Raising kids can certainly be a struggle—but birthing them may truly be the biggest struggle of all. Worldwide, one woman dies every 90 seconds from pregnancy and childbirth complications; 90% of those deaths are preventable. And perhaps shockingly, women in the U.S. are far from immune to this epidemic (we rank 50th worldwide for maternal mortality according to the latest UN report), despite our skyrocketing spending on healthcare. To bring attention to this crisis in women’s health, Christy Turlington Burns, mother of two, activist, women’s health advocate, and fashion icon, has produced and directed her first film, the incredibly moving documentary “No Woman, No Cry” (which follows pregnant women in Tanzania, Bangladesh, Guatemala and the U.S.) and created Every Mother Counts, a five-year outreach campaign dedicated to improving maternal health and reducing maternal mortality around the world.
We recently got a chance to check in with Christy about motherhood and moviemaking, in advance of the next airing of her film, Saturday, June 4th on OWN: The Oprah Winfrey Network at 11 a.m. ET/PT. (Be sure to set your DVR if you’ll be outside playing with your kids!)
You explain in the trailer for No Woman, No Cry, that the day your daughter, Grace, was born was one of the greatest days of your life, but also the scariest, when you suffered a postpartum hemorrhage shortly after delivery. Can you tell us a little bit more about your birth experience—what you had hoped for, and what actually happened? Do you feel that PPH gave you a different perspective on motherhood right from the start?
Before giving birth I had never been hospitalized and those whom I had visited in hospitals were always very sick. I think this is why I wanted to avoid a hospital when going into my pregnancy. I really didn’t want a medicalized birth experience for our family. Of course, to have such a birth—even in a hospital birth center—you are required to take on more responsibility. The orientations are longer and the commitment is considerable. My pregnancy from start to finish was actually quite perfect and everything I’d hoped it could be. I felt great and even practiced yoga right up to term. I enjoyed nesting and educating myself about how to mother and parent to the best of my ability. I had long been an active aunt for my nieces and nephew and felt confident that I knew how to care for a new baby and toddler. The ONLY thing I feared was a medical intervention and because I was two weeks past the approximated due date, we came very close to losing our privileges at the birth center.
What struck me most after the birth experience was the difference in how empowered I felt during my pregnancy and delivery in comparison to how I felt once my complication required an intervention. In the moments following the delivery, I was on my back and not fully understanding or aware of what was being done to me—a complete feeling of powerlessness. In short, I did not progress to the fourth stage of labor (the part that is often glossed over in the childbirth education books). This apparently can happen for a number of reasons, most likely from exhaustion, but it can become dangerous if the placenta remains in the body too long after delivery. And after an hour, my birth team had run out of tricks and then the OB was called. In addition to this experience being entirely disempowering, it was also excruciatingly painful because I could feel everything. It wasn't until the weeks following when I learned that the complication I had is the leading cause of maternal mortality worldwide—postpartum hemorrhage (PPH).
What was the moment you saw yourself as part of a much larger, global picture of the grim state of maternal health? How did you know you wanted to go beyond your own experience to help other women and girls?
The moment I learned that PPH was the leading cause of maternal death worldwide, it no longer mattered that I had access to adequate care when I needed it. I needed to know what the barriers to care were for girls and women around the world. When I learned that hundreds of thousands of women die each year and that 90% of these deaths are preventable, I knew that I had to get involved.
How has becoming a mom changed your outlook on life?
Becoming a mom has made me appreciate being a woman above and beyond anything else. I think the best thing about being a woman is that we have this unlimited capacity to give and to love—an incredibly empowering realization. What breaks my heart is that not every woman and girl will realize this in her lifetime. My wish is for every girl, every woman and every mother to be empowered, to care for herself and to care for her family to the best of her ability.
When did you decide to make No Woman, No Cry? How were you able to balance making a film with all of your other roles as a mom, wife, graduate student, model, public health advocate (and the list goes on!)...?
I traveled with the humanitarian aid organization CARE in 2005 while pregnant with my second child. It was upon meeting with other pregnant women (and new moms) when I realized that had I given birth to my daughter in such a community, I would have likely died. I decided to make, “No Woman, No Cry” following a trip I took to Peru in 2007, again with CARE. By the time we went to Peru, I had already committed myself to the issue but after visiting a community that proved it was possible to reduce maternal deaths, I was inspired to do more. I thought that a documentary film would be the best medium to connect women around the world through the universal experience of pregnancy and childbirth. I felt that if I could put faces behind this issue and humanize the problem, the public at large would feel more compelled to act.
I was so inspired by the women I met and the individuals who cared for them that I wanted to bring their incredible stories into the homes of people who may never know of their struggles. I started pre production on the film in the summer of 2008 and also enrolled in a Masters in Public Health program that fall (which was already a big undertaking with small children at home, even with my commitment to school only being part-time). The film and the courses at school were (and are still) so connected that they each reinforced one another.
We traveled internationally three times over the two-year period it took to complete filming while also having filmed in NY, DC and Florida in between those trips. I was able to plan around our family's needs and properly space the time between each shoot to make sure everyone (including myself) could adjust. I only model for a few companies that I have had longstanding relationships with these days (and very sparingly) so that never really interfered. Everyone in my life, including the companies I work for, were all very supportive of this project and did their best to plan around my shooting/travel schedule. I could only do a fraction of what I do without an incredibly supportive husband, an amazing childcare helper at home, an incredible crew and a career that has earned me the resources to take on such things. I'm quite grateful.
