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

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.

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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

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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

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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

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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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Originally published on January 23, 2018