Seventeen years ago, Nina Martin’s sister almost died in childbirth. “I remember the trauma of that experience really, really, really well,” recalled Martin. “The disorientation of it and then also, the silencing of it afterwards.”
Martin is ProPublica’s sexuality and gender reporter, and Martin and NPR special correspondent Renee Montagne recently co-authored the first of several stories on maternal care in America. The first part of the series aired on NPR last week, and the other was published on ProPublica as “The Last Person You’d Expect to Die in Childbirth.”
Over the next several months, Martin and Montagne will release more stories about maternal care in America which will focus on a host of issues surrounding maternal mortality, including racial disparity in care and women with near misses. Every mother has her own story of birth, and all too often these stories go unnoticed, or are buried under platitudes that focus on the health of the baby. Together, Martin and Montagne want to move the conversation back to the mother, and ask why America is the only developed nation where maternal death rates are rising.
Longreads spoke to both journalists about the process of reporting the story, their passion behind the project, and the impact they hope it will have.
How did you become interested in maternal mortality?
Nina Martin: Amnesty International conducted and published a report in 2010 that showed the U.S. had a terrible maternal mortality rate. The report was a real call to arms for a lot of people in the medical profession who’ve taken steps to make reforms around a rise in maternal mortality.
My first year-and-a-half at ProPublica in 2013 was largely spent reporting on the criminalization of drug use in pregnancy. There’s a clear link between that project and this one, but once we settled on maternal mortality, it actually took a lot of thinking to figure out how to dive in. I’d originally proposed something smaller, involving C-sections, but my editors encouraged me to do the ProPublica thing of thinking big—very big. The Amnesty International report inspired a lot of work among maternal safety advocates in the United States but not much journalism beyond the alarming announcement of the mortality rate. The real inspiration for me was learning about the high rates of C-sections in the South. The project gestated for a couple of years, with the major work taking place since last fall. NPR came on board after the election.
I have an unusual background for an investigative reporter. I live and work in the Bay Area. I have always loved magazine journalism, but there weren’t a lot of magazines here so I ended up at the ones that were available: parenting magazines. I worked specifically at baby magazines. One was called Baby Talk and then a few years later, I actually became the founding editor of BabyCenter’s short-lived print magazine.
As somebody who’s been writing about these issues, or thinking about these issues as an editor, I know what I know. I kept coming across things that confounded my expectations—that’s always a trigger when you’re an investigative reporter.
I also had a sister who nearly died in childbirth in 2000. I remember the trauma of that experience really, really, really well. The disorientation of it and then also, the silencing of it afterwards. All of these different themes have kind of come together for me in this project.
Renee Montagne: I had been working at “Morning Edition” for almost twenty years. It was twelve intense hours a day in the office—I’d move from an interview with a movie star to an interview with the president of Afghanistan. Every one of those stories I had to know something about.
I worked overnight, midnight to about 11:00 a.m., and then took stuff home. You’re kind of jet lagged all the time. Here I was for years and years and years, reaching back and forth between subject matter that I had to know something about.
When I left “Morning Edition,” I knew I wanted to do something molecule for molecule. NPR partners with ProPublica and other non-profit investigative organizations. So I asked if there was anything coming up.
Bob Little, who is in the senior investigations unit at NPR, heard a story on midwives I did in Afghanistan seven years ago. It was the opposite of what is happening in America. In Afghanistan, the maternal death rates are going way down after they started out stunningly high.
I couldn’t believe the numbers of maternal deaths in America, and when you include the 65,000 women who have had really bad experiences to the point of nearly dying—I was pretty shocked.
The ProPublica story notes that women of color are most affected by maternal death rates, but you focused on Lauren Bloomstein, a white woman. What was the reasoning there?
Montagne: One reason was Larry Bloomstein himself. Larry spent two hours with me on tape, unspooling both his early life with Lauren, as well as her death. It was jaw-droppingly sad. I wept when I listened to the interview.
I also was impressed with how careful he was with the information, and how accurate he was. Every single detail could be fact checked. And this was coming from his memory of an event that happened four and five years ago. It was printed on his brain, and he knew how to tell it.
That made a big difference I’ll tell you, because parents won’t often talk to us. People are heart broken. They worry that talking to the press will hurt their chance for justice. It was starting hard to get people to talk, especially those it happened to more recently.
Martin: We’re going to roll out a series of stories about different issues in maternity care over the course of the next year. I think by at the end of the year, it will become clear we didn’t focus just on white women or affluent women.
We really wanted the first story to be surprising to people. Sadly, it may not be as surprising if you tell them that poor women of color die in childbirth in the U.S. When we looked through the list of the 450 women we found, many of them were professors and teachers and lawyers—there was even somebody who founded a website on parenting. These were women who have access to the best healthcare and they’re still dying.
How collaborative was the reporting process between ProPublica and NPR?
Montagne: We shared a byline for all of the work because we went out on nearly all the same interviews, with the same experts, and had the same principles for the story. Sometimes we had a producer go and sit with the tape recorder, but we would both be on the interview at the same time, even when Nina and I are in different cities. These were three-way conversations for the most part.
The stories were aired and published online jointly, which is a bit unusual because my story about Lauren—which is a larger, big picture story—is going up later. Last week’s on-air story, you could call it a curtain raiser for the series. And it was seven minutes long, which is long for NPR.
After six months of reporting, you’ve finally unleashed this heartbreaking and compelling series. How has the response been?
Montagne: The response from listeners was pretty impressive. People heard my story and when they went to website and they don’t just see a written-out version the NPR report, which is the norm, but instead there is link to the ProPublica piece—a massive story. And people were going to the website, maybe thinking they would see a few pictures, and then finding this whole other kind of revelation. And they are staying on the story for six minutes on average, which is huge.
Martin: We kind of got a sense it would be big a couple of months ago. At that point, we’d been working on the project for about maybe three months, doing background reporting and we decided it was time to post our call for families who had been affected. We put together a form, kind of a mini-survey, and just posted it on NPR and posted it on ProPublica. We got 2,500 responses within three days.
We got a lot of responses from people whose family members have died, and the families felt completely lost. Or they have felt that they’ve been pushed to forums where the conversation is private. Part of the impact that we hope to have is to change that conversation, is to really shift the thinking, from this is a private problem, a private tragedy, a private catastrophe, to making it a public health issue.