Birthing While Black

Trekking the politics of race and religion towards the hospital birth of my daughter

Being black isn’t just about being singled out for a particular fate, it’s about a disproportionate chance that you will suffer a particular fate.
— Ta-Nehisi Coates
KELVIN MURRAY VIA GETTY IMAGES
The real political task in a society such as ours is to criticize the workings of institutions that appear to be both neutral and independent, to criticize and attack them in such a manner that the political violence that has always exercised itself obscurely through them will be unmasked, so that one can fight against them.
— Michel Foucault, The Chomsky-Foucault Debate: On Human Nature

Homebody

She wanted a home birth. Like how grandma n’em used to do in the olden days — doulas and midwives that come to your house to help you deliver. It took some convincing but I was won over. For me, a hospital birth was the safe bet. And fearing the possibility of unforeseen complications I preferred my wife, Aïdah, and unborn to be under the care of western medicine. Aïdah, on the other hand, felt that she’d be far more comfortable and safe at home under the care of a Muslim midwife who had delivered babies in our community. She was a “low risk pregnancy” according to the midwife, a paragon of health, the perfect candidate for home birth. It made sense. Aïdah had always been the health guru between the two of us, eating stuff like kimchi, zucchini, beets, and avocado. Okay let’s do it, I said.

That was around twenty eight weeks.

Fast forward three weeks. Thanksgiving day. I get a call from my grandmother. Sit down, she says. Are you sitting down? Papa had a bad asthma attack. This is it, he said. I don’t think I’m coming back this time. He was right, she said. He died. Right in front of her. The news took the breath out of our lungs and the midwife later told us to talk to the baby about it. Tell the baby we’re not grieving because of her. That everything is fine. We did. But baby was trying to tell us something too. We just didn’t know what.

On the first Saturday of December we had a prenatal birthing group session at Kaiser Permanente. It was routine for partners to check mom's’ blood pressure. What wasn’t routine was the result. At the next home visit session with the midwife, she checked Aïdah’s urine and found protein in it. Neither of us really understood what that meant — only that it was not good. Our midwife prescribed homeopathic remedies like magnesium oil spray and passionflower oil. She suggested we watch comedies to lighten the heavy mood caused by so much loss this year. But between work, prenatal classes, and housekeeping we didn’t have much time for television.

Wednesday, December 13th

  • Wake up — ̶5̶:̶4̶5̶ 6:17 am
  • Fajr — 6:24
  • Catch the bus — 7:05
  • Take BART to Glen Park — 7:22
  • Arrive at school — 8:36
  • Counting students — 9:18
  • 8th grade Field Trip to Exploratorium — 9:30
  • Finished reading bone by Yrsa Daley-Ward — 10:13
  • Deboard & enter Exploratorium— 10:20
  • Counting students — 12:30
  • Lunch — 12:43
  • Counting students — 2:15
  • Head back to school — 2:35
  • Call from Aïdah at Kaiser — 3:35
  • Arrive at school — 3:45
  • Black Students Matter Inquiry Group meeting — ̶4̶:̶0̶0̶ 4:08
  • Leave San Francisco — 5:43
  • Arrive at Kaiser Walnut Creek — 6:45

The doctor was a middle aged white woman. Her resting facial expression said “sorry to be telling you this, but…” So when she started explaining that high blood pressure leads to a number of health complications for mothers and babies her facial expressions filled in the gaps. When Aïdah started to cry, she stopped talking mid sentence and suddenly became inarticulate. She excused herself from the room, blurting sentence fragments. I’m going to let. I know that. You folks need. Time. Alright.

They just wanted to monitor her is all. Surveil her. Make sure everything is in proper working order. As Foucault says about the function of both hospitals and prisons, “it is necessary to keep them under surveillance to ensure activity takes place all the time and submit them to a perpetual pyramid of surveillance.” That pyramid of surveillance included a host of orderlies, nurses, and a small group of doctors that were now in formation.

They moved us to a shared room with a white woman in labor watching Housewives of Atlanta. She talked to the characters on the show in between contractions and to her partner during commercial breaks. A new doctor appeared and conducted an ultrasound. Aïdah told her we were keeping the gender a surprise. The doctor replied saying that our child will decide their gender. I laughed, not because it was funny but to try to calm my nerves. She started talking about something called preeclampsia and inducing labor. “Why the rush?”, our midwife texted me when I updated her on the situation. Results from the urine tests hadn’t come back yet but the doctors were thinking three and four steps ahead. Then the doctor starts mentioning a steroid shot to prepare the baby’s lungs for premature birth. Aïdah wasn’t feeling it.

