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Doulas, Anxiety, & Systematic Racism: Three Mothers Speak On Giving Birth While Black In America

They do us differently. They being this country and its systems. Us being Black women. In response, we’re forced to navigate life differently. A time as precious as pregnancy for Black women in America is often ladened with dozens of concerns —some related to medical queries being taken seriously, others as extreme as surviving birth.

The racial disparity in US maternal mortality rates is one of the worst in all of women’s health. The odds just aren't in our favour and there are several-dozen statistics to back this claim.

The Center for Disease Control and Prevention reports Black women are three times more likely to die from a pregnancy-related cause than white women. Citing quality of healthcare and underlying chronic conditions as possible factors contributing to Black maternal mortality in the US.

Having higher income offers no protection for Black women and over time research has also shown that structural racism, and implicit bias plays a part in these staggering statistics.

Just this January, in a survey of 1,000 Black Americans, a third said they’d experienced racism while dealing with the health-care system, leading some to delay making a health decision or stopping treatment altogether.

Thus, the birthing experience for Black woman like me can be daunting for many —constantly questioning if the care provided would meet a higher standard of excellence if a Black woman’s ethnicity met a different societal standard of acceptance.

This article highlights the stories of three Black women who have given birth in the United States. Each story unique to each woman’s experience of birthing while Black.

Erica Sullivan is a mum of three living in Philadelphia, PA. She’s given birth to two boys, the third is her bonus son. At 23 Sullivan was pregnant with her first child. She wasn’t aware of the staggering statistics related to Black maternal mortality then, but as she got older, she learned.

Sullivan admits she was fearful throughout her second pregnancy, but not initially. “It wasn’t until during my pregnancy [when] I presented with some issues that I felt like I wasn’t being taken seriously,” she said.

Six months into her second pregnancy, Sullivan experienced intense “false” labor pain —otherwise known as Braxton Hicks contractions. The American Pregnancy Association suggests this is a common phenomenon for most pregnant women, but Sullivan’s pain was crippling. She was at times immobile, and even dilated one centimeter when she first presented doctors with her concerns.

“They never took me seriously. Even at the third appointment. I remember coming back because I was having the same ongoing labor pains. I was almost in tears because I remember being so stressed out, and I was like, ‘You don’t understand. I know what [labor] feels like, and I know this seems weird and you probably think it’s just stress.’ I think they would have done more if I weren’t Black, but I also think my perceived age played a role,” she said.

What’s more, Sullivan was on state funded health insurance at the time, she felt medical professionals had reduced her to a stereotype.

Her doctor told her there was nothing she could do. She even refused to go on record with a recommendation for bed rest. “She just kept saying, ‘I can’t officially say it. You can stay off your feet, that’s always a bonus, but I’m not going to officially recommend that for you,’ And it was just baffling,” she recalled.

At that point, Sullivan was six and half months pregnant and two centimeters dilated. She decided leaving a job, where she was constantly on her feet, would be best for both her and her baby. Once she did, the labor pains subsided.

“If I weren’t Black I think they would have cared to do more tests. They didn’t even give me a stress test, they didn’t do any of that. They just talked to me and said, ‘You’re fine.’ I think they wrote me off as a poor young adult black girl who doesn’t even know what she’s talking about.”

Both Sullivan’s births were in a hospital, and both were natural. During her labor and delivery she describes an amazing team of nurses by her side along with an amazing doctor —none of which she saw during her nine months of pregnancy. Admittedly, she regrets not taking a stronger stance with those who tried to trivialize her pain.

“I wish I would have been bold enough to ask, ‘Are you stereotyping me? Are you putting me in a box?’ Because then maybe the next girl wouldn’t have to feel the same way,” she said.

What’s more, if Sullivan were to have another child, she said she’d want her birthing experience to look much differently than the first two.

“I always say if I have another, I’m definitely not doing it in a hospital. You’re brining a life into the world, you want to make it an experience, but you’re limited so much in a hospital, and it’s disappointing that you get more freedom in a birthing center than a hospital that’s supposedly the safest place to have a baby, you get no freedoms at all. Whatever they want the outcome to be is what the outcome has to be,” she said.

Dr. Raymond Cox, a former OB-GYN who is now the medical and clinical director at the Hilton Head, South Carolina, branch of Volunteers in Medicine, a free clinic network, has previously told media that throughout his career, he has witnessed patients treated differently based on race.

