TEDWomen 2016
Miriam Zoila Pérez: How racism harms pregnant women -- and what can help
米里亚姆·佐伊拉·佩亚雷斯: 种族歧视如何伤害孕妇健康及如何应对
Filmed:
Readability: 5
954,890 views
“种族歧视让人们生病，特别是黑人女性和婴儿。”米里亚姆·佐伊拉·佩亚雷斯说。这个从孕妇保姆变成记者的人，探索了种族、阶层和疾病的关系。她告诉了我们一个同情心较强的产前护理项目，它能够缓冲怀孕有色人的日常压力。
Miriam Zoila Pérez - Writer, activist
Miriam Zoila Pérez investigates how race and gender affect health -- and the people who create spaces for healing. Full bio
Miriam Zoila Pérez investigates how race and gender affect health -- and the people who create spaces for healing. Full bio
Double-click the English transcript below to play the video.
00:12
Most of you can probably relate
to what I'm feeling right now.
to what I'm feeling right now.
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你们肯定能想象我现在感受。
00:17
My heart is racing in my chest.
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我的心脏砰砰直跳。
我的手变得黏黏的。
00:19
My palms are a little bit clammy.
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我在出汗。
00:22
I'm sweating.
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00:24
And my breath is a little bit shallow.
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我的呼吸有一点急促。
00:27
Now, these familiar sensations
are obviously the result
are obviously the result
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这些熟悉的感觉明显是因为
站在近千名观众的舞台上演讲，
00:30
of standing up
in front of a thousand of you
in front of a thousand of you
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00:32
and giving a talk
that might be streamed online
that might be streamed online
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而且演讲视频还可能放上网
向上百万人播放。
00:35
to perhaps a million more.
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00:37
But the physical sensations
I'm experiencing right now
I'm experiencing right now
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但是我现在身体内正在进行的变化，
实际上比我们感受到的要复杂的多。
00:39
are actually the result of a much more
basic mind-body mechanism.
basic mind-body mechanism.
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00:44
My nervous system is sending
a flood of hormones
a flood of hormones
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我的神经系统正在
向血管输送大量的荷尔蒙，
向血管输送大量的荷尔蒙，
00:47
like cortisol and adrenaline
into my bloodstream.
into my bloodstream.
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比如皮质醇和肾上腺素。
00:51
It's a very old and very necessary
response that sends blood and oxygen
response that sends blood and oxygen
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这是一个很古老且很重要的反应，
它令我在有潜在危险的情况下
能够快速反应，
能够快速反应，
00:56
to the organs and muscles
that I might need
that I might need
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把所需的血和氧气送至器官和肌肉。
00:58
to respond quickly to a potential threat.
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但是这个反应有一个问题，
01:01
But there's a problem with this response,
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它可能会反应过激。
01:03
and that is, it can get over-activated.
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01:06
If I face these kinds of stressors
on a daily basis,
on a daily basis,
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如果每天我都面对这种压力，
特别是经过很长的一段时间后，
01:09
particularly over an extended
period of time,
period of time,
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我的身体会超负荷。
01:12
my system can get overloaded.
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所以简单来说，
如果这种反应只是偶尔发生——
如果这种反应只是偶尔发生——
01:15
So basically, if this response
happens infrequently: super-necessary
happens infrequently: super-necessary
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对我的健康和生命就极为重要。
01:19
for my well-being and survival.
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但是如果这发生得过于频繁，
01:21
But if it happens too much,
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会使我生病。
01:23
it can actually make me sick.
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01:25
There's a growing body of research
examining the relationship
examining the relationship
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越来越多的研究开始调查
长期压力与疾病的联系。
01:28
between chronic stress and illness.
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像心脏病甚至癌症
01:30
Things like heart disease and even cancer
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都被表明和压力有联系。
01:32
are being shown to have
a relationship to stress.
a relationship to stress.
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这是因为，久而久之，
由压力所导致的过度兴奋
由压力所导致的过度兴奋
01:35
And that's because, over time,
too much activation from stress
too much activation from stress
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会妨碍保持我健康的生理过程。
01:40
can interfere with my body's processes
that keep me healthy.
that keep me healthy.
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01:44
Now, let's imagine for a moment
that I was pregnant.
that I was pregnant.
