Ep.3/ Interview with Dr. Samantha Butts Part 2
Let’s talk about maternal health disparities and how to effectively advocate for yourself with Dr. Samantha Butts
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Note: This transcription has been created with a help of an AI thus errors and mistranscriptions may be present.
[00:00:00] Dr. Jill Baker: Hello, maternal Health 9 1 1. What's your emergency?[00:00:08] Dr. Jill Baker: 1, 2, 3, 4.
[00:00:14] Dr. Jill Baker: Hi, I'm Dr. Jill Baker. I'm a wife, a mother, a community health scholar and executive director and a fertility coach. More than 12 years ago, I was on my own infertility journey. Since then, I've made it my personal mission to help anyone who is on their own. To become a parent, as well as shed light on infertility and maternal health experiences of bipo women and couples.
[00:00:42] Dr. Jill Baker: Now let's begin this week's episode of Maternal Health 9 1 1.
[00:00:53] Dr. Jill Baker: Hi everyone. This is Dr. Jill Baker, your host of Maternal Health 9 1 1. We are back with another episode with the amazing, phenomenal trailblazer, Dr. Samantha Butts, who, as you all should know, is one of my favorite doctors of all time since she was my infertility doctor 13 years ago. And I don't know where I would be without her.
[00:01:22] Dr. Jill Baker: And for this part the conversation, , we're gonna talk a little bit about the state of infertility disparities among women of color, and some of her thoughts about strategies that can be helpful for those women and couples. So sit back, everyone and listen to this very special episode, maternal Health 9 1 1.
[00:01:50] Dr. Samantha Butts: I actually think birth control pills are probably one of the greatest medical developments of the 20th century in terms of how they changed women's lives and allowed them. We talked about agency before, right? Also for the non contraceptive benefits. I primarily prescribe birth control pills for my patients who have debilitating periods and can't get outta bed because of pain.
[00:02:12] Dr. Samantha Butts: Yes. The pain heavy menstrual periods and, and, and. Things. There's a lot of mythology around birth control pills as well that has to get debunked because they're often prescribed to manage conditions that were never fully evaluated. First place the patient comes off the birth control pill, has difficulty getting pregnant and blames it on the pill.
[00:02:31] Dr. Samantha Butts: The problem is the pill is the red herring, the pill was treating the underlying cause of why it's difficult for you to get. Just nobody really took the time to understand and work it up and do those kind of things. So now you're 32, you've been on the pill for 10 years because you need a contraception, you needed pain management.
[00:02:53] Dr. Samantha Butts: And oh, now something's different and I don't understand. And you know, it's now it's become, more upsetting and confusing.
[00:03:01] Dr. Jill Baker: Right, right. I love that. Yeah, because we have to talk about all parts. Reproductive health and Absolutely. And not just one part of it or one. And they all do interrelate with each other.
[00:03:15] Dr. Jill Baker: They all connect. And that's why these conversations are so important. I say to people all the time that we were, again, very lucky to have you and have the whole care, the team at Penn Fertility cuz everyone. Treated us so well and was just friendly and just,
[00:03:36] Dr. Samantha Butts: I'm glad, I'm glad that was your experience.
[00:03:39] Dr. Samantha Butts: So glad
[00:03:39] Dr. Jill Baker: So I've heard some horror stories, horror stories people being told that if they didn't write a check that day, they couldn't complete. Go through with the treat with diagnostic testing and treatment and not being counseled during their testing. So I, I've just heard some, some horrible things and I think, like you said, it's very important that you have to advocate for yourself in all of these settings and all of these experiences.
[00:04:11] Dr. Jill Baker: It's. So amazing, especially when you're going through infertility and you have to be at the doctor so much because of all the testing and then you're taking the pregnancy test and then taking a blood test. Did you get pregnant? It's a lot. . It's a lot. and I remember having to do the insemination and still being uncomfortable, like, oh my gosh, I really don't wanna do this.
[00:04:37] Dr. Jill Baker: And the, the nurse would be like, okay, Jill, okay, Jill, you got, you know, its all right. You got this, you know, I'm here for you. And this day might be the day that you might have the baby. So they were just all, they were just so encouraging. and that's just like, that's exactly what you need when you're going through infertility.
[00:04:58] Dr. Samantha Butts: It's, I agree
[00:04:59] Dr. Jill Baker: wholeheartedly. They were, they were amazing so I remember we, we had a conversation so we were doing the Clomid and, and insemination at that point. And then I had to take, I was still taking my, taking ovulation testing and then the directions were, okay, Jill, when you get a positive on the ovulation test, you gotta come in and get inseminated.
[00:05:22] Dr. Jill Baker: So that was my process, everyone. So the ovulation tests are like pregnancy tests, but they. . But they tell you if you're ovulating. So then once I got the confirmation on the test that I was ovulating, then I had to go and get inseminated. And so I think on the, the second time it still didn't work. So I think it was like three rounds at that time.
