TEDWomen 2016
Miriam Zoila Pérez: How racism harms pregnant women -- and what can help
米里亞姆·柔依拉·佩雷斯: 種族歧視如何傷害孕婦，以及如何能有助益
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米里亞姆·柔依拉·佩雷斯說：種族歧視使人們生病，特別是對黑人婦女和嬰兒。 陪產婦出身的新聞記者探討了種族、階級和疾病之間的關係。她告訴我們一個非常友善的產前保健計劃，可以緩解孕婦每天所經歷的對有色人種的壓力。
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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在座的大多數可能可以
體會我現在的感覺。
體會我現在的感覺。
00:17
My heart is racing in my chest.
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我的心臟跳很快。
00:19
My palms are a little bit clammy.
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我的手掌有點黏。
00:22
I'm sweating.
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我在流汗。
00:24
And my breath is a little bit shallow.
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我的呼吸有點急促。
00:27
Now, these familiar sensations
are obviously the result
are obviously the result
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很明顯，這些熟悉的感覺是因為
00:30
of standing up
in front of a thousand of you
in front of a thousand of you
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我站在你們無數人面前演講，
00:32
and giving a talk
that might be streamed online
that might be streamed online
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而且這個演講可能會放到網路上
供上百萬人觀看。
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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但是我現在的這個身體反應
00:39
are actually the result of a much more
basic mind-body mechanism.
basic mind-body mechanism.
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實際上是很基本的身心機制的結果。
00:44
My nervous system is sending
a flood of hormones
a flood of hormones
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我的神經系統正在輸送
許多如皮質醇和腎上腺素等荷爾蒙
到我的血液裡。
到我的血液裡。
00:47
like cortisol and adrenaline
into my bloodstream.
into my bloodstream.
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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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這是一個非常老且非常必要的反應。
它送我所需的血液和氧氣
到器官和肌肉裡
到器官和肌肉裡
00:56
to the organs and muscles
that I might need
that I might need
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讓我可以快速回應潛在的威脅。
00:58
to respond quickly to a potential threat.
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但是這個回應有一個問題，
01:01
But there's a problem with this response,
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01:03
and that is, it can get over-activated.
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那就是，它可能反應過度。
如果我每天面對這些種種壓力，
01:06
If I face these kinds of stressors
on a daily basis,
on a daily basis,
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01:09
particularly over an extended
period of time,
period of time,
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持續一段時間後，
我的系統可能會不堪負荷。
01:12
my system can get overloaded.
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01:15
So basically, if this response
happens infrequently: super-necessary
happens infrequently: super-necessary
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基本上，如果這個反應不常發生，
那對於我的健康和生存是很必要的。
01:19
for my well-being and survival.
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01:21
But if it happens too much,
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但是如果它經常發生，
01:23
it can actually make me sick.
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那就可能會讓我生病。
01:25
There's a growing body of research
examining the relationship
examining the relationship
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有越來越多的研究檢視
慢性壓力和疾病之間的關係。
01:28
between chronic stress and illness.
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01:30
Things like heart disease and even cancer
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心臟病，甚至癌症等疾病
01:32
are being shown to have
a relationship to stress.
a relationship to stress.
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顯然與壓力有關係。
01:35
And that's because, over time,
too much activation from stress
too much activation from stress
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那是因為，長時間
太多來自壓力的激活
太多來自壓力的激活
01:40
can interfere with my body's processes
that keep me healthy.
that keep me healthy.
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會干擾我的身體保持健康的過程。
01:44
Now, let's imagine for a moment
that I was pregnant.
that I was pregnant.
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現在，我們想像一下
我現在懷孕了。
我現在懷孕了。
01:48
What might this kind of stress,
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這種壓力，
特別在整個懷孕期間，
01:50
particularly over the length
of my pregnancy,
of my pregnancy,
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對我體內正在發育的胎兒
01:52
what kind of impact might that have
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01:54
on the health of my developing fetus?
