

1314
00:54:26,476 --> 00:54:29,913
MOTORCYCLE AND HE LOOKED LIKE A 

1315
00:54:29,913 --> 00:54:30,647
BIKER.

1316
00:54:30,647 --> 00:54:32,015
EVERYBODY IN THAT CLASS HAD A 

1317
00:54:32,015 --> 00:54:33,917
LOT OF PRECONCEIVED NOTIONS 

1318
00:54:33,917 --> 00:54:37,220
ABOUT WHO HE WAS AND WHO HE 

1319
00:54:37,220 --> 00:54:38,855
REPRESENTED AND HOW THE CHOICES 

1320
00:54:38,855 --> 00:54:41,258
THAT HE WAS MAKING OR NOT MAKING

1321
00:54:41,258 --> 00:54:43,327
WERE RESPONSIBLE FOR THE 

1322
00:54:43,327 --> 00:54:44,728
OUTCOMES OF HIS HEALTH.

1323
00:54:44,728 --> 00:54:46,530
BUT ALMOST IMMEDIATELY IN THAT 

1324
00:54:46,530 --> 00:54:51,034
ROOM HE BEGAN TO SEE ME.

1325
00:54:51,034 --> 00:54:54,037
AND HE SAW ME AND HE SPOKE TO 

1326
00:54:54,037 --> 00:54:55,872
ME.

1327
00:54:55,872 --> 00:54:59,076
WE EXCHANGED WORDS IN LAKOTA 

1328
00:54:59,076 --> 00:54:59,876
LANGUAGE.

1329
00:54:59,876 --> 00:55:01,678
WE CONNECTED BECAUSE HE SAW WHO 

1330
00:55:01,678 --> 00:55:05,415
I WAS AT MY CORE.

1331
00:55:05,415 --> 00:55:09,720
BECAUSE WE RECOGNIZE EACH OTHER.

1332
00:55:09,720 --> 00:55:11,621
FOR THE MOST PART, WE KNOW.

1333
00:55:11,621 --> 00:55:14,725
SO IT IS NOTHING DIFFERENT THAN 

1334
00:55:14,725 --> 00:55:15,859
HAVING THE, YOU KNOW, 

1335
00:55:15,859 --> 00:55:17,894
UNDERGROUND RAILROAD AND THOSE 

1336
00:55:17,894 --> 00:55:23,400
CONNECTIONS AND HAVING, YOU 

1337
00:55:23,400 --> 00:55:26,870
KNOW, THE GREEN BOOK, RIGHT, AS 

1338
00:55:26,870 --> 00:55:30,574
WE NAVIGATED RACISM AND 

1339
00:55:30,574 --> 00:55:32,743
OPPRESSION IN NATIVE AMERICAN 

1340
00:55:32,743 --> 00:55:35,245
COMMUNITIES TO NAVIGATE SAFE 

1341
00:55:35,245 --> 00:55:39,649
SPACES, SAFE PEOPLE, SAFE THE 

1342
00:55:39,649 --> 00:55:41,051
COUNT -- SAFE TOWNS.

1343
00:55:41,051 --> 00:55:46,623
YOU KNOW IN YOUR COMMUNITY WHO 

1344
00:55:46,623 --> 00:55:51,495
IS A GOOD PERSON AND WHO IS 

1345
00:55:51,495 --> 00:55:53,930
PROVIDING GOOD QUALITY CARE, 

1346
00:55:53,930 --> 00:55:54,998
WHICH HOSPITALS ARE SAFE.

1347
00:55:54,998 --> 00:55:58,602
WE ARE DOING THE SAME.

1348
00:55:58,602 --> 00:55:59,870
I'M PART OF AN ORGANIZATION THAT

1349
00:55:59,870 --> 00:56:03,874
IS CREATING LISTS OF PROVIDERS 

1350
00:56:03,874 --> 00:56:05,942
THAT ARE SAFE.

1351
00:56:05,942 --> 00:56:07,778
PROVIDERS THAT RESPECT A WOMAN'S

1352
00:56:07,778 --> 00:56:12,582
RIGHT TO CHOOSE.

1353
00:56:12,582 --> 00:56:14,551
PROVIDERS WHO RESPECT THE CHOICE

1354
00:56:14,551 --> 00:56:17,888
TO BE A NONCHILD BEARING WOMAN.

1355
00:56:17,888 --> 00:56:20,223
A LOT OF OPPRESSION COMES ON THE

1356
00:56:20,223 --> 00:56:22,059
HEALTH CARE OF WOMEN BOTH IN THE

1357
00:56:22,059 --> 00:56:27,464
FORM OF FORCED CHILD BEARING, 

1358
00:56:27,464 --> 00:56:32,169
BUT ALSO IN FORCED, YOU KNOW, 

1359
00:56:32,169 --> 00:56:35,338
FORCING THEM TO NOT CONCEIVE.

1360
00:56:35,338 --> 00:56:35,872
FORCED STERILIZATION.

1361
00:56:35,872 --> 00:56:37,741
WE HAVE SEEN THAT IN OUR 

1362
00:56:37,741 --> 00:56:38,041
COMMUNITIES.

1363
00:56:38,041 --> 00:56:40,677
I THINK CREATING THESE NETWORKS 

1364
00:56:40,677 --> 00:56:45,282
OF SAFE PEOPLE, BUT ULTIMATELY 

1365
00:56:45,282 --> 00:56:47,751
INVESTING, INVESTING, INVESTING 

1366
00:56:47,751 --> 00:56:49,352
IN THESE COMMUNITIES AND THESE 

1367
00:56:49,352 --> 00:56:51,088
PROGRAMS WE SEE WORKING, WE KNOW

1368
00:56:51,088 --> 00:56:53,457
ARE WORKING, THEY HAVE DATA 

1369
00:56:53,457 --> 00:56:55,325
SHOWING THEY WORK, HELP THEM 

1370
00:56:55,325 --> 00:56:55,525
WORK.

1371
00:56:55,525 --> 00:56:58,695
>> ABSOLUTELY.

1372
00:56:58,695 --> 00:57:04,601
I THINK FUNDING IS FUNDAMENTAL 

1373
00:57:04,601 --> 00:57:05,402
NEED.

1374
00:57:05,402 --> 00:57:06,436
YOU NEED RESOURCES.

1375
00:57:06,436 --> 00:57:08,472
WHERE THERE IS A DEARTH OF 

1376
00:57:08,472 --> 00:57:09,806
RESOURCES YOU ARE GOING TO FIND 

1377
00:57:09,806 --> 00:57:13,176
THERE IS GOING TO BE STRUGGLE TO

1378
00:57:13,176 --> 00:57:14,544
JUST GET THINGS DONE THAT IF 

1379
00:57:14,544 --> 00:57:17,314
THEY HAD THE PROPER 

1380
00:57:17,314 --> 00:57:18,782
INFRASTRUCTURE OR RESOURCES 

1381
00:57:18,782 --> 00:57:23,253
COULD BE EASILY MAINTAINED.

1382
00:57:23,253 --> 00:57:26,189
WHAT IMPACT DO YOU FEEL, 

1383
00:57:26,189 --> 00:57:28,558
DIRECTOR GOLDHAMMER, THAT 

1384
00:57:28,558 --> 00:57:29,926
DISCRIMINATION IS HAVING ON 

1385
00:57:29,926 --> 00:57:33,630
NATIVE BIRTHING PEOPLES, NATIVE 

1386
00:57:33,630 --> 00:57:35,866
CLINICAL PROFESSIONALS, NATIVE 

1387
00:57:35,866 --> 00:57:36,399
BIRTH WORKERS?

1388
00:57:36,399 --> 00:57:38,068
WHAT DOES IT REALLY LOOK LIKE?

1389
00:57:38,068 --> 00:57:42,672
I KNOW WE ARE SEEING IT IN THE 

1390
00:57:42,672 --> 00:57:47,077
NUMBERS OF BEING ASTRONOMICALLY 

1391
00:57:47,077 --> 00:57:50,847
HIGH FOR MATERNAL MORBIDITY AND 

1392
00:57:50,847 --> 00:57:51,548
MORTALITIES, RIGHT?

1393
00:57:51,548 --> 00:57:52,983
BUT WHAT ARE THE IMPACTS YOU 

1394
00:57:52,983 --> 00:57:59,890
THINK THIS IS HAVING?

1395
00:57:59,890 --> 00:58:07,531
>> YEAH, I MEAN, IT'S
ROUGH OUT 

1396
00:58:07,531 --> 00:58:07,864
THERE.

1397
00:58:07,864 --> 00:58:16,706
AS DOULAS WE SERVE AROUND 30% TO

1398
00:58:16,706 --> 00:58:17,941
50% OF NATIVE FAMILIES IN THE 

1399
00:58:17,941 --> 00:58:18,909
KING COUNTY AREA.

1400
00:58:18,909 --> 00:58:21,178
WE ARE REACHING A LOT OF 

1401
00:58:21,178 --> 00:58:21,444
FAMILIES.

1402
00:58:21,444 --> 00:58:29,052
WE ARE CONSTANTLY AMAZED AT WHAT

1403
00:58:29,052 --> 00:58:31,221
HAPPENS IN FRONT OF US AT 

1404
00:58:31,221 --> 00:58:33,523
HOSPITALS TO WHERE WE HAVE TO 

1405
00:58:33,523 --> 00:58:34,724
QUESTION WHAT HAPPENS WHEN WE 

1406
00:58:34,724 --> 00:58:36,626
ARE NOT IN THE ROOM.

1407
00:58:36,626 --> 00:58:39,896
YOU KNOW?

1408
00:58:39,896 --> 00:58:43,867
BECAUSE AT THIS POINT WE'RE 

1409
00:58:43,867 --> 00:58:47,504
FAIRLY WELL KNOWN PEOPLE.

1410
00:58:47,504 --> 00:58:49,072
MOST BIRTHING HOSPITALS KNOW 

1411
00:58:49,072 --> 00:58:49,573
ABOUT HUMMINGBIRD.

1412
00:58:49,573 --> 00:58:52,142
OH, YOU HAVE A HUMMINGBIRD 

1413
00:58:52,142 --> 00:58:52,742
DOULA, OKAY.

1414
00:58:52,742 --> 00:58:54,010
THAT KIND OF STUFF.

1415
00:58:54,010 --> 00:58:56,646
I HAVE A LOT OF CONNECTIONS IN 

1416
00:58:56,646 --> 00:58:59,849
THE HOSPITALS, TOO.

1417
00:58:59,849 --> 00:59:03,420
AND I -- IT STILL SHOCKS ME, YOU

1418
00:59:03,420 --> 00:59:05,956
KNOW, LIKE WHAT HAPPENS TO 

1419
00:59:05,956 --> 00:59:08,358
FAMILIES AND WHAT WE SEE.

1420
00:59:08,358 --> 00:59:11,962
WHETHER THAT IS COERCION, 

1421
00:59:11,962 --> 00:59:17,434
IGNORING THEM, NOT RESPONDING TO

1422
00:59:17,434 --> 00:59:20,604
THEIR NEEDS, NOT ADDRESSING 

1423
00:59:20,604 --> 00:59:22,739
PROBLEMS THAT ARE VERY CLEAR, 

1424
00:59:22,739 --> 00:59:28,445
VERY CLEAR PROBLEMS.

