Paula Eiselt and Tonya Lewis Lee’s infuriating and impassioned documentary Aftershock (2022) explores the abysmal maternal mortality rate among Black women in the US. Centers for Disease Control and Prevention’s (CDC) stats say that 43 black women are more likely to die per 100,000 live births, whereas the national maternal mortality rate in the US is about 17 per 100,000 live births. Other researches state that black women face a maternal death rate of 3.5 times compared to their white counterparts. The stats alone are alarming enough to raise pertinent questions regarding the healthcare system (I am from a country where the maternal mortality ratio is 100-113 per 100,000 live births). But within this oft-overlooked healthcare crisis, each number represents a preventable tragedy that robs a woman of her life and her family is left to deal with the trauma for the rest of their lives.
Lee and Eiselt’s Sundance Grand Jury Prize-winning Aftershock digs deeper into the problem through first-hand stories, by understanding the historical context, and by addressing systemic racism. Eventually, Aftershock inspires activism on the subject and offers some solutions to fix the epidemic.
Coping in the Wake of Preventable Maternal Deaths:
Aftershock opens with the compilation of home videos of a vivacious and young New York woman named Shamony Makeba Gibson. The clips are played during Shamony’s memorial service. She died from pulmonary embolism, 13 days after giving birth to her second child in October 2019. Shamony’s partner Omari Maynard and her mother Shawnee Benton Gibson recall how their repeated concerns about Shamony’s post-natal symptoms were casually dismissed by the doctors. Even when it was clear that she was experiencing the symptoms of a blood clot, the apathetic first responders were only questioning if she was on drugs. Months after Shamony’s death, 26-year-old Amber Rose Isaac, a fellow New Yorker, died immediately after an emergency C-section procedure. In Amber’s case, the doctors ignored her dangerously low blood platelet count and performed C-section.
Omari Maynard reaches out to Amber’s partner Bruce McIntyre, and these two bereaving single fathers take the crucial step to instigate support groups for people in a similar situation. Moreover, they turn their indelible grief and harsh experiences with the healthcare system to galvanize a community of committed activists. Shamony’s mother Shawnee also spearheads the campaign in order to raise awareness about the epidemic that’s claiming black mothers’ lives. The documentarians brilliantly turn the story of personal pain into the story of solidarity as the two determined dads juggle between work, parenting, and activism.
The Systemic Racism and Inequities
Covert racism is, unfortunately, a fundamental aspect of US social institutions which causes huge disparities between white and non-white populations. The institution that fails to address structural racism is in a way reinforcing the inequities. In Aftershock, we follow American physician and social entrepreneur Neel Shah trying to address the issues from within. He comes up with simple methods to ensure open communication between the healthcare providers and the pregnant woman and their partners. “What people are dying of is not the clinical condition on the death certificate. It’s a failure of communication and teamwork”, Neel says while addressing a small group of white doctors and nurses.
Neel Shah also understands how he is trained in a system, where ‘it’s possible that really well-intentioned people can be doing racist things.’ Black mothers’ health concerns are rarely addressed and the red flags on their medical charts are somehow ignored. The healthcare system also relies on the data whose basis of collection and results upholds the same covert racism. Instead of closing the white-black maternal mortality gap, the healthcare system dependent on algorithms is widening the disparities.
The Indomitable Money Factor in the Privatized Medical Care:
While systemic racism in the US pre and the antenatal system is an issue that immediately needs some attention, the broader issue is always the money. The question lies in what’s prioritized in a ‘profitable’ healthcare model. The capitalist institutions encourage homogeneity and either see everything as a commodity to sell or a problem to instantly solve. In Aftershock, Helena Grant, the Director of Midwifery at Brookyln’s Woodhull Medical Center, comments on how “childbirth has become more technologically driven”, and how pregnancy is deemed as “a healthcare care challenge to manage”. She further calls the system as ‘medical technocratic patriarchal model’.
Helena Grant gives us some hard truths to swallow, which is not only happening in the US, but in privatized maternal healthcare system around the globe. The explosion in C-section surgery is directly connected to a hospital’s financial needs. Caesareans are quicker than a natural birth but considerably risky from a patient’s perspective. The insurers pay more money for caesareans than vaginal deliveries. In fact, the upward trend in C-sections in many countries confirms that financial incentives are the motivating factor behind it. The insured families of black women are not only denied the right information about their condition but also forced to choose medical intervention during childbirth.
Moreover, Helena Grant mentions how C-sections remain as practice sessions for residents to learn the procedures. And black women are often left to be cut open by the residents. One young interviewee sadly notes how “her mother’s generation had better odds in the hospital than she does.”
The Dark Historical Context:
In Aftershock, directors Eiselt and Lee start from a deeply personal perspective, then jump to the social, political, and economical factors of the devastating epidemic. They also assign space to contextualize the perpetual violence against black women and their bodies from a historical perspective. It is no secret that slavery played a crucial role in American economic development. Slave labor facilitated America’s transformation from being a colonial economy into an industrial power. Therefore, the first and foremost commodity in Pre-Civil War America was the black people.
The history of violence against blacks, of course, extended to pregnant black women’s bodies. Aftershock recounts how slave owners used crude surgical methods to sew the black mothers quickly and send them back to the plantation field. There’s also mention of how the so-called revolutionary gynecologist of the 19th century used enslaved black mothers as guinea pigs for childbirth experiments.
At the same time, black mid-wives were important members of a slave owner’s plantation. They aided in the natural childbirth of both black and white women. Even George Washington seems to have paid a midwife belonging to his plantation. However, as the healthcare system was gradually institutionalized and commoditized after World War II, the practice of midwifery was turned into a ‘book knowledge profession’. And in the process, the propaganda of powerful white men tarnished the reputation of black midwives.
Helena Grant digs even deeper and examines how the patriarchal urge to control women’s bodies turned pregnancy into a healthcare challenge and the need to ‘deliver’ women from it. Naturally, it all traces back to ancient religious institutions.
Hope, Positive Energy, and New Beginnings:
While directors Eiselt and Lee, burden us with undeniable truths, they also leave us on a hopeful note. The heart of Aftershock is the three individuals’ – Shawnee, Bruce, and Omar – journey to turn their pain into activism. Omar the artist directs his grief into painting portraits of the women who lost their lives like Shamony. Apart from campaigning to create awareness of the epidemic, Bruce focuses on birthing center options and building one in their community. Shawnee continues her work as a maternal health advocate and tries to create a nationwide momentum to address the crisis. “Black wombs matter because a Black womb delivered you!”, roars Shawnee in a crowded rally in Washington D.C.
Aftershock also documents the heartfelt journey of expectant mother Felicia Ellis. Earlier, when anxiously waiting at the hospital, Felicia notes, “A black woman having a baby is like a black man in a traffic stop with the police”. She and her partner Paul eventually opt for a birthing center, whose members show how the maternal healthcare system should work. Felicia goes through the natural childbirth she desires and the director films this beautiful occasion in such a graceful manner.
Final Thoughts on Aftershock (2022)
Paula Eiselt and Tonya Lewis Lee’s documentary comforts the bereaved, immortalizes the lost lives, never shies away from the dark truths, and most importantly champions the commitment and energy of the people working together to shape the hopeful future. Lee is a producer, entrepreneur, and a women’s health advocate. Paula Eiselt is an independent filmmaker, previously known for her critically acclaimed documentary 93Queen (2018). Aftershock (88 minutes) ultimately finds its power in their allyship. The documentary stays remarkable for addressing the vast topic of US Black maternal health crisis in a compelling manner and without losing its scope or focus.
