In 2009, when I was giving birth to my first (and only) child, there was a moment I was certain I was going to die.
Then the panic set in. I couldn’t feel anything from my nose down; I became nauseated, then started dry heaving and having an anxiety attack — all at the same time. I couldn’t breathe, and I couldn’t speak, so I tried desperately with my eyes to alert the anesthesiologist standing behind me that I was in danger. I’ll never forget his words:
“I can see your heart racing on the monitor — sometimes the beeping gives people anxiety. Just try to calm down.”
And neither will I forget my obstetrician’s:
“Every time you move, your uterus contracts, and it’s making it difficult for me to stitch you up. I need you to try and control your breathing or you could be at risk of bleeding out.”
I’m not sure whether it was the tugging and pulling of my abdomen, the delusion of what I thought new motherhood was supposed to be, or the drugs coursing through my body, but when the doctor held my daughter up over the curtain for me to see for the first time, I willed myself to cry. I felt eerily detached, and questioned (aloud) how a very brown woman could give birth to a very white baby. As they stitched me up and wheeled me into my room, all I could think was, “I don’t ever want to do this again.”
Coming home wasn’t any easier. I suffered from intense postpartum depression and an already stressful home life. As my body fought to navigate its way through mental, emotional and physical fatigue, I suffered in silence.
Still, even through all of that, I was one of the fortunate ones: I survived my birthing experience. For far too many Black mothers, this is not the case.
According to the Centers for Disease Control and Prevention, the maternal mortality rate for Black mothers is three times as high as that of White women. It’s only a worsening problem: Over the past 20 years, cases of severe maternal morbidity have increased by more than 200 percent, and cases disproportionately affect Black women, according to the American Journal of Managed Care. And yet two out of three pregnancy-related deaths are preventable.
Now, with the overturning of Roe v. Wade, the consequences for Black birthing people look even more dire.
Experts agree that Black women, who lack access to health care and contraceptive care, will be disproportionately impacted by this ruling: The abortion rate for Black women — 23.8 abortions per 1,000 women — is four times as high as the abortion rate for White women. And the more Black women who are forced to carry their pregnancies to term, the higher our maternal mortality rate will be.
Adia Jamille, a full-spectrum doula based in Tucson, says that for Black women in particular, these higher maternal morbidity rates are part of the legacy of slavery and the systemic racism that came after. In addition to sharecropping and higher-paying jobs, the joy of pregnancy, birth and postpartum have been systematically stripped from Black women.
But some, including Jamille, believe that a solution lies within the very fabric of our culture. Doulas, by definition, are professional labor assistants who provide physical and emotional support to pregnant people (and their partners) during pregnancy, childbirth and the postpartum period. There are also doulas who specialize in the planning and preparation of the body for pregnancy, abortion care, lactation and extended postpartum care.
Mortality rate for Black babies is cut dramatically when Black doctors care for them after birth, researchers say
In African cultures, doula work is seen as community work — immediate and extended family friends are called in to help new families. In the United States, ancestral rituals and traditions are often passed down through Black families. Others learn about birthing support through doula courses offered by various institutions.
Jamille says that she went into this line of work to not only heal from the trauma she experienced at the hands of medical professionals during her own birthing experiences, but to also help others heal and undo the damage that is done by the Western approach to birth and mothering.
“A lot of cultures have a 40-day period after birth where they’re not even supposed to leave the house. So it’s not just your little family — you, your partner and your new baby … it’s you, your partner, your parents, your partner’s parents, your siblings and whoever else is there to help,” she said. “Everybody comes together and works to make sure that the birthing parent is safe and cared for. Whereas here, you’re essentially left to do everything by yourself.”
Her job, she says, is to help the birth parent create community that will help keep that person safe and supported before, during and after pregnancy — that, she says, is the lifesaving work.
But doulas aren’t typically covered by health insurance, making them often inaccessible to people who need them most. In the wake of my own birthing experience, I’ve learned there are still other ways Black women can be equipped to navigate pregnancy and giving birth.
Gayle Dean, an OB/GYN and chief of staff at Tucson Medical Center, says that one way we can help turn the tide for ourselves is by having a strong sense of empowerment and a personal patient advocate.
Her advice? “You don’t want to be a passive participant in your health care.” First, that means selecting a physician carefully, she said.
Dean offered some guiding questions to find the right doctor for you, especially if you’ve found out you are pregnant: What qualities do I want in my physician? What kind of relationship do I want to have with my physician? How do I want my birthing experience to be?
And once you’ve picked a physician to guide you through your pregnancy, these next questions are equally as important, Dean said: Can I have a support person on the phone with me during our appointments? Can you please explain this to me in layman’s terms? What is the reason for this test/procedure?
Dean also thinks it’s very important for birthing people to know that they have the right to change their physician during their pregnancy.
For me, anxiety was a huge part of the pregnancy and postpartum periods. So I asked experts what new or expecting parents can do if they find themselves filled with anxiety about abortion, pregnancy or abortion aftercare. They suggested writing down questions, building your village/support system, finding a spiritual practice that works for you and, most important, giving yourself grace.
Post-delivery, Dean says, engaging in yoga, being out in nature, taking 30 minutes once a week to do nothing (or something just for you), or even taking one minute a day for mindful breathing and meditation can do wonders for a new parent who is struggling.
In speaking with friends and professionals and in doing my own research, I’ve compiled these helpful resources that can be used at any point in your pregnancy and parenting journey, to help ease the stress of it all.
Expectful: This mental health app is built specifically for before, during and after pregnancy. It has a section specifically for Black parents and meditation.
Irth: This app helps you find prenatal, birthing, postpartum and pediatric reviews of care from other Black and Brown women.
Mater Mea: This is an online platform for Black moms looking for community and resources.
Kindred by Parents: This is Parents magazine’s newest online vertical platform built for and by Black parents.
Edinburgh Postnatal Depression Scale: You can use assessment tools like this to track your postpartum mental health.
Books are great resources, too. I recommend “The Body Keeps the Score” by Sean Pratt and Bessel A. van der Kolk, “Black Girl in Love With Herself” by Trey Anthony and “The Mocha Manual to a Fabulous Pregnancy” by Kimberly Seals-Allers.
Whether it’s a mental health app, a caring physician who empowers you, access to safe, legal abortions, or a doula who is with you from Day 1, the evidence is clear — the high tide of Black maternal mortality rates in this country can turn. But the weight of it, for now, lies squarely with Black women.
And while the fear of high maternal mortality rates will only grow because of the overturning of Roe v. Wade, one thing rings loud and true. As Black mothers have been saying for centuries: “We all we got.”