1425
00:59:28,445 --> 00:59:29,813
BUT THE LAST NATIVE MOM THAT WE 

1426
00:59:29,813 --> 00:59:33,416
KNOW OF WHO DIED, WHICH WAS A 

1427
00:59:33,416 --> 00:59:35,252
BIG PART OF WHY I STARTED 

1428
00:59:35,252 --> 00:59:36,686
HUMMINGBIRD AND STARTING OUR 

1429
00:59:36,686 --> 00:59:40,824
DOULA ORG WAS AFTER HER LOSS WAS

1430
00:59:40,824 --> 00:59:44,628
A MOTHER, SHE'S PREGNANT WITH 

1431
00:59:44,628 --> 00:59:51,134
TWINS HAD A HEART CONDITION, WAS

1432
00:59:51,134 --> 00:59:52,836
FULL TERM, WORKING AT A STADIUM 

1433
00:59:52,836 --> 00:59:55,872
FOR A BASEBALL GAME AND STARTED 

1434
00:59:55,872 --> 00:59:57,407
NOT FEELING WELL.

1435
00:59:57,407 --> 00:59:59,142
WENT TO THE HOSPITAL, WENT TO 

1436
00:59:59,142 --> 01:00:02,646
THE ER AND THEY TOLD HER TO GO 

1437
01:00:02,646 --> 01:00:03,780
HOME AND REST.

1438
01:00:03,780 --> 01:00:06,082
AND HER AND HER BABIES DIED.

1439
01:00:06,082 --> 01:00:09,486
YOU KNOW, IT WAS JUST, LIKE, HOW

1440
01:00:09,486 --> 01:00:14,291
THERE WAS NO OB CONSULT, HOW NO 

1441
01:00:14,291 --> 01:00:17,227
ONE THOUGHT TO, YOU KNOW, ADMIT 

1442
01:00:17,227 --> 01:00:17,794
HER.

1443
01:00:17,794 --> 01:00:20,330
LET'S REALLY DIG INTO THIS, 

1444
01:00:20,330 --> 01:00:20,597
RIGHT?

1445
01:00:20,597 --> 01:00:23,867
I MEAN, THERE WERE SO MANY 

1446
01:00:23,867 --> 01:00:27,203
THINGS GOING ON THAT WOULD 

1447
01:00:27,203 --> 01:00:29,139
TRIGGER THIS IS A PRETTY HIGH 

1448
01:00:29,139 --> 01:00:30,373
RISK SITUATION.

1449
01:00:30,373 --> 01:00:31,875
LET'S SEE WHAT WE CAN DO.

1450
01:00:31,875 --> 01:00:36,646
BUT IT WAS KIND OFFEN DETERMINE 

1451
01:00:36,646 --> 01:00:38,448
THAT SHE WAS OVERWEIGHT AND THAT

1452
01:00:38,448 --> 01:00:41,318
IS WHY SHE WASN'T FEELING WELL 

1453
01:00:41,318 --> 01:00:42,819
BECAUSE SHE WAS WORKING AT A 

1454
01:00:42,819 --> 01:00:45,288
BASEBALL GAME AND THAT IS THAT.

1455
01:00:45,288 --> 01:00:45,488
RIGHT?

1456
01:00:45,488 --> 01:00:47,057
AND THEY SENT HER HOME.

1457
01:00:47,057 --> 01:00:51,027
SO IT IS THINGS LIKE THAT AND 

1458
01:00:51,027 --> 01:00:52,996
THEN BEING, YOU KNOW, FOR HER, 

1459
01:00:52,996 --> 01:00:55,231
TOO, HAVING NO ONE WHO WENT WITH

1460
01:00:55,231 --> 01:00:59,235
HER, NO ONE TO ADVOCATE FOR HER,

1461
01:00:59,235 --> 01:01:01,938
NO ONE TO SAY WE NEED A SECOND 

1462
01:01:01,938 --> 01:01:02,172
OPINION.

1463
01:01:02,172 --> 01:01:03,573
WE NEED SOMEONE ELSE TO CHECK 

1464
01:01:03,573 --> 01:01:04,207
HER OUT.

1465
01:01:04,207 --> 01:01:06,376
PLEASE CALL THE OB.

1466
01:01:06,376 --> 01:01:06,643
RIGHT?

1467
01:01:06,643 --> 01:01:10,880
WHATEVER IT IS.

1468
01:01:10,880 --> 01:01:12,716
THERE WAS NOBODY THERE WHO WAS 

1469
01:01:12,716 --> 01:01:13,917
THINKING WHAT COULD WE DO 

1470
01:01:13,917 --> 01:01:15,885
DIFFERENTLY, RIGHT?

1471
01:01:15,885 --> 01:01:18,321
HOW CAN WE HELP THIS PERSON?

1472
01:01:18,321 --> 01:01:22,058
AND, YEAH, AND THAT'S WHY WE 

1473
01:01:22,058 --> 01:01:22,959
STARTED OUR DOULA PROGRAM 

1474
01:01:22,959 --> 01:01:24,728
BECAUSE IT WAS ONE OF THOSE 

1475
01:01:24,728 --> 01:01:26,296
THINGS THAT, LIKE, WE ARE 

1476
01:01:26,296 --> 01:01:32,135
RECOGNIZING THAT OUR FAMILIES 

1477
01:01:32,135 --> 01:01:35,872
ARE GOING AND INTERSECTING WITH 

1478
01:01:35,872 --> 01:01:37,207
THESE SYSTEMS THAT JUST AREN'T 

1479
01:01:37,207 --> 01:01:41,077
WORKING IN OUR FAVOR, RIGHT?

1480
01:01:41,077 --> 01:01:43,613
IS AND KIND OF WHAT DR. GRAHAM 

1481
01:01:43,613 --> 01:01:45,849
SAID EARLY ON, OUR FAMILIES 

1482
01:01:45,849 --> 01:01:48,051
DON'T FEEL SAFE BEING INVOLVED 

1483
01:01:48,051 --> 01:01:49,686
IN THEIR HEALTH CARE.

1484
01:01:49,686 --> 01:01:51,221
I KNOW WE HAVE KIND OF ALLUDED 

1485
01:01:51,221 --> 01:01:54,591
TO IT, BUT WE TALKED ABOUT IT 

1486
01:01:54,591 --> 01:01:57,360
FRANKLY IN OUR PRECONFERENCE 

1487
01:01:57,360 --> 01:01:59,195
CALL AROUND EVERY NATIVE MOM IS 

1488
01:01:59,195 --> 01:02:00,663
AFRAID HER BABY IS GOING TO BE 

1489
01:02:00,663 --> 01:02:01,331
TAKEN AWAY.

1490
01:02:01,331 --> 01:02:03,867
THAT IS AT THE FOREFRONT OF OUR 

1491
01:02:03,867 --> 01:02:05,502
MINDS WHEN WE'RE PREGNANT, WHEN 

1492
01:02:05,502 --> 01:02:11,007
WE HAVE BABIES AND CHILDREN.

1493
01:02:11,007 --> 01:02:12,575
AND THAT'S NOT AN IRRATIONAL 

1494
01:02:12,575 --> 01:02:13,443
FEAR, RIGHT?

1495
01:02:13,443 --> 01:02:16,346
IT IS NOT AN IRRATIONAL FEAR 

1496
01:02:16,346 --> 01:02:19,082
BECAUSE EVERY GENERATION BEFORE 

1497
01:02:19,082 --> 01:02:23,119
US THAT HAS HAPPENED.

1498
01:02:23,119 --> 01:02:26,289
AND CONTINUES TO HAPPEN AT 

1499
01:02:26,289 --> 01:02:27,157
DISPROPORTIONATE RATES.

1500
01:02:27,157 --> 01:02:29,959
AND I THINK WHEN FOLKS, AND I 

1501
01:02:29,959 --> 01:02:32,495
SAY THIS AS A MANDATORY REPORTER

1502
01:02:32,495 --> 01:02:35,331
AND RECOGNIZING LIKE WHAT THAT 

1503
01:02:35,331 --> 01:02:36,599
MEANS, BUT WHEN PEOPLE IN OUR 

1504
01:02:36,599 --> 01:02:38,535
COMMUNITY ARE INTERACTING WITH 

1505
01:02:38,535 --> 01:02:41,438
FOLKS THAT THEY SEE AS MANDATORY

1506
01:02:41,438 --> 01:02:43,873
REPORTERS OR KNOW OF THAT HOLD A

1507
01:02:43,873 --> 01:02:47,010
LOT OF POWER, WHICH A DOCTOR 

1508
01:02:47,010 --> 01:02:51,281
DOES HOLD A LOT OF POWER IN A 

1509
01:02:51,281 --> 01:02:51,648
RELATIONSHIP.

1510
01:02:51,648 --> 01:02:53,450
MOST NATIVE FAMILIES ARE NOT 

1511
01:02:53,450 --> 01:02:54,684
GOING TO RUFFLE FEATHERS.

1512
01:02:54,684 --> 01:02:57,887
LIKE DR. GRAHAM SAID, THEY ARE 

1513
01:02:57,887 --> 01:02:59,656
GOING TO FLY UNDER THE RADAR AND

1514
01:02:59,656 --> 01:03:01,357
DO AS LITTLE AS THEY CAN TO 

1515
01:03:01,357 --> 01:03:04,027
RAISE ANY FLAGS FOR A PROVIDER 

1516
01:03:04,027 --> 01:03:10,800
THAT MAY BE COMBATIVE OR MIGHT 

1517
01:03:10,800 --> 01:03:11,868
DO THINGS AGAINST MEDICAL ADVICE

1518
01:03:11,868 --> 01:03:13,236
OR WHAT HAVE YOU.

1519
01:03:13,236 --> 01:03:16,406
THAT FEAR REALLY, REALLY, REALLY

1520
01:03:16,406 --> 01:03:18,374
IMPACTS THE DECISIONS THAT WE 

1521
01:03:18,374 --> 01:03:19,542
MAKE AROUND OUR OWN HEALTH CARE 

1522
01:03:19,542 --> 01:03:23,880
AND THE WAY WE INTERACT WITH THE

1523
01:03:23,880 --> 01:03:26,683
HEALTH CARE SYSTEM.

1524
01:03:26,683 --> 01:03:28,518
SO, YEAH, I THINK THOSE ARE JUST

1525
01:03:28,518 --> 01:03:29,953
SOME OF THE THINGS WE SEE.

1526
01:03:29,953 --> 01:03:34,557
THAT KIND OF IGNORING, TREATING 

1527
01:03:34,557 --> 01:03:37,794
TERRIBLY, I CAN'T EVEN TELL YOU 

1528
01:03:37,794 --> 01:03:40,230
THE THINGS, LITERALLY IT WOULD 

1529
01:03:40,230 --> 01:03:42,866
GIVE PEOPLE SECONDARY TRAUMA TO 

1530
01:03:42,866 --> 01:03:46,536
REPEAT THE STORIES OF THINGS I 

1531
01:03:46,536 --> 01:03:49,205
HAVE SEEN PROFESSIONALS, 

1532
01:03:49,205 --> 01:03:54,043
PROVIDERS DO TO NATIVE MOMS 

1533
01:03:54,043 --> 01:03:55,512
DURING THEIR MOST SACRED 

1534
01:03:55,512 --> 01:03:56,880
CEREMONY, WHICH IS HAVING A 

1535
01:03:56,880 --> 01:03:57,380
BABY.

1536
01:03:57,380 --> 01:03:59,883
>> I THINK IT IS ALSO A
LACK OF 

1537
01:03:59,883 --> 01:04:00,950
UNDERSTANDING.