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可能造成什麼影響？
01:58
You probably won't be surprised
when I tell you
when I tell you
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你們可能不會驚訝
當我告訴你們
當我告訴你們
懷孕期間的這種壓力很不好。
02:00
that this kind of stress
during pregnancy is not good.
during pregnancy is not good.
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02:04
It can even cause the body
to initiate labor too early,
to initiate labor too early,
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它甚至可能導致身體太早生產，
02:07
because in a basic sense,
the stress communicates
the stress communicates
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因為，基本上，壓力告知身體
02:10
that the womb is no longer
a safe place for the child.
a safe place for the child.
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子宮已經不是胎兒的安全所在了。
懷孕期間的壓力與高血壓
02:14
Stress during pregnancy is linked
with things like high blood pressure
with things like high blood pressure
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和嬰兒體重不足等有關聯，
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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而這些啟動一連串的健康挑戰，
02:21
that make birth much more dangerous
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使母親和胎兒在生產時更加危險。
02:23
for both parent and child.
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02:27
Now of course stress,
particularly in our modern lifestyle,
particularly in our modern lifestyle,
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當然，特別是我們現代的生活方式，
壓力是相對普遍的經驗，對嗎？
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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或許你未曾在台上做 TED 的演講，
02:34
but you've faced a big
presentation at work,
presentation at work,
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但是你曾在工作場合做過大型的發表，
02:37
a sudden job loss,
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或是突然失去工作，
02:39
a big test,
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面對一個大的考驗，
02:40
a heated conflict
with a family member or friend.
with a family member or friend.
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甚至與家庭成員或朋友有熱烈的衝突。
02:43
But it turns out that the kind
of stress we experience
of stress we experience
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但事實證明，我們經驗的那種壓力，
以及我們是否能夠
足夠長久地保持放鬆狀態，
足夠長久地保持放鬆狀態，
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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02:50
to keep our bodies working properly
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使我們的身體保持正常運作，
02:52
depends a lot on who we are.
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基本上取決於我們是那種人。
02:55
There's also a growing body of research
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有越來越多的研究顯示
02:57
showing that people who experience
more discrimination
more discrimination
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經歷更多的歧視的人
03:01
are more likely to have poor health.
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更可能有比較差的健康狀態。
03:04
Even the threat of discrimination,
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即使是歧視的威脅，
03:06
like worrying you might be stopped
by police while driving your car,
by police while driving your car,
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像是擔心你可能會在開車時
被警察攔下來，
被警察攔下來，
03:09
can have a negative impact on your health.
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就可能對你的健康有負面影響。
03:14
Harvard Professor Dr. David Williams,
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哈佛大學教授大衛 · 威廉斯博士
03:17
the person who pioneered
the tools that have proven these linkages,
the tools that have proven these linkages,
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是開發能證明關連的工具的先驅。
03:20
says that the more marginalized
groups in our society
groups in our society
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他說在我們的社會，
越是被邊緣化的族群，
越是被邊緣化的族群，
03:23
experience more discrimination
and more impacts on their health.
and more impacts on their health.
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經歷越多的歧視
和遭受越多對於健康的影響。
和遭受越多對於健康的影響。
03:28
I've been interested in these issues
for over a decade.
for over a decade.
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我十多年來一直對這些問題感興趣。
03:31
I became interested in maternal health
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特別是有關孕婦的健康
03:34
when a failed premed trajectory
instead sent me down a path
instead sent me down a path
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讀醫科的計劃的失敗，
反而把我送上了
反而把我送上了
03:38
looking for other ways
to help pregnant people.
to help pregnant people.
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尋找其他方式幫助孕婦之路。
03:40
I became a doula,
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我成了一個陪產婦，
03:42
a lay person trained to provide support
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一位受訓練的非專業人士，
03:44
to people during pregnancy and childbirth.