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现在，让我们设想一下，我怀孕了。
01:48
What might this kind of stress,
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这种压力，
特别是在我怀孕的这段时间里，
01:50
particularly over the length
of my pregnancy,
of my pregnancy,
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01:52
what kind of impact might that have
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会对胎儿的发育
01:54
on the health of my developing fetus?
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有什么影响呢？
01:58
You probably won't be surprised
when I tell you
when I tell you
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当我告诉你时，这种怀孕期间的压力
是有害的，你可能不会感到惊讶。
02:00
that this kind of stress
during pregnancy is not good.
during pregnancy is not good.
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这甚至会引起早产，
02:04
It can even cause the body
to initiate labor too early,
to initiate labor too early,
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原因很简单，压力会提示
02:07
because in a basic sense,
the stress communicates
the stress communicates
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子宫对孩子已经
不再是一个安全的地方了。
不再是一个安全的地方了。
02:10
that the womb is no longer
a safe place for the child.
a safe place for the child.
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02:14
Stress during pregnancy is linked
with things like high blood pressure
with things like high blood pressure
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怀孕期间的压力和高血压、
婴儿体重过轻这样的
婴儿体重过轻这样的
事情都有关系，
02:17
and low infant birth weight,
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02:19
and it can begin a cascade
of health challenges
of health challenges
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而且它能够引发一系列的健康问题，
02:21
that make birth much more dangerous
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让分娩对母亲和孩子
02:23
for both parent and child.
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都变得更危险。
02:27
Now of course stress,
particularly in our modern lifestyle,
particularly in our modern lifestyle,
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当然压力，特别是在现代生活中，
是非常普遍的现象，对吧？
02:30
is a somewhat universal experience, right?
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02:32
Maybe you've never stood up
to give a TED Talk,
to give a TED Talk,
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可能你没有做过TED演讲，
02:34
but you've faced a big
presentation at work,
presentation at work,
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但是你可能做过重要的工作汇报，
02:37
a sudden job loss,
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或是突然地被解雇，
面临一场重要的考试，
02:39
a big test,
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02:40
a heated conflict
with a family member or friend.
with a family member or friend.
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或是跟家庭成员或朋友
有过激烈的冲突。
有过激烈的冲突。
但结果是我们所承受的那种压力
02:43
But it turns out that the kind
of stress we experience
of stress we experience
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02:47
and whether we're able to stay
in a relaxed state long enough
in a relaxed state long enough
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和我们是否能够在
足够的时间内保持放松状态，
足够的时间内保持放松状态，
来让我们的身体正常运行，
02:50
to keep our bodies working properly
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很大程度上，取决于我们是谁。
02:52
depends a lot on who we are.
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越来越多的研究表明，
02:55
There's also a growing body of research
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经历较多歧视的人
02:57
showing that people who experience
more discrimination
more discrimination
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03:01
are more likely to have poor health.
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身体更有可能不健康。
03:04
Even the threat of discrimination,
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甚至可能潜存的歧视，
03:06
like worrying you might be stopped
by police while driving your car,
by police while driving your car,
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如开车时，你担心会被警察拦下，
03:09
can have a negative impact on your health.
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都会对你的健康产生不良影响。
03:14
Harvard Professor Dr. David Williams,
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哈佛教授大卫·威廉姆斯博士，
03:17
the person who pioneered
the tools that have proven these linkages,
the tools that have proven these linkages,
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他研发了各种手段来证明这种联系，
03:20
says that the more marginalized
groups in our society
groups in our society
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他说社会上越被边缘化的人
03:23
experience more discrimination
and more impacts on their health.
and more impacts on their health.
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被歧视越多，对自身健康影响就越大。
03:28
I've been interested in these issues
for over a decade.
for over a decade.
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我对这些问题的研究
已经有十年多了。
已经有十年多了。
03:31
I became interested in maternal health
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我开始对母婴健康感兴趣，
03:34
when a failed premed trajectory
instead sent me down a path
instead sent me down a path
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虽然我考医学院的努力失败了，
但我找到了帮助孕妇的另一种方式。
03:38
looking for other ways
to help pregnant people.
to help pregnant people.
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我成为了一名“导乐”（孕妇保姆），
03:40
I became a doula,
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03:42
a lay person trained to provide support
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一个接受过训练专门在孕期和分娩时
03:44
to people during pregnancy and childbirth.