Jazlyn Avinger

Sullivan’s ideal pregnancy was Jazlyn Avinger’s reality, twice. Avinger lives in Detroit, MI. She describes her labor and delivery as tranquil after giving birth in the natural birthing department of an area hospital.

Avinger’s a married mom of two baby girls —her newborn audibility cooing in the background as she shared her story.

“With my first daughter, it was a little scary just because you tend to hear a lot of stories of [pregnanci

es] gone wrong,” Avinger said. “So, when I found out I was pregnant with my first daughter I wanted to make sure I educated myself as much as possible,” she continued.

And that she did, researching unconventional pregnancy plans, and ensuring she was aware of her care and birthing options. She knew she wanted a natural birth, but when she told others of her intentions she was met with discouraging responses. “Many people told me that I wouldn’t be able to do it. They suggested I was inexperienced, and didn’t know what I was getting myself into,” she said.

So, Avinger consulted a doula, who just so happened to be her best friend. She was finishing her birth doula certification at the time, and agreed to support Avinger throughout her pregnancy, labor, and postnatal care. “I just knew I did not want to have a negative experience. I wanted to be able to say, ‘I have control of my birth.’”

Avinger is like so many other millennial Black women in America rejecting births in hospitals, opting instead for a quality of care and better suited for their needs.

She explained her greatest concern was surviving birth. “I wanted to live. I wanted my babies to know who I am. I just wanted to be okay, but it is scary,” she said.

At about 20 weeks pregnant, Avinger’s doula attended midwifery appointments alongside her. Explaining medical terminology, recommending how to best prepare for the birthing experience, and serving as Avinger’s advocate from beginning to end.

“A doula is an emotional and physical support for a woman, even after you give birth,” Avinger said.

But the cost of a doula may not be feasible for most women especially Black women living at or below the poverty line. Fortunately, doula’s and doula co-ops are working to model their fee structure in an equitable way. Some even allowing payment plans and pay arrangements on a case-by-case basis.

Mary Ferguson Hunter

Mary Ferguson Hunter is a mother of one living in Stratford, CT. Her son is four-years-old. She believes she manifested him.

“Before I got pregnant, I prayed to God literally for a whole year straight. I would get in the shower, place my hand on my womb, and ask God to allow me to be the vehicle that would allow my husband to recreate the relationship he should have had with his father,” she said. God answered her prayer, allowing her to birth a beautiful baby boy.

Ferguson Hunter delivered her son in a hospital in New York state. She had her own plan and her own terms. She refused tradition or the sake of tradition. Ferguson Hunter educated herself throughout her pregnancy.

The mother questioned policies, and stood firm in what she desired for birthing her baby —labouring at home as long as she could per the advice of her lamaze coach.

Laboring at home allowed Ferguson Hunter to eat a solid meal before arriving to the hospital, something that isn’t permitted once you’re admitted to the hospital for labour.

She refused erythromycin —an eye ointment administered to babies after birth to prevent Ophthalmia Neonatorum, an eye infection contracted during birth as baby makes contact with a mother’s birth canal that is infected with a sexually-transmitted disease. Ferguson Hunter didn’t have an STD.

So, she squashed the idea of administering something she felt her baby didn’t need.

“I didn’t want him to have that. I told my doctor when it’s time to actually deliver him, I don’t want any coaching. I want the room quiet. I want the first voices my child hears to be that of his mom and dad. I went so far as to do a page infographic of what I wanted, and what I didn’t.”

Ferguson Hunter admits being vocal and persistent came at a cost, often feeling medical staff had marked her with a scarlet letter. Yet, she didn’t acquiesce.

“I really felt a way, but I was determined to be the advocate and champion for my son before he gets here. I’m not allowing the health care industry, a money making industry, to dictate what I should do and what I shouldn’t do as a parent,” she said.

On the day of her delivery she arrived to the hospital eight centimeters dilated, and though persistent about her plan, she trusted care providers during an instance of trauma while labouring.

“During delivery, they had to give me oxygen because my water broke while I was contracting and my son couldn’t ride the wave of both. They said his heart rate dipped, I was in survival mode,” Ferguson Hunter said.

Figures from the CDC’s report on racial and ethnic disparities in pregnancy related deaths confirm approximately 700 women die annually in the US as a result of pregnancy or its complications. Ferguson Hunter said outreach and education could help correct this issue.

“Sometimes we as African American women don’t know what we don’t know. Generationally we are at a disadvantage when it comes to the healthcare system, and when it comes to the law enforcement system. These systems weren’t built for us. We need people to lobby for our wombs. ”