While becoming a mom is one of the most exciting milestones in life; there are severe risks Black mothers face while pregnant that cannot be ignored. Commonly, these pregnancy-related complications include hypertension, preeclampsia, and hemorrhage. Despite the promise of doctors being trained in implicit bias, Black women have significantly poorer birthing outcomes than other women giving birth each year, according to the CDC.
Outside of the healthcare field, a phenomenon called “weathering” is affecting Black mothers of every socioeconomic level.
Coined by Dr. Arline T. Geronimus in 1992, weathering describes the devastating effects of systemic oppression—including racism and classism—on the body. The never-ending demands of having to work twice as hard while navigating overt and covert racism erodes the body’s stress signals, putting Black women at a higher risk for maternal mortality.
Are these statistics alarming? Yes. But the good news is there’s much we can do to safeguard our health while pregnant. Organizations such as Health4Equity, a Centre of Excellence at global advertising agency VML that is funded by the WPP Racial Equity Programme, work to raise awareness about racial bias in the healthcare field and equip Black women with the knowledge to self-advocate.
If you’re an expecting parent, it’s essential to be armed with the right questions before each doctor visit to ensure you have a plan to mitigate risks as much as possible. Here are five questions pregnant Black moms can ask their doctors to help plan for a safe and stress-free birth.
1."What is my chosen hospital's track record in terms of maternal outcomes for Black women?"
Poet Yvette Perry, a collaborator with Health4Equity’s new digital zine RxUCKUS, acknowledges that “A common theme expressed during my listening sessions with the women we engaged for this project was the experience of not being adequately listened to by healthcare providers.” Sharday Pierre, a New York City-based mother of one who had to navigate pre-existing conditions through her pregnancy, told xoNecole exclusively, “The same way we take time to find a partner, we need to invest that time in finding a capable physician or birthing center.” Pierre, whose obstetrician had been her gynecologist for years, shared that she chose him because he is also Black, and she felt more heard by him than the other practitioners she’d seen prior. Trusting him for delivery made sense. Pierre advises, “Ask questions, listen to your body, and trust your instincts.”
The fact is Black women are three times more likely to die during childbirth than our white counterparts. Your hospital’s track record matters. Knowing this will give you insight into the quality of care the hospital provides, allowing you to assess the risks and benefits of giving birth at that particular facility. This transparency can help with your decision-making process and put your mind at ease.
2."What is the hospital/birthing center’s policy on doula care?"
A doula is trained to provide emotional, informational, and physical support to a birthing mom and their partner throughout the pregnancy process. A doula’s role is usually focused on aiding and advocating for the mother and her family during pregnancy and childbirth, which works in tandem with the clinical care you might receive. Hospital and birthing center policies vary, so it’s important to ask your birthing center or hospital about their policy on allowing doula care. Many often do, and offer supportive procedures. Brooklyn native Ariel Delande told xoNecole that she sought the help of a small-practice birthing center when giving birth to her son nearly two years ago. The center’s policy was that their network of 8-10 midwives all needed to be familiar with her birthing plan if her midwife was unavailable when Delande needed them.
If you plan on having a doula, it’s essential to discuss your birthing plan with your physician well in advance of your due date. If the hospital does have restrictions, try negotiating with your healthcare team. Open communication makes for a positive experience.
3."How will I know if I'm experiencing complications or issues during my pregnancy, and when should I seek immediate medical attention?"
Some aspects of pregnancy issues are generally considered normal among women, including weight gain, nausea, hormonal changes that affect your skin and hair, and mild contractions called Braxton Hicks contractions. But ultimately, it's important that expecting moms trust what they know about their bodies. As a result, they should feel comfortable alerting their doctors of symptoms that seem concerning. If you’re experiencing painful complications or issues that don’t feel what you consider normal during your pregnancy, consult your doctor immediately. For Delande, carpal tunnel was an unexpected issue. “My hand would just fall asleep. It was the most uncomfortable experience of my life,” explains Delande.
“My doctor expressed that this is a normal symptom [and explained to me that it happens when] the majority of the nutrients you take go to the baby. That was the first sign that motherhood is sacrifice.” Each pregnancy is unique; however, an attentive physician should adequately communicate what you can expect and what symptoms, if any, are of concern.
4."What kind of additional support and health education services can you connect me to?"
Trained healthcare professionals should be culturally competent and equipped to serve the needs and concerns of pregnant Black mothers, and there are ways you can ensure your birthing needs will be met. Ask the hospital if they offer prenatal classes covering labor and delivery or pain management options. Ask them if they offer nutritional counseling or breastfeeding education on the benefits and proper latch techniques. Postpartum care is another invaluable resource to help navigate life after delivery. Ensure that your doctor will give you equitable access to their services.
Seek services outside of the hospital. By researching and tapping into community resources, you can gain insight into effective interventions your doctor may have not mentioned. RxUCKUS, created by Health4Equity, is a great place to start. Through a collection of creative pieces and articles, like the feature focused on Dr. Arline Geronimus’s research on the effects of “weathering” on Black mothers brought on by racism and stress, Black women can identify and discover tools to counter these effects.
5."What are some ways I can reduce my stress levels throughout my pregnancy?"
Dr. Geronimus’ research suggests that weathering causes comorbidities such as diabetes, hypertension, and obesity. Stress can exacerbate complications during pregnancy, so it's essential to connect with your doctor about how best to minimize stress during your pregnancy. For Delande, getting proper sleep was paramount. She used a body pillow to support her back in her third trimester, which helped keep her comfortable. RxUCKUS Zine also provides tools for resilience such as helping you to discover healing through the arts, teaching you to create new neurons to combat weathering through meditation, and exercising the power of positive affirmations.
Staying informed, whether through asking medical professionals specific questions or seeking out resources such as RxUCKUS, is vital to not stressing yourself or your developing baby.
Featured image by urbazon/Getty Images
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