“This is the best first decision you can make as a parent to your baby”, the doctor said matter of factly.

The ludicrousness of this exhortation made my leaning in favor of the shot feel like betrayal. The same doctor that was so savvy when it came to the politics of gender identity was ostensibly clueless when it came to the politics of race and hospitals. Trusting white doctors in the U.S. to inject a pregnant black woman in a hospital hardly seemed to be the quintessence of parenting. And yet here I was on her side. Hoping Aïdah would agree to take the shot.

“No more updates for now. Just think it over. No rush.” Then she disappeared.

Thursday, December 14th

The “appropriate” behavior for the mother is to conform to the routines and procedures of hospital staff unquestioningly. The regulation and surveillance of the mother’s body through medical activities is the norm for the birth process, and any objection or departure from these norms, however unnecessary the procedures may be, is considered deviant and unacceptable.
Dr. Jen Pylypa, Associate Professor, Department of Sociology & Anthropology, Carleton University

I awoke after only a few hours of sleep. We were now in an “isolation room” at the end of the hall. They moved us late Wednesday night into what looked like the penthouse suite of Labor and Delivery rooms.

“Have you decided yet about the betamethasone?” one of the nurses asked.

“The steroid shot you mean?” Aïdah asked. She wanted to hold out as long as she could. I was anxious for her to take it because it was clear to me by this point that the baby’s coming was likely imminent. And that we had very little control over it.

“Will it hurt?”she asked, tentatively.

“Just two shots, twenty four hours apart, on the meaty part of your butt. That’s it!”

She took the first shot around two in the morning, sitting straight up on the edge of the left side of the bed. I stood in front of her clasping her hands in mine. The nurse gave a countdown and Aïdah wailed when the needle went in.

“All done!” the nurse said, chipper. Then she vanished.

“I just want to go home”, Aïdah said wearily.

“I know you do”, I said.

I found myself on my feet for most of that day. Standing. At bedside waiting on Aïdah. Praying. In line waiting on cashier. Praying. On elevator waiting for floor two. And there was praying.

The nurses came and went all day too, each providing pieces of the puzzle that we needed more time to make sense of. The picture was becoming clearer but it wasn’t the one we wanted to see. It wasn’t that familiar one from our imagination.

Consolation came in the form of a black nurse who showed up at some point during the day or perhaps the night. She was gentle, empathic, and reassuring. She talked with Aïdah about her three boys. About family. About things that comforted us. She had become a saving grace, a familiar face in a sea of unknown ones. But she was only one woman.

Friday, December 15th

Monday, at this point, seemed an eon ago: a blur of meetings and faces, muted voices, and the tediously rote transitions between home and work. Fridays in my classroom tends to be set aside for either journaling or assessments. Sometimes both. When students arrive in class at the beginning of the week we go over the learning objectives together. It provides an overview of what they should expect to know and be able to do by the end of the week and why it matters. When Friday comes, students have time and space to reflect on the week, to assess how much they learned and understood, and to make meaning out of their experiences. During this time I often play soft background music. I’ll open the window to let a nice breeze in and sometimes dim the lights.

The pedagogical routine and ambiance of the hospital was almost the opposite. Any objectives were reviewed between nurses and doctors — not with us. What we learned were facts like the the different types of high blood pressure diseases and the rates of women who suffer from them. Our minds were treated like empty pails that needed to be filled. Instead of time to reflect on our experience we had routinely interrupted time to think about the information we’d be given.

I found myself, though, becoming a lay expert on preeclampsia, the high blood pressure disease that Aïdah had now been officially diagnosed with. I knew that five percent of pregnant women are diagnosed with it, the short term effects on the mother, the long term effects on the baby, and so on. When family, close friends, or the doula began asking for updates, I was able to rattle off statistics and research without fully understanding what any of it meant. Or how true it was.

The fluorescent lights made it hard to feel comfortable enough to really process everything. We put up our own softer star shaped lights around the room. We asked one of the nurses to turn down the volume on the machines that beeped in various patterns as they made their computations. A friend suggested playing a recitation of surah Maryam from the Qur’an aloud.

None of this, however, alleviated the anxiety we felt about the situation much. And now the doctors and nurses were telling us that there was no way our baby would reach term. That it was too dangerous to even try and therefore they needed to induce labor right away. They had been giving us these fact based updates ever since we arrived as though the more research and numbers they cited the easier it would be to make good medical choices. Except we were only ever presented one choice since arriving — theirs.

