To Christy Turlington Burns, Every Mother Counts

WASHINGTON, DC—The day that Christy Turlington Burns became a mother is the day she became a maternal health advocate, she shared at a recent gathering of public health advocates.

After delivering her daughter, she hemorrhaged. Thankfully, she recovered, but she was stunned to learn how many women suffer from childbirth complications, including in the US. That experience inspired her to earn her MPH at Columbia University, make the film No Woman, No Cry, and found the US-based grantmaking organization Every Mother Counts. Her organization currently provides grants to smaller, community-led organizations in 7 countries, and works to lift up the stories of women affected by pregnancy and childbirth complications. “When you hear the numbers, they are outrageous, they are embarrassing and they are shocking, Turlington Burns said at the recent Bloomberg American Health Summit. But, she added, hearing women—and the providers trying to help them—share their experiences, she realized that their stories are a powerful advocacy tool. After the summit, she sat down with GHN’s Dayna Kerecman Myers to talk about Every Mother Counts and what led her to devote her career to improving maternal health care.

Can you share the stories of some of the women you’ve met through your foundation’s work? How can their stories be used to advance maternal health care?

Outside the US, I think about the first woman I filmed for No Woman, No Cry in Tanzania, Janet. We arrived in Tanzania, at a small dispensary—not too far from a city, but rural, without a lot of transportation options—and we met Janet, who was pregnant with her third child. She had walked to this clinic, but was turned away after they didn’t feel that they could do anything for her. She was left with the choice to either walk all the way back, to the top of a hill very far away, or stay put and see what happened.

Luckily, we were able to help her, by negotiating a ride to take her to the local hospital about 45 miles away. That little bit of help through transportation made all the difference for her. In rural Tanzania, women can live many miles away from a facility. It showed me that not only do we need more trained providers, we need better transportation access as well.

Here in the US, I think of our grantee partner Jennie Joseph, featured in the same film. She’s remarkable: A clinician, a small business owner, mentor, and a birth justice advocate. She’s out there demanding that people listen to their patients, and helping people negotiate the bureaucracy of our Medicaid system. She’s an example of what needs to be replicated, and yet there aren’t enough women like her to meet the need.

You’ve shared that you gave birth with a midwife and feel you received the best possible care—has that encouraged you to look at the role of midwives in your advocacy work?

Yes, very much. When we look at solutions that exist out there, midwives and doulas are incredibly underutilized.

I always wanted an unmedicated birth, so to me that meant midwife. I was fortunate at the time that I had access to a birth center within a hospital, which no longer exists. Often, if women are even aware of the quality and services that midwives can provide, being able to access that option is very rare. And so we’re trying to educate the public on how to find that kind of experience that so many women are craving.

I’ve always found that unless you’re a high-risk pregnancy a midwife is the best way to go. Doctors often don’t have the ability or time in our system to be able to provide the same kind of care. Midwives are mostly women, not always, but predominantly, and we don’t even reimburse them properly. That has made it difficult for midwives to practice; there are less than 10,000 practicing midwives in the US. In the UK and some other countries, midwives are integrated into the health system, giving every woman a choice between an obstetrician and a midwife.

When we look at systems where maternal mortality is not on the rise, usually there are midwives in the system. It’s much more cost-effective as well, which is another angle I think should attract more interest.

What are the long-term goals for Every Mother Counts?

Our goal is ambitious: We hope to ensure that every mother everywhere has access to quality, respectful, and equitable maternity care. That could take many years, many lifetimes—but we are getting closer to that goal. Since I became a mom, the global figures have dropped from 530,000 estimated girls and women who die from pregnancy and childbirth complications to 303,000. That’s quite a jump in a relatively short amount of time. We hope to see those numbers come down more, yet right now is a very precarious time, with women’s health care being taken away and so many options being closed. That’s true even in the District of Columbia, where hospital closures are forcing women outside of the health system. And, all too often it's the women who need the care the most who are left in the dark about the closures, and where to find alternatives.

That urgency is a big motivator for us, and that’s why advocacy is such an important track for us right now. There’s an appetite for it, and there are a record number of maternity-focused pieces of legislation nationally. Globally is a little bit trickier right now, however, we’re also interested in global opportunities that we’ve been exploring in Guatemala, Haiti, and Tanzania.

When you set out to get your MPH, did you know what you wanted to do with the degree when you graduated? Has it proved valuable?

I’d been doing a lot of advocacy around public health prior to doing maternal health—smoking cessation and prevention was a big focus of mine in my early 20s. When I became a mom, it led me to maternal health. The public health degree was just the next step in the advocacy work I’d been doing on maternal health and HIV/AIDS with international groups like CARE, One, and others. They all advised me that an MPH was the best path to what I wanted to accomplish, and I would say that was very true.

I went back to school for my undergrad as well, and I think there’s a lot of fear and trepidation around going back to school once you are an adult … but Mailman’s MPH program requires life experience before people can enter the program, so you have people of all ages from all over the world—which is really exciting. I was on the family health track, the more flexible track for a mom with young children. If I’d done the global health program at the time, I would have had to do a practicum for 6 months abroad, and that wasn’t feasible as a mom of young children. But academia has changed, with lots of great remote learning options for moms.

This interview has been lightly edited for length and clarity.

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