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為婦女在懷孕期間和生產時提供支持。
03:46
And because I'm Latina
and a Spanish speaker,
and a Spanish speaker,
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而且因為我會講西班牙語，
是拉丁美洲裔，
是拉丁美洲裔，
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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當我在北卡羅來納州的
一家公立醫院擔任陪產婦志工時，
一家公立醫院擔任陪產婦志工時，
03:53
I saw clearly how race and class
impacted the experiences
impacted the experiences
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我清楚地看到了種族和階級
如何影響到
如何影響到
03:56
of the women that I supported.
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我所陪產的婦女的經驗。
03:58
If we take a look at the statistics
about the rates of illness
about the rates of illness
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如果我們看看懷孕期間
和生產時的疾病的比率的統計資料，
和生產時的疾病的比率的統計資料，
04:02
during pregnancy and childbirth,
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04:04
we see clearly the pattern
outlined by Dr. Williams.
outlined by Dr. Williams.
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我們就會清楚地看到
由威廉姆斯博士概述的模式。
由威廉姆斯博士概述的模式。
04:07
African-American women in particular
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特別是非裔美國婦女，
04:09
have an entirely different
experience than white women
experience than white women
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她們的嬰兒出生時是否健康，
有著與白人婦女完全不同的經驗。
有著與白人婦女完全不同的經驗。
04:12
when it comes to whether
their babies are born healthy.
their babies are born healthy.
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04:16
In certain parts of the country,
particularly the Deep South,
particularly the Deep South,
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特別是在美國的最南部地區，
04:19
the rates of mother
and infant death for black women
and infant death for black women
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黑人婦女中的母親和嬰兒的死亡率，
04:22
actually approximate
those rates in Sub-Saharan African.
those rates in Sub-Saharan African.
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實際上與撒哈拉以南非洲人的
這些比率相似。
這些比率相似。
04:26
In those same communities,
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在那些社區，
04:28
the rates for white women are near zero.
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白人婦女的那些比率接近零。
04:32
Even nationally, black women
are four times more likely
are four times more likely
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甚至在全國，黑人婦女
在懷孕和分娩期間死亡的比率
04:36
to die during pregnancy and childbirth
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04:38
than white women.
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是白人婦女的四倍。
04:40
Four times more likely to die.
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四倍的死亡率。
04:43
They're also twice as likely
for their infants to die
for their infants to die
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黑人嬰兒在滿一歲前的死亡率
也是白人的兩倍。
也是白人的兩倍。
04:46
before the first year of life
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04:47
than white infants,
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04:49
and two to three times more likely
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黑人嬰兒早產和出生時重量太輕，
那是發展不足的跡象，
那是發展不足的跡象，
04:51
to give birth too early or too skinny --
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04:54
a sign of insufficient development.
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是白人嬰兒的兩三倍。
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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本土印第安婦女這些問題的比率
05:01
than white women,
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也比白人婦女高，
05:02
as are some groups of Latinas.
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有些拉丁美裔的族群也是如此。
05:05
For the last decade as a doula
turned journalist and blogger,
turned journalist and blogger,
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在過去十年，
作為一個陪產婦轉業的記者和博主，
作為一個陪產婦轉業的記者和博主，
05:08
I've been trying to raise the alarm
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我一直在試圖提出
05:10
about just how different
the experiences of women of color,
the experiences of women of color,
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關於美國有色人種婦女，
特別是黑人婦女，
05:13
but particularly black women,
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在懷孕和生產的經驗
是如何不同的警報。
是如何不同的警報。
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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但是當我告訴人
關於這些令人震驚的統計，
關於這些令人震驚的統計，
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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我通常聽到的假設是
那是因為貧窮，或是得不到醫療照顧。
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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但事實證明，這些不是全部的原因。
05:29
Even middle-class black women
still have much worse outcomes
still have much worse outcomes
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即使中產階級的黑人婦女，
比起中產階級的白人婦女，
比起中產階級的白人婦女，
05:34
than their middle-class
white counterparts.
white counterparts.