1538
01:04:00,950 --> 01:04:02,151
I'M GOING TO GO TO DR. GRAHAM 

1539
01:04:02,151 --> 01:04:02,752
ABOUT THIS.

1540
01:04:02,752 --> 01:04:07,857
I THINK IT IS A LACK OF 

1541
01:04:07,857 --> 01:04:15,865
UNDERSTANDING OF THE INTRICACIES

1542
01:04:15,865 --> 01:04:18,034
IN THE NATIVE CULTURE, LACK OF 

1543
01:04:18,034 --> 01:04:19,335
UNDERSTANDING THE CULTURE, THE 

1544
01:04:19,335 --> 01:04:23,072
NATIVE WOMAN HERSELF OR THE 

1545
01:04:23,072 --> 01:04:24,440
NATIVE BIRTHING PERSON.

1546
01:04:24,440 --> 01:04:27,210
OUR TWO-SPIRIT FAMILY MEMBERS.

1547
01:04:27,210 --> 01:04:29,679
WITH THAT LACK OF UNDERSTANDING 

1548
01:04:29,679 --> 01:04:35,285
AND THE STEREOTYPES THAT OCCURS,

1549
01:04:35,285 --> 01:04:37,520
YOU MAY BE A DRUG USER SAYING 

1550
01:04:37,520 --> 01:04:41,691
THIS TO A PERSON THAT IT DOESN'T

1551
01:04:41,691 --> 01:04:44,527
HOLD TRUE FOR OR EVEN SAYING IT 

1552
01:04:44,527 --> 01:04:45,828
TO A PERSON IT MAY HOLD TRUE 

1553
01:04:45,828 --> 01:04:52,735
FOR, HOW IS THAT A GOOD BEDSIDE 

1554
01:04:52,735 --> 01:04:54,070
MANNER?

1555
01:04:54,070 --> 01:05:02,078
HOW DO YOU APPROACH SPECIFIC 

1556
01:05:02,078 --> 01:05:10,520
TRAINING AND HOW TO -- AND ALSO 

1557
01:05:10,520 --> 01:05:13,389
THE OTHER THING THAT SHOULD BE A

1558
01:05:13,389 --> 01:05:15,091
CONCERN OR AN ISSUE -- HOLD ON, 

1559
01:05:15,091 --> 01:05:25,635
I'M GOING TO ADJUST MY HEAD SET.

1560
01:05:33,776 --> 01:05:35,078
I APOLOGIZE FOR THE TECHNICAL 

1561
01:05:35,078 --> 01:05:35,878
ISSUE.

1562
01:05:35,878 --> 01:05:39,882
BUT THE OTHER THING THAT SHOULD 

1563
01:05:39,882 --> 01:05:42,485
BE NOTED IS THE MEDICAL 

1564
01:05:42,485 --> 01:05:42,785
CONDITIONS.

1565
01:05:42,785 --> 01:05:45,521
WHEN THERE ARE PREEXISTING 

1566
01:05:45,521 --> 01:05:46,990
MEDICAL CONDITIONS OR MEDICAL 

1567
01:05:46,990 --> 01:05:47,890
CONDITIONS THAT PRESENT 

1568
01:05:47,890 --> 01:05:48,191
THEMSELVES.

1569
01:05:48,191 --> 01:05:50,193
FOR EXAMPLE, THREE OF THE 

1570
01:05:50,193 --> 01:05:53,963
LEADING CAUSES OF PREGNANCY 

1571
01:05:53,963 --> 01:05:55,865
RELATED DEATH IN NATIVE AMERICAN

1572
01:05:55,865 --> 01:06:02,972
BIRTHING PEOPLES IS HEMORRHAGE, 

1573
01:06:02,972 --> 01:06:03,673
CARDIOMYOPATHIES AND 

1574
01:06:03,673 --> 01:06:06,042
HYPERTENSION DISORDERS.

1575
01:06:06,042 --> 01:06:10,279
THESE ARE ISSUES CONSISTENTLY 

1576
01:06:10,279 --> 01:06:11,881
THAT CAUSE DEATH.

1577
01:06:11,881 --> 01:06:17,587
THE POINT OF FACT IS ONE THIRD 

1578
01:06:17,587 --> 01:06:20,923
OF DEATHS, MATERNAL MORTALITY, 

1579
01:06:20,923 --> 01:06:23,026
OCCUR DURING PREGNANCY, BUT 52% 

1580
01:06:23,026 --> 01:06:27,030
OF DEATHS OCCUR AFTER THE DAY OF

1581
01:06:27,030 --> 01:06:27,296
DELIVERY.

1582
01:06:27,296 --> 01:06:31,901
HOW DO WE COMBAT THAT WITH A 

1583
01:06:31,901 --> 01:06:36,072
SYSTEM, A WESTERNIZED SYSTEM, A 

1584
01:06:36,072 --> 01:06:39,208
SYSTEM THAT STEMS FROM 

1585
01:06:39,208 --> 01:06:40,176
COLONIZATION?

1586
01:06:40,176 --> 01:06:47,884
HOW DO WE COMBAT SOME OF THE 

1587
01:06:47,884 --> 01:06:51,888
NEGATIVE IMPACT THAT HAS ON 

1588
01:06:51,888 --> 01:06:54,023
MATERNAL MORTALITY RATES FOR 

1589
01:06:54,023 --> 01:06:55,792
NATIVE AMERICAN PEOPLES?

1590
01:06:55,792 --> 01:06:58,795
OR ANY, EVEN OTHER PEOPLES 

1591
01:06:58,795 --> 01:07:01,097
BECAUSE WE MAY NOT HAVE THAT 

1592
01:07:01,097 --> 01:07:05,902
MUCH DATA, BUT THERE ARE 

1593
01:07:05,902 --> 01:07:07,737
PLETHORA OF DATA FOR OTHER RACE 

1594
01:07:07,737 --> 01:07:13,242
AND ETHNIC GROUPS THAT CERTAINLY

1595
01:07:13,242 --> 01:07:14,644
APPLY AS MODELS.

1596
01:07:14,644 --> 01:07:16,713
SO WHAT ARE YOUR THOUGHTS ON 

1597
01:07:16,713 --> 01:07:18,681
WHERE DO WE GO FROM THERE, DR. 

1598
01:07:18,681 --> 01:07:23,619
GRAHAM AND I WOULD LIKE TO ALSO 

1599
01:07:23,619 --> 01:07:24,187
ANSWER THAT SAME QUESTION 

1600
01:07:24,187 --> 01:07:28,291
DIRECTOR GOLDHAMMER.

1601
01:07:28,291 --> 01:07:28,725
>> YEAH.

1602
01:07:28,725 --> 01:07:31,260
I MEAN, I THINK -- I WOULD HAVE 

1603
01:07:31,260 --> 01:07:34,731
TO SAY THAT I THINK OUR 

1604
01:07:34,731 --> 01:07:35,865
TRADITIONAL HEALTH CARE SYSTEM 

1605
01:07:35,865 --> 01:07:39,669
OF WESTERNIZED MEDICINE IS BUILT

1606
01:07:39,669 --> 01:07:46,609
UPON PATERNALISTIC VIEWS.

1607
01:07:46,609 --> 01:07:47,110
RIGHT?

1608
01:07:47,110 --> 01:07:51,881
IS BUILT UPON A POWER-BASED 

1609
01:07:51,881 --> 01:07:59,856
STRUCTURE AND A HIERARCHY OF I 

1610
01:07:59,856 --> 01:08:04,360
KNOW BETTER, I'M SMARTER, THIS 

1611
01:08:04,360 --> 01:08:06,028
IS WHAT YOU SHOULD DO, YOU 

1612
01:08:06,028 --> 01:08:07,497
SHOULD DO IT.

1613
01:08:07,497 --> 01:08:09,198
IT ALSO REFLECTS OUR VIEW OF 

1614
01:08:09,198 --> 01:08:11,334
WOMEN AND OUR VIEW OF THEIR 

1615
01:08:11,334 --> 01:08:14,604
WORTH, THEIR WORTH IN SOCIETY, 

1616
01:08:14,604 --> 01:08:15,605
THEIR WORTH, ET CETERA.

1617
01:08:15,605 --> 01:08:19,742
NOT JUST WOMEN, BUT PEOPLE.

1618
01:08:19,742 --> 01:08:22,178
IF WE VALUE THE PERSON, IF WE 

1619
01:08:22,178 --> 01:08:25,214
VIEW THEM AS WORTHY, THEN WE 

1620
01:08:25,214 --> 01:08:27,884
TREAT THEM DIFFERENT.

1621
01:08:27,884 --> 01:08:29,886
WE APPROACH THEM DIFFERENT.

1622
01:08:29,886 --> 01:08:31,020
FUNDAMENTALLY THE CARE THEY GIVE

1623
01:08:31,020 --> 01:08:32,822
IS DIFFERENT.

1624
01:08:32,822 --> 01:08:35,158
WE SEE THAT IN EVERY WALK OF 

1625
01:08:35,158 --> 01:08:37,493
LIFE, EVERY ASPECT OF LIFE, 

1626
01:08:37,493 --> 01:08:38,895
INCLUDING THAT FINANCIALLY, 

1627
01:08:38,895 --> 01:08:39,095
RIGHT?

1628
01:08:39,095 --> 01:08:46,469
WHAT ARE OUR COMMUNITIES 

1629
01:08:46,469 --> 01:08:47,336
INVESTING IN?

1630
01:08:47,336 --> 01:08:49,572
WHAT DO OUR LEGISLATURES VALUE?

1631
01:08:49,572 --> 01:08:51,073
WHERE ARE THEY PUTTING THEIR 

1632
01:08:51,073 --> 01:08:53,543
MONEY AND THEIR RESOURCES?

1633
01:08:53,543 --> 01:08:55,511
AND WOMEN'S HEALTH, 

1634
01:08:55,511 --> 01:08:58,781
UNFORTUNATELY, HAS NEVER BEEN 

1635
01:08:58,781 --> 01:08:59,015
VALUED.

1636
01:08:59,015 --> 01:09:01,617
WE'VE NOT BEEN VALUED AS PEOPLE.

1637
01:09:01,617 --> 01:09:08,624
AND THAT, I THINK, IS 

1638
01:09:08,624 --> 01:09:09,826
FUNDAMENTALLY HAS TO CHANGE.

1639
01:09:09,826 --> 01:09:10,526
THAT FUNDAMENTALLY HAS TO 

1640
01:09:10,526 --> 01:09:11,194
CHANGE.

1641
01:09:11,194 --> 01:09:15,898
WE HAVE TO BE IN FULL FACULTY OF

1642
01:09:15,898 --> 01:09:18,000
OU

1643
01:09:18,000 --> 01:09:19,802
OUR BODIES, FULL ABILITY TO MAKE

1644
01:09:19,802 --> 01:09:22,505
DECISIONS FOR OUR BODIES AND WE 

1645
01:09:22,505 --> 01:09:25,274
HAVE TO VALUE THAT AND INVEST IN

1646
01:09:25,274 --> 01:09:31,881
RESOURCES REGARDING THAT.

1647
01:09:31,881 --> 01:09:34,617
BECAUSE THE HOSPITAL AND THE BAD

1648
01:09:34,617 --> 01:09:36,252
THINGS THAT SHE HAS SEEN, THAT I

1649
01:09:36,252 --> 01:09:38,087
HAVE SEEN, THEY STEM 

1650
01:09:38,087 --> 01:09:39,388
FUNDAMENTALLY FROM THAT 

1651
01:09:39,388 --> 01:09:39,689
PERSPECTIVE.

