cover of episode S23 E14: S23 Roundtable with MAMA founders Kristen & Markeda and Dr. Shannon M. Clark, MD, FACOG

S23 E14: S23 Roundtable with MAMA founders Kristen & Markeda and Dr. Shannon M. Clark, MD, FACOG

2025/5/15
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Shannon Clark: 我是一名双认证妇产科医生和母胎医学专家,在大型学术机构工作。我处理各种孕期并发症,并对长时间工作和随时待命的情况习以为常。我关注的是生育中心护理的风险,特别是对于那些在孕期护理不当或存在潜在风险因素的产妇。在生育中心,一旦出现问题,时间至关重要,透明度和充分的知情同意至关重要。我并不反对助产模式,但它必须适用于患者,并能及时应对孕期变化和并发症。我们不能忽视危险信号,而应进行适当的评估和管理,以确保产妇和胎儿的最佳结果。 关于胎粪,我们不能忽视它,因为它可能导致严重后果,包括胎粪吸入综合征和新生儿缺氧缺血性脑病。一旦出现胎粪,应立即通知新生儿复苏团队,并进行持续的胎儿监护。生育中心应有明确的应对胎粪的方案。 关于医疗记录,更改记录应有审计追踪,以确保透明度和问责制。 孕产妇死亡危机是多方面因素造成的,包括孕产妇死亡率上升、种族差异、获得护理的机会有限以及社会决定因素的影响。我们需要关注公平的医疗保健,承认社会决定因素的作用,并继续进行研究和数据收集。我们必须承认产科护理中的种族主义是一个问题,并追究相关人员的责任。 关于生理性分娩,它的定义因人而异,重要的是产妇和胎儿的最佳结果,无论采取何种方式。 医疗专业人员不应与患者在社交媒体上进行私人沟通,这可能会影响客观性。 Kristen: 我在产后寻找答案的过程中,发现了Shannon Clark医生的社交媒体平台,并被她为孕妇提供准确信息,打破对干预、硬膜外麻醉或住院等热门话题的负面偏见的做法所吸引。 在生育中心分娩,产妇可能无法获得充分的信息来做出明智的决定,例如,关于剖腹产后再次怀孕的风险。 我个人经历中,一些危险信号被医生轻描淡写,没有及时转诊到更高水平的医疗机构。 我们创建了Moms Advocating for Moms非营利组织,旨在提高孕产妇保健意识,解决护理中的差距,并为母亲提供信息和支持。 Markeda: 我们创建了Moms Advocating for Moms非营利组织,旨在解决孕产妇保健中的差距,并为母亲提供信息和支持。 我们参与起草了德克萨斯州的马利克法案(HB 4553),该法案旨在提高助产士的报告要求,以改善数据收集和透明度,让消费者能够做出更明智的决定。 目前,助产士的报告是自愿的,并且数据仅限于助产士内部,公众无法访问。马利克法案将提供更多信息,帮助我们更好地了解院外分娩环境中的情况。 助产士和生育中心有时会夸大其安全性的说法,而缺乏公开的数据支持。 我们希望通过Moms Advocating for Moms提供更多资源、教育和工具,并为母亲和婴儿提供一个安全的空间,包括精神健康支持。

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*Content warning: pregnancy and birth trauma, medical trauma and negligence. 

*Free + Confidential Resources + Safety Tips: somethingwaswrong.com/resources)   

Moms Advocating For Moms

S23 survivors Markeda, Kristen and Amanda have created a nonprofit, Moms Advocating for Moms, in hopes to create a future where maternal well-being is prioritized, disparities are addressed, and every mother has the resources and support she needs to thrive: https://www.momsadvocatingformoms.org/take-action)

https://linktr.ee/momsadvocatingformoms

Please sign the survivors petitions below to improve midwifery education and regulation in Texas

https://www.change.org/p/improve-midwifery-education-and-regulation-in-texas?recruiter=1336781649&recruited_by_id=74bf3b50-fd98-11ee-9e3f-a55a14340b5a&utm_source=share_petition&utm_campaign=share_for_starters_page&utm_medium=copylink

Malik's Law 

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB4553

M.A.M.A. has helped file a Texas bill called Malik's Law, which is intended to implement requirements for midwives in Texas to report birth outcomes in hopes of improving transparency and data collection in the midwifery field in partnership with Senator Claudia Ordaz. 

Markeda’s Instagram:

https://www.instagram.com/markedasimone/)

Moms Advocating for Moms Alliance:

https://www.instagram.com/momsadvocatingformomsalliance/)

Dr. Shannon Clark’s website

https://www.babiesafter35.com/)

Dr. Shannon Clark on TikTok

https://www.tiktok.com/@babies_after_35)

Dr. Shannon Clark on Instagram

https://www.instagram.com/babiesafter35/)

*Sources:

American College of Nurse Midwives

https://midwife.org/

American College of Obstetricians and Gynecologists (ACOG)

https://www.acog.org/)  

ACOG's Texas Levels of Maternal Care Verification Program: Quality Through Partnership

https://www.acog.org/news/news-articles/2018/09/texas-lomc-verification-program-quality-through-partnership)  