[00:05:43] Dr. Jill Baker: And I remember asking you, well, what will we have to do? Like if the clate and insemination do not, don't work? And you said, well, then at that point you all may wanna consider I V F. and I said, oh my goodness, I can't do iv. I said, I hate needle. Like I'm just so, mm-hmm. . Everyone knows I'm so anti needles. M me, my fear of needles is what kept me from becoming a medical doctor.
[00:06:10] Dr. Jill Baker: My fear of needles and my, I hate blood. at blood, those two things. But I was supposed to be a medical doctor, but nevertheless, so I was like, I really don't wanna do I. And you were like, okay, we don't know yet, so let's not worry about it yet. and let's just kind of see what happens. And then fast forward, it was September and it was like the week right before mine and Gamal's anniversary, and I got the positive ovulation.
[00:06:44] Dr. Jill Baker: I kid you not, I was on Starbucks at 30. and Chestnut.
[00:06:49] Dr. Samantha Butts: Yes, I know that's
[00:06:50] Dr. Jill Baker: Starbucks. Yep. Had my ovulation test kits in my bag in my book bag. So I had to keep them on me just so I had to be that prepared. Yes. People, when you're trying to get pregnant, you, you have to be so prepared. So I was like, okay, let me just take the test and see if I'm ovulating.
[00:07:08] Dr. Jill Baker: Go in the bathroom. Yep. Went in the bathroom. People took the test and said that I was ovulating. So fortunately, Penn Fertility was right down the block, so I literally had to walk one block, but I called, I was like, positive ovulation. They're like, all right, Mrs. Baker, come on in and let's get inseminated.
[00:07:28] Dr. Jill Baker: Just so everyone knows, that was mine. And Gamal's wedding anniversary was September 17th, and I had called one of my dear friends, my dear friend. Shout out to Robin Stevens and I said to her, Dr. Robin Stevens. I said, Robin, I guess said, I was feeling so low that day. And, and people who go through infertility, you go through these really hard lows of where you're like, I can't, I don't know if I have it in me to do this anymore.
[00:07:58] Dr. Jill Baker: And I called her on the phone. I was like, Robin, I don't think I, I can't do this today. And she was like, Jill, just go. Just go. Down the block, go get inseminated. Maybe today is the day you guys get pregnant. I was like, why would it be today outta all day like we hadn't been getting pregnant. So sure enough, fast forward.
[00:08:19] Dr. Jill Baker: So I get inseminated, go home, and then Gamal and I go out later and celebrate our anniversary. And a week later, no, period. And then I take a pregnancy test on, that's the next Saturday. And the pregnancy. Was PO was positive. So I take an another one, like just to be sure. So the next day I took another pregnancy test on October 1st, and that was Gamal's birthday.
[00:08:47] Dr. Jill Baker: So I said, Look at this pregnancy
[00:08:50] Dr. Samantha Butts: positive pregnancy test. Right? I guess you didn't have to buy him again. Happy
[00:08:54] Dr. Jill Baker: birthday. Exactly. I said happy birthday. And so, but in how Gaal is, you know, and because of this whole ride, because this is now two and a half years at this point, he said, I wanna be excited, but we've had so many false alarms that I can't get excited right now.
[00:09:14] Dr. Jill Baker: So he said, so once you get a blood, Then we can, you know, hand deal with it, react accordingly. Okay. So the next day went to get the blood test and I went and got my blood taken and the nurse said to me, she said, okay, well, she was like, Jill, we might have to call you back tomorrow with your results.
[00:09:36] Dr. Jill Baker: I was like, okay, that's fine. That's not a problem. Then she ends up calling like a few hours later and she was like, well, Mrs. Baker. You are definitely pregnant. She's like, but I have to let you know that your hormone levels are so high that it's definitely twins. Or it might be triplets.
[00:09:59] Dr. Jill Baker: Oh my
[00:09:59] Dr. Samantha Butts: gosh, yes. Disbelief goes to sheer panic. Right? This
[00:10:04] Dr. Jill Baker: total disbelief. and then Gamal was like, oh, uh huh. Okay. . Oh my gosh. So then we, so then that week, we see you on that Friday. So this was Monday. And then we have our, so I don't know if you remember this. So we had our first ultrasound of the babies right with you that Friday.
[00:10:27] Dr. Jill Baker: So they were like, all right, you, you guys are gonna see Dr. Butts on Friday. We're gonna see how many are in there and see what's going on. We're like, okay, cool. So then we go to see you. You do the ultrasound and then they come up on the screen and you were like, okay, there's two in, there's definitely, there's two in there.
