Going on 20 years ago, Christy Turlington Burns had a difficult time delivering her daughter Grace. The postpartum complications she experienced made her look at women and motherhood “in a different way” and “opened her up” to the fact that “women’s bodies are more at risk for a whole host of reasons.”
It was the starting point of a decades-long commitment to making pregnancy and childbirth safer for mothers everywhere.
After 10 years of advocacy work, the model and social entrepreneur founded Every Mother Counts (EMC), a public philanthropy that envisions “a world where all women have the opportunity to enter motherhood and not only survive, but thrive.” Since 2010, EMC has invested more than $24 million in improving health outcomes for mothers, distributing 100 grants that support “models of care” in the U.S. and a dozen other countries, like Bangladesh, India and Nepal.
IP spoke with Turlington Burns about how she became an effective advocate and the three tactics EMC employs to put mothers at the center of maternal health work: advocacy, awareness and grantmaking.
A focus on mothers
By the time of her daughter’s birth, Turlington Burns’ global modeling career had already provided a platform for advocacy work across a number of public health and wellness campaigns, including around HIV.
Spurred by her own experience, she turned to supporting mothers and spent years as a maternal advocate within larger efforts by CARE and (RED). But why, she wondered, weren’t mothers at the center of maternal health work? “Women,” she said, “were not the priority.”
Instead, she said, the focus quickly flips upon delivery, and support becomes all about the child. For example, premature birth often means round-the-clock care in a hospital setting for an infant, while mothers “are sent home.” Typically, women see their doctors six weeks after delivery — what Turlington Burns called “an eternity” — while infants receive near-constant attention.
The consequences can be deadly. Even in a high-income country like the U.S., maternal death is on the rise. In 2019, there were 754 deaths per live birth. By 2021, the number had swollen to 1,205. Rates for Black and Hispanic women are 2.6 times higher.
While a number of U.S. funders are on the case these days, a standalone effort focused solely on mothers was missing from the landscape when Turlington Burns got started. She decided to help make them the priority.
Becoming a better advocate
A comparative religion and philosophy major at NYU, Turlington Burns returned to school at 39 to work toward a master’s at the Mailman School of Public Health at Columbia University, which inspired her to become a better advocate. She credits the timing of her education there with establishing the human rights framework that EMC’s work grew around.
“There was a moment in 2010 when maternal health was suddenly on the agenda,” she said. The U.N.’s Millennium Development Goals offered a “great opportunity for platform-building globally.” And she saw opportunity in a “movement in 2008 to 2010 that approached global health as a human right,” following Hillary Clinton’s 1995 assertion that human rights are women’s rights, and women’s rights are human rights.
That was a statement that “not everyone believed,” Turlington Burns said, before Clinton’s declaration “helped turn the tide.” But once that premise is accepted, logic follows that maternal rights are human rights, too.
Awareness through storytelling
Turlington Burns then took “a step beyond advocacy,” and turned to storytelling. While still a student in 2008, she began work on the 2010 documentary “No Woman, No Cry,” which shone a light on maternal health issues in Tanzania, Bangladesh and the U.S.
Well-received, it was the first of eight films on the subject that EMC has produced, including a series of seven focused on the United States. The most recent, “Giving Birth in America: Arkansas,” spotlights the postpartum experiences of mothers who live in the state with the worst maternal health outcomes in the U.S. and the mental health consequences of isolation.
Except during the COVID lockdown period, Turlington Burns said she has promoted awareness by presenting each film at festivals like South by Southwest via televised partners and in the media. Her introductions provide context that broadens the content while creating a “perfect opportunity for conversations.” EMC’s films are also a way to inspire viewers to take action by becoming advocates and supporting the foundation’s grantmaking.
Mother-centric grantmaking
So what does Every Mother Counts support through its grants? Since 2012, EWC has employed the lessons it learned in its first years to improve access to “quality, respectful and equitable maternity care around the world.”
Fifty percent of EMC’s grantmaking is U.S.-based; 50% is global. In the decade that it’s been making grants, EMC has supported work in a dozen countries including Afghanistan, Bangladesh, Guatemala, Haiti, India, Indonesia, Mexico, Nepal and Ukraine. Since 2010, it has made more than 100 grants totaling more than $24 million.
Turlington Burns said that a primary goal in creating a 501(c)(3) was bringing a multistakeholder conversation to the forefront, including by engaging academics and policymakers.
EMC’s giving is organized around the ideas of demonstrated impact and sustainability — that is, working with partners that have the capacity to stay in it for the long term, like local government. Transparency is key for EMC, as is the capacity to reach communities through public platforms, and a shared vision of safe pregnancy and childbirth.
EWC also intentionally works to lift women-led, mother-centric organizations in marginalized communities, where positive outcomes are constrained by discrimination, cultural practices and scant resources.
For example, its partnerships in Haiti address a midwifery shortage in a country where the norm is to give birth at home. And in Tanzania, where a lack of roads and resources severely impacts care, EMC provides access to transportation and training for health workers. All told, EMC estimates that its work has impacted 1 million lives and has provided skilled reproductive care and transportation to 400 million mothers. The organization also reports good stewardship, spending an average of 89 cents on the dollar on program-related expenses.
Asked how she spreads herself across goals of awareness, advocacy and grantmaking, Turlington Burns said she considers everything as ways to raise awareness, but commits the majority of resources to grantmaking, where most of EMC’s budget is allocated.
Moving mothers forward
Since developing an expertise in the field, Turlington Burns said she’s seen overall progress in a few areas, including improvements in the functional lack of consistent data collection in the U.S., advances in U.S. Medicaid postpartum coverage, and increased maternal health accountability and review boards.
Now, after roughly a dozen years of funding, EMC has entered a strategic planning process to help “crystalize” the work ahead. Its founder said the process will help the organization see “what still works” and root out the “things that we have tried, but are not best suited.”
After a “scrappy” period during COVID, Turlington Burns decided a review would offer an important chance to “make time to really recognize things that best amplify women’s voices and the providers of care, and examine ways mothers can come through the childbirth experience able to thrive.”
When asked what EMC may prioritize in the future, she said, “One area over time has become more and more important — the 24 hours of delivery when most deaths happen and mortality is highest.” Other priorities may include building postpartum support, and attention to the mental health issues surrounding pregnancy illustrated in EMC’s film about mothers in Arkansas.
Turlington Burns shared something she learned in college from Dr. Alison Stuebe, whose current research focuses on the health of mothers and infants in the first year of life. Steube said, “In our current system of care, the baby is the candy and the mother is the wrapper. Once the candy is out of the wrapper, the wrapper is cast aside.”
In all of its future priorities, Every Mother Counts will continue using advocacy, awareness and grantmaking to help change that.
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