by Erin Newton, LCPC

Part I: Black Women and the Maternal Health System

Back in June I wrote this post discussing my privilege as a white female therapist. If you haven’t read it, you may want to read it before you start this one. After the death of George Floyd, we at Wellness & Co. wanted to combine our passions of working with moms and social justice and write some pieces about what it’s like to be a Black mom in America. The thing is, while I am a mom…I’m not Black. And so my experiences didn’t feel authentic enough to write about, and that’s one of the things we live for here at Wellness & Co. – authenticity.    

So I started thinking, how can I use our platform to tell the stories of those I have left out of the conversation? For the rest of June and into July, I spent a total of nine hours interviewing six different Black women on what it means to them to be a Black mother in America. These women run the gamut in education, everything from a high school diploma to multiple masters degrees. Most are civilian, some are military. Among them are a therapist, a social worker, an IT project manager, an IT specialist, a server at a restaurant, and a quality assurance manager. They have lived not just all over the country but in many cases, all over the world. It was an honor to be invited into their world if only for a little while and to be trusted with their thoughts, feelings and fears. 

There is so much to say here, friends. So much that after writing for a few days (and having written six pages with much more to say…) I decided to split this into a series of blog posts. I know June was months ago, I know your facebook feeds are likely no longer flooded with Black lives matter posts. But the thing is, Black lives STILL matter. I haven’t forgotten that and you shouldn’t either. 

And so, September will be dedicated to Black mothers in our country. Four posts to educate, illuminate, and celebrate the stories of some amazing women that I have the pleasure of knowing. This first post is focusing on the maternal health statistics of Black women, the racist comments and behaviors that Black women often experience from medical professionals, and their feelings of not being heard. Other posts in this series will focus on birth trauma, the myth of the angry Black woman, the importance of representation in health care, the collective trauma suffered by all Black women, and other important topics.    

I know some of this will be hard to read. I invite you to listen with an open heart and an open mind. I invite you to get comfortable with feeling uncomfortable. If you read these stories and your first reaction is to invalidate that experience in any way (such as thoughts like “well I’m sure they didn’t mean it like that/we’re missing part of the story”) I invite you to sit with the idea that your lived experience is not everyone’s experience. I invite you to reflect on Brene Brown’s quote, “In order to empathize with someone’s experience, you must be willing to believe them as they see it, and not how you imagine their experience to be.”   

Let’s Look at the Stats 

In January of 2020, The National Center for Health Statistics released new data on the maternal mortality rate, which is defined as deaths caused or aggravated by pregnancy. This data estimates approximately 17.4 deaths per 100,000 women occurred in 2018 (around 658 women), which is similar to data from the CDC, who found that 700 women died in childbirth in 2018. This abysmal statistic puts the US in last place among all developed nations with regards to maternal mortality. LAST. PLACE. 

The difference with this new data is that in 2017, a standardized checkbox was added to ensure that these deaths were being coded properly. Using this new coding method, researchers found that Black women are dying at a rate 2.5 times higher than White women, approximately 37 Black women per 100,000 births, compared to 14 White women. From 2007 to 2016, those numbers were even higher, nearly 43 Black women for every 100,00 births, compared to 11 White women for every 100,000 births. Those are huge numbers!

And the reason why?

Researchers only cite systemic racism in both society and the health care system, as well as Black women’s increased risk to certain health conditions, such as obesity and hypertension, and the fact that they are less likely to have access to quality prenatal care (spoiler alert….those last reasons are also systemic racism…I’ll explain).

“Did the condom break? Did you forget to take your pill?”

All of the women I interviewed were asked about their experiences during pregnancy and birth that they believe were related to their race. None of them had to think about what to share with me – all of them seemed to know right away the things that have happened to them because they are Black.  

Shizuko Shearl was a Client Systems Technician in the Airforce when she had all four of her children, currently ages 17, 16, 13, and 10. She tells me that she was “very young” when she first got pregnant and had her children close together. When she got pregnant with her fourth child, the Chaplain on base suggested that she consider putting that child up for adoption. The doctors had similar comments. He told her, “well the military isn’t a welfare program.” She also stated that there was this assumption that she didn’t plan to get pregnant. “The doctors would ask me, “Did the condom break? Did you forget to take the pill?”