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仍然有更不好的結果。
05:37
The gap actually widens among this group.
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這個群組內的差距實際上更大。
05:40
And while access to care
is definitely still a problem,
is definitely still a problem,
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雖然是否得到醫療照顧
肯定還是個問題，
肯定還是個問題，
05:44
even women of color who receive
the recommended prenatal care
the recommended prenatal care
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即使有色人種的婦女
接受到推薦的產前保健，
接受到推薦的產前保健，
05:47
still suffer from these high rates.
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在前述比率上她們仍然偏高。
05:50
And so we come back to the path
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所以我們回來追溯
05:52
from discrimination to stress
to poor health,
to poor health,
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從歧視到壓力，
到健康欠佳的過程，
到健康欠佳的過程，
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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這個許多有色人種
都相信的圖開始成形：
都相信的圖開始成形：
06:00
racism is actually making us sick.
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種族歧視真的使我們生病。
06:04
Still sound like a stretch?
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仍然聽起來過於誇張嗎？
06:05
Consider this: immigrants,
particularly black and Latina immigrants,
particularly black and Latina immigrants,
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請聽聽以下：移民，
特別是黑人和拉丁移民，
特別是黑人和拉丁移民，
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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在剛抵達美國時，
他們實際上有比較好的健康狀態。
他們實際上有比較好的健康狀態。
06:13
But the longer they stay in this country,
the worse their health becomes.
the worse their health becomes.
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但當他們留在這個國家的時間越長，
他們的健康越惡化。
他們的健康越惡化。
06:18
People like me, born in the United States
to Cuban immigrant parents,
to Cuban immigrant parents,
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和我一樣出生在美國的
古巴移民家庭的人，
古巴移民家庭的人，
06:22
are actually more likely to have
worse health than my grandparents did.
worse health than my grandparents did.
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實際上更有可能
有比我的祖父母更差的健康狀態。
有比我的祖父母更差的健康狀態。
06:26
It's what researchers call
"the immigrant paradox,"
"the immigrant paradox,"
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研究人員稱之為「移民者的矛盾」。
06:29
and it further illustrates
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它並進一步說明了
06:30
that there's something
in the US environment
in the US environment
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美國的環境裡，
有使我們生病的東西。
06:32
that is making us sick.
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06:34
But here's the thing:
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但是事情是這樣的：
06:35
this problem, that racism
is making people of color,
is making people of color,
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種族歧視使有色人種生病，
特別是黑人婦女和嬰兒，
是個很巨大的問題。
是個很巨大的問題。
06:38
but especially black
women and babies, sick, is vast.
women and babies, sick, is vast.
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06:41
I could spend all of my time
with you talking about it,
with you talking about it,
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我可以花所有的時間
與你談論它，
與你談論它，
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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但我不會如此做，
因為我想告訴你一個解決方案。
因為我想告訴你一個解決方案。
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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好消息是，
有一個不是特別昂貴解決方案。
有一個不是特別昂貴解決方案。
06:51
and doesn't require
any fancy drug treatments
any fancy drug treatments
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它不需要任何昂貴的藥物治療，
06:54
or new technologies.
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或是新的科技。
06:55
The solution is called, "The JJ Way."
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這個解決方案叫做「JJ 方式」。
06:59
Meet Jennie Joseph.
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這位是珍妮 · 喬瑟夫。
07:01
She's a midwife
in the Orlando, Florida area
in the Orlando, Florida area
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她是佛羅里達州奧蘭多市的助產士，
07:03
who has been serving
pregnant women for over a decade.
pregnant women for over a decade.
