Christy Turlington on how to be an ally

Christy has one of the best-known faces in the world. But for over a decade, she’s skillfully championed global maternal health, while never becoming the face of the movement.

I’ve admired Christy Turlington Burns for a long time. Initially, for the reasons everybody does. Growing up, her image seemed like a kind of aesthetic diplomacy,  gracing both the magazine covers that lined the check-out aisle of my hometown grocery store—and also, the billboards towering above the roadways 7,500 miles away, where my cousins in India lived. 

Decades later, I had the opportunity to meet her and, through our shared work, get to know her. She is warm and welcoming and unfailingly optimistic. 

Christy, who studied public health at Columbia University, first reached out to me in 2014 after reading my research investigating the reasons why c-section rates in the United States had skyrocketed. At the time, she’d already released her directorial debut film, “No Woman, No Cry” about our global maternal health crisis, and founded her corresponding nonprofit Every Mother Counts, which works to improve access to quality, respectful, and equitable maternal care around the world. 

Christy deemed me the “data detective” (a title I accepted proudly) for a series she was producing with CNN’s Great Big Story. The project took my work out of the academic cloisters and into the realm of mass media. With her support, my research found new audiences that have informed and sustained my perspective ever since.

I came to understand that this is how Christy works. Through EMC she has consistently amplified people working for better maternal health while she herself, the consummate ally, remains in the background. In the years that followed, I have had the opportunity to work alongside her team and many of her grantees. I’ve always admired Christy’s ability to find unsung heroes and her effectiveness at augmenting their collective impact. 

Christy recently sat down with me and shared some of the less known parts of her story and work with my team at Maven Clinic. And now, I’m excited to share some of her wisdom with you: 

You’ve said that even while at the height of your career in fashion, you had your eyes on your next move. Eventually you pursued a Master’s in Public Health at Columbia. What motivated that experience, and why maternal health specifically? 

It was my experience with the birth of my daughter. What I received in terms of care when I became a mom is what I wish for every mother: I had great midwives, a doula, a fantastic back-up physician, and a great birth center within a hospital, just a couple blocks from my home. And then after a really good healthy pregnancy, and feeling really well supported throughout the whole thing, what I didn't expect was a challenging fourth stage of labor. And while it was painful, certainly, I felt safe. I learned that so many women I knew had incredibly frightening experiences delivering their children. So I really just wanted to start the conversation. 

I got inspired to go back to school because I'd started to hang out with more people who were public health people. And they kept saying, like, oh, if you want to pursue anything in this space, this is the degree that you want, because this is the degree that's going to bring you your peers and your friend group for the rest of your days. And it has in such a deep way. When I travel around the world today, the people that I met when I was in that program in 2008 to 2010…those are the people running the organizations in the communities that I spend time in. I wanted to become the best advocate I could, which meant that I needed to dig in and really understand the challenges and the physiological components of public health.

To be a little more specific, you experienced a postpartum hemorrhage. It’s a serious, traumatic complication that explicitly requires a surgeon in the operating room. You speak so openly about how much that experience affected you. But you’re also a true believer in midwives and birth centers. Some people might see those views as contradictory. How do you advocate for both? 

I do a lot of thinking about the whole ecosystem of women's health providers, all of whom are so important. Depending on the circumstances and the options available, any one of those providers alone, let alone together, make up a unified support system. It just makes sense to me that low risk pregnancies should be handled by midwives. But I was certainly grateful to have an experienced physician come in to support my midwife when it was necessary. I believe that every person that's a part of that ecosystem, every person that's in a room, when things turn, when things shift, is essential. The janitor coming in and cleaning the room up after a hemorrhage situation…they’re essential. 

With Every Mother Counts, you’ve traveled to Haiti and Tanzania; Bangladesh and Guatemala, and to other countries as well. You’ve witnessed maternal health all over the world on the frontlines. What are some of your most surprising observations?

I find that there's so much that can be learned and shared across high and low resource countries settings. I love to travel with providers in other countries outside of the circumstances that they work in, because I think it always gives you some perspective. Jennie Joseph is one of those midwives, who I've traveled to Haiti with and I love to experience through a provider's eyes how bare, and how basic, a lot of the facilities are set up, but even with that kind of simplicity, how innovation is happening all the time. 

I've seen incredible uterine tamponade devices made with a condom and saline solution. I've seen people demonstrate incredible innovation that costs nothing with just what's there and what's available in the supply closet. Learning what happens in some of these settings has proven to be really effective, obviously, in emergencies and disaster relief settings. 

As a nonprofit, Every Mother Counts makes bets on innovators. Your remit is the entire globe, and you in many ways discover, uplift, and empower individuals who are already essential to their communities, but can have even more impact with more resources. To me, that’s good investing, but it’s also what great allyship looks like. How do you choose those bets?

