Why Is Surviving Motherhood While Black a Revolutionary Act?
The cruel truth of Black Maternal Health in the U.S.A.
As a Black Woman, trying to find the balance between mourning and celebration is a constant seesaw. No matter how well things may be going in your personal or professional life it doesn’t take much but reading literally any headline from any national news source to remind you of the inherent injustices of our world.
Quick fact: motherhood only exacerbates this.
Almost a month ago, the nation recognized Black Maternal Health Week from April 11th through the 17th. It was a proclamation officially put in place by President Biden and VP Harris in 2021, but organically grown from scratch by the Black Female Founders of Black Mamas Matter back in 2018.
But why does a week centered around Black Maternal Health need to even exist?
Because for the last four decades, Black women have been dying in childbirth at a rate three to four times their White counterparts in the United States.
And here we are in the new month of May celebrating all mothers when a significant percentage of Black Mothers never even get to make it to Mother’s Day because of embedded discriminatory treatment in hospitals and the simple fact that when Black women express their medical concerns too often than not they are not heard, believed, or helped to receive the best quality care.
At BHM we want our clients, readers, and sisters to be both celebrated and informed. When it comes to black mothers dying, ignorance is not bliss and we want the nation as a whole to be aware of the problems and equipped with solutions.
As we celebrate mothers this month for their unyielding love and sacrifice, it is our duty to speak on behalf of Black Mamas who are falling through the gaping hole of a US healthcare system that was never created with them in mind.
Medicine has never been immune to racism.
CNN interviewed Carolyn Roberts, a historian of medicine and science at Yale University, who says slavery and the American medical system were in a codependent relationship for much of the 19th century and well into the 20th.
“They relied on one another to thrive,” Roberts says.
In 2016, researchers asked White medical students and residents about 15 alleged differences between Black and White bodies. Forty percent of first-year medical students and 25% of residents said they believed Black people have thicker skin, and 7% of all students and residents surveyed said Black people have less sensitive nerve endings. The doctors-in-training who believed these myths — and they are myths — were less likely to prescribe adequate pain medication to Black patients.
Race adjustment, also known as race correction, is the calculating of a result that takes into account race. It is commonly used in medical algorithms in several specialties including cardiology, nephrology, urology, obstetrics, endocrinology, oncology, and respiratory medicine.
How do harmful practices like race correction lead to the disparities of Black Maternal Health?
One obstetrics example is called the Vaginal Birth After Cesarean calculator. Doctors use this calculator to predict the likelihood of successful vaginal delivery after a prior C-section. If you are Black or Hispanic, your score is adjusted to show a lower chance of success.
That means your doctor is more likely to encourage another C-section, which could put you at risk for blood loss, infection, and a longer recovery period.
The birthing process is a journey and a woman’s health and economic standing do play a large part in survival before ever making it to the delivery room.
In May 2014, the Center for Reproductive Rights (CRR) and SisterSong Women of Color Reproductive Justice Collective (SisterSong) spoke to Black women of reproductive age living in the South about their sexual and reproductive histories.
The purpose of the project was to gather first-hand accounts of Southern Black women’s sexual and reproductive lives from their first sexual activity through early parenthood in order to better understand the role of racial and gender discrimination. In May 2014, SisterSong facilitated two conversations, one in Jackson, Mississippi, and another in Atlanta, Georgia, with a total of 25 women.
It is with this research that SisterSong paired with CRR to found The Black Mamas Matter Alliance.
We’ve combed through their exhaustive report to highlight the inadequacies shared at each step of a Black Woman’s sexual development. While the results collected are not from a randomized study and cannot be generalized, they serve as legitimate insight into the black female experience from contraceptive education to postpartum care.
Contraception
- Lack of access to information on sexual and reproductive health.
- Negative stereotypes around (young) black female sexuality.
Aaliyah from Jackson said her doctor had assumed she would not or could not effectively use contraception: “After I had the baby, and I went back for my checkup . . . [the doctor] told me, ‘I’ll see you in six weeks.’ I said, ‘Why?’ He said I’d be pregnant again.”
Prenatal Care:
- Women covered by Medicaid reported inadequate or poor quality prenatal care at local public hospitals.
[H]e told me, “You didn’t have a sonogram since you first found out you were pregnant.” I said, “Yeah, I thought you knew that.” He said, “No. Let’s go check the baby.” Then [I] came to find out that my baby had no fluids around him, so [the doctor] had to send me over to be induced . . . He said, “Don’t worry about nothing. The baby will be okay. You only have one week left.”
[When the baby was born], he wasn’t breathing. You know how you [usually] hear the baby crying? He wasn’t crying. I asked, “Momma, what’s wrong?” She said, “He’s blue.” She asked the doctor, “Why is he blue?” The doctor said, “Oh, he’s okay. He’s just choking.” Come to find out, they put my baby on C-PAP [breathing mask], then he went through all these tubes [intubation]. He went through three weeks of this.
Labor & Delivery:
- Lack of inherent trust in the provider.
- Evidence of having no one present to help them make informed decisions.
- Forced Cesareans.