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服務孕婦十多年了。
07:07
In what she calls her easy-access clinics,
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在她稱之為便利診所裡，
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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珍妮和她的團隊
每年為超過 600 名婦女
產前護理。
產前護理。
07:14
Her clients, most of whom are black,
Haitian and Latina,
Haitian and Latina,
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她的客戶，大多數是黑人、
海地裔，和拉丁裔婦女。
海地裔，和拉丁裔婦女。
07:19
deliver at the local hospital.
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她們在當地醫院分娩。
07:21
But by providing accessible
and respectful prenatal care,
and respectful prenatal care,
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通過提供方便和尊重的產前保健，
07:25
Jennie has achieved something remarkable:
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珍妮得到很不可思議的成就：
07:28
almost all of her clients give birth
to healthy, full-term babies.
to healthy, full-term babies.
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幾乎所有她的客戶
都生了健康、足月的嬰兒。
都生了健康、足月的嬰兒。
07:33
Her method is deceptively simple.
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她的方法看起來很簡單。
07:35
Jennie says that all of her appointments
start at the front desk.
start at the front desk.
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珍妮說她所有的訪視
從櫃檯開始。
從櫃檯開始。
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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她的團隊中的每個成員
時時刻刻都對她診所的每個婦女
時時刻刻都對她診所的每個婦女
07:42
is as supportive as possible.
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都盡可能提供支持。
07:45
No one is turned away
due to lack of funds.
due to lack of funds.
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沒有人由於缺錢而被拒絕。
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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JJ 方式是無論有什麼障礙，
他們都不會讓財務成為問題。
他們都不會讓財務成為問題。
07:51
No one is chastised for showing up
late to their appointments.
late to their appointments.
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沒有人會因為比預約時間晚到被責備。
07:54
No one is talked down to or belittled.
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沒有人在言語上被貶低或輕視。
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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珍妮的候診室，比起診所，
感覺更像你的阿姨的客廳。
感覺更像你的阿姨的客廳。
08:02
She calls this space
"a classroom in disguise."
"a classroom in disguise."
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她稱這個空間是「變相的教室」。
08:05
With the plush chairs
arranged in a circle,
arranged in a circle,
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坐在排列成一個圓圈的
鬆軟舒適的椅子上，
鬆軟舒適的椅子上，
08:08
women wait for their appointments
in one-on-one chats
in one-on-one chats
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孕婦在等待她們的預約時，
與一位負責教育的工作人員
一對一聊天，
一對一聊天，
08:10
with a staff educator,
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08:12
or in group prenatal classes.
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或上團體產前課程。
08:14
When you finally are called back
to your appointment,
to your appointment,
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當你終於被叫去做
你的預約檢查時，
你的預約檢查時，
你會見到阿里克斯或崔伊娜
08:17
you are greeted by Alexis or Trina,
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她們是珍妮的醫療助理。
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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兩位都是年輕的黑人婦女，
她們本身也都是母親。
她們本身也都是母親。
她們的方法是非正式和友好的。
08:24
Their approach is casual and friendly.
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08:27
During one visit I observed,
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在一次參訪時我觀察到，
崔伊娜和一位年輕的準媽媽聊天，
08:29
Trina chatted with a young soon-to-be mom
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08:32
while she took her blood pressure.
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一面量著她的血壓。
08:33
This Latina mom was having trouble
keeping food down due to nausea.
keeping food down due to nausea.
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這個拉丁裔媽媽一直有孕吐的問題。
08:38
As Trina deflated the blood pressure cuff,
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當崔伊娜在為血壓袖帶放氣時，
她說：「我們改改你的處方，好嗎？
08:40
she said, "We'll see about changing
your prescription, OK?
your prescription, OK?
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08:43
We can't have you not eating."
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我們不能任由你吃不下東西。」
08:45
That "we" is actually a really crucial
aspect of Jennie's model.
aspect of Jennie's model.
