Expectant mothers, you are preparing for a transformative experience. You have a right to give birth in a supportive environment that lifts you up as you go through one of the great miracles of life: the birth of a new family.
By reading this blog, you are already taking steps to get advice and to ready yourself for this moment. Congratulations! That’s a huge step to bring you into this experience prepared for what can happen. Unfortunately, the facts about birth are not always as rosy. Take a deep breath before you start reading because this is going to be hard.
From the CDC
Black women in the US are three to four times as likely to die from pregnancy or childbirth-related causes than white women.
Black women who have at a college degree still had a significantly higher pregnancy-related mortality rate. It was 5.2 times white women with a comparable education level.
The pregnancy-related mortality rate for Black, American Indian, and Alaska Native women over 30 is 4-5 times higher than it is for white women.
From “Without an Ounce of Empathy”
The infant mortality rate for Black and brown babies is twice that of white babies.
Every year in the United States, approximately 700 women die from complications related to pregnancy. Of those deaths, 60% of them are preventable. That’s approximately 420 women that should still be alive.
Severe Maternal Morbidity (SMM), or the near-death experiences in childbirth, affects Black women 2.1 times more than white women.
In just the last 20 years, SMM events have increased by 200%.
The legacy of policies of systemic racism has led to inequality and de-facto segregation in housing. Where a mother lives is what determines how much exposure she has to toxic environmental elements. This exposure is linked to psychological stress, which can result in low birth weight for the babies, among other health outcome inequities.
These are just the numbers. This does not include the incidents of implicit bias and institutional racism against Black women that contribute to trauma for these new mothers. This does not include the overall rise in cesarean sections, the lack of sensitivity to the 1 in 4 women who have been sexually assaulted, and the generational trauma that Black mothers have experienced. The complex layers you bring to birth lead to an increased chance of being retraumatized and revictimized in your birth experience.
How is your heart rate right now? Are you filled with righteous indignation? We are too. This is not right. Hold onto that frustration, because that will be what will propel you to act, to advocate for yourself, to require the high standard of care you deserve.
We share this with you not to scare you, but rather to empower you, to shake you, to make you mad. This is not right. Everybody deserves respectful maternity care. For your well-being, you need to be aware of this going in so that you can help to prevent something like this happening to you or someone else in your community. Remember, this is your body; the birthing area is your space. By advocating for yourself, you are managing future trauma that can even affect how you relate to your precious little one.
Take a deep breath in. We are going to get to the solution.
What can we do to prevent negative birth outcomes for all women, but especially for our Black mothers?
Here are 7 key action steps:
1) Take time for research and education
You are already taking this step right now by reading this article. But it is important to continue to take time to research.
Take a birthing class before labor to help get information about the birthing process.
Educate yourself about your health and any potential health risks or pre-existing conditions you currently have or for which you are at risk. Optimizing your health and knowing your risks benefits both you and your baby.
2) Vet your practice
This goes hand-in-hand with research. You need to research your provider to find out how your provider will support you during your pregnancy and birth.
It’s important to ask for the practice data from the practice manager to find out their rates of cesarean sections, inductions, episiotomies, and any other outcomes that are important to you. Be wary if they cannot provide you with this information.
3) Get a support system
Your advocates include a knowledgeable partner, a doula, a midwife, and other care providers.
Doulas are professionals who are knowledgeable about pregnancy and birth. They work specifically with the mothers through this process to provide close support and encouragement.
Places to look for a Doula: National Black Doulas Association Virginia Registry, Doulas of Tidewater, and Dona International Doula Registry
Midwives are not exclusive to home birth and birth centers. In fact, the majority of midwife-attended care occurs in regular OB/GYN offices and births take place in a hospital, so their services are covered by insurance. Regardless of where you birth, midwives attend to your physical, mental, emotional, relational, and nutritional health. They utilize a wellness approach and avoid unnecessary interventions in an effort to prevent complications in pregnancy and birth.
Don’t let cost get in the way, women in birth work are there because they are compassionate and care about women. You can always ask if they have scholarships or would be able to work with you financially. Check with Medicaid and your insurance provider to see if they will help cover the cost of services.
Because the Hampton Roads area has such a high concentration of military people, a lot of women and couples don’t have the support of their extended family before, during, and after birth.
Create for yourself an extended network of support from friends, professional care providers, those from your church or community of faith, and other grassroots movements. Not only will they support and uplift you, but they can also be the ones to speak out if something is happening that you do not want or like.
4) Attend pre-birth counseling
This can help you address previous traumas and help to prevent shut-down during labor. Just like before you give birth there is often this urge to “clean house” and make sure everything is ready for when the baby arrives, you need to clean your mental house to prepare for birth and life afterward with your baby.
Don’t ignore your anxiety or depression. Not only can these conditions negatively impact your birth experience and recovery, but the hormonal shift, life change, and lack of sleep that occur postpartum tend to magnify these states. Do what you can to prepare yourself and protect the relationship you are building with your baby. By caring for yourself in this way, you are literally impacting future generations.
5) Set boundaries
You have autonomy over your own body throughout the entire birthing process. If someone touches you and you don’t like it or aren’t ready, speak up. Be firm with your boundaries. You always have the power to say no.
You have the power to receive pain-relief treatment when you ask for it as well. You know your body and you know your pain limits, so speak up when you need pain relief. Speak up again if you are ignored.
Additionally, you have the right to limit who can come into your birthing space both during and after. You have the right to wait before you allow people to see you and the baby post-birth, especially if they are not going to respect the rules of your house.
6) Consider all your options:
If you are not receiving the care that you need, go somewhere else. You don’t have to continue to see and employ someone who is not supporting you through this process.
Consider all your options like at-home birth, birthing centers, and different hospitals.
Keep in mind that if you have pre-existing conditions or have a high-risk pregnancy, some of these options might not be available to you. But that does not mean that you have to stick with a practice, hospital, or doctor that does not treat you with respect.
7) Advocate, even if this does not affect you personally
Push for discrimination training for OB/GYN and other birth professionals.
Support organizations working to bring change for Black mothers and babies such as the National Birth Equity Collaborative.
Look for providers that specialize in respectful maternity care.
Recognize that your birth experience can impact you and your family for years to come. Prepare for and invest in it accordingly.
This is a lot. It's okay to feel overwhelmed. But don't despair; this is not hopeless. There is a community of compassionate birth workers that are in this work to help you through this process. There are people in your community willing to support you. Reach out to those people, and surround yourself with love and support as you create your family.
All external links are included as a starting point for your personal additional research. Covenant Way Wellness does not have a relationship with these organizations.