April 11-17 is Black Maternal Health Week. Be informed. Be your best advocate. – Team Lifestyle
The Black maternal health crisis in America deserves our immediate attention. Black women in the U.S. are three times more likely to die from a pregnancy-related cause than white women. And while this shameful statistic has been true for quite some time, we continue to see evidence that little has changed in recent years.
Just weeks ago, former Kansas City Chiefs cheerleader Krystal Anderson died from sepsis-related organ failure shortly after delivering her daughter, Charlotte Willow, who was stillborn. Anderson was just 40 years old. Back in 2018, tennis champ Serena Williams famously shared that she developed blood clots after giving birth to her first child via C-section and that her doctors ignored her symptoms until she insisted on having a CT scan. These women’s harrowing stories are startling reminders that Black women are still in the midst of a global maternal health crisis that has not improved.
Each year in the United States, Black women are dying during pregnancy or after pregnancy. What’s worse, more than 80% of pregnancy-related deaths in the U.S. are preventable, according to the CDC. Unconscious racial bias in the medical field, as well as a lack of adequate resources in Black communities, are said to be the driving forces behind America’s Black maternal health crisis. As Anderson and Williams’s stories have shown us, the risks for Black women are still present no matter our level of wealth, education, or fame.
To no surprise, statistics show that Black patients, including Black mothers, have better outcomes when treated by Black doctors. Unfortunately, only about 5% of doctors in the U.S. are Black. For Black women who are currently pregnant or thinking about becoming pregnant in the near future but don’t have access to Black practitioners in their area, there is a lot that these doctors want you to know so that you can be armed with the right information and advocate for yourself. We spoke with two of them — Chicago-based obstetrician-gynecologist Constants Adams, M.D., and Kimberly Middleton, M.D., a Garland, Texas-based board-certified family medicine physician and vein surgeon who previously specialized in high-risk pregnancies — and asked what Black mothers should know and do before they give birth.
Plan Before You Get Pregnant
If you know you want to become pregnant in the future, get the conversations with your doctors started now. The earlier you can identify any preexisting risk factors, the earlier you can mitigate them. “What I encourage a lot of people to do is meet with [their OB-GYN] before they get pregnant,” says Adams. “I’ll have people who come to meet me and talk to me about their future pregnancy plans. We go through their history, and we find out if there’s anything that puts them at a higher risk in pregnancy so that we can hopefully address those risks before they conceive. It is the best way for us to optimize their overall health.” Pre-pregnancy is also an ideal time to look into the hospitals in your area and their C-section rates, do your research on doctors, and develop a contingency plan in the rare event that your doctor can’t be there to deliver your baby. “Before you get pregnant is a great time to do that, “says Adams. “Once you are pregnant, it can be really difficult to doctor shop because it can lead to disruption of care.”
Find Your Birthing Team
Speaking of doctor shopping, part of having a safe and peaceful birthing experience is finding a medical team with whom you trust and have a solid rapport. While you may already have a gynecologist you regularly see for annual exams, pap smears, and other reproductive health visits, be aware that not all of them deliver babies. Find out whether your doctor can do both, and if not, ask them to refer you to an obstetrician who aligns with your birth plan.
When looking for an OB-GYN, Adams recommends listening to your gut and paying careful attention to how they are addressing your concerns. “Read [their] body language. ‘Is this someone who is more dismissive of what my questions are? Are they making me feel less than or dumb when I’m asking these questions? Am I meshing well with them? Are they communicating with me in a way that I can actually understand and find effective?’” she says to ask yourself. Middleton agrees that doing research on your doctor and their success rates will give you added peace of mind.
“You have to vet your doctor like you vet anyone else,” she says. “We check reviews for restaurants, we check the reviews for hotels, and so you have to check the reviews of your physician. If you dig deep, you can check the lawsuits or complaints of your doctor. A lot of information is public. And by doing your research, you’re giving yourself a heads-up. If you find a doctor you’re considering, talk to other people and get their recommendation.”
Remain As Active As Possible
Movement is necessary for your overall health, but it’s especially vital when pregnant. Middleton says keeping yourself active by walking or doing moderate exercise will help you maintain healthy blood flow. “It’s really important to try not to be sedentary, to try to move around as much as possible,” she says, “because the more that blood sits in the veins, the more likely it is that the veins will descend and increase your risk of having a devastating blood clot.” She also recommends staying in tune with any changes in the body and not dismissing “normal” pregnancy symptoms, which can signal a problem like swelling, redness around the ankles, or frequent headaches that won’t go away.
Know Your History
Middleton advises that knowing your family history, including any birthing complications your biological mother faced, is key for Black women who are pregnant because it helps paint a clear picture of your risk factors and what your care team should look out for. “I find that when people come to my office, they don’t know their family history, they don’t know anything about what’s happened in the past with their family members, and that’s a key factor in determining your outcome when you’re pregnant,” says Middleton.
“Genetics plays a huge role in pregnancy and delivery, and oftentimes what happened with your mother is often the case with you,” she adds. “So, knowing your family history and knowing your own medical history is important.” Keeping an up-to-date list of your family’s medical history on your phone or a notepad, along with a list of detailed questions you want to ask your doctor about your birth plan, is the best way to stay prepared for every doctor’s visit. And as the saying goes, stay ready so you don’t have to get ready.
Consider Working With a Doula
The positive impact a doula can have on a pregnant woman’s life has been well documented. Studies show that Black mothers, in particular, have better birthing outcomes when they’re supported by one. Doula care is now recognized as a valuable resource for pregnant and birthing people, and several states in the U.S. cover doula care under their Medicaid programs.
Though you may think doulas are only there to help you give birth, they can also step in to assist you on your journey toward pregnancy and are available for postpartum care. Middleton thinks they’re an excellent addition to a woman’s motherhood tribe.
“I think an important component to having adequate healthcare is recruiting your own support team,” she says, “That could be your partner, your mother, your grandmother, a doula, or a nurse midwife. I think that is so important because you have a second set of ears and voices. Sometimes, you’re in a situation where you’re unable to voice your opinion, [a doula] you’ve recruited can voice those concerns for you.” Adams agrees and recommends asking your practice how they feel about doula care when vetting your care team. “There’s been a lot of really great evidence that shows that having a doula present in BIPOC populations can be a huge resource and a great way to lower risk because you have someone who’s there as your personal advocate.”