1652
01:09:39,689 --> 01:09:41,357
IF WE DON'T VALUE THAT PERSON, 

1653
01:09:41,357 --> 01:09:43,492
WE DON'T VALUE THEIR LIFE, THEIR

1654
01:09:43,492 --> 01:09:44,961
EXISTENCE, THEIR WELL BEING, 

1655
01:09:44,961 --> 01:09:47,396
RIGHT, WE CAN'T EVER DO RIGHT BY

1656
01:09:47,396 --> 01:09:47,864
THEM.

1657
01:09:47,864 --> 01:09:53,803
WE CAN'T EVER DO RIGHT BY THEM.

1658
01:09:53,803 --> 01:09:55,238
AND THAT IS THE HARD PART AND 

1659
01:09:55,238 --> 01:09:57,240
THE HARD WORK THAT HAS TO BE 

1660
01:09:57,240 --> 01:09:57,440
DONE.

1661
01:09:57,440 --> 01:10:03,579
THAT CAN'T BE DONE IN A FEW 

1662
01:10:03,579 --> 01:10:04,814
SEMINARS ON DIVERSITY AND 

1663
01:10:04,814 --> 01:10:05,681
INCLUSION, RIGHT?

1664
01:10:05,681 --> 01:10:11,621
THAT HAS TO FUNDAMENTALLY CHANGE

1665
01:10:11,621 --> 01:10:12,021
FROM WITHIN.

1666
01:10:12,021 --> 01:10:13,823
AND THAT IS THE HARD PART.

1667
01:10:13,823 --> 01:10:15,391
WE HAVE TO VALUE PEOPLE, ONE 

1668
01:10:15,391 --> 01:10:17,260
ANOTHER AS PEOPLE.

1669
01:10:17,260 --> 01:10:19,262
I MEAN, MICHAEL BLOOMBERG JUST 

1670
01:10:19,262 --> 01:10:21,797
DONATED A TON OF MONEY, RIGHT, 

1671
01:10:21,797 --> 01:10:25,501
MILLIONS OF DOLLARS TO JOHNS 

1672
01:10:25,501 --> 01:10:27,136
HOPKINS TO FUND THEIR MEDICAL 

1673
01:10:27,136 --> 01:10:28,571
SCHOOL, TO MAKE MEDICAL SCHOOL 

1674
01:10:28,571 --> 01:10:30,206
FREE, RIGHT?

1675
01:10:30,206 --> 01:10:31,908
SIMULTANEOUSLY RECENTLY HE HAS 

1676
01:10:31,908 --> 01:10:39,048
FUNDED A TON OF MONEY TO HBCUs 

1677
01:10:39,048 --> 01:10:41,183
PARTICULARLY TO FOCUS ON 

1678
01:10:41,183 --> 01:10:42,685
EDUCATION AND HEALTH CARE TO 

1679
01:10:42,685 --> 01:10:44,153
QUOTE-UNQUOTE EQUAL THE PLAYING 

1680
01:10:44,153 --> 01:10:45,054
FIELD AND TO HELP THOSE 

1681
01:10:45,054 --> 01:10:47,657
COMMUNITIES.

1682
01:10:47,657 --> 01:10:49,825
I THINK WHAT IS INTRIGUING IS 

1683
01:10:49,825 --> 01:10:52,762
THE DOLLAR AMOUNT HE PAID WAS 

1684
01:10:52,762 --> 01:10:53,029
DIFFERENT.

1685
01:10:53,029 --> 01:10:54,063
IT WAS LESS IN THE BLACK 

1686
01:10:54,063 --> 01:10:54,463
COMMUNITY.

1687
01:10:54,463 --> 01:10:57,500
IT WAS LESS FOR THESE HBCUs.

1688
01:10:57,500 --> 01:11:00,469
I CAN'T SPEAK FOR HIM AS A 

1689
01:11:00,469 --> 01:11:03,372
PERSON OR HIS MOTIVATION BEHIND 

1690
01:11:03,372 --> 01:11:05,007
CHOOSING THOSE DOLLAR AMOUNTS, 

1691
01:11:05,007 --> 01:11:07,076
BUT PEOPLE IN THESE COMMUNITIES 

1692
01:11:07,076 --> 01:11:08,511
CAN'T HELP BUT THINK IS THAT A 

1693
01:11:08,511 --> 01:11:08,711
VALUE?

1694
01:11:08,711 --> 01:11:11,580
RIGHT?

1695
01:11:11,580 --> 01:11:13,449
WAS THAT A VALUE CHOICE FOR HIM?

1696
01:11:13,449 --> 01:11:15,484
AND THIS HAPPENS WITH OUR 

1697
01:11:15,484 --> 01:11:17,920
LEGISLATURE AND THE THINGS THAT 

1698
01:11:17,920 --> 01:11:19,755
WE ARE PURSUING, RIGHT?

1699
01:11:19,755 --> 01:11:23,559
WHERE DO WE FOCUS?

1700
01:11:23,559 --> 01:11:25,628
WHAT DO WE PUT FOCUS ON?

1701
01:11:25,628 --> 01:11:28,297
WE FOCUS ON WHAT WE VALUE.

1702
01:11:28,297 --> 01:11:29,665
WE HAVE TO VALUE WOMEN.

1703
01:11:29,665 --> 01:11:32,034
WE HAVE TO CARE FOR THEM SUCH 

1704
01:11:32,034 --> 01:11:33,803
THAT WHEN THEY COME INTO OUR 

1705
01:11:33,803 --> 01:11:35,171
OFFICE, WHEN THEY COME INTO OUR 

1706
01:11:35,171 --> 01:11:36,706
HOSPITAL WITH A HEADACHE, WHEN 

1707
01:11:36,706 --> 01:11:38,808
THEY COME IN WITH SHORTNESS OF 

1708
01:11:38,808 --> 01:11:41,143
BREATH, WHEN THEY COME IN WITH 

1709
01:11:41,143 --> 01:11:44,480
FATIGUE, WE DON'T DISMISS IT AS 

1710
01:11:44,480 --> 01:11:46,749
OBESITY, WE DON'T DISMISS IT AS 

1711
01:11:46,749 --> 01:11:49,518
BEING OVERWORKED, OH, THEY ARE 

1712
01:11:49,518 --> 01:11:51,120
JUST BEING HISTRIONIC, RIGHT?

1713
01:11:51,120 --> 01:11:53,389
BECAUSE THAT IS WHAT IS 

1714
01:11:53,389 --> 01:11:54,190
HAPPENING EVERY DAY.

1715
01:11:54,190 --> 01:11:56,292
THESE WOMEN'S CONCERNS ARE 

1716
01:11:56,292 --> 01:11:57,426
GETTING DISMISSED.

1717
01:11:57,426 --> 01:12:00,096
THEY ARE NOT BEING HEARD, RIGHT?

1718
01:12:00,096 --> 01:12:04,200
AND SOMETIMES THAT SWELLING IS 

1719
01:12:04,200 --> 01:12:05,835
NORMAL, BUT SOMETIMES IT CAN 

1720
01:12:05,835 --> 01:12:07,103
KILL YOU.

1721
01:12:07,103 --> 01:12:08,137
SOMETIMES THAT HEADACHE IS 

1722
01:12:08,137 --> 01:12:11,674
NOTHING AND YOU JUST NEED A 

1723
01:12:11,674 --> 01:12:14,010
TYLENOL AND A NAP AND SOME 

1724
01:12:14,010 --> 01:12:16,045
FLUIDS, INCREASED HYDRATION, BUT

1725
01:12:16,045 --> 01:12:18,948
SOMETIMES IT IS A STROKE.

1726
01:12:18,948 --> 01:12:19,248
RIGHT?

1727
01:12:19,248 --> 01:12:19,882
IT'S DEADLY.

1728
01:12:19,882 --> 01:12:23,819
YOU HAVE TO SEE THE PATIENT.

1729
01:12:23,819 --> 01:12:25,921
YOU HAVE TO EVALUATE THEM.

1730
01:12:25,921 --> 01:12:28,057
YOU HAVE TO PUT HANDS ON THEM.

1731
01:12:28,057 --> 01:12:30,059
YOU CAN'T DO THIS OVER THE 

1732
01:12:30,059 --> 01:12:30,526
PHONE, RIGHT?

1733
01:12:30,526 --> 01:12:35,898
YOU CANNOT EVALUATE THE PERSON 

1734
01:12:35,898 --> 01:12:38,367
OVER THE PHONE.

1735
01:12:38,367 --> 01:12:41,270
A LOT OF MY MOMS GET FRUSTRATED 

1736
01:12:41,270 --> 01:12:43,873
WHEN THEY CALL AND I'M LIKE, ALL

1737
01:12:43,873 --> 01:12:46,475
RIGHT, YOU'VE GOT COME IN.

1738
01:12:46,475 --> 01:12:47,877
THEY SAID DR. GRAHAM, YOU ALWAYS

1739
01:12:47,877 --> 01:12:49,912
SAY I HAVE TO COME IN.

1740
01:12:49,912 --> 01:12:50,546
YOU DO.

1741
01:12:50,546 --> 01:12:52,481
I NEED TO LAY HANDS ON YOU, I 

1742
01:12:52,481 --> 01:12:53,682
NEED TO SEE YOU.

1743
01:12:53,682 --> 01:12:55,284
THERE IS SO MUCH ABOUT THE 

1744
01:12:55,284 --> 01:12:57,820
PHYSICAL EXAM, THE WAY YOU ARE 

1745
01:12:57,820 --> 01:13:01,824
CARRYING YOURSELF, THE WAY YOU 

1746
01:13:01,824 --> 01:13:03,359
LOOK AND FEEL.

1747
01:13:03,359 --> 01:13:05,661
BY LAYING HANDS ON THEM AND 

1748
01:13:05,661 --> 01:13:09,432
LOOKING AT THEM AND SAYING I 

1749
01:13:09,432 --> 01:13:11,167
DON'T KNOW WHAT IS WRONG, BUT I 

1750
01:13:11,167 --> 01:13:12,468
KNOW SOMETHING IS WRONG.

1751
01:13:12,468 --> 01:13:14,637
I WANT YOU TO COME IN AND SAVE 

1752
01:13:14,637 --> 01:13:16,539
TESTS SO I CAN FIND OUT WHAT IT 

1753
01:13:16,539 --> 01:13:19,608
IS THAT I HAVE SAVED WOMEN'S 

1754
01:13:19,608 --> 01:13:19,875
LIVES.

1755
01:13:19,875 --> 01:13:22,511
BECAUSE I HAD THE THRESHOLD OF 

1756
01:13:22,511 --> 01:13:23,546
SUSPICION THAT SOMETHING IS 

1757
01:13:23,546 --> 01:13:26,182
NOT -- IT IS DIFFERENT WITH THIS

1758
01:13:26,182 --> 01:13:26,415
PATIENT.

1759
01:13:26,415 --> 01:13:27,249
YOU KNOW?

1760
01:13:27,249 --> 01:13:28,784
SHE DOESN'T LOOK WELL.

1761
01:13:28,784 --> 01:13:29,985
RIGHT?