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帮助孕妇的女性。
03:46
And because I'm Latina
and a Spanish speaker,
and a Spanish speaker,
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因为我是拉丁美洲裔，
而且会说西班牙语，
而且会说西班牙语，
03:49
in my first volunteer doula gig
at a public hospital in North Carolina,
at a public hospital in North Carolina,
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我第一个志愿孕妇保姆工作
是在北卡罗来纳州的一个公共医院，
是在北卡罗来纳州的一个公共医院，
03:53
I saw clearly how race and class
impacted the experiences
impacted the experiences
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我清楚地意识到种族和阶层是如何影响
那些我帮助过的妇女们。
03:56
of the women that I supported.
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03:58
If we take a look at the statistics
about the rates of illness
about the rates of illness
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如果我们看看怀孕和分娩期间
04:02
during pregnancy and childbirth,
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得病机率的统计数据，
04:04
we see clearly the pattern
outlined by Dr. Williams.
outlined by Dr. Williams.
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我们可以清楚地印证威廉姆斯教授的概述。
04:07
African-American women in particular
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当谈到她们的婴儿是否健康时，
特别是非裔美国人，和白人孕妇有着
04:09
have an entirely different
experience than white women
experience than white women
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04:12
when it comes to whether
their babies are born healthy.
their babies are born healthy.
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完全不同的经历。
04:16
In certain parts of the country,
particularly the Deep South,
particularly the Deep South,
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这个国家的一些地方，特别是南部，
黑人孕妇和婴儿的死亡率
04:19
the rates of mother
and infant death for black women
and infant death for black women
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和撒哈拉以南非洲的死亡率差不多。
04:22
actually approximate
those rates in Sub-Saharan African.
those rates in Sub-Saharan African.
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04:26
In those same communities,
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在同样的社区里，
04:28
the rates for white women are near zero.
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白人孕妇的死亡概率几乎为零。
04:32
Even nationally, black women
are four times more likely
are four times more likely
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甚至从全国层面来说，
黑人孕妇比起白人孕妇，
黑人孕妇比起白人孕妇，
在怀孕期及分娩时的死亡率
04:36
to die during pregnancy and childbirth
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04:38
than white women.
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要高出四倍。
近乎四倍的死亡率。
04:40
Four times more likely to die.
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04:43
They're also twice as likely
for their infants to die
for their infants to die
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她们的婴儿在一岁之前
死亡的可能性
04:46
before the first year of life
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是白人婴儿的两倍，
04:47
than white infants,
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04:49
and two to three times more likely
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并且有两到三倍的可能性
出现早产或体重过轻——
04:51
to give birth too early or too skinny --
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这都是婴儿发育不良的信号。
04:54
a sign of insufficient development.
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04:56
Native women are also more likely
to have higher rates of these problems
to have higher rates of these problems
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印第安女人也比白人更有可能
遭遇这些问题，
05:01
than white women,
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05:02
as are some groups of Latinas.
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拉丁裔女人也是这样的。
05:05
For the last decade as a doula
turned journalist and blogger,
turned journalist and blogger,
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在过去十年来，作为导乐、记者和博主，
我一直尝试提高人们对
05:08
I've been trying to raise the alarm
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有色人种非常不同的经历的注意，
05:10
about just how different
the experiences of women of color,
the experiences of women of color,
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特别是黑人妇女，
05:13
but particularly black women,
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在美国的怀孕和分娩。
05:14
are when it comes to pregnancy
and birth in the US.
and birth in the US.
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05:17
But when I tell people
about these appalling statistics,
about these appalling statistics,
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当我和人们提起这些
令人惊讶的数据时，
令人惊讶的数据时，
05:20
I'm usually met with an assumption
that it's about either poverty
that it's about either poverty
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我经常假定这和贫困或者
医疗系统不健全有关。
05:24
or lack of access to care.
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05:26
But it turns out, neither of these things
tell the whole story.
tell the whole story.
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但结果是，这些不是全部的原因。
05:29
Even middle-class black women
still have much worse outcomes
still have much worse outcomes
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甚至中产阶级的黑人孕妇也比白人孕妇
有更糟糕的健康状况。
05:34
than their middle-class
white counterparts.
white counterparts.
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05:37
The gap actually widens among this group.
