What Black Women Should Know About Childbirth & Being Their Own Advocates

They want us to think we might die having children. I want you to understand how amazing your body is.

Women's Health

By now, I'm sure you've heard all the reports circulating about black mothers dying.

Black women are dying at astronomically high rates compared to their white counterparts. In fact, the maternal mortality rate is three to four times higher among black women. And if you are a black woman that's never given birth, you're probably absolutely terrified at the thought of pregnancy and childbirth for that reason.

Those initial feelings of joy when we find out that we are expecting are now replaced with anxiety and a fear that nearly paralyzes us. Our concerns have shifted from whether or not we'll deliver a healthy baby to questions of if we'll make it out of the delivery room alive.

When I heard the story of Serena Williams' near-death experience after giving birth, it didn't surprise me. It also didn't surprise me that she knew exactly how to identify an epileptic embolism and notify her doctors before it was too late.

She's an athlete who has undergone multiple surgeries and faced multiple injuries. She knows her body at its best and she knows when it is momentarily failing her. But Serena's relationship with her own body served as a life-saving reminder that knowledge of self is most important kind to have. Right now, the narrative is that no one knows why black women are dying during childbirth. But for Serena and any other black woman who has been pregnant and seen a doctor, we know exactly why.

Doctors are not pregnancy advocates.


They see patients, assess risk, and prescribe a course of action. If you're Black, they tend to see you quicker, assess you without investigation and prescribe courses of action that minimize our options and influence you to make risky choices. Epidurals, induced labor, fetal monitoring - all things that are suggested by doctors as normal procedure but are actually linked to a host of complications that put women and their baby at risk. When it was me in the stirrups, I was shocked by how quickly my desire to have a natural childbirth was laughed off by my doctor.

I can remember having not one but two seperate male doctors tell me that having a child is "risky" and painful and I would do best to give birth in a hospital in case of emergency. It was in that moment that I realized had I not already read three books about pregnancy and childbirth and spoken to half a dozen midwives that I might have even believed them. Instead, I walked out of their office both times insisting that I knew my body better than that did. I've read Serena's birth story over and my biggest takeaway is that we are capable of anything we put our mind to - but we do have to put our mind to it.

If having children is anywhere on your list of life plans, arm yourself with as much understanding about birth as you can - it could save your life.

Pregnancy and Childbirth Are a Marathon


My midwife told me this and it always stuck with me. "You're training for a marathon," she said after advising me to pack on the protein. This is something I think a lot of women tend to forget or not be told. Childbirth is not a test you can cram for, the preparation begins as soon as those two lines show up. Talk to a nutritionist to design a meal plan for the duration of your pregnancy. If you can't afford a nutritionist, read up on what foods support your body during each trimester.

The "eating for two" approach to prenatal nutrition might be fun, but it can also land you on bed rest. But gestational diabetes isn't the worst side effect of bad eating. Giving birth is a very athletic process. It involved pushing and breathing and incredible stamina. Being strong and energized could be the difference between an easy birth and a difficult one. Stay fit now and through your entire pregnancy.

The More You Know

One of the best decisions I made was taking a birthing class with my partner. Checking in every week with a midwife and interacting with other expectant couples eased a lot of my stress and answered all of my "how does labor feel" questions. It was also a chance for my son's father to get educated on how to support me during the entire process. If the dad isn't in the picture, choose a friend or family member to be your partner - the point is to have a support system.

Look online for birth plan templates and fill it out with every detail of how you want your birth to play out. Filling out this plan will help guide you to questions you ask your doctor or midwife. Learn as much as you can about pregnancy so you have a full understanding of what to expect, what's normal and what signals a problem. My favorites were A Thinking Woman's Guide to a Better Birth by Henci Goer, The Mindful Mom-to-Be and Birthing Justice: Black Women, Pregnancy and Childbirth.

Don't Believe the Pain Hype


Does childbirth hurt? Of course it does. But so does motherhood and there's no epidural for getting through 4 am feedings or potty training. I consider the pain I endured to be the prerequisite for raising a human person. Especially when I came to learn the realities of epidurals. For example, an epidural will cause your blood pressure to drop suddenly. After an epidural is placed your ability to move around is severely limited which can put your baby in distress as it tries to make its way through the birth canal. As I went through the stages of delivery I moved from place to place - bed, bath, squatting on the floor - whatever helped my son safely get himself into position.

Find Your People

A lot of us received our first education about having babies from our mothers. Usually, whatever route our mothers took with childbirth is the same one we are inclined to take as well. My mother, who also have a natural birth for me and my sister, told me, "Eh, it's not so bad" when I asked her what labor felt like. Thanks, mom.

I was so thankful that I lived in the information age and could easily find a little online community of women who were going through exactly what I was. Websites like Baby Center allow you to join micro-communities of women who share your due date. Find support among other women who have similar goals so you can encourage each other through the process. Support makes a world of difference.