1762
01:13:29,985 --> 01:13:33,422
BUT WE LOSE THAT WHEN WE TRIAGE 

1763
01:13:33,422 --> 01:13:35,424
OVER THE PHONE, WHEN WE DON'T 

1764
01:13:35,424 --> 01:13:37,626
SIT DOWN AND TAKE A LOOK AND A 

1765
01:13:37,626 --> 01:13:38,094
LISTEN.

1766
01:13:38,094 --> 01:13:40,262
WHEN WE PUT OUR TRIAGE 

1767
01:13:40,262 --> 01:13:46,402
CAPABILITIES, RIGHT, IN THE ER, 

1768
01:13:46,402 --> 01:13:49,939
TO NURSE PRACTITIONERS OR THE 

1769
01:13:49,939 --> 01:13:56,512
NURSES OR TO OTHER 

1770
01:13:56,512 --> 01:13:57,346
NONOBSTETRICIANS, RIGHT?

1771
01:13:57,346 --> 01:13:59,415
THOSE PEOPLE ARE AMAZING ASSETS 

1772
01:13:59,415 --> 01:14:01,217
TO OUR HEALTH CARE SYSTEM AND 

1773
01:14:01,217 --> 01:14:03,853
THEY EACH SERVE A VITAL ROLE, WE

1774
01:14:03,853 --> 01:14:06,755
DON'T KNOW WHAT WE DON'T KNOW.

1775
01:14:06,755 --> 01:14:10,826
THAT PERSON HAS NOT ENCOUNTERED 

1776
01:14:10,826 --> 01:14:14,430
A POSTPARTUM CARDIOMYOPATHY 

1777
01:14:14,430 --> 01:14:15,865
PATIENT BEFORE, THEY MAYBE DON'T

1778
01:14:15,865 --> 01:14:19,068
RECOGNIZE THE SYMPTOMS BEING 

1779
01:14:19,068 --> 01:14:21,103
PRESENTED AS BEING PART OF THAT 

1780
01:14:21,103 --> 01:14:22,171
CONSTELLATION AND SOMETHING 

1781
01:14:22,171 --> 01:14:23,873
CONCERNING FOR THEM AND SO THEY 

1782
01:14:23,873 --> 01:14:26,108
DON'T DIG DEEPER, RIGHT?

1783
01:14:26,108 --> 01:14:30,079
SO I THINK OUR COMMUNITIES, OUR 

1784
01:14:30,079 --> 01:14:32,014
HOSPITALS, YOU KNOW, SOME OF 

1785
01:14:32,014 --> 01:14:34,416
THEM ARE PUTTING FORTH WHAT WE 

1786
01:14:34,416 --> 01:14:38,287
CALL OBED, OBSTETRIC EMERGENCY 

1787
01:14:38,287 --> 01:14:39,688
DEPARTMENTS THAT ARE SPECIFIC TO

1788
01:14:39,688 --> 01:14:39,922
OB/GYN.

1789
01:14:39,922 --> 01:14:42,091
THEY ARE STAFFING THEM WITH 

1790
01:14:42,091 --> 01:14:47,163
BOARD CERTIFIED OBSTETRICIANS OR

1791
01:14:47,163 --> 01:14:52,535
NURSE MIDWIVES TO BE PRESENT 

1792
01:14:52,535 --> 01:14:53,969
24/7 TO SERVE, TO BE THERE, TO 

1793
01:14:53,969 --> 01:14:56,839
LAY HANDS, TO SEE THOSE 

1794
01:14:56,839 --> 01:14:57,173
PATIENTS.

1795
01:14:57,173 --> 01:14:58,574
SOME STATES AND SOME AREAS ARE 

1796
01:14:58,574 --> 01:15:02,111
BETTER THAN OTHERS, BUT A LOT OF

1797
01:15:02,111 --> 01:15:05,548
CREATING THESE MATERNAL 

1798
01:15:05,548 --> 01:15:07,883
MORBIDITY, MORTALITY COMMITTEES,

1799
01:15:07,883 --> 01:15:09,218
CONSORTIUMS TO HAVE A 

1800
01:15:09,218 --> 01:15:11,086
COLLABORATIVE CARE MODEL TO 

1801
01:15:11,086 --> 01:15:12,755
CREATE POLICIES AND PROCEDURES 

1802
01:15:12,755 --> 01:15:15,858
THAT CAN HELP IDENTIFY PATIENTS.

1803
01:15:15,858 --> 01:15:17,760
I MEAN, THANKFULLY IN THE STATE 

1804
01:15:17,760 --> 01:15:20,362
OF DELAWARE WE HAVE SEVERAL 

1805
01:15:20,362 --> 01:15:23,365
DIFFERENT REPRESENTATIVES THAT 

1806
01:15:23,365 --> 01:15:25,167
ARE IMPASSIONED ABOUT THIS AREA.

1807
01:15:25,167 --> 01:15:27,369
THEY ARE DOING THIS WORK.

1808
01:15:27,369 --> 01:15:29,471
THEY ARE INVESTING IN MANY THESE

1809
01:15:29,471 --> 01:15:31,540
COMMUNITIES, IN THESE PROJECTS.

1810
01:15:31,540 --> 01:15:33,976
YOU CREATE ACCESS, YOU CREATE 

1811
01:15:33,976 --> 01:15:34,977
IDENTIFIABLE THINGS.

1812
01:15:34,977 --> 01:15:37,947
ONE OF THE THINGS OUR HOSPITAL 

1813
01:15:37,947 --> 01:15:39,448
CURRENTLY IN DELAWARE IS DOING 

1814
01:15:39,448 --> 01:15:41,550
IS SOMETHING AS SIMPLE AS HAVING

1815
01:15:41,550 --> 01:15:45,354
A BRACELET, A PINK BRACELET THAT

1816
01:15:45,354 --> 01:15:47,456
THE PREGNANT BIRTHING MOM GOES 

1817
01:15:47,456 --> 01:15:51,594
HOME WITH THAT HAS JUST, I JUST 

1818
01:15:51,594 --> 01:15:53,495
DELIVERED ON THIS DATE.

1819
01:15:53,495 --> 01:15:55,097
THAT WAY IF SHE IS ENCOUNTERED 

1820
01:15:55,097 --> 01:15:57,533
IN THE NEXT SIX WEEKS, SIX 

1821
01:15:57,533 --> 01:16:01,070
MONTHS, WHAT HAVE YOU, IF SHE IS

1822
01:16:01,070 --> 01:16:02,838
UNCONSCIOUS SHE CAN'T SPEAK FOR 

1823
01:16:02,838 --> 01:16:04,273
HERSELF.

1824
01:16:04,273 --> 01:16:06,942
EMS, EMERGENCY SERVICES, POLICE,

1825
01:16:06,942 --> 01:16:08,377
FIREFIGHTERS THEY KNOW THAT THIS

1826
01:16:08,377 --> 01:16:09,745
WOMAN JUST GAVE BIRTH.

1827
01:16:09,745 --> 01:16:11,647
THEY KNOW THERE IS A CHILD.

1828
01:16:11,647 --> 01:16:14,083
THEY KNOW TO DIG A LITTLE 

1829
01:16:14,083 --> 01:16:15,884
FURTHER AND THAT THIS PATIENT 

1830
01:16:15,884 --> 01:16:17,786
PARTICULARLY IS AT HIGHER RISK 

1831
01:16:17,786 --> 01:16:20,723
FOR CERTAIN CONDITIONS THAT 

1832
01:16:20,723 --> 01:16:23,492
MAYBE SOMEBODY ELSE WHO HAS NOT 

1833
01:16:23,492 --> 01:16:25,761
JUST GIVEN BIRTH IS HIGH RISK 

1834
01:16:25,761 --> 01:16:25,928
FOR.

1835
01:16:25,928 --> 01:16:28,330
SOMETHING AS SIMPLE AS THAT.

1836
01:16:28,330 --> 01:16:31,567
WE DO IT FOR WOMEN WHO HAVE 

1837
01:16:31,567 --> 01:16:33,969
RECENTLY HAD A PREGNANCY LOSS, 

1838
01:16:33,969 --> 01:16:34,236
TOO.

1839
01:16:34,236 --> 01:16:35,671
EVEN IF THEY DIDN'T CARRY THAT 

1840
01:16:35,671 --> 01:16:38,040
BABY HOME, THEY WENT THROUGH THE

1841
01:16:38,040 --> 01:16:40,643
PROCESS, THE INCREASED MEDICAL 

1842
01:16:40,643 --> 01:16:42,311
RISK IN HEALTH CARE THINGS.

1843
01:16:42,311 --> 01:16:47,216
WE'VE GOT TO INVEST AND IT HAS 

1844
01:16:47,216 --> 01:16:48,817
TO COME DOWN TO, YOU KNOW, WE 

1845
01:16:48,817 --> 01:16:50,653
HAVE TO VALUE LIFE.

1846
01:16:50,653 --> 01:16:52,588
WE HAVE TO VALUE LIFEGIVERS.

1847
01:16:52,588 --> 01:16:55,457
>> THERE WAS A QUESTION
THAT WAS

1848
01:16:55,457 --> 01:16:59,094
PRESENTED, HAVE THERE BEEN ANY 

1849
01:16:59,094 --> 01:17:01,497
SUCCESS STORIES OF 

1850
01:17:01,497 --> 01:17:01,997
NON-INDIGENOUS MEDICAL 

1851
01:17:01,997 --> 01:17:03,666
PROFESSIONALS PARTNERING WITH 

1852
01:17:03,666 --> 01:17:05,200
INDIGENOUS COMMUNITIES THAT 

1853
01:17:05,200 --> 01:17:07,870
IMPROVED HEALTH OUTCOMES FOR 

1854
01:17:07,870 --> 01:17:10,506
ANYTHING ANYTHING PEOPLE?

1855
01:17:10,506 --> 01:17:14,109
AND I'M GOING TO PRESENT THIS TO

1856
01:17:14,109 --> 01:17:16,278
BOTH DIRECTOR GOLDHAMMER AND 

1857
01:17:16,278 --> 01:17:26,822
THEN YOU, DR. GRAHAM TO ANSWER.

1858
01:17:27,756 --> 01:17:31,360
I CAN SAY THAT INDIAN HEALTH 

1859
01:17:31,360 --> 01:17:35,964
SERVICES, THE U.S. DEPARTMENT OF

1860
01:17:35,964 --> 01:17:37,099
HEALTH AND HUMAN SERVICES, NIH, 

1861
01:17:37,099 --> 01:17:42,471
AS WELL AS CDC HAVE BEEN 

1862
01:17:42,471 --> 01:17:45,474
CREATING PROGRAMS AND LAUNCHING 

1863
01:17:45,474 --> 01:17:47,376
PROGRAMS TO IMPROVE THE HEALTH 

1864
01:17:47,376 --> 01:17:49,745
OF NATIVE BIRTHING PEOPLE ACROSS

1865
01:17:49,745 --> 01:17:51,113
THE NATION.

1866
01:17:51,113 --> 01:17:53,882
AND THE PROGRAMS PILOTING HAVE 

1867
01:17:53,882 --> 01:17:54,450
PROVEN SUCCESSFUL.

1868
01:17:54,450 --> 01:17:59,888
I CAN SAY THAT ON A BROADER 

1869
01:17:59,888 --> 01:18:00,389
SPECTRUM, YOU KNOW.

1870
01:18:00,389 --> 01:18:01,990
WITH HOPE FOR THINGS TO COME.