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差距在这个群组里变大。
05:40
And while access to care
is definitely still a problem,
is definitely still a problem,
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缺少基本医保肯定是问题之一，
05:44
even women of color who receive
the recommended prenatal care
the recommended prenatal care
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但是即使是那些进行产前护理的妇女
也深受这些问题的困扰。
05:47
still suffer from these high rates.
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05:50
And so we come back to the path
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所以总结一下就是
歧视导致压力，进而导致健康问题，
05:52
from discrimination to stress
to poor health,
to poor health,
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由此可以得出一件
很多有色人种都知道的事情：
很多有色人种都知道的事情：
05:56
and it begins to paint a picture
that many people of color know to be true:
that many people of color know to be true:
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06:00
racism is actually making us sick.
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种族歧视真的在让我们生病。
06:04
Still sound like a stretch?
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还是有点牵强？
06:05
Consider this: immigrants,
particularly black and Latina immigrants,
particularly black and Latina immigrants,
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想想看，移民，
特别是黑人和拉丁美洲裔，
特别是黑人和拉丁美洲裔，
06:10
actually have better health when
they first arrive in the United States.
they first arrive in the United States.
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在初次到达美国前的健康状况更好。
06:13
But the longer they stay in this country,
the worse their health becomes.
the worse their health becomes.
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但是他们呆的越久，
他们健康出现的问题越多。
他们健康出现的问题越多。
像我一样的人，出生在美国，
父母是古巴移民，
父母是古巴移民，
06:18
People like me, born in the United States
to Cuban immigrant parents,
to Cuban immigrant parents,
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比祖父母更有可能
拥有更多的健康问题。
拥有更多的健康问题。
06:22
are actually more likely to have
worse health than my grandparents did.
worse health than my grandparents did.
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06:26
It's what researchers call
"the immigrant paradox,"
"the immigrant paradox,"
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这就是研究者所说的“移民的矛盾”，
这进一步解释了
06:29
and it further illustrates
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美国环境里有些东西
06:30
that there's something
in the US environment
in the US environment
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让我们生病。
06:32
that is making us sick.
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06:34
But here's the thing:
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但是，
种族歧视让有色人种
06:35
this problem, that racism
is making people of color,
is making people of color,
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特别是黑人女人和
婴儿生病的问题很普遍，
婴儿生病的问题很普遍，
06:38
but especially black
women and babies, sick, is vast.
women and babies, sick, is vast.
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这个问题我可以讨论很久，但是
06:41
I could spend all of my time
with you talking about it,
with you talking about it,
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今天我想要跟大家
说的是一个解决方案。
说的是一个解决方案。
06:44
but I won't, because I want to make sure
to tell you about one solution.
to tell you about one solution.
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好消息是，这是一个
低成本的解决方案，
低成本的解决方案，
06:48
And the good news is, it's a solution
that isn't particularly expensive,
that isn't particularly expensive,
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而且不需要任何昂贵的药物治疗，
06:51
and doesn't require
any fancy drug treatments
any fancy drug treatments
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或者新技术。
06:54
or new technologies.
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这个方案被称作“简宁的方法”。
06:55
The solution is called, "The JJ Way."
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06:59
Meet Jennie Joseph.
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简宁·乔瑟夫，
07:01
She's a midwife
in the Orlando, Florida area
in the Orlando, Florida area
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她是佛罗里达州奥兰多的一个助产士，
服务怀孕女人超过十年。
07:03
who has been serving
pregnant women for over a decade.
pregnant women for over a decade.
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在她所说的便捷诊所中，
07:07
In what she calls her easy-access clinics,
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简宁和她的团队每年
向超过600名妇女提供产前护理。
向超过600名妇女提供产前护理。
07:09
Jennie and her team provide prenatal care
to over 600 women per year.
to over 600 women per year.
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07:14
Her clients, most of whom are black,
Haitian and Latina,
Haitian and Latina,
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她的客户，大多数都是黑人、
海地人和拉丁美洲裔，
海地人和拉丁美洲裔，
07:19
deliver at the local hospital.
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在当地医院分娩。
07:21
But by providing accessible
and respectful prenatal care,
and respectful prenatal care,
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通过提供便宜和高质量的产前护理，
简宁实现了一些非凡的成就：
07:25
Jennie has achieved something remarkable:
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几乎所有的客户都生出了健康的婴儿。
07:28
almost all of her clients give birth
to healthy, full-term babies.
to healthy, full-term babies.