Hospitals Are Not the Best Option


I tell every black woman that will listen to me, do not have your children in a hospital unless you have known complications. Not only are hospital births more expensive than home births or birth centers, they also carry a higher risk.

Most hospitals have a C-section rate that far exceeds what it should. Surgery should be a last ditch effort to save mom and baby but instead it tends to be the go-to move as soon as there is a sign of trouble. I encourage women to consider remaining under the care of a midwife and doula, as opposed to an Obstetrician to receive one-on-one, personalized informed prenatal care. A midwife essentially takes the role as your primary caregiver throughout your pregnancy and can even provide postpartum gynecological care. I saw my midwife instead of an OB-Gyn once I was under her care. She could refer me to a specialist, send me for bloodwork or tests as needed and she constantly offered me words of empowerment and helped me make informed choices.

Our appointments were as long as they needed to be and I never felt rushed. The doula takes a different role, she's more involved in the actual birth process. She was an emotional and mental support to me, provided advice, and was more hands on during the birth.

While I was in labor with my son, my midwife told me that I had to resist pushing for about 45 minutes. She said despite my intense contractions that my son's head wasn't far down enough. Just hearing that made my heart race. Trying not to push was the hardest part of the entire experience.

But my doula came in, rubbed my back and told me to take in deep breathes and let out low baritone moans and I was able to relax. When laboring women are told there's a problem, we panic and when we panic we are giving the hospital the perfect excuse to offer up drugs and surgery in our most desperate moment. Websites like Midwife.org and ZocDoc can help you kick off your search and most midwives can recommend doulas once you're under their care.

As black women, we know the world is constantly trying to give us the short end of the stick. It's a reality we take with us into boardrooms and classrooms. We have to be just as diligent when planning for pregnancy and birth. The numbers we see dancing across headlines and on television screens paint a grim picture of what black childbirth looks like.

But understand this - the system is failing us, our bodies are not.

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Featured image by Shutterstock

Originally published on January 23, 2018

ACLU By ACLUSponsored

Over the past four years, we grew accustomed to a regular barrage of blatant, segregationist-style racism from the White House. Donald Trump tweeted that “the Squad," four Democratic Congresswomen who are Black, Latinx, and South Asian, should “go back" to the “corrupt" countries they came from; that same year, he called Elizabeth Warren “Pocahontas," mocking her belief that she might be descended from Native American ancestors.

But as outrageous as the racist comments Trump regularly spewed were, the racially unjust governmental actions his administration took and, in the case of COVID-19, didn't take, impacted millions more — especially Black and Brown people.

To begin to heal and move toward real racial justice, we must address not only the harms of the past four years, but also the harms tracing back to this country's origins. Racism has played an active role in the creation of our systems of education, health care, ownership, and employment, and virtually every other facet of life since this nation's founding.

Our history has shown us that it's not enough to take racist policies off the books if we are going to achieve true justice. Those past policies have structured our society and created deeply-rooted patterns and practices that can only be disrupted and reformed with new policies of similar strength and efficacy. In short, a systemic problem requires a systemic solution. To combat systemic racism, we must pursue systemic equality.

What is Systemic Racism?

A system is a collection of elements that are organized for a common purpose. Racism in America is a system that combines economic, political, and social components. That system specifically disempowers and disenfranchises Black people, while maintaining and expanding implicit and explicit advantages for white people, leading to better opportunities in jobs, education, and housing, and discrimination in the criminal legal system. For example, the country's voting systems empower white voters at the expense of voters of color, resulting in an unequal system of governance in which those communities have little voice and representation, even in policies that directly impact them.

Systemic Equality is a Systemic Solution

In the years ahead, the ACLU will pursue administrative and legislative campaigns targeting the Biden-Harris administration and Congress. We will leverage legal advocacy to dismantle systemic barriers, and will work with our affiliates to change policies nearer to the communities most harmed by these legacies. The goal is to build a nation where every person can achieve their highest potential, unhampered by structural and institutional racism.

To begin, in 2021, we believe the Biden administration and Congress should take the following crucial steps to advance systemic equality:

Voting Rights

The administration must issue an executive order creating a Justice Department lead staff position on voting rights violations in every U.S. Attorney office. We are seeing a flood of unlawful restrictions on voting across the country, and at every level of state and local government. This nationwide problem requires nationwide investigatory and enforcement resources. Even if it requires new training and approval protocols, a new voting rights enforcement program with the participation of all 93 U.S. Attorney offices is the best way to help ensure nationwide enforcement of voting rights laws.

These assistant U.S. attorneys should begin by ensuring that every American in the custody of the Bureau of Prisons who is eligible to vote can vote, and monitor the Census and redistricting process to fight the dilution of voting power in communities of color.

