Giving birth ranks high on the list of concerns for a majority of American women and that fear grows with the sharing of negative birth stories. Admittedly, the fear around birth can be justified because there is so much uncertainty and unpredictability inherent to the birth process alone. But, if I were to give just one doula tip, I would suggest working with a supportive care team that takes the time to listen and support you throughout your journey. Working with perinatal therapists and coaches can also assist you in working through your fears, concerns, and prenatal planning. Birth does not have to be scary!

IMPACT:

The United States ranks at the bottom of the top 10 industrialized countries in the world for maternal mortality and 55th globally. For Non-White Hispanic birthing people, the risk of death is 2-3 times that of white people. For Black birthing people, the already abysmal rate gets worse. Black birthing people are 3-4 times more likely to die of maternal-related causes in the first year after pregnancy. In New York City, where I live, it skyrockets to 12 times.

Fear of dying in childbirth is a very real concern for many Black birthing people. Risk of pre-eclampsia/eclampsia, cardiomyopathy, hemorrhage, and embolism increase significantly for Black people in pregnancy and postpartum than White people. The next common question is why? We could easily point a finger at statistics about health, access to appropriate and adequate care, higher rates of obesity and diabetes, lower incomes, but what it really comes down to is quite simple and far more dire. Racism. Social racism, historical racism, weathering on the body due to stress and long-held stereotypes of Black people.

IMPLICIT BIAS

Implicit bias happens beyond awareness can oftentimes go against a person’s beliefs. Implicit bias can be so deep-seeded that a person has no idea how it impacts their view of the world, including decision making and clinical assessments. For Black birthing people, these unconscious biases can impact their pregnancy care, interactions with the world, and access to care and support.

GOVERNMENT INTERVENTION

Another often overlooked but all too real concern is fear of government intervention. Black women are tested more often for illicit drugs upon admittance to a hospital for birth. They are also more likely to be reported to social services for being non-compliant or declining routine procedures. This oversight fails to recognize bodily autonomy and the right of each individual to make informed decisions for themselves regardless of medical recommendations. Once reported, the risk of having their newborns taken away goes up along with the stress of opening their lives up to scrutiny and random welfare checks.

POSTPARTUM MOOD AND ANXIETY DISORDERS

Postpartum mood and anxiety disorders (PPMADs) present at higher rates, yet often go untreated, for Black birthing people. Very real concerns about bringing a Black child into the world and the potential challenges that the child may face adds anxiety to a new parent’s mind. Black babies are less likely to reach their 1st birthday than white babies. Concerns about the ability to provide adequate clothing, food/formula, diapers, and childcare add to stress levels. Decreased access to adequate postnatal and pediatric care also increase the risk of anxiety and depression. Combine this with the normal hormonal and life changes of new parenthood and the risk of PPMADs drastically increases. Additionally, culturally competent care, the stigma around seeking care, and the ability to afford mental health support are all barriers to seeking and finding help for families.

IMPACT ON BREASTFEEDING

Breastfeeding rates are lower, and drop sooner, for Black parents than white parents. In studies, 85% of white birthing people initiated breastfeeding at birth while 69% of Black birthing people did. Beyond birth, the rates for both groups drop. Why do Black parents breastfeed and continue to breastfeed at lower rates than white parents? They receive less support and education to encourage a successful breastfeeding relationship. There is also inadequate family leave, for all parents, in the United States, which inhibits the ability to stay home with a new baby and establish a strong breastfeeding relationship before returning back to work. From my own doula experience, the families who have not been able to afford to stay out of work for longer periods of time have struggled more to establish and maintain a breastfeeding relationship, regardless of intent. The complicated and tragic history of Black breastfeeding and wet nursing has also created lasting damage within the psyche of the Black community. Black enslaved women were forced to wet nurse white babies, while their own babies suffered and died from malnourishment. Black enslaved women were not allowed to care for and bond with their children for generations, while simultaneously nurturing white children. How could such history not have a lasting impact?

SOLUTIONS:

If you’ve made it this far in reading, you may be feeling overwhelmed. It’s a lot, I know. There is no one simple solution to solve this deeply seeded problem. How can we prevent more Black people from dying from childbirth? The answer is to take action. Daily steps, big and small will make a lasting change for yourself, your community, and the country as a whole. Get involved, speak up, fund organizations and individuals involved in improvement, support Black birth workers, and write to government officials to enact change.

Support grassroots movements who are on the ground making changes. Some incredible Black women making strides to improve maternal health and wellbeing are Kimberly Seals Aller, Rachel Nicks, Latham Thomas, and midwife Jennie Joseph. Each is actively educating, fundraising, and supporting Black birthing people. Kimberly Seals Aller is a birth worker who founded the Irth App as a way to connect Black families with knowledgeable providers within their communities. Like Yelp but specifically for pregnancy, birth, and postpartum. Rachel Nicks is a fitness trainer, doula, actor, and mother who founded the nonprofit Birth Queen to raise funds for education for Black midwives, doulas, and lactation consultants to empower Black families. Latham Thomas is a doula, yoga teacher, and founder of Mama Glow. She partnered with Carol’s Daughter in founding Love Delivered to educate, fund, and provide doulas for Black birthing families.

I’ve provided a list of resources in various categories that can help you find support or get involved in making lasting and real changes.

RESOURCES:

Black Care Providers

Irth App

National Black Doulas Association

Diaper need

Believe Diapers

National Diaper Bank Network

BxRebirth (Bronx, NY specific)

Formula need

Local WIC office

Speak to your pediatrician, they may have access to formula assistance