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07:33
Her method is deceptively simple.
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她的方法非常简单。
简宁说所有预约都从前台开始，
07:35
Jennie says that all of her appointments
start at the front desk.
start at the front desk.
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她团队中的每一个人，
从每位妇女到诊所的那个时刻
从每位妇女到诊所的那个时刻
07:39
Every member of her team,
and every moment a women is at her clinic,
and every moment a women is at her clinic,
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就会尽量的提供帮助。
07:42
is as supportive as possible.
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没人会因为经济原因被拒绝。
07:45
No one is turned away
due to lack of funds.
due to lack of funds.
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简宁的方法是抛开
任何经济障碍提供帮助。
任何经济障碍提供帮助。
07:47
The JJ Way is to make the finances work
no matter what the hurdles.
no matter what the hurdles.
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07:51
No one is chastised for showing up
late to their appointments.
late to their appointments.
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没人因为预约迟到而被斥责。
没人被嘲讽或者被蔑视。
07:54
No one is talked down to or belittled.
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07:57
Jennie's waiting room feels more like
your aunt's living room than a clinic.
your aunt's living room than a clinic.
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简宁的等候室比起一个诊所
更像是你姑姑的客厅。
更像是你姑姑的客厅。
08:02
She calls this space
"a classroom in disguise."
"a classroom in disguise."
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她称其为“有伪装的教室”。
08:05
With the plush chairs
arranged in a circle,
arranged in a circle,
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舒适的椅子围成一圈，
孕妇们等候着跟医护人员
08:08
women wait for their appointments
in one-on-one chats
in one-on-one chats
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一对一的问诊，
08:10
with a staff educator,
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08:12
or in group prenatal classes.
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或接受产前小组培训。
08:14
When you finally are called back
to your appointment,
to your appointment,
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当你的预约结束以后，
亚历克西斯和特瑞纳会向你问候，
08:17
you are greeted by Alexis or Trina,
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她们是简宁的医疗助理。
08:19
two of Jennie's medical assistants.
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08:21
Both are young, African-American
and moms themselves.
and moms themselves.
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她们都是年轻的非裔美籍母亲。
她们所用的方式非常随意和友善。
08:24
Their approach is casual and friendly.
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08:27
During one visit I observed,
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在一次拜访中，我注意到
特瑞纳在测量一位年轻准妈妈的
08:29
Trina chatted with a young soon-to-be mom
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血压的时候在跟她聊天。
08:32
while she took her blood pressure.
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08:33
This Latina mom was having trouble
keeping food down due to nausea.
keeping food down due to nausea.
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这个拉丁美洲裔女人
因为恶心而无法进食。
因为恶心而无法进食。
08:38
As Trina deflated the blood pressure cuff,
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当特瑞纳放开血压计的气闸时，
她说：“我们会看看如何
改善你的药方，好吗？
改善你的药方，好吗？
08:40
she said, "We'll see about changing
your prescription, OK?
your prescription, OK?
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我们不能让你不吃东西。”
08:43
We can't have you not eating."
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那个“我们”是简宁方法的核心。
08:45
That "we" is actually a really crucial
aspect of Jennie's model.
aspect of Jennie's model.
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08:49
She sees her staff as part of a team that,
alongside the woman and her family,
alongside the woman and her family,
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她和她的员工组成的团队
与孕妇及其家庭紧密合作，
与孕妇及其家庭紧密合作，
08:54
has one goal:
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为了一个目标而努力：
08:55
get mom to term with a healthy baby.
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让这位母亲生出一个健康的宝宝。
08:59
Jennie says that Trina and Alexis
are actually the center of her care model,
are actually the center of her care model,
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简宁说特瑞纳和亚历克西斯
其实是她方法的核心，
其实是她方法的核心，
然而她的角色是支持她们的工作。
09:02
and that her role as a provider
is just to support their work.
is just to support their work.
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09:07
Trina spends a lot of her day
on her cell phone,
on her cell phone,
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特瑞纳每天花很多时间在手机上，
她向客户发送各种短信。
09:09
texting with clients
about all sorts of things.
about all sorts of things.
