There usually are empirical realities confirmed by numerous sources and studies that validate statistics which make evident the rationale for major policy changes and corrective measures. Then, there are stories couched in those validated statistics that are so astounding in their irony that they compel immediate and widespread attention.
In the captivating documentary Aftershock, which received its premiere this week at Sundance, directors Paula Eiselt and Tonya Lewis Lee set the discussion of reproductive justice upon two stories of the utmost tragic irony when Shamony Gibson and Amber Rose Isaac, both expectant mothers, died of childbirth complications despite the fact that they could have been prevented.
The film excels at giving the crucial humanistic context to a maternal health crisis where Black maternal mortality rates far exceed virtually every other demographic group. But, what Aftershock makes most clear is that it is less the result of socioeconomic differences than it is the impact of several intersecting factors that lead to concrete concerns about structural racism in the healthcare system. For instance, even college-educated Black women including those with advanced degrees, who are expectant mothers, see a much higher mortality rate than white women.
Lee and Eiselt use the twin stories of the grieving survivors of Gibson and Isaac in New York City to anchor the painful irony that binds together the documentary’s structure so effectively. Gibson died 13 days after giving birth to her son, despite repeated attempts to press the hospital’s physicians on addressing postpartum complications that were becoming more painful by the day. The tragic irony is that her mother Shawnee Benton Gibson has been a well-known activist for the cause of maternal health issues affecting Black women. The young father, Omari Maynard, is a painter, who eventually reaches out to Bruce McIntyre, who is grieving the death of Rose Isaac, who died after an emergency cesarean section. She was admitted to the same hospital where her mother once worked, yet another tragic irony. McIntyre discovers after his partner’s death that the physicians had ignored the alarming yet steady decline in her platelet counts that had occurred during prenatal examinations. In the film, McIntyre said that her blood was practically like water when they went ahead with the surgery.
While neither of the hospitals involved in the respective tragic deaths offered more than boilerplate statements off camera which did not acknowledge any errors or negligence in procedures, both of the families have pushed forward to heighten awareness and to implement reforms addressing the structural racism underlying such dismaying statistics. One area challenges the exponential rise in the use of cesarean sections, which have gone up by a factor of six times in the last half century. Another seeks to reconcile the lack of integration in the maternal health system by expanding the use of birthing centers and midwives. Another is to push for improved communication so that Black patients are taken seriously by the medical staff. This would assure that Black expectant mothers would receive the best standard of care and access to the most qualified and experienced physicians as would any other expectant mother.
Only recently, have investigative news series, such as ProPublica’s extensive reporting in the Lost Mothers project, compelled federal health reporting requirements be extended to maternal mortality rates, starting four years ago. Among the researchers featured in the film who joined members of both families in their efforts for reform is Dr. Neel Shah, a Harvard Medical School professor of obstetrics and gynecology. An encouraging scene in the film is when Dr. Shah is demonstrating practices for the attending staff in a hospital’s maternal health ward about how communication with patients of color is essential to the expectations of effective treatment. Another sidebar story follows a couple in Tulsa, who are preparing for the arrival of their newborn at a birthing center, which illustrates convincingly the need for the U.S. maternal health infrastructure to promote and facilitate the use of birthing centers, doulas and midwives, as is the case in other advanced and economically developed countries including the U.K. Eiselt and Lee also include a brief historical segment about how midwives once were commonly accepted but then were pushed out by pioneers in gynecology who abused and exploited Black women in their early research.
The documentary also provides a paragon example of how two experienced professionals complemented each other’s strengths to accomplish a powerful cinematic statement on an issue that only has gained visibility within recent years. Eiselt, who is a strict adherent in the practices of her Jewish faith, directed 93Queen, which chronicled Hasidic women in their Borough Park neighborhood who established New York City’s first all-female ambulance corps. This is Lee’s first film with a director’s credit. The wife of filmmaker Spike Lee, in addition to be a creative producer, she has been extensively involved in campaigns for infant mortality awareness and had produced the documentary Crisis in the Crib: Saving Our Nation’s Babies in the last decade.
To accommodate preventive measures during the pandemic, the directors gave iPhones to the documentary subjects so they could film themselves during times when social distancing restrictions were the most extensive. The results turned out marvelously, as the subjects appear naturally at ease without the usual worries about seeming self-conscious on camera. The documentary is entirely genuine in its personal portrayals.
Aftershock is an exemplar of the power of turning grief over the loss of a beloved family member which could have been prevented into a movement that is gathering a critical mass to realize the reforms that will bring this maternal health crisis under control. There are political and moral wills to overcome the stigma that many in the established allopathic American medical community have attached to midwives, doulas and birthing centers. At the very least, there should be more dialogue to address these issues, as is the case in the U.K. where options for birth and delivery extend well beyond traditional hospitalization. Indeed, Eiselt’s earlier film 93Queen and the directors’ latest work in Aftershock combine into a potent package to inspire, activate and expand the movement well beyond New York City and Tulsa to cities and rural areas across the country.
Maynard, a painter, has created portraits of those mothers such as Gibson who died under similar circumstances. This has strengthened the network of single Black fathers who are raising the children who survived. He and Gibson’s mother established a foundation to support postpartum care and other areas of maternal health. Meanwhile, McIntyre, as seen in the film, has led efforts to break ground for the Bronx’s first birthing center.
Aftershock is an Impact Partners Film, fiscally sponsored by the Utah Film Center and executive produced by Geralyn Dreyfous, who also is cofounder and board chair of the center.