In many ways, I’m just like every other pregnant woman in the United States. I’m about halfway through my second pregnancy, and I’ve already navigated the questions of what the birth of my second child, a girl, will mean for me personally and professionally. Like many expectant couples, my husband and I are coming up with baby names (I try not to gag when he makes a repulsive suggestion) and we’re stocking up on diapers now so the expenses don’t hit us all at once. I am excitedly waiting to see my daughter’s face for the first time.

But as a Black woman and a military wife in rural America, my pregnancy is also not like every other pregnant woman’s.

I’ve been socialized by the world around me to believe Blackness is an identity associated with unique consequences, especially relating to my health. To be Black is to be seen as a walking risk factor. Diabetes, high blood pressure, cancer — many conditions are correlated to my genetics. Those risks come with assumptions that dictate the medical system’s willingness to see me as an individual. Naturally, those risks multiply with pregnancy, as do the assumptions. More often than not, medical appointments leave me frustrated and longing for answers.

I’ve been socialized by the world around me to believe Blackness is an identity associated with unique consequences, especially relating to my health.

There are many moments when I feel guilty for bringing another Black child into the world. It hurts me that there is nothing I can do to prepare her for life as a double minority. I must help her develop a positive self-image in a world that only sees value in her parts. It’s an obstacle I haven’t entirely overcome myself.

I’ve already experienced how the assumptions of the medical system put Black mothers’ lives at risk. When I’m alone, I find myself wondering if childbirth will kill me. It came pretty darn close the first time.

My first pregnancy started fine. I was young, but I was well read, educated, and married. I passed the gestational diabetes test with ease and didn’t experience the hypertension and preeclampsia I was told I was at risk for. That should have been enough to afford me a positive birth experience. Instead, like many Black women, I learned that no amount of preparation or social advancement can buffer the effects of bias.

During labor, I was told that my birth plan would not be followed because my son had hydronephrosis, a condition of fluid on the kidneys. My doctor made the executive decision to give me an episiotomy.

When I’m alone, I find myself wondering if childbirth will kill me.

Over the next three weeks, walking became progressively harder due to extreme pain. I started passing large blood clots and experienced discharge. But the prenatal staff, as well as the ER doctor I visited, assured me that my experiences were “normal” and told me to take ibuprofen. It was my first birth, but I knew something wasn’t right. Yet every time I raised concerns, I was told I was wrong. Soon I started experiencing lightheadedness, extreme fatigue, and golf ball–sized clots. At four weeks postpartum, I was finally diagnosed with retained placenta during an ER visit. I’ll never forget how it felt to have my concerns ignored and to be silenced to the point that my life was in jeopardy.

In the two years since that birth, I’ve heard many other Black women’s stories, and it’s become clear to me that my birth trauma was part of a national trend. Black women are three to four times more likely to die from birth-related complications compared to white mothers. A 2007 study found that of five health complications that raise the risk of maternal death and injury, Black women are up to three times more likely to die from them than white women. That doesn’t include the millions of other Black women, like me, who undergo birth trauma and narrowly make it through. The medical system has a long legacy of ignoring the pain in Black bodies. Assumptions about risks, pain tolerance, and education continue to disenfranchise Black individuals and curb our autonomy. I can no longer assume “doctor knows best.” I require extra proof to be seen as an individual, not a risk factor.

I’m excited to meet my daughter. But the ghost of my first birth haunts me. As I read the studies and statistics of the disparities in maternal mortality rates, I feel more anxiety with each doctor’s visit. The loneliness of being one of only a few Black families in my area adds to my feelings of isolation. Sure, Confederate flags in my town are largely outnumbered by Blue Lives Matter bumper stickers, but the value system is the same. The possibility that one of my attending physicians drives one of those vehicles scares me.

The weight of “what if” is heavy on our minds and our wombs at all times.

There are moments when I’m unable to catch my breath and I spiral. My stress turns into Braxton Hicks contractions. How can I protect my daughter from sexism and racism when I’m already exposing her to its consequences in utero? This is the toxic stress that kills Black women and babies. The weight of “what if” is heavy on our minds and our wombs at all times. The lack of culturally competent mental health professionals in my area leaves me feeling powerless, and I’m forced to battle my anxieties alone.

Many local pregnant women can relate to my challenges when it comes to baby naming, the emotional labor involved with being a military spouse, and the lingering anticipation of birth. But my community of Black mothers who share my fears is small, and we all lack answers. I ask myself: What can I control? What are the best ways I can advocate for myself in the event that no one else does? I do my best to keep notes on everything that happens to my body so that, should the need arise, I can demand my condition be explored further. And ultimately, I mentally prepare for the small possibility of my family having to continue existing without me.

I’m heading into my third trimester filled with anticipation of what’s to come. Should I trust the same medical system that so severely let me down the first time? Should I give up on the expectation of fair treatment?

I shouldn’t have to spend my entire pregnancy afraid of how bias and institutional racism will impact the birth of my baby girl. But it’s my reality as a Black woman in America, because every pregnancy is a risk. I’m left wondering if ignorance truly is bliss.