[00:10:48] Dr. Jill Baker: It's not three . And I still have the picture, that picture Wow. Of them. Wow. So I, so they would, you know, dots, so I called them dots. I called them my dots, . And I don't know if you remember. Gamal didn't say anything and
[00:11:09] Dr. Samantha Butts: you were like, and so what do you think he was processing still? No. You said to izing it,
[00:11:15] Dr. Jill Baker: processing it.
[00:11:16] Dr. Jill Baker: You said to him, Gamal. And all this time of us working together. You have never been this quiet. What is going on, ?
[00:11:26] Dr. Samantha Butts: Oh my gosh.
[00:11:27] Dr. Jill Baker: I hope he wasn't mad at me. No, he wa he loved you. He lo you know, it's hard for any, for Gamal to love anybody. He loved you. You know what? And he loved you so much because for him it's like, just give it to us straight.
[00:11:40] Dr. Jill Baker: Like don't give us the, just give it to us. We can take. . And he lo he just loved how upfront you were, but it was a team effort. Like we were all in this journey together. I can't say thank you. I have so much to, to give you for making that happen for us and to carry us the way that you did with the patience and the grace, and understanding all of our concerns and understanding when I was like, , we gotta speed this up.
[00:12:15] Dr. Jill Baker: I've had enough. I'm, I'm tired. . I have to, but I don't believe in con in consequences of the fact that we are pregnant with them on our anniversary. I got that pregnancy test on Gamal's birthday, and then their actual birthday is a day after their grandmother's birthday . So, wow. So it just, what a beautiful arc.
[00:12:40] Dr. Jill Baker: Yes. So it just all, it's all lined up so well, so I just want to give you your, your flowers and then I've had so many other sisters that I've talked to that I'm like, who was your fertility doctor? Like Dr. Butts. I was like, of course your doctor. What's Dr. Butts? And everyone says, I've talked to like five other black women.
[00:13:00] Dr. Jill Baker: They're like, Dr. Butts is the best. Dr. Butts is
[00:13:03] Dr. Samantha Butts: the best. Well, thank you, Jillian. I, it's, listen, I, this is such a sacred place, right? Yes. To be with people and and you have to, I think you've gotta really feel that and honor it. And that's, I think, a guiding principle for me.
[00:13:19] Dr. Jill Baker: Yes. Yeah. Yeah. And there's just, there's still so many people that just need, you know, still need so much more help.
[00:13:32] Dr. Jill Baker: So one of the things that, that I did wanna ask you is so right now in kind of in tw, you know, 2022, what are like some of the, the more common risk factors for, for women of color in terms of infertility and really for, you know, awareness? Because as you said, I think there's still such a, a lack of awareness, you know, for our
[00:13:58] Dr. Samantha Butts: c.
[00:14:00] Dr. Samantha Butts: Right. So one of the other things that you, you wanted to sort of touch on was prevalence of infertility and as infertility prevalence going up. That's hard to know and pin down. The c d C collects this information. We see it ebb and flow and, and things like that.
[00:14:19] Dr. Samantha Butts: I, I, No matter what sort of official source you're getting this data from, it's probably always going to be an underestimate, right? This is hard public health data, hard data to collect. Right. And it really does require people to engage. Right? Right. And, and the CDC data that many people rely on is, is survey data and it's excellent.
[00:14:41] Dr. Samantha Butts: I think we should probably assume that we may not be capturing the full breadth of what is out there in general the causes of infertility fall into a couple of large buckets. Probably about, you know, 20 to 30 or even up to 40% of infertility has to do with sperm factors either as pertains to,
[00:15:02] Dr. Jill Baker: I still think that's a big surprise for
[00:15:04] Dr. Samantha Butts: people.
[00:15:05] Dr. Samantha Butts: When I tell people that, you know, like the sperm analysis is one of the most high yield tests that we do, nobody believes me. But again, this is something else. We gotta keep chipping over that. So I
[00:15:16] Dr. Jill Baker: have to tell you, you probably know this though, that, and when I, you know, talk to coach women going through infertility, especially women of color, you know, they're still, and I'm talking about heterosexual couples, but they're still heterosexual men who are like, I know I'm not getting, I do not wanna get my sperm tested.
[00:15:32] Dr. Jill Baker: Like, well, you can't get a diagnosis.
[00:15:36] Dr. Samantha Butts: And we're very limited in terms of our treatments. Let them know, again, your partner's not gonna engage.
[00:15:41] Dr. Jill Baker: Right. Oh, brothers super, super important men. You need to get the, your sperm tested.
[00:15:46] Dr. Samantha Butts: Right, right. And I, you know, again, I, I think our job is to explain to people why it's important and also then create spaces where people can you.
[00:15:59] Dr. Samantha Butts: Do all the testing in a way that's respectful and humane, right? Right. You just need to collect a sample of sperm at home and bring it to the. Fine. We have discrete ways to have people collect in the office, and it really, the, the important thing is I can't move forward your treatment and unless I have all the data at my, at my behest, so, you know, sperm analysis is important.