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那個「我們」在珍妮的模式裡
是一個非常關鍵的部分。
是一個非常關鍵的部分。
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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她將工作人員、孕婦和她的家人
都視為團隊的一份子，
都視為團隊的一份子，
08:54
has one goal:
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有著共同的目標：
08:55
get mom to term with a healthy baby.
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讓媽媽生出一個健康的嬰兒。
珍妮說崔伊娜和阿里克斯
實際上是她的護理模式的中心。
實際上是她的護理模式的中心。
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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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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作為護理提供者的角色，
她只是支持他們的工作。
她只是支持他們的工作。
09:07
Trina spends a lot of her day
on her cell phone,
on her cell phone,
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崔伊娜每天花很多時間在她的手機上，
09:09
texting with clients
about all sorts of things.
about all sorts of things.
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向客戶發關於各種各樣事情的短信。
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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一位婦女發短信詢問
她在醫院治療時使用的處方藥物，
她在醫院治療時使用的處方藥物，
09:15
was OK to take while pregnant.
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在懷孕時是否可以服用。
09:17
The answer was no.
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答案是不可以。
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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另一位婦女發短信附上
在珍妮的照顧下出生的嬰兒的相片。
在珍妮的照顧下出生的嬰兒的相片。
09:24
Lastly, when you finally are called back
to see the provider,
to see the provider,
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最後，當你終於被叫去
見醫療提供者，
見醫療提供者，
09:27
you've already taken your own weight
in the waiting room,
in the waiting room,
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你已經在候診室量了體重，
09:30
and done your own pee test
in the bathroom.
in the bathroom.
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並在浴室做了尿液測試。
09:33
This is a big departure
from the traditional medical model,
from the traditional medical model,
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這和傳統醫學模式，有很大的不同。
09:35
because it places
responsibility and information
responsibility and information
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因為它將責任和信息
放回到婦女的手中。
放回到婦女的手中。
09:38
back in the woman's hands.
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09:41
So rather than a medical setting
where you might be chastised
where you might be chastised
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在一般的醫療環境，
如果妳沒有遵從他們的推薦，
你可能會被譴責──
你可能會被譴責──
09:44
for not keeping up
with provider recommendations --
with provider recommendations --
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那是低收入婦女經常接觸到的。
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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珍妮的模式是盡可能地支持孕婦。
09:53
And that support provides a crucial buffer
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那個支持對於每天面對
種族主義和歧視壓力的婦女而言，
種族主義和歧視壓力的婦女而言，
09:56
to the stress of racism and discrimination
facing these women every day.
facing these women every day.
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是個關鍵的緩衝。
10:02
But here's the best thing
about Jennie's model:
about Jennie's model:
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珍妮的模式最好的是：
10:05
it's been incredibly successful.
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它非常成功。
10:08
Remember those statistics I told you,
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記得我告訴你們，
有關黑人婦女更有可能早產，
10:10
that black women are more likely
to give birth too early,
to give birth too early,
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10:12
to give birth to low birth weight babies,
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或者生出體重過低的嬰兒，
10:15
to even die due to complications
of pregnancy and childbirth?
of pregnancy and childbirth?
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甚至死於懷孕和分娩併發症的
統計資料嗎？
統計資料嗎？
10:18
Well, The JJ Way has almost entirely
eliminated those problems,
eliminated those problems,
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JJ 方式幾乎完全
消除了這些問題，
消除了這些問題，
10:22
starting with what Jennie calls
"skinny babies."
"skinny babies."
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從珍妮稱為「瘦小寶貝」開始。
10:25
She's been able to get almost all
her clients to term
her clients to term
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她幾乎讓所有她的客戶
10:28
with healthy, chunky babies like this one.
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生出像這個的健康和大塊頭的嬰兒。
10:31
Audience: Aw!
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（聽眾）噢！
10:34
Miriam Zoila Pérez:
This is a baby girl
This is a baby girl
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（米里亞姆·柔依拉·佩雷斯）
這是一位女嬰，
這是一位女嬰，
10:36
born to a client of Jennie's
this past June.
this past June.
