Written by: Hirut E.

This year marked the fourth annual Black Maternal Health Awareness week, taking place April 11-17 to deepen the national conversation about black maternal health in the United States. Black Mamas Matter, the organization who founded this initiative, is determined to “amplifying community-driven policy, research, and care solutions, provide a national platform for black-led entities and efforts on maternal health, birth and reproductive justice, and enhance community organizing on black maternal health.” (Black Mamas Matter)

In the U.S., the month of April is recognized as National Minority Health Month, to bring awareness to the disproportionate burden of premature death and illness in minority populations. It encourages action through health education, early detection and control of disease complications. (nih.gov)

In this blog post, Hirut, a doula and advocate for black maternal health, shares her knowledge of the status of black women and mothers in the U.S. and U.K., how mothers can honor their maternal journey and how they can and should advocate for themselves.

The World Health Organization, defines maternal deaths as “the death of a woman while pregnant or within 42 days of the end of a pregnancy.”

Centers for Disease Control and Prevention defines maternal mortality as “the death of a woman while pregnant or within one year of the end of a pregnancy.”

Both of these agencies ignore the fact that some of these deaths occurred because of accidental death due to neglect and or racism.

When my journey in the birth work community began, one of the most frustrating things for me was seeing the words approximately, around, about and estimated in front of the MMR (maternal mortality rate).

BLACK MATERNAL MORTALITY RATE IN THE U.S. and U.K.

According to the CDC, Black mothers are 3 to 4 time more likely to die from complications during pregnancy, childbirth and postpartum than White moms.

In the U.K., black women are 5 times more likely to die during pregnancy and after childbirth compared to White Women (MBRRACE Collaboration, 2019).

In the U.S. alone, approximately 800 maternal deaths occur every year. Maternal Mortality Rates can vary because different agencies have different definitions for MMR. Also, because states did not have any form of standardized maternal mortality database, until the National center for Health Statistics released the first data in over a decade. That data was released on January 30, 2020.

HISTORY OF OB/GYN IN AMERICA

J. Marion Sims a South Carolina native, known as the “father of modern gynecology,” invented the Speculum and the Sims's position for vaginal exams; both of which are still in use today. He performed surgeries and mastered his skills by experimenting on 12 female slaves in Alabama, and conducted these surgeries without any anesthesia. In 1855, he opened the first hospital in Harlem, New York City, specifically designed for white women. His support came from the New York state legislature with a donation of 50 thousand dollars. Sims then went on to serve as the president of the American Medical Association in 1875 and the American Gynecological Society in 1879.

In 1920, Joseph Bolivar DeLee, a well-respected physician in Chicago, wrote an article for the first edition of the new American Journal of Obstetrics and Gynecology titled, “The Prophylactic Forceps Operation” where he recommended that specialists should use medication to sedate birthers when labor starts, then let the cervix dilate naturally. He also recommended an episiotomy, the use of forceps to lift and pull the baby, the extraction of the placenta, the use of more medication to help the uterus contract and the stitching of the perineal cut.

The only stage of labor DeLee wanted the birthers to have control of is the dilatation of the cervix, and that was only because they did not have the drugs used today to dilate the cervix. Dr. DeLee has somewhat been blamed for over medicalization of birth; however, his work is still very respected in the field.

In 1900, 95% of women gave birth at home. By 1955, 95% of women gave birth in hospitals.

OB/GYN IN AMERICA NOW

From the 1890s up until 2018, Central Park in New York City had a statue of J. Marion Sims in honor of his work. April 17th 2018, the statue was taken down all thanks to Black Youth Project 100 and many others who protested and demanded for the removal.

Historically, racist ideology, practices, books and education are still killing black birthers today. The number alone can cause black birthers stress and anxiety and we all know the dangers stress and anxiety has on any human being, let alone a pregnant black woman.

8 Ways to HONOR YOUR PREGNANCY, BIRTH AND POSTPARTUM

• Get educated and explore all the different places you can give birth. Hospital is not the only place.

• Learn the urgent maternal warning signs. If your provider is not teaching what signs to look for, find a new one. For example: severe headache, dizziness or fainting, changes in your vision, fever, trouble breathing, severe belly pain and thoughts about harming yourself or your baby.

• Take childbirth classes and invite your birth partner to come and learn. 

• Learn and practice stress reducing methods. Expectful is a great App for Fertility, Pregnancy, and Motherhood. 

• Allow yourself to be vulnerable and accept help, if you don't have family and friends near you, hire a local doula during birth and postpartum for support. 

• Prepare for postpartum, interview lactation consultants, pelvic floor therapist, newborn care specialist, postpartum doulas and meal prep. If seeing dirty dishes in your sink stress you out stock up on paper plates. 

• Give yourself time to heal mentally, physically, emotionally and spiritually. 

• Learn the urgent maternal postpartum warning signs. You should not struggle to breathe, you should not experience consistent abdominal pain. Keep an eye on your body temperature and your bleeding should gradually change in the amount and color.
  

Tips for FRIENDS AND FAMILY 

• Give a new mom the space she needs to express how she feels. 

• Educate yourselves about pregnancy, birth and postpartum. 

• Encourage her to seek medical help and go with her and be a chaperon, take notes and hold your medical provider accountable. 

• Offer food and drinks often, spend quality time with baby, so mom can rest and spend time doing what she loves.

RED FLAGS FROM YOUR MEDICAL PROVIDER

Consider finding a new provider if your provider is not teaching you the warning signs for pregnancy, birth and postpartum, if your appointments are five minutes long and/or they rush your concerns or if you feel like you are not being heard or seen.

Also, please look into your provider’s reviews. You can look to see if they have a high C-section rate and bad reviews on Google. Irth – birth without bias (App) is a great platform to see reviews left by black birthers and to leave reviews of your own.

Being informed, doing your research, asking for help and finding a supportive community and appropriate services for your needs are critical in your maternal journey. You are your best advocate. Speak up and keep voicing your needs and requests. You got this.