*The story below is not a part of the original study but a recent case in which the mother was fully insured and college-educated**
“On July 2, Sha-Asia Washington, a 26-year-old expectant mother, was admitted to the Woodhull Medical Center in Brooklyn, New York, for a routine test. Washington had abnormally high blood pressure, so, for fear of preeclampsia, medical staff gave her medication to induce labor.
Shortly after the induction, her labor took a turn for the worse. Washington was rushed to the operating room for an emergency C-section. But the complications worsened, and after 45 minutes of CPR, she was pronounced dead.”
Postnatal
- Lack of thorough Postnatal care and socioeconomic support to allow mothers adequate recovery time.
- Particularly if they were uninsured or enrolled in Medicaid.
“I had to go back to work. My husband had gotten laid off on Father’s Day, his first Father’s Day, and so I had to go back a month and a half earlier [than expected] . . . and I’m telling you it was traumatic. I collapsed going to bed. . . and [I’d] just cry because I didn’t want to leave my baby. It was really difficult, the job . . . I think they pretended to be cooperative, but six months later they let me go. . . They talk about [how] you [will be] popping back a little bit quicker [following a vaginal delivery], but with the C-section I always felt cold, couldn’t lift heavy things for a while, then I wasn’t healing right.”
Black Maternal Health Resources
There are a few key organizations that have made it their mission to proactively lower the death rates and improve the well-being of Black American Women along their journey of motherhood.
Perhaps the most consistent work is by the Black Mamas Matter Alliance (BMMA).
Their goals are to:
- Change Policy: Introduce and advance policy grounded in the human rights framework that addresses Black maternal health inequity and improves Black maternal health outcomes
- Cultivate Research: Leverage the talent and knowledge that exists in Black communities and cultivate innovative research methods to inform the policy agenda to improve Black maternal health
- Advance Care for Black Mamas: Explore, introduce, and enhance holistic and comprehensive approaches to Black mamas’ care
- Shift Culture: Redirect and reframe the conversation on Black maternal health and amplify the voices of Black mamas
Black Maternal Health Week
On April 13th, 2022 President Biden and VP Kamala Harris officially declared April 11 through April 17, 2021, Black Maternal Health Week.
- Black Maternal Health Week is meant to raise awareness of the discriminatory practices against Black Women during pregnancy.
- It is meant to amplify the voices of Black Mamas and create space for shared truth and trauma to be heard.
- It aims to spark community practices rooted in human rights, reproductive justice, and birth justice frameworks.
In tandem with the United Nation’s declaration of April 11th as the International Day for Maternal Rights, this week takes the opportunity to hone in on the unique struggles of motherhood that black women face. Highlighting the work being done to rid injustices that cause added fear to an already life-altering process.
Black Maternal Health Momnibus Act of 2021
In short, this bill is sponsored by Lauren Underwood, Representative for Illinois’s 14th congressional district. A Registered Nurse before working in the Senate, Rep. Lauren has written thesis work around the U.S. pregnancy crisis and has had a close friend pass due to birthing complications.
The Bill that is close to her heart is meant to end preventable maternal mortality and severe maternal morbidity in the United States and close disparities in maternal health outcomes. The Black Maternal Health Momnibus Act of 2021 is in the first stage of the legislative process as it was just introduced into Congress on February 8, 2021.
Black Maternal Health Caucus
With Ms. Underwood of Illinois and Alma Adams of North Carolina as the co-chairs, The Black Maternal Health Caucus is multi-partisan and “aims to raise awareness within Congress to establish Black Maternal Health as a national priority, and explore and advocate for effective, evidence-based, culturally-competent policies and best practices for health outcomes for Black mothers.”
As of 2019, seventy-five members of the United States House of Representatives belong to the caucus, including support from Speaker of the United States House of Representatives Nancy Pelosi, House Majority Leader Steny Hoyer, and other leaders within the Democratic caucus.
Are you currently on the birthing journey?
Here are simple yet effective actions you can take to help solidify your safety and combat fear.
Heart Health As a Key Focus
- The American Medical Association, along with a coalition of national physician organizations and heart health experts, launched a campaign called Release the Pressure with Essence magazine that partners with Black women to promote heart health and healthy blood pressure. Two of the leading causes of pregnancy-related deaths are heart conditions and stroke, which cause more than one in three deaths.
- Being aware of conditions you may be high risk for are key in prevention and talking with your provider during the early stages of pregnancy about how to keep blood pressure and heart function balanced can lead to lesser complications down the line.
Use Your Voice, Feel Heard, Know Your Rights
- Create a clear birth plan.
- Interview the doctor who will be assisting you in your birth. Be clear about your desires and intentions for birth.
- Know that you can refuse treatment. Have a game plan of how you want your birth to look going in and if things change have someone present if you can who you trust to advocate for you.
Hire A Doula
- Black women with doula support have experienced better birth outcomes and rate their birth experiences as more desirable.
- They will have spent enough time with you before the birth planning and prepping that they will know exactly what to do for your physical, mental, and spiritual needs. They can also advocate for you when it comes to your fluctuating needs and desires during the birth process.
- Great news! As of May 5, 2021, Texas State Representative Shawn Thierry passed a bill including Doula services in the existing scope of coverage for pregnant women enrolled in Medicaid. Her bill, HB 158, is another tool in the toolkit to reduce maternal & infant mortality rates in the state.
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