1871
01:18:01,990 --> 01:18:07,863
BUT RIGHT THERE IN THE WEEDS, 

1872
01:18:07,863 --> 01:18:09,965
RIGHT THERE WITH THE PATIENTS, 

1873
01:18:09,965 --> 01:18:13,469
WHAT IS YOUR PERSPECTIVE ON IT 

1874
01:18:13,469 --> 01:18:14,937
DIRECTOR GOLDHAMMER AND YOUR 

1875
01:18:14,937 --> 01:18:15,671
PERSPECTIVE DR. GRAHAM?

1876
01:18:15,671 --> 01:18:16,438
>> YEAH.

1877
01:18:16,438 --> 01:18:21,877
I THINK THERE IS PROBABLY A LOT 

1878
01:18:21,877 --> 01:18:23,712
OF EXAMPLES OF IT.

1879
01:18:23,712 --> 01:18:29,151
I THINK AS NATIVE PEOPLE ARE 

1880
01:18:29,151 --> 01:18:31,086
PRETTY USED TO WORKING WITH AND 

1881
01:18:31,086 --> 01:18:32,821
PARTNERING WITH NON-INDIGENOUS 

1882
01:18:32,821 --> 01:18:38,394
PROVIDERS SO WE CAN LOOK AT THIS

1883
01:18:38,394 --> 01:18:39,862
ON THE MICRO LEVEL, PROVIDER TO 

1884
01:18:39,862 --> 01:18:43,399
PATIENT OR DIAD OR BRING IT UP 

1885
01:18:43,399 --> 01:18:48,103
TO MESO OR MACRO LEVEL TO 

1886
01:18:48,103 --> 01:18:49,238
DIFFERENT CAMPAIGNS THAT 

1887
01:18:49,238 --> 01:18:53,175
CLARISSA IS TALKING ABOUT.

1888
01:18:53,175 --> 01:18:55,844
AND SOME HAVE BEEN SUCCESSFUL.

1889
01:18:55,844 --> 01:19:02,151
I CAN'T NAME ANYTHING LIKE SUPER

1890
01:19:02,151 --> 01:19:03,886
SPECIFICALLY, BUT I THINK, YES, 

1891
01:19:03,886 --> 01:19:06,688
THERE'S A LOT OF NON-NATIVE 

1892
01:19:06,688 --> 01:19:08,924
PEOPLE OR NON-INDIGENOUS PEOPLE 

1893
01:19:08,924 --> 01:19:11,860
WORKING WITH AND FOR NATIVE 

1894
01:19:11,860 --> 01:19:15,164
PEOPLE THAT ARE EXTREMELY 

1895
01:19:15,164 --> 01:19:19,168
VALUABLE AND EXTREMELY HELPFUL.

1896
01:19:19,168 --> 01:19:24,940
I WILL SAY, THOUGH, THAT NONE OF

1897
01:19:24,940 --> 01:19:27,075
IT IS FAST ENOUGH FOR ME.

1898
01:19:27,075 --> 01:19:30,012
SO I, YOU KNOW, I HAVE A PROBLEM

1899
01:19:30,012 --> 01:19:32,915
WITH PATIENCE WHEN IT COMES TO 

1900
01:19:32,915 --> 01:19:36,618
NATIVE MOMS' LIVES AND THEIR 

1901
01:19:36,618 --> 01:19:36,985
BABIES' LIVES.

1902
01:19:36,985 --> 01:19:39,855
I THINK SOME OF THE BIGGER 

1903
01:19:39,855 --> 01:19:41,790
THINGS THAT HAPPEN AT THE 

1904
01:19:41,790 --> 01:19:44,293
FEDERAL LEVEL ARE A REALLY BIG 

1905
01:19:44,293 --> 01:19:44,526
PICTURE.

1906
01:19:44,526 --> 01:19:46,662
LIKE DR. GRAHAM SAID, A LOT OF 

1907
01:19:46,662 --> 01:19:47,863
THIS IS A LONG GAME ESPECIALLY 

1908
01:19:47,863 --> 01:19:50,499
WHEN IT COMES TO WORKFORCE 

1909
01:19:50,499 --> 01:19:50,732
ISSUES.

1910
01:19:50,732 --> 01:19:52,367
IT IS GOING TO TAKE A REALLY 

1911
01:19:52,367 --> 01:19:52,835
LONG TIME.

1912
01:19:52,835 --> 01:19:56,405
EVEN FOR ME AS A DOULA, IF I 

1913
01:19:56,405 --> 01:20:01,510
WANTED TO HIRE A DOULA, LET'S 

1914
01:20:01,510 --> 01:20:03,779
SAY THIS WEEK, I WOULD LITERALLY

1915
01:20:03,779 --> 01:20:07,683
HAVE TO HOLD A DOULA TRAINING.

1916
01:20:07,683 --> 01:20:09,418
THAT IS HOW FEW NATIVE DOULAS 

1917
01:20:09,418 --> 01:20:11,887
THERE ARE AND I LIVE IN 

1918
01:20:11,887 --> 01:20:14,323
LITERALLY A BIRTH BUBBLE.

1919
01:20:14,323 --> 01:20:16,558
SEATTLE IS WHERE THE MODERN DAY 

1920
01:20:16,558 --> 01:20:21,964
FIELD OF DOULAS WERE CREATED BY 

1921
01:20:21,964 --> 01:20:27,002
PENNY SIMPKN AND THERE IS A LACK

1922
01:20:27,002 --> 01:20:28,337
OF NATIVE DOULAS HERE.

1923
01:20:28,337 --> 01:20:31,907
SO FOR ME THERE IS AN URGENCY IN

1924
01:20:31,907 --> 01:20:32,541
THIS.

1925
01:20:32,541 --> 01:20:35,878
THIS IS WHERE I WILL SAY DOULAS 

1926
01:20:35,878 --> 01:20:38,547
PLAY SUCH A HUGE ROLE, 

1927
01:20:38,547 --> 01:20:39,715
INDIGENOUS DOULAS MAKING THESE 

1928
01:20:39,715 --> 01:20:40,482
DIFFERENCES.

1929
01:20:40,482 --> 01:20:42,117
YES, IT REQUIRES PEOPLE OUTSIDE 

1930
01:20:42,117 --> 01:20:47,222
OF OUR COMMUNITY SUPPORTING US 

1931
01:20:47,222 --> 01:20:53,729
AND I THINK THE FASTEST AND THE 

1932
01:20:53,729 --> 01:20:56,665
BEST WAY TO SEE AN IMPACT IS BY 

1933
01:20:56,665 --> 01:20:57,399
SUPPORTING THE COMMUNITY ITSELF 

1934
01:20:57,399 --> 01:20:58,534
AND THOSE THAT ARE DOING THE 

1935
01:20:58,534 --> 01:21:00,435
WORK AND THERE IS A LOT OF 

1936
01:21:00,435 --> 01:21:03,605
AMAZING WORK HAPPENING AT THE 

1937
01:21:03,605 --> 01:21:04,573
COMMUNITY LEVEL.

1938
01:21:04,573 --> 01:21:06,108
ESPECIALLY IN THE BLACK AND 

1939
01:21:06,108 --> 01:21:06,708
NATIVE COMMUNITY.

1940
01:21:06,708 --> 01:21:12,981
I MEAN, IT IS SO INSPIRING, SO 

1941
01:21:12,981 --> 01:21:15,384
BEAUTIFUL TO SEE AND THAT IS 

1942
01:21:15,384 --> 01:21:16,618
ABSOLUTELY WHERE I THINK THE 

1943
01:21:16,618 --> 01:21:21,023
INVESTMENTS NEED TO BE MADE.

1944
01:21:21,023 --> 01:21:24,993
>> I THINK THERE HAVE BEEN

1945
01:21:24,993 --> 01:21:25,994
THROUGHOUT HISTORY, 

1946
01:21:25,994 --> 01:21:27,863
FUNDAMENTALLY FROM THE VERY 

1947
01:21:27,863 --> 01:21:30,966
BEGINNING WE'VE HAD ALLIES.

1948
01:21:30,966 --> 01:21:33,235
WE'VE HAD ALLIES THAT HAVE 

1949
01:21:33,235 --> 01:21:36,405
CROSSED AND PLACED THEIR OWN 

1950
01:21:36,405 --> 01:21:39,074
SELVES, THEIR OWN LIVELIHOOD, 

1951
01:21:39,074 --> 01:21:40,409
THEIR OWN INTERESTS, YOU KNOW, 

1952
01:21:40,409 --> 01:21:42,244
IN HARM'S WAY TO BE EXCELLENT 

1953
01:21:42,244 --> 01:21:43,211
ALLIES FOR US.

1954
01:21:43,211 --> 01:21:47,883
SO ABSOLUTELY I THINK THERE ARE 

1955
01:21:47,883 --> 01:21:51,153
GREAT EXAMPLES OF NON-NATIVE 

1956
01:21:51,153 --> 01:21:55,857
PARTNERS THAT HAVE COME TO OUR 

1957
01:21:55,857 --> 01:21:58,660
AID, COME AS ALLIES IN THIS 

1958
01:21:58,660 --> 01:22:01,263
FIGHT, RIGHT, BOTH FOR WOMEN'S 

1959
01:22:01,263 --> 01:22:03,599
REPRODUCTIVE RIGHTS, WOMEN'S 

1960
01:22:03,599 --> 01:22:09,705
HEALTH CARE AND, YEAH.

1961
01:22:09,705 --> 01:22:11,740
SO -- AND WE CAN'T DO THIS 

1962
01:22:11,740 --> 01:22:11,940
ALONE.

1963
01:22:11,940 --> 01:22:13,308
THE WORK IS SO HARD.

1964
01:22:13,308 --> 01:22:15,577
THERE IS SO MUCH WORK TO BE 

1965
01:22:15,577 --> 01:22:15,777
DONE.

1966
01:22:15,777 --> 01:22:18,647
WE CANNOT DO IT WITHOUT ALLIES.

1967
01:22:18,647 --> 01:22:20,849
BUT THEY HAVE TO APPROACH IT AS 

1968
01:22:20,849 --> 01:22:23,018
ALLIES, AS PARTNERS, RIGHT?

1969
01:22:23,018 --> 01:22:24,753
I THINK WHEN WE START TO 

1970
01:22:24,753 --> 01:22:28,090
APPROACH IT FROM A PATERNALISTIC

1971
01:22:28,090 --> 01:22:31,860
STANDPOINT OF A SAVIOR COMPLEX, 

1972
01:22:31,860 --> 01:22:34,062
RIGHT, THEN THINGS START TO GO 

1973
01:22:34,062 --> 01:22:34,262
SOUTH.

1974
01:22:34,262 --> 01:22:37,866
BUT ALL OF THE EXAMPLES THAT I 

1975
01:22:37,866 --> 01:22:39,868
HAVE SEEN, YOU KNOW, BOTH IN 

1976
01:22:39,868 --> 01:22:44,573
NATIVE COMMUNITIES RIGHT HERE IN

1977
01:22:44,573 --> 01:22:46,208
AFRICAN-AMERICAN COMMUNITIES IN 

1978
01:22:46,208 --> 01:22:48,043
DELAWARE, ET CETERA, IS THE TRUE

1979
01:22:48,043 --> 01:22:49,011
PARTNERSHIP.

