Video footage of a white nurse practitioner accusing a Black pregnant woman of fraud has gone viral and incited outrage online.
In October, a woman named Jillian — who asked to have her last name withheld from this story for privacy and safety reasons — shared a video of her interaction with a nurse practitioner at a Philadelphia clinic. Jillian told TODAY Parents that on the day she captured the video on her phone, she was seven months pregnant and experiencing pain and other complications. She had asked her doctor for a note that would allow her to begin her maternity leave from her job as a home health aide.
“What were you thinking about when you got pregnant? That you were not going to work?” the nurse asks Jillian in the clinic’s lobby as she is waiting to receive her doctor’s note. “Because I had three kids. I worked up until the second they were born.”
“I was thinking about having a kid,” replies Jillian, 25, who is the mom of a 3-year-old daughter.
The interaction escalates further, with the nurse telling Jillian that her request for a doctor’s note constitutes fraud.
“It’s not fraud — if it was fraud, the doctor wouldn’t be getting me my note right now,” Jillian responds. “How do you know how I feel? How do you know how my body feels inside?”
“Because I stuck my hand in there and checked your cervix,” the nurse replies.
“OK, you checked my cervix, but how do you know how my bones feel? But how do you know how my body feels? My legs? My back? How do you know how that feels? How you know how my nausea feels? How you know how my cramps feel?” Jillian asks.
The recording of the incident sparked an outcry on social media and prompted renewed discussions about the mistreatment of Black women in medical settings and the implicit bias that can occur.
“This is how Black women experience maternal mortality at such high rates,” one person wrote on Twitter. “And, why is this nurse second guessing the doctor? Furthermore, what business is it of this nurse IF the patient doesn’t want to work during her pregnancy?”
In an interview with TODAY, Jillian explained that the incident occurred at the Philly Pregnancy Center in Norristown, Pennsylvania, where she has been a patient since the start of her pregnancy. On Oct. 6, Jillian said she stopped by the clinic to pick up a doctor’s note that had already been approved for her.
Jillian said that up until that point, she’d seen the same nurse practitioner about three times throughout her pregnancy and had become wary of her behavior. Jillian said she explained to the nurse that she has scoliosis, a curvature of the spine.
“Our first interaction was a little bit shaky,” Jillian recalled. “I gave her the benefit of the doubt. I just kind of overlooked certain things, like the way she was like speaking to me.”
Over time, Jillian said she got the impression that the nurse’s behavior was related to Jillian’s race and religious background. Jillian is Muslim.
“I felt like it was all racial because of my ethnic background and also maybe because of my religious background — all of it,” Jillian explained. “I just felt like it was definitely discrimination.”
TODAY tried unsuccessfully to reach the nurse practitioner, Theresa Smigo, for comment.
The Norristown Police Department told TODAY that on Oct. 6, an incident occurred between a patient and Smigo in the waiting room of the Philly Pregnancy Center. A staff member of the clinic called the police department as the incident was escalating. Police advised the parties in the dispute to avoid future contact.
“I was devastated. I was really upset,” Jillian recalled about her interaction with the police. “My heart was pounding like the baby’s kicking. I was so upset. And I just kept on asking them, ‘Why are you guys here? Why did you guys feel the need to come here?’ … Because, like, you could look at me and see I’m not — I don’t want to hurt nobody.”
Briana Lynn Pearson, a lawyer representing Jillian, issued a statement to TODAY about what happened.
“Jill deserves a public apology and so much more. The Philadelphia Pregnancy Center should be held accountable, but more importantly we as a society need to hold each other accountable,” Pearson’s statement said. “Every day in this country someone is discriminated against by a medical provider because of their immutable characteristics. Sometimes this discriminatory treatment is fatal.”
The Philly Pregnancy Center also issued a statement to TODAY and stressed that the incident is being taken very seriously.
“The incident, (Smigo’s) response, and the entire matter is under investigation. We have never encountered anything like this,” the clinic’s statement said in part. “We are deeply sorry for the entire incident, and we will continue serving our patients as always with love and care.”
In a separate email message, the center noted that Smigo was not an employee of the center but an independent per diem contractor.
Online, people pointed out that Jillian’s personal health information should not have been discussed in the clinic’s waiting room within earshot of others. The incident also sparked discussions about how racism can impact Black women’s health outcomes and access to health care.
In 2021, the Philadelphia Maternal Mortality Review Committee published a maternal mortality report on pregnancy-related deaths in Philadelphia. The report found that non-Hispanic Black women made up 73% of pregnancy-related deaths in Philadelphia.
The study noted that implicit bias and systemic racism were underlying issues contributing to the racial disparity in the maternal mortality rate.
In recent years, health professionals, activists and high-profile figures have raised concerns regarding the mistreatment of pregnant women of color in medical settings. Many have underlined that pregnant women of color who report pain are denied pain medication.
Tennis player Serena Williams detailed her own experience of being dismissed while delivering her daughter Olympia in 2017. Williams, who has a high-risk tendency to develop blood clots, had to fight to be listened to when she began to experience extreme pain, a symptom of a blood clot in her lungs.
According to the Centers for Disease Control and Prevention, in the United States, Black, Native American and Native Alaskan women are two to three times more likely to die from a pregnancy-related cause than white women.
A 2016 study published in the Proceedings of the National Academies of Sciences highlighted the issue of how false beliefs regarding biological differences between white and Black patients influence medical providers’ approach to patients. The study found that 40% of first- and second-year medical students supported the belief that “black people’s skin is thicker than white people’s.”