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一位妇女发短信问医院开出的药方
09:12
One woman texted to ask if a medication
she was prescribed at the hospital
she was prescribed at the hospital
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09:15
was OK to take while pregnant.
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能否在她怀孕的时候服用。
答案是不能。
09:17
The answer was no.
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另一位妇女向简宁发送婴儿的照片，
是在简宁照料下的出生的婴儿。
是在简宁照料下的出生的婴儿。
09:19
Another woman texted with pictures
of an infant born under Jennie's care.
of an infant born under Jennie's care.
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09:24
Lastly, when you finally are called back
to see the provider,
to see the provider,
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最后，当你（孕妇）去见医生的时候，
09:27
you've already taken your own weight
in the waiting room,
in the waiting room,
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你已经在等候室测好了体重，
在卫生间做完了小便测试。
09:30
and done your own pee test
in the bathroom.
in the bathroom.
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09:33
This is a big departure
from the traditional medical model,
from the traditional medical model,
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这和传统医疗模型很不一样，
因为它将责任和数据
09:35
because it places
responsibility and information
responsibility and information
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09:38
back in the woman's hands.
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都交还给了孕妇。
09:41
So rather than a medical setting
where you might be chastised
where you might be chastised
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所以当你没有能够遵守医生的医嘱时，
在简宁这里你不会因此被斥责——
09:44
for not keeping up
with provider recommendations --
with provider recommendations --
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这在低收入女性中很常见——
09:46
the kind of settings often available
to low-income women --
to low-income women --
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09:49
Jennie's model is to be
as supportive as possible.
as supportive as possible.
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简宁的模型是尽可能的支持。
09:53
And that support provides a crucial buffer
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这种支持提供了一个关键性的缓冲，
09:56
to the stress of racism and discrimination
facing these women every day.
facing these women every day.
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减缓了这些妇女因每天面对的
种族歧视而获得的压力。
种族歧视而获得的压力。
10:02
But here's the best thing
about Jennie's model:
about Jennie's model:
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但是简宁模型最出色的部分是
10:05
it's been incredibly successful.
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它出乎意料的非常成功。
10:08
Remember those statistics I told you,
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还记得我告诉你的那些数据，
黑人妇女更有可能早产，
10:10
that black women are more likely
to give birth too early,
to give birth too early,
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更有可能生出体重不达标的婴儿，
10:12
to give birth to low birth weight babies,
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10:15
to even die due to complications
of pregnancy and childbirth?
of pregnancy and childbirth?
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甚至更有可能因为怀孕与分娩而死亡？
10:18
Well, The JJ Way has almost entirely
eliminated those problems,
eliminated those problems,
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简宁的方法几乎可以解决所有这些问题，
从简宁称之为“瘦弱的婴儿”开始。
10:22
starting with what Jennie calls
"skinny babies."
"skinny babies."
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10:25
She's been able to get almost all
her clients to term
her clients to term
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她已经能够解决
几乎所有客户的健康问题
几乎所有客户的健康问题
并生出像这样可爱的宝宝。
10:28
with healthy, chunky babies like this one.
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10:31
Audience: Aw!
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观众：噢！
10:34
Miriam Zoila Pérez:
This is a baby girl
This is a baby girl
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米里亚姆·佐伊拉·佩亚雷斯：
这一个女孩是
这一个女孩是
10:36
born to a client of Jennie's
this past June.
this past June.
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上个六月在简宁的诊所里出生。
10:39
A similar demographic
of women in Jennie's area
of women in Jennie's area
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在简宁所在地区的同样条件的女人，
10:42
who gave birth at the same
hospital her clients did
hospital her clients did
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在同一个医院里分娩，
10:45
were three times more likely to give birth
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生出低于健康标准体重的
婴儿的可能性比
婴儿的可能性比
10:48
to a baby below a healthy weight.
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简宁的诊所照料过的高出三倍。
10:50
Jennie is making headway
into what has been seen for decades
into what has been seen for decades
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简宁被认为是在几十年来最复杂的问题中
找到了解决方法。
10:53
as an almost intractable problem.
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你们可能会想，
10:57
Some of you might be thinking,
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10:58
all this one-on-one attention
that The JJ Way requires
that The JJ Way requires
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简宁的这种一对一的关注
一定太昂贵而不能大范围运用。
11:01
must be too expensive to scale.
