Giving Birth with Confidence: Advice from Black mothers on the importance of self-advocacy during pregnancy.

The U.S. has a problem with pregnancy-related death, especially for women of color.

Given the number of advancements made across nearly every aspect of health care in the last quarter-century, women in the U.S. are still more likely to suffer a pregnancy-related death today than they were 20 years ago. A report from the CDC found that Black women were three to four times more likely than white women to die from a pregnancy-related cause. The number of women who die during childbirth in the Black community is disturbing, mainly because most deaths are preventable.

Delivering the proper maternity care is a challenge in the U.S. Too often, maternity care does not align with quality or choice. In this latest blog, we spoke to a few moms to get their perspectives on the black maternal health crisis and giving birth with confidence.  

The road to health equity

60% of pregnancy-related deaths are considered preventable. Given that Black women and other women of color often receive insufficient quality care and are victims of racial bias in traditional health care settings, consider the following factors that contribute to the rising maternal mortality rate:

  • Lack of insurance or inadequate coverage
  • Hypertension or gestational diabetes due to stress
  • Clinicians are not listening, resulting in delayed diagnosis
  • Economic and social conditions that produce health inequities

New mothers face endless streams of new information and decisions to make from pregnancy to birth. Sometimes, what your doctor tells you isn’t necessarily what you’re comfortable with or something you don’t understand fully. However, the theme emerging from endless studies about health inequities confirms the challenges Black women of childbearing years faced during pregnancy. “It’s critical to know that you have a voice in your doctor’s office, and advocating and speaking up for yourself is okay,” states Katherine Crooms, therapist and mom of four, ages eight to fourteen. “While you might not always be comfortable asking the hard questions or requesting clarification, your mental and physical health is worth it.” 

Still, uncertainty in navigating these spaces leaves most feeling less likely to advocate for themselves during pregnancy. And women who advocate for themselves during pregnancy are far more likely to have a positive birth experience.

Social determinants of health

Inequities are produced. They do not just happen. The people who are negatively impacted by experiencing injustice are not to blame. “There are structures and systems in place that contribute to poor outcomes for pregnant women, especially those of color,” says Britt Ervin, non-profit director and mom of a six-year-old son. “Don’t be afraid to ask for a second opinion, especially if you have a high-risk pregnancy or a complex medical situation. I would sometimes get anxious about offending my doctor when asking for another opinion”, Ervin continues. “ But if you have a good relationship with your provider, they’ll be understanding and supportive.” 

Social determinants of health influence where and how people live, learn, work and receive adequate health care.  They provide context to a person’s life and play just as big of a role in affecting health as medications and physical lifestyle changes. Unfortunately, structural racism in healthcare exists and often results in inferior quality care. Social determinants of health such as public policies, laws, and racism mean denial of care when black people seek help when enduring pain or when healthcare providers fail to treat them with dignity and respect due to their own racial biases. These factors and the cumulative experience of racism trigger long-term physical and mental breakdowns. “Whether you want more eyes on your medical condition, access to research, or simply want to feel more comfortable with a diagnosis or treatment plan, you have the right to discuss your plan with another doctor. A second opinion is more commonplace today,” says Robert Webb, Jr. MD, UTSW Medical Center.

High-quality, proactive care must be the standard

Offering Black women more choices in birthing options and prenatal care can lead to more positive birth experiences and healthy pregnancies. Reasons for the increased rate of complications and, sadly, death are wide-ranging. Fixing this problem will require significant systemic change. Thanks to a variety of organizations whose mission is to improve Black maternal health outcomes, you have the opportunity to educate yourself. “ I researched the risks, warning signs, and protocol for care so that I could be as prepared as possible,” says Elisha Gregory, mom of two who recently gave birth during the pandemic. “ This was my second pregnancy, and this one did not come without lots of questions. Especially being pregnant while Covid-19 is happening.”

The compounded demands of motherhood and physical strains make pregnancy a stressful period for women.

But we don’t have to feel powerless:

  • You can say “No”
  • Ask for a second opinion
  • Realize you’re not alone
  • Be specific about what you need
  • Hire a doula or seek out a doula-volunteer program

Childbirth is your unique journey. Knowing your preferences is the first step to accessing the resources you need to have a safe, healthy, and joyful pregnancy. Interested in how Mae can support your pregnancy experience? Learn more at meetmae.com.