1980
01:22:49,011 --> 01:22:50,679
THE ALLIES OF PEOPLE WHO REALLY 

1981
01:22:50,679 --> 01:22:53,315
CARE FOR THESE PATIENTS AND 

1982
01:22:53,315 --> 01:22:56,518
REALLY WANT TO SEE THEM SUCCEED,

1983
01:22:56,518 --> 01:22:59,888
THRIVE, AND WANT WHAT IS BEST 

1984
01:22:59,888 --> 01:23:01,590
FOR THEM.

1985
01:23:01,590 --> 01:23:08,697
>> I THINK THAT THE MAIN 

1986
01:23:08,697 --> 01:23:09,831
THOUGHTS MOVING FORWARD 

1987
01:23:09,831 --> 01:23:11,867
ESPECIALLY NOTHING IS DONE ON AN

1988
01:23:11,867 --> 01:23:13,035
ISLAND ALL BY ITSELF.

1989
01:23:13,035 --> 01:23:16,872
IT TAKES COLLABORATIVE EFFORT 

1990
01:23:16,872 --> 01:23:22,077
AND COMMUNITY TO HELP PROTECT 

1991
01:23:22,077 --> 01:23:22,744
INDIVIDUAL LIVES.

1992
01:23:22,744 --> 01:23:24,813
AND THOSE ARE THINGS THAT WE ARE

1993
01:23:24,813 --> 01:23:29,051
LOOKING FORWARD TO DOING, 

1994
01:23:29,051 --> 01:23:31,753
PROTECTING INDIVIDUAL LIVES, AS 

1995
01:23:31,753 --> 01:23:33,689
MANY AS POSSIBLE, AND COMMUNITY 

1996
01:23:33,689 --> 01:23:33,889
LIVES.

1997
01:23:33,889 --> 01:23:35,957
AND THEN THE LIVES ACROSS THE 

1998
01:23:35,957 --> 01:23:40,095
NATION ACROSS THE GLOBE.

1999
01:23:40,095 --> 01:23:41,730
NOT JUST HERE BUT ABROAD AS 

2000
01:23:41,730 --> 01:23:42,097
WELL.

2001
01:23:42,097 --> 01:23:44,199
THE FACT THAT THE CHALLENGES WE 

2002
01:23:44,199 --> 01:23:47,703
DISCUSSED TODAY HAVE CREATED 

2003
01:23:47,703 --> 01:23:49,104
THIS SERIOUS MENTAL HEALTH 

2004
01:23:49,104 --> 01:23:51,173
CRISIS IN THE UNITED STATES THAT

2005
01:23:51,173 --> 01:23:55,777
HAS A PALPABLE EFFECT ON FUTURE 

2006
01:23:55,777 --> 01:23:58,947
GENERATIONS MAKES THIS ISSUE 

2007
01:23:58,947 --> 01:24:00,248
EVERYONE'S CONCERN.

2008
01:24:00,248 --> 01:24:02,117
ALTHOUGH INFORMATION SPECIFIC TO

2009
01:24:02,117 --> 01:24:02,951
JUST NATIVE AMERICAN PEOPLE MAY 

2010
01:24:02,951 --> 01:24:05,620
BE LACKING IN CERTAIN AREAS, 

2011
01:24:05,620 --> 01:24:07,889
AGAIN, EXISTS MODELS ARE 

2012
01:24:07,889 --> 01:24:08,190
APPLICABLE.

2013
01:24:08,190 --> 01:24:11,493
THE ISSUES ARE DEEPER THAN JUST 

2014
01:24:11,493 --> 01:24:13,862
TIMING AND THE NUMBER OF DOCTOR 

2015
01:24:13,862 --> 01:24:15,864
VISITS OR INADEQUATE CARE BOTH 

2016
01:24:15,864 --> 01:24:19,868
IN RURAL AND URBAN AREAS FOR 

2017
01:24:19,868 --> 01:24:21,203
UNDERSTANDING OF NATIVE AMERICAN

2018
01:24:21,203 --> 01:24:24,473
CULTURE AND NEGATIVE PROVIDER 

2019
01:24:24,473 --> 01:24:26,575
EXPERIENCES, VIA DISRESPECT AND 

2020
01:24:26,575 --> 01:24:27,876
BEING STEREOTYPED.

2021
01:24:27,876 --> 01:24:30,112
THE INABILITY TO TAILOR CARE TO 

2022
01:24:30,112 --> 01:24:34,916
THE UNIQUE NEEDS OF NATIVE 

2023
01:24:34,916 --> 01:24:38,487
BIRTHING PEOPLE TO NOT REMAIN AN

2024
01:24:38,487 --> 01:24:39,755
UNADDRESSED ISSUE.

2025
01:24:39,755 --> 01:24:42,124
AND ALLIES IN PARTNERSHIP WITH 

2026
01:24:42,124 --> 01:24:47,129
COMMUNITIES AND COMMUNITY 

2027
01:24:47,129 --> 01:24:48,463
PARTICIPATORY PRACTICE DOES 

2028
01:24:48,463 --> 01:24:48,663
WORK.

2029
01:24:48,663 --> 01:24:55,170
SYSTEM LEVEL FACTORS CAN BE 

2030
01:24:55,170 --> 01:24:55,771
COMBAT

2031
01:24:55,771 --> 01:24:56,037
COMBATTED.

2032
01:24:56,037 --> 01:24:58,306
THERE WAS A SUGGESTION WITH 

2033
01:24:58,306 --> 01:25:00,208
WIDESPREAD USE OF DOULA AND 

2034
01:25:00,208 --> 01:25:02,544
MIDWIFE SERVICES HAVE SHOWN 

2035
01:25:02,544 --> 01:25:03,678
IMPROVEMENTS IN THE QUALITY OF 

2036
01:25:03,678 --> 01:25:06,214
CARE IN PRENATAL OUTCOMES WHEN 

2037
01:25:06,214 --> 01:25:09,684
PARTNERING WITH PROVIDERS.

2038
01:25:09,684 --> 01:25:12,687
AND THESE PARTNERSHIPS ARE 

2039
01:25:12,687 --> 01:25:13,889
VIABLE.

2040
01:25:13,889 --> 01:25:14,923
THESE PARTNERSHIPS ARE HAPPENING

2041
01:25:14,923 --> 01:25:17,292
RIGHT THERE IN DELAWARE.

2042
01:25:17,292 --> 01:25:19,594
THESE PARTNERSHIPS WILL CONTINUE

2043
01:25:19,594 --> 01:25:20,595
TO CREATE WONDERFUL CHANGE AND 

2044
01:25:20,595 --> 01:25:22,397
THAT IS ONE OF THE THINGS THAT 

2045
01:25:22,397 --> 01:25:25,634
WE WANT TO DO IS HAVE THE 

2046
01:25:25,634 --> 01:25:28,036
CHANGES THAT CAN MOVE THINGS 

2047
01:25:28,036 --> 01:25:31,940
FORWARD AND WE ALSO CAN LOOK AT 

2048
01:25:31,940 --> 01:25:34,776
THAT COORDINATING CARE, HOME 

2049
01:25:34,776 --> 01:25:35,977
VISITS, TELEHEALTH, PEER SUPPORT

2050
01:25:35,977 --> 01:25:39,414
AND SEEK TO ELIMINATE THE RASHT 

2051
01:25:39,414 --> 01:25:42,450
AND ETHNIC DISPARITIES ON THE 

2052
01:25:42,450 --> 01:25:46,488
PROVIDER RELATED LEVELS, ON 

2053
01:25:46,488 --> 01:25:50,425
SYSTEMIC LEVEL OF INAPPROPRIATE 

2054
01:25:50,425 --> 01:25:50,725
MANAGEMENT.

2055
01:25:50,725 --> 01:25:54,696
WE CAN DO TARGETED CULTURAL 

2056
01:25:54,696 --> 01:25:57,265
HUMILITY AND TRAINING 

2057
01:25:57,265 --> 01:25:59,801
TRAUMA-INFORMED CARE, QUALITY 

2058
01:25:59,801 --> 01:26:02,304
IMPROVEMENTS AND OTHER TYPES OF 

2059
01:26:02,304 --> 01:26:02,571
TRAINING.

2060
01:26:02,571 --> 01:26:04,606
I THINK THE BIG TAKE-HOME 

2061
01:26:04,606 --> 01:26:06,808
MESSAGE IS WE HAVE TO DO IT IN 

2062
01:26:06,808 --> 01:26:08,410
COMMUNITY WITH ONE ANOTHER, WITH

2063
01:26:08,410 --> 01:26:09,845
ALLIES, WITH MEMBERS OF THE 

2064
01:26:09,845 --> 01:26:10,912
COMMUNITY, WITH PEOPLE IN 

2065
01:26:10,912 --> 01:26:13,849
POSITIONS OF POWER, WITH PEOPLE 

2066
01:26:13,849 --> 01:26:17,118
WHO CAN FUND THESE IMPORTANT 

2067
01:26:17,118 --> 01:26:19,387
INITIATIVES OR CREATE IMPORTANT 

2068
01:26:19,387 --> 01:26:22,591
INITIATIVES WITH THE PEOPLE THEY

2069
01:26:22,591 --> 01:26:24,826
ARE TRYING TO CREATE THE 

2070
01:26:24,826 --> 01:26:25,694
INITIATIVES FOR.

2071
01:26:25,694 --> 01:26:27,729
HAVING AN EQUAL SEAT AT THAT 

2072
01:26:27,729 --> 01:26:30,098
TABLE, EVEN IF THEY DON'T HAVE 

2073
01:26:30,098 --> 01:26:33,902
THE FUNDING DOLLAR, I THINK 

2074
01:26:33,902 --> 01:26:38,373
THOSE THINGS ALONG WITH SEVERAL 

2075
01:26:38,373 --> 01:26:39,908
OTHERS CAN BE VIABLE STEPS 

2076
01:26:39,908 --> 01:26:44,246
FORWARD FOR OUR FUTURE.

2077
01:26:44,246 --> 01:26:47,082
AND NOT JUST THE FUTURE OF A FEW

2078
01:26:47,082 --> 01:26:49,618
OR ONE PARTICULAR POPULATION, 

2079
01:26:49,618 --> 01:26:53,922
BUT A FUTURE FOR ALL BIRTHING 

2080
01:26:53,922 --> 01:26:55,023
PEOPLE BECAUSE HERE IN THE 

2081
01:26:55,023 --> 01:26:58,059
UNITED STATES IT IS AN ISSUE 

2082
01:26:58,059 --> 01:26:59,761
ACROSS THE BOARD.

2083
01:26:59,761 --> 01:27:01,730
BUT IT DOES HAVE THE TWO TO 

2084
01:27:01,730 --> 01:27:06,768
THREE TIME HIGHER IMPACT 

2085
01:27:06,768 --> 01:27:08,703
SPECIFICALLY ON NATIVE AMERICAN 

2086
01:27:08,703 --> 01:27:10,572
BIRTHING PEOPLE AND BLACK 

2087
01:27:10,572 --> 01:27:10,939
BIRTHING PEOPLE.

2088
01:27:10,939 --> 01:27:13,508
SO THAT'S THE REASON THIS 

2089
01:27:13,508 --> 01:27:14,676
DISCUSSION IS TAKING PLACE.

2090
01:27:14,676 --> 01:27:17,679
BUT I WOULD LIKE FOR YOU, DR. 

2091
01:27:17,679 --> 01:27:19,748
GRAHAM, AND YOU DIRECTOR 

2092
01:27:19,748 --> 01:27:23,885
GOLDHAMMER, TO GIVE SOME CLOSING

2093
01:27:23,885 --> 01:27:26,454
THOUGHTS.