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那你可错了。
11:03
Well, you'd be wrong.
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11:05
The visit with the provider
is not the center of Jennie's model,
is not the center of Jennie's model,
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一对一拜访并不是简宁模型的核心，
11:08
and for good reason.
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原因很简单。
11:10
Those visits are expensive,
and in order to maintain her model,
and in order to maintain her model,
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这些拜访很昂贵，为了维持她的模型，
她要见很多客户来平衡成本。
11:13
she's got to see a lot
of clients to cover costs.
of clients to cover costs.
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11:16
But Jennie doesn't have to spend
a ton of time with each woman,
a ton of time with each woman,
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但是简宁并不需要在
每个女人上花很多时间，
每个女人上花很多时间，
11:19
if all of the members of her team
can provide the support, information
can provide the support, information
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如果她团队的所有人
都能够提供客户需要的
都能够提供客户需要的
支持、信息和照顾。
11:23
and care that her clients need.
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11:26
The beauty of Jennie's model
is that she actually believes
is that she actually believes
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简宁模型的优势是她真的相信
这能够推广到所有医疗保健中。
11:29
it can be implemented
in pretty much any health care setting.
in pretty much any health care setting.
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11:33
It's a revolution in care
just waiting to happen.
just waiting to happen.
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这是一个未来医疗保健的革命。
11:37
These problems I've been sharing
with you are big.
with you are big.
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我分享给你们的这些问题
复杂而又庞大。
复杂而又庞大。
这些源于历史中的种族歧视、阶级歧视，
11:39
They come from long histories
of racism, classism,
of racism, classism,
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一个基于种族和阶级的社会。
11:43
a society based on race
and class stratification.
and class stratification.
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它们和用来保护我们的
11:46
They involve elaborate
physiological mechanisms
physiological mechanisms
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系统有关，
11:48
meant to protect us,
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但过度情况下，会让我们生病。
11:49
that, when overstimulated,
actually make us sick.
actually make us sick.
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11:52
But if there's one thing I've learned
from my work as a doula,
from my work as a doula,
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但是我从当孕妇保姆中学到一件事，
微小的无条件的支持
可以带来巨大的改变。
可以带来巨大的改变。
11:55
it's that a little bit of unconditional
support can go a really long way.
support can go a really long way.
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历史告诉我们人类的适应能力很强，
11:59
History has shown that people
are incredibly resilient,
are incredibly resilient,
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当我们无法解决种族歧视，
12:02
and while we can't eradicate racism
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或者种族歧视产生的压力时，
12:04
or the stress that results
from it overnight,
from it overnight,
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我们也许能够创造一个缓冲的环境，
12:06
we might just be able to create
environments that provide a buffer
environments that provide a buffer
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缓冲有色人种每天面对的困境。
12:09
to what people of color
experience on a daily basis.
experience on a daily basis.
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在怀孕期间，这种缓冲可以非常有用，
12:12
And during pregnancy,
that buffer can be an incredible tool
that buffer can be an incredible tool
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能够有效的降低种族因素
12:16
towards shifting the impact of racism
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对下一代的影响。
12:18
for generations to come.
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12:20
Thank you.
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谢谢。
（鼓掌）
12:21
(Applause)
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ABOUT THE SPEAKER
Miriam Zoila Pérez - Writer, activistMiriam Zoila Pérez investigates how race and gender affect health -- and the people who create spaces for healing.
Why you should listen
Miriam Zoila Pérez began her career as a doula, a layperson who provides support to people during pregnancy and childbirth. That work led her to explore the complex ways our identities shape our health, especially for people of color, LGBT folks and women. As a writer, Pérez has illuminated these topics, and much more, for outlets like Fusion, Talking Points Memo, The American Prospect, Feministing and Colorlines, where she is the gender columnist.
For ten years Pérez has run Radical Doula, a blog that explores the political aspects of doula work. She's the author of The Radical Doula Guide, a political primer that has influenced a generation of activist doulas.
A frequent speaker at colleges, universities and conferences around the US, Pérez brings her perspective as a queer Cuban-American to the issues she explores. A lover of music, Pérez is also the co-host for the popular Latinx music podcast Radio Menea with Verónica Bayetti Flores.
Miriam Zoila Pérez | Speaker | TED.com