The United States has the highest maternal mortality rate in the industrialized world, with Arkansas experiencing the highest rate in the country. “Giving Birth in America: Arkansas” is a compelling narrative of the state’s maternal health conditions. As the seventh installment in the “Giving Birth in America” series, the film is part of the mission of the nonprofit Every Mother Counts, or EMC, to improve maternal health worldwide.
GlobeDocs, an event series run by The Boston Globe, held a discussion with Nicole Mackinlay Hahn Jan. 30, moderated by Jessica Bartlett, a medical reporter at The Boston Globe. Bartlett led a genuine conversation with Hahn reminiscent of the film’s overall message, inspiring further discussion on this nuanced issue within maternal care.
“Giving Birth in America: Arkansas,” directed by Hahn, explores the postpartum experiences of three mothers and the challenges they face in accessing essential care. The film highlights struggles such as mental health support, insufficient paid leave, and other barriers during the first year after childbirth, revealing significant gaps in postpartum care and the resulting dependency on individual support networks. With over half of all maternal deaths occurring between one week and one year after birth, the film sheds light on a critical yet often overlooked healthcare issue.
Hahn’s work is a powerful intersection of storytelling and advocacy that has the potential to inspire important conversation among families, healthcare providers, advocacy groups and policymakers in Arkansas and nationwide.
Hahn, a documentary filmmaker who has previously worked with EMC, alongside a small team of experts from EMC, shaped the approach to working with the mothers in the film. All the while, the mission of equitable maternal care remained the objective.
“Filmmaking is how [EMC] gets their message out and helps push the needle on legislation and policy,” Hahn said in an interview with The Huntington News.
Hahn’s artistic lens was focused on what she described as the “culture of care” surrounding motherhood.
“You just see how profound it is, to be supported and have that advocate around you, which is a doula,” Hahn said. “This film focuses on the doula and the doula’s role in carrying the mom beyond the birth into postpartum and how you still need support from the doula and your community.”
As an environmental futurist, Hahn was also excited to work in Arkansas, the Natural State. The film opens with a scene of one of the mothers, who works at a state park, caring for a turtle.
“I thought the turtle was a great metaphor for that transition into being like a caretaker and nurturer to a much more profound mother role, forever nurturing a child,” Hahn said.
Bartlett said much of the conversation around maternal healthcare today is dominated by reproductive rights, whereas the film remains focused on access to postpartum care.
“To include too much of a conversation about reproductive rights would turn people off from an issue that there is more collective agreement on,” Bartlett said. “I think we can collectively agree that the mental healthcare of birthing people matters immensely, not just for them, but for their children, for their broader family unit and if we can at least agree fundamentally on that, maybe that makes change more achievable.”
EMC also does grant-making, policy and advocacy work, but storytelling and raising awareness have always been central to its mission.
“A lot of people think that maternal health challenges are something that happens ‘over there,’ in other places, and so recognizing that it’s a problem here in the United States is one of our big goals,” said Nina Rabinovitch Blecker, the vice president of communications and marketing at EMC.
“We find that storytelling, especially storytelling through film, and films like ‘Giving Birth in America’ are a way to help humanize statistics that otherwise might just feel tough to relate to,” Blecker said.
Another maternal healthcare issue in Arkansas is the prevalence of maternity deserts, defined as a lack of prenatal care and delivering hospitals available nearby. Zenobia Harris, the executive director of the Arkansas Birthing Project, a mentoring program for pregnant women, was featured in the film. As a local expert in direct advocacy work in the community, Harris believed the film was an important way to tell women’s experiences in birthing spaces.
“I’m still amazed at how many people don’t know this,” Harris said, referring to the height of the maternal mortality rate in Arkansas. “There’s the other load that we don’t talk about a lot, and that is that whole concept of women dealing with additional stress during this period, particularly women who live in circumstances where they’re really struggling to take care of their families or themselves.”
The film, which is available online, was screened at the Bentonville Film Festival and later at the DC/DOX Film Festival and the Tribeca Film Festival. In addition to leveraging the reach of the art world, the focus on Arkansas also drew the attention of state advocacy groups, policymakers and legislators.
“No policymaker wants their state to be known as the state with the poorest health outcomes for mothers, and so in some ways, the film was helpful because it elevated that without shaming anybody,” Blecker said. “This is not an unsolvable issue, but something that we all have the ability to do something about pretty easily.”