2094
01:27:26,454 --> 01:27:31,893
>> I MEAN, I THINK THIS IS
SUCH 

2095
01:27:31,893 --> 01:27:34,429
A PASSION OF MINE.

2096
01:27:34,429 --> 01:27:36,164
YOU KNOW, AND I THINK DEFINITELY

2097
01:27:36,164 --> 01:27:39,467
HAVING A SEAT AT THE TABLES, 

2098
01:27:39,467 --> 01:27:41,836
BEING IN THE ROOMS WHERE THE 

2099
01:27:41,836 --> 01:27:45,206
DECISIONS ARE BEING MADE, 

2100
01:27:45,206 --> 01:27:47,709
SERVING ON THE COMMUNITIES, 

2101
01:27:47,709 --> 01:27:51,112
SERVING ON THE, YOU KNOW, IN THE

2102
01:27:51,112 --> 01:27:52,247
COMMUNITY, THAT IS WHERE YOU 

2103
01:27:52,247 --> 01:27:53,648
MAKE CHANGE.

2104
01:27:53,648 --> 01:27:56,918
THAT IS WHERE YOU FIND ALLIES.

2105
01:27:56,918 --> 01:27:59,888
THAT'S WHERE YOU BUILD 

2106
01:27:59,888 --> 01:28:00,522
RELATIONSHIPS.

2107
01:28:00,522 --> 01:28:04,693
TO, I THINK, TRULY HAVE BROADER 

2108
01:28:04,693 --> 01:28:07,128
IMPACT THAN JUST INDIVIDUAL 

2109
01:28:07,128 --> 01:28:09,364
PATIENT CARE.

2110
01:28:09,364 --> 01:28:10,999
AND I JUST HOPE THAT THOSE THAT 

2111
01:28:10,999 --> 01:28:13,601
HAVE BEEN WATCHING TODAY WHO 

2112
01:28:13,601 --> 01:28:15,203
HAVE BEEN LISTENING, YOU KNOW, 

2113
01:28:15,203 --> 01:28:19,741
HAVE BEEN ABLE TO TAKE AWAY FROM

2114
01:28:19,741 --> 01:28:23,144
THIS, YOU KNOW, THE UNIQUE 

2115
01:28:23,144 --> 01:28:26,715
CHALLENGES THAT INDIGENOUS WOMEN

2116
01:28:26,715 --> 01:28:29,584
FACE AND LISTEN A LITTLE HARDER.

2117
01:28:29,584 --> 01:28:33,488
LISTEN A LITTLE LONGER.

2118
01:28:33,488 --> 01:28:36,157
YOU KNOW, THINK TWICE, YOU KNOW,

2119
01:28:36,157 --> 01:28:39,661
ABOUT OUR OWN BIASES ON OKAY WHY

2120
01:28:39,661 --> 01:28:41,529
DID I JUMP TO THAT THOUGHT FOR 

2121
01:28:41,529 --> 01:28:43,031
THAT MOM?

2122
01:28:43,031 --> 01:28:45,367
WHY DID I JUMP TO THAT PLAN?

2123
01:28:45,367 --> 01:28:48,069
IS THAT TRULY WHAT IS GOING ON 

2124
01:28:48,069 --> 01:28:48,269
HERE?

2125
01:28:48,269 --> 01:28:50,171
TAKE A SECOND, YOU KNOW.

2126
01:28:50,171 --> 01:28:57,312
WORK HARD TO BE A PARTNER WITH 

2127
01:28:57,312 --> 01:28:59,147
THAT MOM TO HELP THAT PERSON 

2128
01:28:59,147 --> 01:29:00,849
FEEL COMFORTABLE IN YOUR CARE, 

2129
01:29:00,849 --> 01:29:03,385
FEEL COMFORTABLE OPENING UP TO 

2130
01:29:03,385 --> 01:29:05,420
YOU ABOUT POTENTIAL SYMPTOMS SHE

2131
01:29:05,420 --> 01:29:07,155
MAY BE HAVING OR STRUGGLES THEY 

2132
01:29:07,155 --> 01:29:09,491
MAY BE HAVING SO THAT YOU CAN 

2133
01:29:09,491 --> 01:29:12,160
TRULY ADDRESS THEM AND NAVIGATE 

2134
01:29:12,160 --> 01:29:12,360
THEM.

2135
01:29:12,360 --> 01:29:15,864
TO MAKE IT A TRUE PARTNERSHIP.

2136
01:29:15,864 --> 01:29:17,699
>> I AGREE.

2137
01:29:17,699 --> 01:29:19,868
>> INFORMED CONSENT.

2138
01:29:19,868 --> 01:29:21,369
CONSENT IS PARAMOUNT.

2139
01:29:21,369 --> 01:29:22,270
WOMEN NEED TO HAVE AUTHORITY OF 

2140
01:29:22,270 --> 01:29:25,440
THEIR BODIES.

2141
01:29:25,440 --> 01:29:28,276
AND COERCION FORCED THINGS, THAT

2142
01:29:28,276 --> 01:29:31,179
IS NEVER, EVEN IF IT IS FOR THE 

2143
01:29:31,179 --> 01:29:32,480
GREATER GOOD IN YOUR MIND, THAT 

2144
01:29:32,480 --> 01:29:34,315
IS NEVER THE WAY TO GET THERE.

2145
01:29:34,315 --> 01:29:37,519
>> ABSOLUTELY.

2146
01:29:37,519 --> 01:29:40,055
AND SO IN CLOSING WE HAVE ONE 

2147
01:29:40,055 --> 01:29:43,291
LAST MINUTE LEFT, WE'LL CLOSE 

2148
01:29:43,291 --> 01:29:44,826
WITH DIRECTOR GOLDHAMMER'S 

2149
01:29:44,826 --> 01:29:45,126
STATEMENTS.

2150
01:29:45,126 --> 01:29:46,261
>> YEAH.

2151
01:29:46,261 --> 01:29:47,595
I KNOW.

2152
01:29:47,595 --> 01:29:47,862
THANK YOU.

2153
01:29:47,862 --> 01:29:53,501
I THINK JUST IN CLOSING I JUST 

2154
01:29:53,501 --> 01:29:56,938
WANT TO SAY, LIKE, TRUST US.

2155
01:29:56,938 --> 01:29:59,074
I KNOW I HAVE SAID IT SEVERAL 

2156
01:29:59,074 --> 01:29:59,274
TIMES.

2157
01:29:59,274 --> 01:30:03,878
WE DO HAVE THE ANSWERS.

2158
01:30:03,878 --> 01:30:07,849
AND AS I HEAD OVER TO THE 

2159
01:30:07,849 --> 01:30:09,184
INDIGENOUS MEDICINE 

2160
01:30:09,184 --> 01:30:10,318
CONVERSATION, DAY TWO OF OUR 

2161
01:30:10,318 --> 01:30:11,719
CONFERENCE FROM HERE, THE THING 

2162
01:30:11,719 --> 01:30:13,521
I SAID TO PARTICIPANTS YESTERDAY

2163
01:30:13,521 --> 01:30:20,762
ON DAY ONE OF THE CONFERENCE WAS

2164
01:30:20,762 --> 01:30:25,467
YOU ARE VERY PRIVILEGED AND 

2165
01:30:25,467 --> 01:30:27,635
LUCKY TO BE IN THE PRESENCE AND 

2166
01:30:27,635 --> 01:30:29,404
WORK IN NATIVE COMMUNITIES.

2167
01:30:29,404 --> 01:30:36,177
WE ARE REALLY, REALLY, REALLY 

2168
01:30:36,177 --> 01:30:36,644
EXCEPTIONAL PEOPLE.

2169
01:30:36,644 --> 01:30:39,747
AND I THINK WHAT I WANT FOLKS TO

2170
01:30:39,747 --> 01:30:41,583
KNOW IS WE ARE WORTH INVESTING 

2171
01:30:41,583 --> 01:30:42,117
IN.

2172
01:30:42,117 --> 01:30:43,885
WE ARE ABSOLUTELY WORTH 

2173
01:30:43,885 --> 01:30:45,753
INVESTING IN AND WE CAN DO 

2174
01:30:45,753 --> 01:30:46,488
SOMETHING ABOUT THIS CRISIS THAT

2175
01:30:46,488 --> 01:30:48,490
WE'RE IN.

2176
01:30:48,490 --> 01:30:50,158
>> THANK YOU ALL FOR
COMING.

2177
01:30:50,158 --> 01:30:51,960
THANK YOU FOR YOUR CLOSING 

2178
01:30:51,960 --> 01:30:52,193
REMARKS.

2179
01:30:52,193 --> 01:30:55,430
AND WE'D LIKE TO THANK ALL OF 

2180
01:30:55,430 --> 01:30:58,900
THE MEMBERS OF OUR AUDIENCE AND 

2181
01:30:58,900 --> 01:31:00,201
ALL OF OUR AD HOC COMMITTEE 

2182
01:31:00,201 --> 01:31:02,504
MEMBERS THAT ALLOWED THIS PANEL 

2183
01:31:02,504 --> 01:31:04,339
DISCUSSION TO TAKE PLACE AND WE 

2184
01:31:04,339 --> 01:31:08,643
LOOK FORWARD TO MANY MORE IN 

2185
01:31:08,643 --> 01:31:11,379
COLLABORATION WITH U.S. 

2186
01:31:11,379 --> 01:31:12,013
DEPARTMENT OF HEALTH AND HUMAN 

2187
01:31:12,013 --> 01:31:16,317
SERVICES AND INDIAN HEALTH 

2188
01:31:16,317 --> 01:31:16,584
SERVICES.

2189
01:31:16,584 --> 01:31:19,554
SPECIAL THANKS TO EVERYONE ON 

2190
01:31:19,554 --> 01:31:20,155
THE INDIGENOUS ENGAGEMENT 

2191
01:31:20,155 --> 01:31:22,123
COMMITTEE AND THE OFFICE OF 

2192
01:31:22,123 --> 01:31:23,424
EQUITY, DIVERSITY AND INCLUSION 

2193
01:31:23,424 --> 01:31:23,958
AT NIH.

2194
01:31:23,958 --> 01:31:26,194
WE WOULD LIKE TO THANK YOU ALL 

2195
01:31:26,194 --> 01:31:27,862
FOR COMING AND WE HOPE YOU ENJOY

2196
01:31:27,862 --> 01:31:29,597
THE REST OF YOUR DAY AND THAT 

2197
01:31:29,597 --> 01:31:31,866
YOU HAVE LEARNED SOMETHING.

2198
01:31:31,866 --> 01:31:35,103
ALLYSHIP DOES WORK.

2199
01:31:35,103 --> 01:31:36,771
SO PLEASE JOIN US, CONTINUE TO 

2200
01:31:36,771 --> 01:31:38,173
SUPPORT US AS WE CONTINUE TO 

2201
01:31:38,173 --> 01:31:39,107
SUPPORT THE COMMUNITY.

2202
01:31:39,107 --> 01:31:40,041
HAVE A WONDERFUL REST OF THE 

2203
01:31:40,041 --> 01:31:41,943
DAY, EVERYONE.

2204
01:31:41,943 --> 01:31:42,744
THANK YOU FOR COMING.

2205
01:31:42,744 --> 01:31:43,978
>> HAVE A GREAT DAY.

2206
01:31:43,978 --> 01:31:54,222
>> THANK YOU.