How did you decide which countries to include in the film? Which women’s stories?
I knew that I wanted to convey that this is a global tragedy but also understood that there are limits to how much audiences can absorb without feeling lost or overwhelmed. My producer and I settled on profiling four countries: Tanzania, Bangladesh, Guatemala and the United States. We wanted to highlight the barriers to accessing adequate care (or any care, really) in each location but in countries where success was possible with the right kind of targeted support.
In Tanzania we examined barriers such as the lack of human resources and shortage of doctors. We also focused on the fact that so many women live in rural areas, far from qualified healthcare providers and without transportation to reach them at the critical junctures in their pregnancy. We identified a government clinic and filmed there for a few weeks in June of 2009. We met several women through the nurse and midwife at the clinic and filmed many of them. However, when Janet came through the door, we were all so intrigued by her and followed our instincts that her story was one that could convey nearly all of the barriers to maternal care for poor women living in Tanzania.
In Bangladesh, we found a program through an NGO (non governmental organization) in the slums of Dhaka and followed a community health worker named, Yasmine, on home visits for several days in January 2009. Through her we met Monica whom we followed one day after Yasmine had referred her to the hospital for a sonogram to find out when she was due. We were so intrigued by all that we saw there and shocked by the treatment she received that we continued to follow her.
We chose Guatemala after hearing about the incredible OB that we profiled, who also happened to be eight months pregnant! We traveled around the country with Linda as she provided training and services to women with little to no access to care, putting her own health at risk in order to do so.
I knew that the US had to be in the film, not only because I am American and delivered my children here but also because I learned that shockingly, we rank very poorly amongst developed nations on safe deliveries. We were ranked 41st when we completed the film last year and have fallen back to 50th in the latest UN report—behind countries such as Saudi Arabia, Croatia and Bulgaria. This is not acceptable, particularly when you consider that we spend more per capita on health care than any other country in the world. Ultimately we weaved some of my personal story in with a story about a midwife in Central Florida who helps women without insurance navigate the system so that they can get prenatal care to examine some of the disparities in maternal health care in America.
What was it like to make this documentary? Did your husband participate in the process in any way? Were your children involved at all?
Making this film and traveling around the world to share it with the varied audiences has been an incredible experience. My hope has always been to contribute a useful tool to inspire activism, which it is proving to do already. My husband was an amazing support and was especially helpful throughout the editing process when we were trying to build back suspense and drama to put the audience in our shoes, as we filmed not knowing the outcomes. He was a great objective voice who only had my best interests at heart. We ultimately used home movie footage of our birth and subsequent complication throughout the film interstitially to show the passage of time and to ground it in between the international stories. It was not really my plan but it became apparent in the edit room that we needed to glue the stories together and since ours inspired my making the film, it was a natural fit.
What were some of the most surprising things you learned during the making of No Woman, No Cry? Were you more dismayed by what you found abroad, or what you discovered in the U.S.?
I learned a lot about a lot of things but especially all that goes into documentary filmmaking and I have a much greater understanding of all that women endure, often unnecessarily. I was not so much surprised as I was in awe of the strength and resilience of the women we filmed. This always struck me and gave me strength and courage to do my best to represent them with the dignity and respect they deserve. I continue to be hopeful about what is possible. We are not waiting for a cure here. We know what needs to be done. We do need more voices for maternal health and I am hoping to inspire new champions for this cause by sharing the film widely.
Does the film’s completion and release feel like the end of something—or just the beginning?
The recent OWN broadcasts over Mother’s Day felt like the beginning in many ways. It was the first time that the public at large was able to see the film and invited to engage. I'm excited to see what develops now that hundreds of thousands of people are equipped with knowledge on the issue of maternal health and the facts about maternal mortality, facts that propelled me to begin on this journey. The potential for impact is tremendous.
What do you hope to accomplish through the Every Mother Counts campaign? Your involvement in the Mobile Alliance for Maternal Action?
I founded the Every Mother Counts campaign to offer audiences who are moved to learn more with information and options to take action and participate in a movement. We will continue to partner and shine a light on individuals, innovations and organizations who are making and can make lasting change.
After watching, “No Woman, No Cry” this weekend, what do you hope viewers will do next?
I believe that we all have unique skills that we can contribute in a meaningful way to issues that touch our hearts. Mother's Day was the ideal time to launch this film but I don't see it as the only opportunity. Every day, 1,000 women die from pregnancy or childbirth related causes. That's 350,000 women every year. Even one preventable death is too many.
What do you hope the picture of global maternal health will look like by the time it’s your daughter’s turn to become a mother?
There had not been any progress on this issue for 20 years and now things are starting to shift. Maternal mortality has dropped by 1/3 in that time. I am optimistic that in 20 to 25 years time, when my daughter is planning her family, the momentum that has been building will have continued, proving to us all that our collective commitment to the health of mothers and their families was the right thing to do now.
To learn more, follow Christy on Twitter or Facebook, or to make a donation to help make the world healthier for moms and their babies, check out the Moms4Moms Movement, which is helping to raise funds for Every Mother Counts.