From the beginning, with the foundation, I didn't want to rush anything. At first, it was really listening and figuring out, do we need another organization? What should we be contributing in terms of value-add? I found that, certainly, it’s resources, because we do bring resources to the table, but the resources we contribute are so tiny, in terms of what's actually needed and required. It's really the resources plus identifying the skills of a community leader. We know the surest investment, best bang for the dollar, is the leadership. 

We started very slowly in the U.S., and it looks slightly different in each of the countries where we work, but it usually starts with one partner. In selecting Jennie Joseph as our sort of starting partner back in 2008 while working on “No Woman, No Cry,” she opened the door to so many other partners.  She's a mentor to so many other people working in this space, and she has allowed people to trust me to trust our organization. And now we can make those introductions too. Like in Tanzania, for example, three of our partners don't necessarily know each other, they know of each other, and now they're starting to work together. And that, I think, is my favorite thing.

You’ve been in the maternal health space for a while now. From my perspective, it feels like we’ve reached a real point of inflection in the birth equity movement, where community based energy and organizing is starting to change the landscape in the same way ACT UP did for AIDS in the 1980s. Have you observed the same thing? 

I have. It’s interesting…when I was at Columbia, there was definitely already the human rights framework on public health and on global health. And that was huge. But the big conversation at that time, too, was access. I feel like there's been this really wonderful sort of deepening of the understanding of not just access to care, but quality, experience and equity, right? To me, human rights and equity are symbiotic. And I think the pandemic honestly made all of our jobs a little bit easier in the sense that people understood maybe for the first time for many Americans, certainly, what health care access and mistrust looks like. All of a sudden, more of us understood what some of those barriers are, that have been historical, ongoing forever, and how that impacts the health and wellbeing of individuals and communities. 

I am a huge fan of Rep. Lauren Underwood, one of the co-leads of the Black Maternal Health Caucus. What I love about when she started using her voice in this conversation was that she was like, we're not waiting, we're going to lead this conversation. Much like ACT UP, she was like, you all don't have the urgency that we have, we are seeing friends and family members die, and no more. We're gonna take the lead. I love that. It's exciting to play any role to be honest, in this kind of movement. And, again, I love that, if we have something that we can add, it’s greater exposure. It’s silly that that's needed. But we live in a very busy world. And it's hard to get media and it's hard to get people to be quiet for a second to hear you out. 

If we can create a platform where we can bring those voices or those experiences to light in a way, but also continue to let those partners lead, that's the role we want to play. I often will say, and we're not unique to this, as an organization we want to be a doula for the doulas; a doula for the midwives. We want to ask: what do you need to help you thrive and be able to provide the best quality of care to the people you're serving? 

What my team is reading, thinking about, and building against:

• Since 2010, Every Mother Counts has invested more than $42 million in over 100 grants for proven models of care in 16 countries, awareness raising activities, and advocacy for systems change. You can find a series of powerful short films that highlight the inspiring leaders EMC supports in Guatemala, India, and Bangladesh here. After watching, if you want to do more with that inspiration, you can raise awareness of maternal health disparities by running under the EMC banner at a number of upcoming races here. We’ll be donating all proceeds from paid subscriptions to this Preprint to their invaluable work! 

• Jennie Joseph, the thought partner and EMC advocate that Christy refers to, and a dear mutual friend, is the first Black person in the U.S. to privately own a nationally accredited midwifery school. She has devoted her life to leveraging the power of midwives to reverse public health outcomes, and bolster communities. She is, as Christy told me, “someone I’d love to clone.” You can learn more about Jennie’s magic in this excellent profile of her as a TIME Woman of the Year. 

• I first started to think about the birth equity movement as a sequel to AIDS/HIV organizing after reading Sarah Schulman’s masterpiece, “Let the Record Show: A Political History of ACT UP New York, 1987-1993.” The book answers lofty questions with grounded, tactical instructions, like: how do you build a movement? How do you sustain a movement? How do you truly change hearts and minds? The hard and often messy work of change has been done before…with the notes to prove it! My favorite idea from the book is that it may not be reasonable to expect everyone to get along. Change does not always require consensus. Rather, it requires everyone doing what they can from the position they occupy—what Schulman calls a “simultaneity of response.” 

• Christy’s work is an excellent reminder that adopting a global perspective is essential to recognizing cross-cutting trends. A new analysis from the Lancet about falling global fertility rates hammers this home. Toplines include: the global live birth rate peaked in 2016, high income countries have been below the population "replacement" fertility rate of two children per woman for decades, and by 2030 all continents except Africa will be there too. We have much more to say about this at Maven…more on that soon!