In recent years there has been a lot of discussion around the health disparities in maternal mortality. The CDC reports that black women are two to three times more likely to die of pregnancy related causes than white women. There are several issues we need to address such as cultural competence of health care providers, implicit bias and misconceptions about black women. But personally I believe the main thing we can do is listen to black women. PERIOD.
When I found out I was pregnant with my first child I was nervous about being a mom. I was afraid of bringing a child into the world. I was only familiar with the scene of screaming and the unbearable pain as portrayed on TV and movies. Labor and delivery scenes always seemed like horror films ending with the arrival of a beautiful baby. These scenes gave me anxiety and made me nervous, but I just assumed this is what everyone goes through.
For the first 6-7 months of my pregnancy on the day of my appointments I would let everyone know it was appointment day, arrive at the hospital, take the elevator up to the 7th floor and check in for my 9 am appointment. Each time I was in the lobby I felt the same excitement and anxiousness to learn something new about this child I was carrying. Once I was called back I would go and pee in a cup, which I was told at an earlier appointment, was to check for bladder or kidney infections, diabetes, dehydration, Preeclampsia, and etc. After my urine test, I would wait in the exam room for the doctor. My doctor, an intelligent white woman, would say “ well, everything looks good and you’re young, so you have nothing to worry about. See you next time.” While I tried to find comfort in the fact that nothing was wrong, I also wanted more information and support, but once again, I assumed this is what everyone goes through.
At this time in my life, I was working in reproductive health as a Sexual Health Educator so I started asking co workers and talking to different women and began finding the answers I sought. One woman told me to watch the documentary: The Business of Being Born. Another person told me to look into finding a Doula [a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.]; One lady told me the hospital I was currently attending didn’t have many options for women looking to possibly go natural. She gave me other hospitals in the area to look into. I was so excited to get all of this new information I began researching quickly. My partner and I started with watching the suggested documentary and it was eye opening and my mind was blown. Through watching the documentary my partner also recognized that the labor and delivering experience with my bonus son was traumatizing and he didn’t know there was another way.
My partner came with me to my next appointment at 31 weeks where my doctor said “let’s talk about labor and delivery.” I was so excited! This was the conversation I had been waiting on, and now I had some ideas of how I wanted it to go. My doctor says “let’s schedule you for Tuesday, June 9th to be induced and meet your bundle of joy.” My partner and I looked at each other, then I said, “actually, I want to know if we can discuss what a natural birth may look like?” My doctor looked at me crazy and said, “Oh no you don’t want that, it’s just a hassle. No need to experience that pain when we have epidurals.” I was so shocked, I froze. I wasn’t ruling out any medications; I just wanted to know about the process. My partner jumped in and asked, “ why are we scheduling her birth on that day?” My doctor responded with: “ because I am in the office on Tuesdays.” I felt so ashamed that I had never asked any questions and researched my options. I earned a Masters in Public Health, so I figured I was informed. Of course my ideas about my medical care would be respected. However, at that moment, I felt like my doctor just saw me as a black woman who didn’t know what she needed and she knew what was best for me. I realized my doctor really didn’t have my best interest in mind. Instead, her schedule and convenience took priority over my birth plan. She didn’t listen to me.
After that conversation, I connected with a doula; she helped me switch health care providers, at 32 weeks, to someone whom I felt more comfortable with and listened to me. After 37 weeks, I had a natural birth, resulting in giving birth to a healthy baby girl. Since then, I have changed cities, had another natural birth with my second daughter, and found a midwifery practice that offered the support I needed. These steps helped me gather all the information needed to make an informed decision about my care. Both of my birthing experiences were beautiful… not traumatic. Both of my experiences were affirming… not demeaning. This is what every woman deserves.
Every birth is different and some things are out of our control. It doesn’t matter if the patient requests pain medication, laughing gas, a natural birth, or etc. It matters most that the healthcare provider is listening to the mother and partnering with her throughout the labor experience. Nothing should be done to her, but everything should be done with her.
Listen to black women.