Our dilemma was two fold:

  1. We didn’t want a birth experience that conflicted with our faith values. We are Muslim. We believe in the existence of the soul. We believe the process of birth is a deeply sacred experience. We know that as an institution, the hospital operates on a materialist understanding of life.
  2. We didn’t want Aïdah’s body to be a site of experimentation, unnecessary medical interventions, or subconscious racialized malevolence. We didn’t want anyone to die.

To put it more succinctly, as Muslims our predicament was related to western secularism’s denial of spirit and as Black folks our danger was white supremacy’s hatred of blackness.

They began trying to induce labor that night. Aïdah began to have contractions but baby’s heart rate kept dipping with each one. She won’t be able to handle the labor, they said. We’re going to have to do a c-section. It was scheduled for Saturday at 3:30am.

I called our doula to tell her. She said she was going to get some sleep and come about half hour or so before the operation. “You should try to get some rest too,” she said.

Saturday, December 16th

A report was written in the LA Times on October 26th, 2017 about the inexplicably high rates of black mothers dying during pregnancy and childbirth. Three weeks later CNN had figured it out. Then on December 7th, nine days before the birth of our daughter, Solène, NPR published a story about the mother of a black baby named Soleil. Soleil’s mother died from complications of high blood pressure just three weeks after her birth.

Aïdah mentioned to me at various points throughout her pregnancy her latent fear of dying in childbirth. In the late stages of her pregnancy she had even brought up recent reports about the high rates of mortality among black mothers. I told her to not worry because we weren’t having a hospital birth anyways; we were having a home birth. Plus, she was a low risk pregnancy so she shouldn’t worry so much.


12:05 am — Black pediatrician comes in and goes over the risks of a c-section

12:27 — Shower

12:46 — Maghrib & Isha’a

12:58 — Lay on couch-bed and try to get some sleep

1:03 — Nurse comes in for routine blood pressure check. Says c-section is being moved up. I text the doula to let her know

1:30 — Several nurses reappear to prepare us for the operating room

1:35 — Doula arrives

3̶:̶3̶0̶ 2:00 — C-Section

We sat outside the operating room waiting. She gave me some sort of homeopathic treat to put under my tongue. Said it calms the nerves. Everytime a nurse walked by she stopped them to ask questions, press them on fulfilling as much of the birth plan she had devised for us the day before. I watched time inch by on the clock in front of me. They told me I could go in at 2:30. It came and went. I wondered what was taking so long. If something had happened. I felt myself gradually sliding up to the edge of my seat with each passing minute. One of the nurses came around the corner. Said that they had issues putting the spinal anesthesia in but they were almost ready for me. Finally they bring me in.

When I stepped in the room the cold air enveloped me. I walked in treading softly, as though the ground was littered with mines. I could see the doctors through my peripheral, on the left, loosely hovering over Aïdah. I didn’t want to look over there. When the pediatrician from earlier saw me he said something and gave me a reassuring smile and pat on the shoulder. I kept my gaze straight till I got to the top of the table where she was. She looked at me with glazed over eyes, filled with tears that refused to fall. I kissed her on the hand and tried to tune out the sound of cold metal on flesh.

Everything between that moment and the doctors pulling Solène out of the womb is a blur now. When Solène was out, she announced her arrival with a single cry.

“What is it dad?” one of the doctors asked me. I stood up and looked over the veil.

“It’s a girl”, I said my eyes overflowing with tears. I turned and sat back down next to Aïdah whose eyes were now flowing. They took Solène over to a small table adjacent to where I was sitting and called me over.

I walked over slowly and stood in silence, awed by the sheer violence and beauty of it all. My wife carved up on a table behind me and my daughter lying on a adjacent pedestal trying to take the first breaths of life. I’d never before experienced a moment as bloody yet glorious than this. When it was clear that she was able to breathe on her own I cut the umbilical cord and they brought her over to Aïdah who was still on the operating table. I whispered the call to prayer over Solène as she laid on her mother’s chest. My daughter looked up at me with solemn, beady eyes. I looked back with reverential ones.

Sunday, December 17th

Nothing could have prepared me for this unplanned pilgrimage towards the birth of my first child. Over these five days the hospital had become hallowed ground. The place where my wife and child tarried. The place where I participated in rituals that led to my rebirth. A place full of paradoxes, of fear and joy, laughter and tears.

When I went home I discovered that the heels of my feet were dry, cracked, and peeling. It reminded me of the feet of the pilgrims in Mecca during our Hajj in 2012. Their feet were cracked, I supposed, because of the long journey they made to the holy land. Many took multiple means of transportation, including by foot. Or perhaps their feet were signs of a long and arduous life journey. Whichever it was, they were present. In the moment. Between the stations of fear and love.