What does it mean to be your own advocate? How can you navigate the system of black maternal health? These two questions I wish to have answered by the end of this blog post.
In the U.S black maternal deaths are on the rise and far outweigh death among white women. Weird for a developed country with a complex healthcare system with billions being spent. Yet maternal health is low on the list of priorities in our health system. A lot of these deaths could have been prevented.
What is maternal health and why should I be concerned?
Maternal health is the care a pregnant woman receives. This care should be of the highest quality to ensure healthy outcomes for mom and baby. Black moms are at a disadvantage for receiving high quality maternal healthcare. This includes prenatal visits, transportation to and from appointments, social services, and preventing disease.
There are so many stories of black women seeming to be fine, leave the hospital looking fine, and die within days or weeks after giving birth. Every child needs their mother.
What does this disadvantage look like?
Well statistics say that black women are 3 times more likely to have a maternal death than white women. Pregnancy related mortality is defined as the death of the mother during pregnancy, delivery, or within one year postpartum. More than 800 occur each year and 2/3 of these deaths were preventable.
For black women causes of maternal mortality include cardiovascular conditions, cardiomyopathy, pre-eclampsia, and eclampsia. Black women are 3 times more likely to have fibroids, which are benign tumors found in the reproductive system.
Why is this happening?
Black serving hospitals are found to provide lower quality maternity care. Now why is that? It is a combination of factors that are structured in systemic racism.
- Lack of funding to neighborhood clinics,
- severely understaffed,
- discrimination against black women and not taking our concerns seriously,
- disrespectful treatment deterring women from utilizing services or asking for help,
- harmful practices like forced marriage and genital mutilation,
- shortages of trained healthcare providers who speak that woman’s preferred language,
- community health facilities,
- essential supplies limited
Too often there are stories of women constantly warning the doctor about how she feels, and she is dismissed. Something horrible goes wrong, or there is a death to either the mother or baby.
Have you been to a neighborhood clinic? There is nothing “neighborly” about it. It is outdated, usually dirty or damaged, and the customer service sucks. If this is all you can afford or what your health insurance will cover, what else can you do? Not having prenatal care can be detrimental as real.
Now in 2021 more women are leaning towards holistic maternal care. Midwives, doulas, and home births are increasing in popularity. These services cost and most insurance does not cover these services. There are agencies willing to help and below is a short list of Midwife and Doula agencies if you are interested.
- Doulas of Cincinnati 9a-7p 513-655-7941 doulasofcincinnati.com
- Gentle Seed Doulas 9a-5p 513-814-1137 gentleseeddoulas.com
- Mama Glow 10a-6p mamaglow.com
- DONA International dona.org
- National Black Doulas Association blackdoulas.org
- Sista Midwife Productions sistamidwifedirectory.com
- Shafia Monroe Consulting 503-281-1688 shafiamonroe.com
For black women common causes of maternal mortality (death) includes:
- Cardiovascular conditions
- Cardiomyopathy
- Hypertensive conditions (pre-eclampsia and eclampsia)
- Hemorrhage
- Sepsis/Infection
- Unsafe abortion
- HIV
- Embolism
Why do women not get the care they need?
This is the power question. No one can pinpoint one reason why the health system is failing black women. Black people have been disappointed and used by health professionals we trusted. Remember the Tuskegee experiment?
Not getting proper care can be situational such as poverty, distance to facilities or lack of information. Black women living in poverty affect their attitude toward getting care and limits resources. There are ways around this such as getting public assistance which will pay for doctor visits, transportation to and from appointments, and may have a reward system for attending all prenatal appointments.
Other causes are found in a flawed U.S healthcare system. Inadequate and poor-quality services, such as neglect or discrimination, are too prevalent. Even receiving care at a top hospital is not good enough. Some people in healthcare should not be working in healthcare.
So, what can we do? Learn to be your own advocate
How to be your own advocate and navigate maternal health care
Always be informed. Know your body and the general progression of pregnancy. I say general because each woman is different and handles pregnancy differently. For example, some women have morning sickness others do not. Some women develop a health condition such as pre-eclampsia (like I did), and others have a healthy pregnancy.
When you are in tune with your body, you will know when something is wrong. You will feel it. Do not be afraid to speak up for yourself and voice your concerns. Ask for more testing. Get a second opinion. If you feel you cannot do the talking, ask family or a friend to be there with you who you know will speak on your behalf. That is also what doulas are for. They are an advocate and an extra layer of protection for you.
Do not let doctors perform experiments on you. They always need your permission to provide any care. If you do not know what something is, you can always decline until you have more information. Do your own research.
Remember this is your body, your baby.
Do not feel guilty for speaking up and voicing your concerns. Baby not kicking as much, make a call. You have severe headaches and shortness of breath, make a call. You are vomiting obsessively or have diarrhea, make a call. You feel tightness in your stomach or vagina, make a call. You have a question, make a call.
No problem is too small when your job is so big. You are bringing a life into the world. It is a dangerous job. Protect yourself and your baby.
Short story
I woke up one morning with a bad headache. I was 30 weeks pregnant and figured I was just tired. I rarely had sleep with my other 3 children and a kicking baby in my belly. It is hard finding a good sleeping position after 25 weeks.
I took a couple Tylenol and went to cook breakfast. A couple hours later the headache was still bad, and I felt short of breath. No matter how much I breathed in it felt like I was not getting enough air. I felt something was wrong because I know my body.
I went to the emergency room at the hospital I received prenatal care. They checked my blood pressure, and it was 170/101.
Now this is where the more you know helps. A normal blood pressure reading is around 120/80, it can be a little less no less than 110/70 or a little more no more than 130/90.
As you can see my blood pressure was crazy high for a 30-week pregnant woman. They ran tests, a CAT scan to make sure I did not have a blood clot (embolism) in my body. The hospital ended up keeping me for a total of two weeks before they finally agreed to induce me. I was relieved honestly. In my heart I felt this decision was best and my baby would be fine.
And he was. He only spent two weeks in NICU and received a feeding tube. No breathing problems like they thought.
Conclusion
Moral of the story? Know your body and be your own advocate. Even while in the hospital I asked questions. I did not want to keep waiting to be induced if none of the medication to bring my blood pressure down is working consistently. I expressed my concerns, and I held my faith.
I hope this article was informative and shed a light on another problem within the black community. What is a life worth to you? Raising awareness and support for black mothers is essential in producing healthy outcomes for mom and baby. Black maternal health matters too.
Did you experience discrimination while pregnant? How did you be your own advocate and ensure a healthy delivery? Reply by commenting down below.
As always,
Be You Confidently
*If you or someone you know may be dealing with postpartum depression, I highly recommend you read and share this post 7 Tips When Dealing With Postpartum Depression
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I have experienced childbirth yet, but this is definitely a concern. As we get closer to expanding our family, I am paying closer attention to my current GYN to make sure that is who I want to be my OB when the time comes. I think relationship helps in matters of healthcare and representation matters for us as Black women. Thanks for sharing your story.
Thank you for reading. Representation matters and for us to feel safe and cared for by our birth support team. I am hosting a family planning class in 2 weeks if you are interested I can send you a sign up form.