[00:16:20] Dr. Samantha Butts: Probably about. 15 to 20% of the time, there may be an issue with the fallopian tubes. What's the purpose of your fallopian tubes in your life? Fallopian tubes sit between the uterus and the ovaries. Their job is to pick up an egg when ovulation happens, and allow sperm to get to the egg if a tube is blocked, damaged.
[00:16:43] Dr. Samantha Butts: Scar tissue, the tube cannot function in that capacity. The risk factors for that include things like prior pelvic infections, some, P I D, yep. P id, p i D, some prior surgical surgical procedures. Endometriosis can do this. These are not uncommon things. Those are very uncommon experience.
[00:17:02] Dr. Samantha Butts: Right. We talked a little bit about polycystic ovary syndrome, which is one. Manifestation of a, a larger infertility cause, which is not ovulating. If you are not ovulating, it's,
[00:17:15] Dr. Jill Baker: you're not getting pregnant, it's, it's a wrap, right? You're
[00:17:17] Dr. Samantha Butts: not gonna get pregnant. And so understanding the underlying causes and then tailoring the treatments as incredibly important.
[00:17:25] Dr. Samantha Butts: There's probably about 20% of our patients who have what's called. Planes infertility, which means we did all this testing and all of the assessments are unremarkable. Doesn't mean that there aren't still options to treat and optimize you getting there, and so that's important. I I also wanna just speak briefly about fibroids, please.
[00:17:46] Dr. Samantha Butts: We're. Fertility outcomes in women of color. My thinking about fibroids is a little nuanced, I think in general, fibroids do more. CH are more challenging in terms of how they impact pregnancy once it's established, as opposed to being a frank barrier to pregnancy. But it can do that too, depending on how much of the uterus is involved, whether surgery has happened and now maybe there's scar tissue from the fibroids and, and you know, certainly fibroids.
[00:18:20] Dr. Samantha Butts: Show up in ways that increase the risk of miscarriage and later pregnancy complications. And, and as many of us know, but I'm going to call it out again, fibroids are much, much more common in women of color. They're more severe. More aggressive. And, and by that I mean more numerous, they grow more quickly.
[00:18:43] Dr. Samantha Butts: This is something that needs to be front of mind for everybody. One of the most important tests we talked about sperm analysis being an important test. One of the other most important tests, every woman who has. Difficulties becoming pregnant. Suge is a pelvic ultrasound. Yes, because that's where you're gonna find fibroids and maybe other anatomic pathology that could be addressed.
[00:19:04] Dr. Samantha Butts: These things are imminently correctable, but you know, we have to understand. The scope for, for any given woman. Right. So those are the things I'm so glad you talked about that. Yeah. Yeah. Lab tests also help us understand ovarian functioning ovarian reserve, which I think like to think about more as a prognostic indicator as opposed to a diagnostic indicator for treatment success. Those are the assessments and the underlying causes.
[00:19:32] Dr. Jill Baker: Fibroids are so critical. Yes. And as you said they're just so, so common. But there's still more awareness that needs to happen. Yes. But with the overturn of Roe versus Wade, and we were, you know, talking about, you know, the reproductive health over the life course and all of it connecting, do you think that this overturn will have.
[00:20:01] Dr. Jill Baker: Effects on, on infertility outcomes, especially for Women of color.
[00:20:08] Dr. Samantha Butts: Right. I, I'm so glad you asked this question, Jolene. I'm happy to answer it. And part of my answer is not gonna be very satisfying, which is to say this is a moving target. Yeah. Right. And it, and it really depends on the state that you live in.
[00:20:21] Dr. Samantha Butts: To
[00:20:21] Dr. Jill Baker: extent, this is so specific to this state at this.
[00:20:25] Dr. Samantha Butts: Right. You know, and I think patients, every time they see an infertility doctor, Over the course of their relationship should ask that question on more than one occasion, because the answer that I'm giving you on December 2nd, 22 may be different in the spring of 23, depending on a lot of factors and, and things like that.
[00:20:44] Dr. Samantha Butts: I would also mention and really like to call out outstanding organization called Resolve. This is a national fertility advocacy organization. It's a great clearing house for information about. What the laws are in relationship to coverage for infertility and, and all of these things. It's a great accessible
[00:21:06] Dr. Jill Baker: and they're reliable with
[00:21:08] Dr. Samantha Butts: the data a hundred percent.
[00:21:10] Dr. Samantha Butts: So that, that's a great resource. Today, December 2nd, 2022, I, IVF is not illegal in this country, but I've had patients say to me, I have embryos stored in X, Y, Z state, and I'm not going to name names. Can you help me get them out of there? Because they're worried about what's going to happen. And patients worry that maybe I don't bank embryos because what's going to happen?
