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Paula James-Martinez

When fashion editor Paula James-Martinez gave birth to her daughter, she did what a lot of people do: started googling. What she learned about maternal health was so horrifying—i.e. the US has the highest maternal mortality rate in the developed world—that she decided to make an entire documentary about it (as a first time director, no less!). The result is Born Free, a new film about “a fight for our lives.”
by Sollis Health

How did you become so passionate about maternal health?

In all honesty I don’t really know—it just sort of happened. I think many pregnant people find that there is suddenly this strange world that opens up of questions you’d never had to ask before. Coming from a journalism background, I questioned a lot. In fact, when my OB wanted to schedule an induction a week early because she was “on a trip” around my due date, I actually questioned the very system I was giving birth in and left the hospital and never came back. I ended up having my daughter with midwives at a birth center and it was an incredible and empowering experience. However, it took a lot of privilege to make that choice. It’s out of pocket care as there were no birth centers in network, I had very little fear of birth, and knew and respected the work of midwives as they are the norm where I grew up in the UK. Around the same time a friend who didn’t have the same privilege of choice ended up having an induction for similar reasons it had been suggested I did, and she ended up having an emergency C-section and almost dying. I suddenly had so many more questions? Was it luck? Was it education? Was it privilege? Was it providers?

What inspired you to make an entire documentary about it?

So in trying to answer my own questions I opened up a Pandora’s box on Google about just how bad maternal healthcare in the US is. One particular stat—we are 50 percent more likely to die in childbirth than our own mothers in the US—particularly shook me. Every other nation in the developed world has a maternal mortality rate that is going down. I sat there sort of spinning out on this information feeding my newborn and I asked my husband, “Why doesn’t everyone know this? Why didn’t I know this? How can I tell people about this?” He was like, “Make a film.” And so basically I did.

“Let’s stop infantilizing people when they are pregnant. Yes it hurts, yes it’s hard, yes you need help. But it’s hopeful and joyful and literally world-changing too. And let’s share that spectrum.”

What are some of the most surprising things you learned about birth and maternity while working on the doc, and how did it change your perspective?

I think I went in probably with a very aggressive stance personally against the hospital system, but the majority of OB’s want to do the right thing, and most nurses are downright superheroes. But they are operating under incredibly difficult conditions. There is a staffing crisis, a systemic issue in how many are trained, care deserts, and aggressive targets and constraints coming from the administration and insurance companies in most hospitals. Also, the fact that the US doesn’t have midwives is not by accident. In most developed nations maternal healthcare is run by midwives; in the US the practice of midwifery was systemically dismantled, driven by racism and capitalism and absolutely not based on medical data.

Why do you think the United States, of all places, has the highest maternity mortality rate in the developed world, and what can we all do to help change that?

It’s complicated but I would lean on the lack of midwives, I’d say healthcare care deserts, and I’d say that racism meets many people as soon as they enter the system and before. I think we can push for insurance companies to cover birth centers and I think we should have federal grants to train both nurses into midwives and new midwives so care can be given in each community—for them to be trained in an unbiased model of care.

What’s the worst medical horror story you heard while working on the film?

Gosh it’s so hard. Charles Johnson who set up 4Kira4moms lost his wife in childbirth after she bled out in 12 hours. He was dismissed with, “She just wasn’t a priority right now.” That lack of urgency and empathy killed her. Also Kimberly in the film who literally said no and was cut anyway for no medical reason. But there are so many stories. One of the brand partners mentioned her birth story was so traumatic that they literally broke her spine by force during labour. I think unfortunately if you ask a room full of women about their birth, there will be far, far too many stories of awful trauma.

How has your own experience with motherhood affected the way you view these issues?

I had a fantastic birth—my daughter was born at 5am, I had two cups of tea, and by 11am I was home eating a breakfast burrito with a newborn. I know everyone’s story can’t be like that but I think trauma comes from how we are treated. I have a friend who needed an emergency C-section after two days of home labor, but the doctor was so kind and gentle, and her midwife so supportive, that she feels very empowered by the birth. Being heard and treated as a person should be the minimum of care we all get.

Is there anything doctors didn’t tell you before you went into labor that you wish they had?

Doctors didn’t tell me anything about labor and unfortunately most of the time they do not tell you much. They don’t have time. Most of us are left with Google and hopefully a good support network of friends.

“When my OB wanted to schedule an induction a week early because she was ‘on a trip’ around my due date, I questioned the very system I was giving birth in and left the hospital and never came back.”

You also started a nonprofit, The Mother Lovers, to raise awareness about maternal health. What sort of work does it do, and what can people do to help?

We started it first and foremost to raise awareness of the issues and to educate. Born Free is a conversation starter and Mother Lovers aims to support some of the answers—supporting grassroots orgs to make change at local levels, but also wider media programming and events to bring education to all.

How do you think Sollis can be a beneficial resource for women who are pregnant?

Not only is birthing very difficult, the first trimester is often scary and uncertain due to the high rates of miscarriage and other complications. Having 24/7 access to a doctor during that very critical period is a total godsend.

What do you think are the biggest misconceptions about maternal health, and what do you wish you could make people understand better?

I think honestly there are so many: one being that it’s shameful to talk about and two that it has to be awful. It doesn’t, it’s not weird, it can be healthy and empowering. It’s also hard as F. And I think let’s stop infantilizing people when they are pregnant. Yes it hurts, yes it’s hard, yes you need help. But it’s hopeful and joyful and literally world-changing too. And let’s share that spectrum.

Any good words to live by?

If you don’t ask, you don’t get. I have asked so many people and brands to step outside their comfort zone or their lane to help with maternal health amplification and people have stepped up and shown up in ways I could never imagine. Remember the worst anyone can say is no.
The views and opinions expressed in this campaign are those of the participants, and do not necessarily reflect the views of Sollis Health.
Sollis Health is a 24/7 doctor, private ER and concierge service rolled into one. Whether it’s an emergency or simply to diagnose the symptoms that you typically Google in the middle of the night, our emergency-trained doctors are ready for anything. Interested in becoming a Sollis member?

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