Michelle Santos, a Black-Japanese American living in Florida echoes these experiences, stating that there’s a stereotype that Black women have lots of babies with lots of different fathers that they can’t take care of. She shared with me that she is questioned frequently as to if all of her children are her husbands because they are all various skin colors – as in, strangers stop her on the street to ask her. (Side-note: I have three children who all look different and no one has ever asked me if they are all fathered by the same man.)     

Natalia Brawley Deloatch also had two different experiences while she was pregnant with her children that she feels were not only related to her race, but the race of her providers as well. Her first OB, a Black woman, made her feel supported and cared for. Her second, an older White man, had what she describes as a “horrible bedside manner” and she says she was harassed about her weight at her appointments. Due to these experiences, after the birth of her children she says she actively sought out a Black pediatrician (which, studies are now confirming was a smart move on her part…more on that in the future). 

“No one wanted to listen to me” 

Jesska (Jess) Ross is currently a licensed therapist living in Essex, Maryland. Her family is a military family and she’s traveled extensively throughout her life. Four years ago, Jess was pregnant with her first daughter, Audrey. She had hyperemesis gravidarum (HG), a condition during pregnancy that causes near constant vomiting and frequent dehydration. Because of her condition, she couldn’t work and had to go on state insurance.

“All my life, I’ve had military insurance and pretty good experiences with doctors. Then I have to go on state insurance because I was just too sick to work. That was a completely different experience. It was terrible. I was treated terribly.”

Jess goes on to explain that around halfway through her pregnancy, she started bleeding and cramping. She went to the hospital, where she was told multiple times that she was ok and to go back home. Jess felt strongly that she was not ok and eventually refused to go home. Unfortunately, it was eventually discovered that Jess’s baby had died, but Jess says that was never clearly explained to her, nor was what she was going to have to go through before she could go home.

“I didn’t even know that she had died. They just kept telling me not to stand up. I also didn’t know I was going to have to deliver her. I thought she was small enough that she would just pass on her own. I didn’t realize I was going to have to be in labor and be in pain and physically deliver her. No one was clear with me.”   

Every woman I interviewed stated they were regularly not listened to during their appointments and in the hospital, stating phrases like, “no one cares,” and even more damning, “if people don’t look like you, they don’t treat you the same.” Erin Travers, a social worker in Waldorf, describes it as a “culture of not listening” and states that it seems medical personnel struggle to listen to what Black women are saying about their bodies.

Another woman I interviewed, Jayme Ross, shared that she was very sick with all of her pregnancies, and, just like her sister Jesska, no one really believed how sick she was, and no one seemed to care.  

The experiences of these women match the data. The Listening to Mothers in California survey, completed in 2018, was the first state level version of this survey, which surveys women all over the country. Its purpose is to provide new information to the public regarding the experiences and views of childbearing women during their maternity and postpartum care. A total of 11% of Black women surveyed reported to feel they were being treated unfairly due to their race or ethnicity and that they were handled roughly during their birth experience. Nine percent felt they were being treated poorly due to their state insurance and that staff used harsh, rude or threatening language with them. It’s also important to note that only 2500 women took part in this survey and of that number, only 5% identified as Black. Black women being left out of the conversation again.  

Takeaways 

As a therapist trained in maternal mental health and a mother, it is no surprise to me that women are being treated unfairly during pregnancy and birth. I know from research, the stories of clients I work with, and personal experiences, that women are often treated very differently than any other individual in a hospital for a medical procedure. Everyone is entitled to true informed consent, which means explaining procedures, discussing what happens if we do nothing, allowing for questions, and encouraging mutual decision making between the provider and the patient. Many moms do not get actual informed consent. And if you’re a Black mom, your chances of getting that experience is even lower. Why are we accepting this? Why are we not demanding better for Black moms everywhere?

I invite you to sit with these stories, friends. Resist your urge to belittle or challenge or find fault with the experiences I have presented here. Try to really sit with the idea that someone’s perspective of their experience IS the experience; whether you would have felt differently about it is irrelevant. We are too easily clouded by the idea that our experience is our own reality, but often fail to see that other people’s experiences are their reality too. 

Next week, we will focus on birth trauma, the myth of the angry Black women, and the importance of representation in healthcare. Keep learning and growing until then.