[00:21:39] Dr. Samantha Butts: You know, like one of the beautiful things about IBF is that. One of the best options we have available to us to optimize your fertility goals today and perhaps optimize your fertility goals in the future if you're cryo preserving embryos, right? But that philosophy has been a little bit turned on its head.
[00:22:01] Dr. Samantha Butts: In terms of how patients are really fearful. And so I see it as my job just to be transparent with the information that I'm getting and also reassuring. And so I would say Jillian, more to come, but let's, I think we should just need to continue to have
[00:22:16] Dr. Jill Baker: these conversations. I'm so glad that you said that also.
[00:22:20] Dr. Jill Baker: Yeah. And then also, what about donor?
[00:22:22] Dr. Samantha Butts: Yeah, I mean as well, donor egg IBF is an outstanding resource,
[00:22:27] Dr. Jill Baker: Because I've heard that soon. I've heard a, a one, a number of, a handful of successful donor egg stories. Yes, I guess that we had on our show. Made me cry of course, but I was like, Oh my goodness.
[00:22:41] Dr. Samantha Butts: This worked for you? Yes, and and, and again, like everything in the pandemic that became shortened supply donor, GA meats, including eggs and sperm were also harder to come by. I think we're getting back to a little bit of better access, but also for people of color. If you are a black couple and you want to.
[00:23:06] Dr. Samantha Butts: Donor eggs from a black donor, it's going to be harder for you to find that or sperm from a black, donor as well. And so this is also an incredibly important area where we have to build net networks and knowledge and understanding so people can have as many options before them as possible.
[00:23:25] Dr. Jill Baker: That's possible.
[00:23:27] Dr. Jill Baker: Yeah. This particular this sister and, and her husband ended. Using one, they were able to get an egg. Mm-hmm. donor from a black woman, but the sperm was from a white man. But those, but they said it, they knew that if they waited to get the sperm and the egg from two black parents, that they were gonna have to wait a long time.
[00:23:51] Dr. Jill Baker: But then the beautiful baby that everyone was like, oh, the baby looks like you. It doesn't . Right. But it was such a beautiful, beautiful Yes. Story. Okay, one more, two more things I want to ask you regarding, and this kind of also falls in line as well, but infertility, so access to treatments and.
[00:24:17] Dr. Jill Baker: Insurance covering your pa you know, payment and knowing that there are financial disparities for couples of color, it's almost like the infertility. If you look at it as a game and that there are different levels, it's almost sometimes like couples of color are. , but we're trying to even get on level one, right?
[00:24:38] Dr. Jill Baker: Like in terms of money, right? But our count white counterparts are already, they're on level five in the game, right? And it's not really our game, right? It's
[00:24:49] Dr. Samantha Butts: a lot, you know? So it's a lot. So what I'll tell you, Jillian, this is another area where Resolve is fantastic because they have a map that has in yellow all of the states that have some types of laws on the books that require insurance companies to cover.
[00:25:05] Dr. Samantha Butts: The cost of the workup or the treatment. Wow. So yeah, if you go to resolve, it's
[00:25:11] Dr. Jill Baker: all, everyone. I'll put a link to resolve in the show notes so everyone can have the,
[00:25:16] Dr. Samantha Butts: but again, as you said, there's levels, right? The level of treatment that I can get, let's say in a state like Illinois or Massachusetts, which are two of the most.
[00:25:25] Dr. Samantha Butts: Generous states, it's very different than others and within each of those states, there are exceptions to the rule, of course. We don't live in Nirvana. This is shouldn't be no surprise. Right? The exceptions are if you work for. A small business that employs less than 50 people.
[00:25:43] Dr. Samantha Butts: They don't have to abide by the mandate. If you work for a large company that self-insure, they don't have to abide by the mandate. Other, Payers like Medicare and Medicaid do not have to abide by the mandate either. So there are these things that make mandates wonderful, but they're not as broadly applicable as we would really like for them to be.
[00:26:08] Dr. Samantha Butts: And this can box out a lot of people of color depending on who they work for or where they get their insurance coverage from. The research on this suggests. that on balance, if you are a black person who lives in a mandated state, your access is a little bit better compared to those who do not live in mandated states.
[00:26:33] Dr. Samantha Butts: But ultimately, the mandates primarily help access for people who are educated, wealthy, and. This is what the literature shows. So we should be striving to make any impending legislation as comprehensive as possible. The state of Pennsylvania, almost, almost a year ago introduced legislation to try to Insurance mandates for infertility care and fertility preservation, right?
[00:27:06] Dr. Samantha Butts: The fertility preservation is both about banking your eggs because you have future fertility goals and you're completely healthy. But the other thing it's about right is banking your eggs or sperm because somebody just told you as a 19 year old, you have acute leukemia and you have to start chemotherapy in a few.