A Comprehensive Case Report Emphasizing the Role of Caesarean Section, Antibiotic Prophylaxis, and Post-operative Care in Meconium-Stained Fetal Distress Syndrome

https://pmc.ncbi.nlm.nih.gov/articles/PMC11370710/#:~:text=Meconium%2Dstainedamnioticfluid(MSAF)oftenleadstomore,andneonatalmortality%5B3%5D)  

The Difference Between Health Equity and Equality

https://www.hopkinsacg.org/health-equity-equality-and-disparities/

EMTALA – Transfer Policy

https://hcahealthcare.com/util/forms/ethics/policies/legal/emtala-facility-sample-policies/generic-emtala-transfer-policy-a.pdf

How cuts at the National Institutes of Health could impact Americans' health

https://www.cbsnews.com/news/nih-layoffs-budget-cuts-medical-research-60-minutes/

Individualized, supportive care key to positive childbirth experience, says WHO

https://www.who.int/news/item/15-02-2018-individualized-supportive-care-key-to-positive-childbirth-experience-says-who)  

Is a HIPAA Violation Grounds for Termination?

https://www.hipaajournal.com/hipaa-violation-grounds-for-termination/#:~:text=AHIPAAviolationcanbe,sanctionspolicyoftheemployer)    

March of Dimes

https://www.marchofdimes.org/peristats/about-us)     

Maternal Safety Series: Joint Commission Case Review Requirements

https://www.greeley.com/insights/maternal-safety-series-joint-commission-case-review-requirements)  

Meconium

https://my.clevelandclinic.org/health/body/24102-meconium)  

Meconium Aspiration Syndrome

https://my.clevelandclinic.org/health/diseases/24620-meconium-aspiration-syndrome)  

Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia-A Recipe for Severe Pulmonary Hypertension?

https://pubmed.ncbi.nlm.nih.gov/38929252/#:~:text=Infantsbornthroughmeconium%2Dstained,ofthenewborn(PPHN))   

Medical Auditing Frequently Asked Questions

https://www.aapc.com/resources/medical-auditing-frequently-asked-questions?srsltid=AfmBOooNLHrxkJi3hp2CO-3OkVj1heZAqWFVu7B-M8njnrJs8R78BBoM

Midwifery continuity of care: A scoping review of where, how, by whom and for whom?

https://pmc.ncbi.nlm.nih.gov/articles/PMC10021789/#:~:text=Midwife%2Dledcontinuitymodelsin,plausiblehypothesesrequirefurtherinvestigation)

 

National Midwifery Institute

https://www.nationalmidwiferyinstitute.com/midwifery)    

North American Registry of Midwives (NARM)

https://narm.org/)       

Outcome of subsequent pregnancies in women with complete uterine rupture: A population-based case-control study

https://pubmed.ncbi.nlm.nih.gov/35233771/

Physiology, Pregnancy

https://www.ncbi.nlm.nih.gov/books/NBK559304/

Pregnant women are less and less able to access maternity care

https://www.nbcnews.com/health/health-news/pregnant-women-cant-find-doctors-growing-maternity-care-deserts-rcna169609

State investigating Dallas birth center and midwives, following multiple complaints from patients

https://www.wfaa.com/article/news/local/investigates/state-investigating-dallas-birth-center-midwives-following-multiple-complaints-from-patients/287-ea77eb18-c637-44d4-aaa2-fe8fd7a2fcef)     

Texas Department of Licensing and Regulation (TDLR)

https://www.tdlr.texas.gov/)     

 

Texas Occupations Code, Chapter 203. Midwives 

https://statutes.capitol.texas.gov/Docs/OC/htm/OC.203.htm)

Types of Health Care Quality Measures

https://www.ahrq.gov/talkingquality/measures/types.html#:~:text=Outcomemeasuresmayseemto,informationabouthealthcarequality)   

The US has the highest rate of maternal deaths among high-income nations. Norway has zero

https://amp.cnn.com/cnn/2024/06/04/health/maternal-deaths-high-income-nations)  

U.S. maternal deaths doubled during COVID-19 pandemic, among other findings in new study

https://www.brown.edu/news/2025-04-28/maternal-mortality#:~:text=Maternalmortalityratesdeclinedagainin2022,dieeachyearintheUnitedStates

What is ‘physiological birth’? A scoping review of the perspectives of women and care providers

https://www.sciencedirect.com/science/article/pii/S0266613824000482)  

World Health Organization, Maternal mortality

https://www.who.int/news-room/fact-sheets/detail/maternal-mortality

Zucker School of Medicine, Amos Grunebaum, MD

https://faculty.medicine.hofstra.edu/13732-amos-grunebaum/publications)  

*SWW S23 Theme Song & Artwork: 

Thank you so much to Emily Wolfe for covering Glad Rag’s original song, U Think U for us this season!

Hear more from Emily Wolfe:

On Spotify)

On Apple Music)

https://www.emilywolfemusic.com/)

instagram.com/emilywolfemusic)

Glad Rags: https://www.gladragsmusic.com/

The S23 cover art is by the Amazing Sara Stewart)

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