We are also calling on Congress to pass the John Lewis Voting Rights Advancement Act to finally create a fair and equal national voting system, the cause for which John Lewis devoted his life.

Student Debt

Black borrowers pay more than other students for the same degrees, and graduate with an average of $7,400 more in debt than their white peers. In the years following graduation, the debt gap more than triples. Nearly half of Black borrowers will default within 12 years. In other words, for Black Americans, the American dream costs more. Last week, Majority Leader Chuck Schumer and Sen. Elizabeth Warren, along with House Reps. Ayanna Pressley, Maxine Waters, and others, called on President Biden to cancel up to $50,000 in federal student loan debt per borrower.

We couldn't agree more. By forgiving $50,000 of student debt, President Biden can unleash pent up economic potential in Black communities, while relieving them of a burden that forestalls so many hopes and dreams. Black women in particular will benefit from this executive action, as they are proportionately the most indebted group of all Americans.

Postal Banking

In both low and high income majority-Black communities, traditional bank branches are 50 percent more likely to close than in white communities. The result is that nearly 50 percent of Black Americans are unbanked or underbanked, and many pay more than $2,000 in fees associated with subprime financial institutions. Over their lifetime, those fees can add up to as much as two years of annual income for the average Black family.

The U.S. Postal Service can and should meet this crisis by providing competitive, low-cost financial services to help advance economic equality. We call on President Biden to appoint new members to the Postal Board of Governors so that the Post Office can do the work of providing essential services to every American.

Fair Housing

Across the country, millions of people are living in communities of concentrated poverty, including 26 percent of all Black children. The Biden administration should again implement the 2015 Affirmatively Furthering Fair Housing rule, which required localities that receive federal funds for housing to investigate and address barriers to fair housing and patterns or practices that promote bias. In 1980, the average Black person lived in a neighborhood that was 62 percent Black and 31 percent white. By 2010, the average Black person's neighborhood was 48 percent Black and 34 percent white. Reinstating the Obama-era Fair Housing Rule will combat this ongoing segregation and set us on a path to true integration.

Congress should also pass the American Housing and Economic Mobility Act, or a similar measure, to finally redress the legacy of redlining and break down the walls of segregation once and for all.

Broadband Access

To realize broadband's potential to benefit our democracy and connect us to one another, all people in the United States must have equal access and broadband must be made affordable for the most vulnerable. Yet today, 15 percent of American households with school-age children do not have subscriptions to any form of broadband, including one-quarter of Black households (an additional 23 percent of African Americans are “smartphone-only" internet users, meaning they lack traditional home broadband service but do own a smartphone, which is insufficient to attend class, do homework, or apply for a job). The Biden administration, Federal Communications Commission, and Congress must develop and implement plans to increase funding for broadband to expand universal access.

Enhanced, Refundable Child Tax Credits

The United States faces a crisis of child poverty. Seventeen percent of all American children are impoverished — a rate higher than not just peer nations like Canada and the U.K., but Mexico and Russia as well. Currently, more than 50 percent of Black and Latinx children in the U.S. do not qualify for the full benefit, compared to 23 percent of white children, and nearly one in five Black children do not receive any credit at all.

To combat this crisis, President Biden and Congress should enhance the child tax credit and make it fully refundable. If we enhance the child tax credit, we can cut child poverty by 40 percent and instantly lift over 50 percent of Black children out of poverty.


We cannot repair harms that we have not fully diagnosed. We must commit to a thorough examination of the impact of the legacy of chattel slavery on racial inequality today. In 2021, Congress must pass H.R. 40, which would establish a commission to study reparations and make recommendations for Black Americans.

The Long View

For the past century, the ACLU has fought for racial justice in legislatures and in courts, including through several landmark Supreme Court cases. While the court has not always ruled in favor of racial justice, incremental wins throughout history have helped to chip away at different forms of racism such as school segregation ( Brown v. Board), racial bias in the criminal legal system (Powell v. Alabama, i.e. the Scottsboro Boys), and marriage inequality (Loving v. Virginia). While these landmark victories initiated necessary reforms, they were only a starting point.

Systemic racism continues to pervade the lives of Black people through voter suppression, lack of financial services, housing discrimination, and other areas. More than anything, doing this work has taught the ACLU that we must fight on every front in order to overcome our country's legacies of racism. That is what our Systemic Equality agenda is all about.

In the weeks ahead, we will both expand on our views of why these campaigns are crucial to systemic equality and signal the path this country must take. We will also dive into our work to build organizing, advocacy, and legal power in the South — a region with a unique history of racial oppression and violence alongside a rich history of antiracist organizing and advocacy. We are committed to four principles throughout this campaign: reconciliation, access, prosperity, and empowerment. We hope that our actions can meet our ambition to, as Dr. King said, lead this nation to live out the true meaning of its creed.

What you can do:
Take the pledge: Systemic Equality Agenda
Sign up

Featured image by Shutterstock

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