[00:27:25] Dr. Samantha Butts: Right. Why should my ability to have a family because something happened to me that is not my fault, and I have no control over hinge on my zip code or the state I live in. Completely unfair,
[00:27:39] Dr. Jill Baker: right? Completely unfair. Yes. Like any other big social determination.
[00:27:44] Dr. Samantha Butts: Right? It's completely unfair and random.
[00:27:45] Dr. Samantha Butts: That's the underlying common thread so this legislation was introduced last year. You know, like a lot of things it has, its. Temporal sequence of how it's reviewed and voted on. And, and I've been to the Pennsylvania State House twice now to support this and that's what we have to do.
[00:28:04] Dr. Samantha Butts: Right. My job is to see patients and, and run a division, but there's a bigger thing too, and we've gotta be about that as well. It's the bigger sort of social aspect of the mission, which is reproductive access, right. For people. Exactly.
[00:28:21] Dr. Jill Baker: From your perspective, and with all your hats, why is maternal health an emergency in this country?
[00:28:31] Dr. Samantha Butts: Oh boy. Do we have two more hours to stop? We do . Well, I mean, maternal health is an emergency because, you know, maternal health is like the bedrock of family health. It's the bedrocks of, of our society. Does anybody question that anymore? They shouldn't. You know, women are the primary drivers of so many of the decisions for families and so many of the healthcare decisions for families.
[00:28:59] Dr. Samantha Butts: Yes. I think maternal health is a, is an emergency because unfortunately, like a lot of health outcomes in this country, we pour a lot of money into things and we do not get the outcomes that our patients deserve. Why? Yes. Why? Yeah. The troubling thing to me is that there are so many wonderful people out there who want to do the right thing, who want to be outstanding.
[00:29:22] Dr. Samantha Butts: Researchers, providers take care of women. And I think that there are some systems issues that, you know, just have made that challenging and those are the things that are so hard to fix. This is one of the primary reasons I do what I do for a living. Um, mm-hmm. , you know, I, I don't, I don't think you know this, Jillian, and this, obviously this podcast is more about you than me, but, um,
[00:29:46] Dr. Jill Baker: no, it's about,
[00:29:48] Dr. Samantha Butts: we talked about maternal mortality.
[00:29:50] Dr. Samantha Butts: There was a pretty good chance when I was born that I, my mother was not gonna leave the hospital and my dad was gonna raise me and my three, two sisters by myself, by him. So did I ever, I don't think I ever shared this with you yet. No. Yeah, my mom got super, super sick, was in the intensive care unit like severe preeclampsia.
[00:30:10] Dr. Samantha Butts: Oh. I, I don't know that I, I, I shared this with you, Jillian and I, and I've typically been really private about this, but I, I, but I share it when I think it makes an impact and it, this is part of my calling. I'm a triplet. Did I ever share that with
[00:30:24] Dr. Jill Baker: you? I know that, yeah.
[00:30:29] Dr. Samantha Butts: me and my sister is spontaneous triplets.
[00:30:31] Dr. Samantha Butts: You know, this was, we were born before IVF And so obviously my mom had all, and your mother, all the risk factors
[00:30:38] Dr. Jill Baker: carried. Three of you. Yeah, I
[00:30:41] Dr. Samantha Butts: had to carry too. So, you know, my mother had all of the risk factors for developing preeclampsia that you could have multiples. First pregnancy black woman and age 40 and and older.
[00:30:52] Dr. Samantha Butts: So these, she had, so it wasn't a question of if it was kind of a question of when, of when. So she was developing higher blood pressure. She got much sicker after delivery, which is a little bit paradoxical and got really sick, like kidney failure unit. She had a C-section. She needed blood transfusions for the blood loss.
[00:31:14] Dr. Samantha Butts: You know, I think the difference between my mother having been here and not having been here was a couple of things. Number one, and I have to acknowledge that this is my privilege and my family's privilege versus my dad was a doctor, right? So he was there and the postpartum unit with her, and he rings the bell and he asked the team, he's like, no, I'm a psychiatrist, but even I know there should be some urine in that Foley.
[00:31:40] Dr. Samantha Butts: So that was the sign. Her kidneys were no longer working, but my dad had the agency, the privilege, you know, we don't, we don't usually talk about black people having privilege, but you know, no we
[00:31:51] Dr. Jill Baker: don't. And not in healthcare
[00:31:53] Dr. Samantha Butts: setting. But she was able to say, I'm really worried about my wife and you guys aren't gonna let her die.
[00:31:59] Dr. Samantha Butts: Okay? That's what's gonna happen here. And the other thing is she had a healthcare team that came, like, she tells, she used to tell these stories about her obstetrician coming back in the middle of the night and to take care of her and make sure she didn't die right. So I have to acknowledge that that is part of my story and it's why I had a mother.
