Protecting Your Birth: A Guide For Black Mothers

How can you best communicate with your OB-GYN as a Black Mother? The data is difficultly clear: “Black women in America have more than three times higher risk of death related to pregnancy and childbirth than their white peers. This is regardless of factors like higher education and financial means, and for women over 30, the risk is as much as five times higher.”

The New York Times shares advice on how racism can impact your pre and postnatal care through a newly created educational guide. The full article can be found here, but here is a summary of what you should know:

Step 1: Acknowledge Race and Racism In The Room

• Discussions of race can bring up anxiety for all involved, but addressing it is a necessary step toward creating safety and combating implicit bias. Implicit bias means our subconscious associations based on characteristics such as race, ethnicity, age and appearance.

Step 2: Create a Care Plan Anticipating That Racism May Impact Pregnancy

• Approximately 1 in 6 Black women in America will have a preterm delivery which increases risks to newborns, as nearly two-thirds of all newborn deaths to Black women can be attributed to prematurity. Women with a history of preterm birth are more likely to have another preterm delivery. If you’ve had a preterm birth before, talk to your care provider about what monitoring and treatment may be appropriate for you.

Step 3: Identify How Racism May Impact Labor

• Many studies have demonstrated that medical professionals have perceived Black people as having higher pain tolerances, leading to disparities in pain management that cannot be explained by perceived lesser pain. This is one of the many ways that the history of slavery impacts the treatment that laboring mothers receive. It is important for patients and providers to be aware of and actively combat these assumptions.
• With your support team and provider, think through pain options you might want ahead of your delivery. Ask what you should do if you feel that your pain is being inadequately treated. The following sample language could help:“I know that research has shown that Black women are more likely to have their pain under-treated. I am worried about being in pain and not receiving appropriate treatment. How can we make sure that doesn’t happen?”

Step 4: Identify How Racism May Impact Postpartum

• The postpartum period is critically important and often overlooked. Up to 45 percent of maternal deaths happen in the weeks after delivery, a time where people are generally more removed from medical care and their regular support systems. Also, those affected often don’t have insurance coverage. In the United States, the postpartum time period is commonly thought of as the six weeks after delivery due to insurance coverage changes at that time. However — medically and physiologically — it is at least the entire year after birth, as this is how long the physical changes of pregnancy persist.
• As of 2018, The American College of Obstetricians and Gynecologists (ACOG) recommends that women see their providers within three weeks of delivery. Women who have had more complicated pregnancies, including problems with blood pressure like pre-eclampsia, should be seen within a week of delivery, ideally a few days after leaving the hospital, for a check-in that includes a blood-pressure evaluation.