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珍妮的一位客戶在六月生產的。
10:39
A similar demographic
of women in Jennie's area
of women in Jennie's area
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在珍妮服務的地區，
一位有類似背景的的婦女，
一位有類似背景的的婦女，
10:42
who gave birth at the same
hospital her clients did
hospital her clients did
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在和她的客戶同一家醫院生產，
10:45
were three times more likely to give birth
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有三倍的機率
會生出低於正常體重的嬰兒。
10:48
to a baby below a healthy weight.
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10:50
Jennie is making headway
into what has been seen for decades
into what has been seen for decades
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珍妮突破了一個幾十年來
幾乎無法解決的問題。
幾乎無法解決的問題。
10:53
as an almost intractable problem.
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你們有些人可能會想，
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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JJ 方式所需要的一對一的關注，
11:01
must be too expensive to scale.
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要擴展的話，可能成本會很高。
11:03
Well, you'd be wrong.
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但你們的想法是錯的。
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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與醫療提供者見面
不是珍妮模型的中心，
不是珍妮模型的中心，
11:08
and for good reason.
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這是有好理由的。
11:10
Those visits are expensive,
and in order to maintain her model,
and in order to maintain her model,
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與醫療提供者見面是很貴的，
為了維持她的模式，
她必須看很多客戶才能打平。
她必須看很多客戶才能打平。
11:13
she's got to see a lot
of clients to cover costs.
of clients to cover costs.
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但是珍妮對每一位婦女
不需要花很多時間，
不需要花很多時間，
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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11:19
if all of the members of her team
can provide the support, information
can provide the support, information
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如果她的團隊成員可以提供
客戶所需要的支持、資訊和照顧。
客戶所需要的支持、資訊和照顧。
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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珍妮模式的美是她實際上相信
這個模式在幾乎任何衛生保健機構
都可以做到的。
都可以做到的。
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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這是等待發生的一個醫療照顧的革命。
11:37
These problems I've been sharing
with you are big.
with you are big.
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那些我與你們分享的問題是很大的。
11:39
They come from long histories
of racism, classism,
of racism, classism,
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它們來自悠久歷史
基於種族和階級分層的社會裡的
種族和階級歧視。
種族和階級歧視。
11:43
a society based on race
and class stratification.
and class stratification.
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11:46
They involve elaborate
physiological mechanisms
physiological mechanisms
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它涉及為了要保護我們所產生的
複雜生理機制。
複雜生理機制。
11:48
meant to protect us,
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11:49
that, when overstimulated,
actually make us sick.
actually make us sick.
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當這個機制被過度刺激時，
反而讓我們生病。
反而讓我們生病。
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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從我作為一個陪產婦的工作，
我至少學到了一件事，
我至少學到了一件事，
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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那就是一點點無條件的支持
是很有效的。
是很有效的。
11:59
History has shown that people
are incredibly resilient,
are incredibly resilient,
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歷史證明人們有令人難以置信的韌性，
12:02
and while we can't eradicate racism
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雖然我們無法一夜之間消除種族歧視，
12:04
or the stress that results
from it overnight,
from it overnight,
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以及它造成的壓力，
12:06
we might just be able to create
environments that provide a buffer
environments that provide a buffer
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我們或許能夠為每天承受壓力的
有色人種提供一個緩衝的環境。
有色人種提供一個緩衝的環境。
12:09
to what people of color
experience on a daily basis.
experience on a daily basis.
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12:12
And during pregnancy,
that buffer can be an incredible tool
that buffer can be an incredible tool
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在懷孕期間，
那個緩衝可以長長久久
成為轉移種族主義的影響的
一個不可思議的工具。
一個不可思議的工具。
12:16
towards shifting the impact of racism
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12:18
for generations to come.
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12:20
Thank you.
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謝謝！
12:21
(Applause)
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（掌聲）
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