[00:32:21] Dr. Samantha Butts: It's part of my privilege and I have to acknowledge that that's why I work hard to pay it forward. But the fact that my mother. After childbirth shouldn't have anything to do with the fact that my dad was a, a doctor and the zip code that they lived in that is right. You know, so that's why this is all an emergency because oh my gosh, it shouldn't, those things should not matter.
[00:32:47] Dr. Samantha Butts: They should not drive the outcome. And to the extent that they do, we can pour all this money into healthcare and it's still not gonna make the impact that we. And this applies to the work I do to maternal and child health, to all aspects of women's health, women's healthcare, and ultimately to medicine broadly.
[00:33:08] Dr. Samantha Butts: So, I channel that story a lot. I've been channeling on a lot recently, such an important story, that. I feel very
[00:33:18] Dr. Jill Baker: close. Can I give a shout? Your father?
[00:33:20] Dr. Samantha Butts: Yeah. Oh yeah, yeah. My dad knew how to speak truth to power. He was pretty, he knew he was pretty good at he,
[00:33:26] Dr. Jill Baker: he knew he knew what to do.
[00:33:28] Dr. Jill Baker: He did. He, he knew how to advocate effectively in that situation.
[00:33:36] Dr. Samantha Butts: Right. And again, he was engaging the team. He wasn't like trying to emotionally eviscerate anybody. He's like, look, I'm scared. Let's like, let's all take care of my. Okay.
[00:33:47] Dr. Jill Baker: Right. Yeah. Oh my gosh. When were you told this about your mom?
[00:33:54] Dr. Samantha Butts: So my mom was very open and transparent.
[00:33:56] Dr. Samantha Butts: She shared the story with us when we were kids. And like when you're six years old, you don't really , you don't really understand. But as I moved through the paces of my medical training and then by the time I became a resident, I was like, mom, we need to talk . I just, I now fully understand. I can't believe it.
[00:34:16] Dr. Samantha Butts: She's like, I'm fine . I love she's, she was amazing. She was amazing. Yeah.
[00:34:23] Dr. Jill Baker: Your mother is everything. Yeah, I agree. I agree. She was a fighter and she, yeah, she was a against all odds.
[00:34:33] Dr. Samantha Butts: Yeah. So I'm, I'm, I'm, you have incredibly fortunate and I, I think about that and it's why I work this. Oh,
[00:34:43] Dr. Jill Baker: Dr. Betsy. Now I, I love you even more.
[00:34:45] Dr. Jill Baker: Now you're gonna have me cry
[00:34:46] Dr. Samantha Butts: over here. My, that's right. You told us you're a crier. I'm sorry, Jillian. Oh my gosh. . But, um, but everybody's gotta have that story, right? What drives you? Yes. Yeah. Because you can't make it in medicine or in healthcare if you don't have that, right?
[00:35:04] Dr. Jill Baker: Yeah. And yeah, I'm crying. I'm sorry.
[00:35:08] Dr. Jill Baker: No. Cause it's so, It's so real. Like your mother's story is my story. It's my sister's story who, who almost didn't make it. And some of 'em and my sisters who did make it, and my sister's who? Same category. Who, old, older, educated, black woman, high risk pregnancy. Check, check, check, check. Some of us may have made it and thank goodness I did, cuz that could have been me too.
[00:35:41] Dr. Samantha Butts: But this is why Jillian, the work you're doing is so important and I just can't thank you enough honored to have been a part of your journey honored to still be in your life. And so Proud of what you're doing. Really this is, this is critical. We cannot move the needle on this unless we're having these conversations, honestly.
[00:36:02] Dr. Samantha Butts: And that's where the difference comes, I think.
[00:36:06] Dr. Jill Baker: Thank you, Dr. Butz. Samuel. Thank you everything to me.
[00:36:08] Dr. Jill Baker: Thank you. Jamal said hi.
[00:36:12] Dr. Samantha Butts: He best, he wanted
[00:36:14] Dr. Jill Baker: me to say hi. And they are now, you know we have the third kid. I know we have the baby Amari who just came with no for two.
[00:36:23] Dr. Samantha Butts: Yes. . The we. We have these stories happen as well.
[00:36:27] Dr. Samantha Butts: Yes.
[00:36:27] Dr. Jill Baker: This is Amari. Yeah. Amari was the complete opposite of the twins. Amari was a, I was 39 and. Period. Didn't come for a week. I was like, lemme just take a test and see. And then the test was positive and I'm like, holy crap. Okay. The completely different ,
[00:36:46] Dr. Samantha Butts: right? Feast to famine. Or famine to feast. Whichever.
[00:36:49] Dr. Samantha Butts: Whichever you want. Yeah.
