In a cellphone video taken by her husband, Folashade Butler lies in a hospital bed after giving birth to twins. The doctor who delivered them, Lynne Lightfoote, holds a newborn in each arm. Butler and Lightfoote are wearing protective masks, but you can hear their muffled expressions of awe.
That’s how childbirth is supposed to be. A blessed event.
For too many women, though, it’s a death sentence. Maternal and infant mortality rates in the United States are the highest among developed nations. And the racial disparities are stunning, with Black women three times more likely to die of pregnancy-related causes than White women, according to the Centers for Disease Control and Prevention.
“As I prayed for myself during my pregnancy, I prayed for Dr. Lightfoote and her team,” Butler wrote on Instagram after the Sept. 29 birth. “In this time where #BlackMaternalHealth is experiencing major losses and tragedies, my level of gratitude for Dr. Lightfoote is at an all time high!”
I recently spoke with Butler and Lightfoote, checked up on the twins, and found out more about the teamwork that led to that happy birthday. Now four months old, the girl named Majesty and the boy named Royal are doing fine. Butler and Lightfoote stay in touch because complications related to a pregnancy can sometimes show up six months to a year later.
Butler is quite pleased with her doctor — a relationship made stronger by their shared experience of being Black women.
“She not only gives wise advice about pregnancy and gynecological care, but we can also talk about my overall well-being — my weight, how I’m feeling about the racial unrest, concerns about the covid pandemic, the racial disparities with that,” said Butler, who also has two older children. “Dr. Lightfoote is like a big sister.”
Lightfoote, a D.C. native, has been an OB/GYN since 2001. She graduated from Wellesley College and the University of Virginia Medical School. Her mother, Marilyn Madry Lightfoote, was a renowned molecular immunologist at the National Institutes of Health, and her father, William Lightfoote, was a neurologist at Greater Southeast Community Hospital.
Lynne Lightfoote works at Foxhall OB/GYN Associates in Northwest Washington, and she delivered the Butler twins at nearby Sibley Memorial Hospital. Physicians with such pedigree are sometimes referred to as “country club doctors.”
Lightfoote is definitely known for giving her patients five-star treatment, but she’s very down to earth.
Butler recalled her first appointment with Lightfoote 15 years ago. “My husband, who was my boyfriend at the time, came with me and she put him out — or maybe I should say invited him to leave the room — so she and I could make a connection,” Butler said.
Lightfoote will hold a patient’s hand while explaining a medical condition or procedure and not let go until she’s sure the patient understands.
Gentle, but also tough.
“If you say you can’t make an appointment for a checkup and then show up later with a new hairdo, I’ll call you out on it,” Lightfoote said. “But I’ll do it out of love. I’m not trying to get the most ‘likes’ on social media. I’m trying to save the lives of mothers and their babies.”
She’s not alone. Efforts to reduce Black maternal and infant deaths include legislation, such as the Anti-Racism in Public Health Act under consideration in Congress. There are also state initiatives, such as the “Black agenda,” unveiled earlier this month by Maryland House Speaker Adrienne A. Jones.
Both measures are aimed at attacking systemic racial inequalities. And they reflect a growing awareness that disparities arise from the cumulative effects of centuries of racial oppression, in which unequal access to education, employment and health care were enshrined in law.
Dismantling the structures is essential but will take decades if not centuries to achieve. The timetable for human development is much tighter. Nine months from conception to birth.
In the end, success will probably look a lot like Butler in consultation with Lightfoote. Access to more affordable, high-quality health-care facilities. More highly skilled doctors aware of the dangers Black women and their babies face — and willing to listen to Black women when they tell them something is wrong.
We need more doctors who, like Lightfoote, talk to their patients, not at them.
Linda Green, an OB/GYN in Coral Springs, Fla., who is Black, told me that female patients who are Black often come to her after having unpleasant encounters with male physicians, Black and White.
“They’d say things like, ‘It just didn’t feel right when I was talking to him,’ ” she said. “Or, ‘He wouldn’t look me in the eye when I had a question; he didn’t respect my intelligence.’ And, ‘He just didn’t seem to care.’ ”
In the February 2021 issue of the journal Obstetrics & Gynecology, the lead commentary addressed those issues:
“Women of color must be listened to with empathy and solidarity, so that care and treatment responses can be appropriate; this requires a more racially and ethnically diverse workforce, anti-racist education at every level of clinical training, and increased inclusion of doulas and other patient advocates in maternal care,” it read. “This requires cultural humility, mindfulness, transparency, and acknowledgment of the historical injustices that have occurred and a commitment to relegate them to history.”
Do that and there will be a lot more births ending in awe and celebration.
A relieved if somewhat exhausted mother, like Butler. A proud dad — her husband, Brandon — steadying his hand while trying to focus a cellphone camera. A doctor pacing joyfully with healthy twins in her arms.
That’s what a delivery room is supposed to look like. Full of life, not like a morgue.
An earlier version of this column incorrectly spelled the name of Folashade Butler. The error has been corrected.
To read previous columns, go to washingtonpost.com/people/courtland-milloy.