Racism and Discrimination in Maternal Health: What Can You Do?
The American Academy of Pediatrics made a bold statement last fall about racism in the United States, and has admitted that it should be treated as a "socially transmitted disease." The disease is showing itself by way of chronic stress, and is connected to many health problems. Research from 10 years ago linked racism and discrimination to low birth weight in African American populations. More and more connections are being made to widespread institutionalized racism during pregnancy and childbirth, and well-known women of color, like Serena Williams and Beyonce, are giving the problem a recognizable face. Racism is not new news, but it is starting to be taken seriously in the birth world.
The worry for many Black women is obvious - if Serena and Beyonce can't get the help they need, what hope do "normal" women have to be treated well?
The question is warranted.
So, what sorts of things can you do while pregnant to help have a safer experience now and through labor and postpartum?
Become your own best advocate: Ask questions, don't stop until you get an answer you find satisfactory, and don't shy from uncomfortable power dynamics. Your voice deserves to be heard. Your questions deserve to be addressed with thought and consideration. If you feel that your concerns are not being validated do not be afraid to change providers.
Have people around you who know what you want: your support people are your people. They may not know what is medically typical or expected, but they will know you, and what is important to you — the more people who understand your preferences, the better.
Learn about pregnancy and birth: Knowledge is power. Learn what "normal" looks like by taking childbirth education classes or through self-study. Talk with your medical team about what is considered safe and healthy for someone with your medical history. Become aware of your baseline of normal for things like weight, swelling, blood pressure, nausea, mood, and energy level. Tracking your numbers from your prenatal appointments is part of safeguarding your health.
Ask your care team about their statistics: What are the statistics for vaginal birth, cesarean birth, maternal mortality, and stillbirth for both your provider and the hospital that you plan to use for delivery. Let your care team know you are invested in your care and want to work collectively. Refuse to be a passive patient.
Add a labor doula to your team: One option presented in many states with high maternal mortality rates is the use of doulas. Doulas are professional support people who stay focused on the emotional and physical needs of laboring people. A doula for your birth will help ensure you are getting the answers you need, the attention that is warranted, and the support that can make a huge difference to having a birth that feels both safe and fulfilling. Your doula is NOT a part of the hospital staff, but they do translate between you and the on duty staff very well. Your doula not only wants you to have the best birth possible, but they also want you to have the best experience possible. Communication, tools, tips, and collaboration are a part of making that a reality.
Choose your provider with care: The quality care you receive should be respectful, culturally competent, and safe. If it is possible in your area, hire a medical provider that looks like you. In Kansas City that option may be very limited especially when you are looking for a provider whose beliefs about birth align with yours. In this case ask your peers who they have used and trusted for their births.
For more information about safety and advocacy, I recommend visiting: NAABB (National Association to Advance Black Birth)