[00:36:50] Dr. Jill Baker: We have another positive. Right? But everyone said, you know, you could get pre, I knew it, but I, you know, still didn't think it would happen to me. Denial. The floodgates are open now. You can probably just get pregnant without any help. Oh, they all happened to me. I did have no but healthy baby, healthy pregnancy, still high risk.
[00:37:12] Dr. Jill Baker: Easy pregnancy compared to the twins, and I was like, Ooh, singleton pregnancy. I know. Very different from a multiples pregnancy, . I know.
[00:37:21] Dr. Samantha Butts: What are you all complaining about . That's right, because your frame of reference was so
[00:37:25] Dr. Jill Baker: different. So glad I had the twins first and then the, the singleton later and the people are like, what's a singleton?
[00:37:32] Dr. Jill Baker: Like all one baby? For those of you who don't, who have not been through infertility, yeah, Singleton means one baby. And multiples means more than one . All right, everyone. So this has been, oh my gosh, it's such an amazing, episode. I'm, I'm still kind of crying, but oh my gosh, this is just so, so great on so many levels.
[00:37:57] Dr. Jill Baker: Dr. Butts, thank you from the bottom of my heart for being with me today, and I hope that this will be the first of many conversations. I'm happy to come
[00:38:07] Dr. Samantha Butts: back.
[00:38:08] Dr. Jill Baker: There's so much we have to talk. There's so much more that we all have to talk about. Agree, and all of these events that are gonna come up ne you know, next year and yes.
[00:38:17] Dr. Jill Baker: Black Maternal Health Week, next spring. So we'll definitely have to talk again. So everyone, thank you for tuning in to this very special episode with my beloved Dr. Butts. Thank you for, sharing your personal journey, your expertise, your researcher expertise, your doctor being a doc, everything that you do the policy work that you do.
[00:38:43] Dr. Jill Baker: To reduce infer, infertility and maternal health disparities in this country. Dr. Butts can you let the listeners know how they can find you if they want to find you in terms Of course.
[00:38:54] Dr. Samantha Butts: I probably, the best way to find me would be through would be to Google me and then through Penn State Health Channels.
[00:39:02] Dr. Samantha Butts: I'm also on LinkedIn, so you are on, you're on LinkedIn. So those are be,
[00:39:07] Dr. Jill Baker: and you respond cuz you responded to me, but I know I'm
[00:39:10] Dr. Samantha Butts: special . Yeah, of course. You're, you're special. So I, I enjoy these conversations and this is just an, a wonderful full circle moment for me, Jillian. And again, I can't thank you enough.
[00:39:21] Dr. Samantha Butts: No,
[00:39:21] Dr. Jill Baker: me too. I really appreciate it. So everyone else, you can find the Maternal Health 9 1 1 podcast on all platforms where you listen to podcasts and you can find the show on Instagram and Twitter. You can DM me with your questions, thoughts, or to share your fertility and maternal health story. And for more information on your podcast host, you can visit ww dot dr joe baker.com.
[00:39:49] Dr. Jill Baker: And if you're listening to us on Apple Podcast, Greet and review us. It helps the show and I welcome the feedback. So thank you everyone. Until next time and be safe, everyone.
In part 2 of the interview with Dr. Butts, Jill recounted her experience and how her experience was working with Dr. Butts.
A wide spectrum of subjects from taking pills before pregnancy, the disparity in maternal healthcare, and why Maternal Health is an emergency from Dr. Butts’ point of view.
About Our Guest:
Samantha Butts, MD MSCE is a Professor of Obstetrics and Gynecology and Chief of the Division of Reproductive Endocrinology and Infertility at Penn State Health and Penn State College of Medicine. In this role, she oversees an academic practice that offers a broad array of clinical services and conducts innovative clinical research. After graduating from Harvard Medical School, she competed her residency in Obstetrics and Gynecology, her fellowship in Reproductive Endocrinology and Infertility, and a Masters in Clinical Epidemiology and the University of Pennsylvania.
Dr. Butts specializes in treating individuals and couples who require fertility treatments in order to achieve pregnancy and has extensive experience in providing the full spectrum of state-of-the art treatments to meet the needs of people who are single, coupled, LGBTQ, and those whose complex medical histories impact their reproductive health. Dr. Butts also has expertise in treating conditions such as amenorrhea, premature ovarian failure, surgical menopause, endometriosis, polycystic ovary syndrome, and uterine fibroids. As an experienced educator, Dr. Butts devotes significant effort to the oversight and hands-on training of residents and students and conducts research to understand how to best train learners in medicine. Dr. Butts is also a reproductive epidemiologist and has dedicated her research career to studying the impact of nutritional and environmental factors on fertility, factors associated with reproductive changes as women age, and the impact of race on reproductive functioning and access to care.
Dr. Jill’s Fertility Story
Learn more about Dr. Jill here.
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