For decades, there have been racial disparities within maternal and infant health in the United States. With Black birthing people three times more likely to die during and after childbirth than their White counterparts, and Black babies two times more likely to die, the system is clearly broken.
There are numerous reasons why these numbers are so high, and they are all rooted in racism, systemic medical bias, and discrimination. In order to combat the effects of these socioeconomic inequalities that make it more difficult for Black people to have healthy and successful pregnancies. Black parents ultimately need to know how to advocate for themselves before, during, and after childbirth. We’ve spoken to experts who can provide insight into why there are such vast disparities, as well as tips on how Black birthing people can advocate throughout the pregnancy process.
Why is the Mortality Rate Higher for Black Parents and Infants?
The United States has high maternal mortality rates in comparison to other developed countries, and racial disparities make the risk of death even greater for Black pregnant people. According to the Centers for Disease Control and Prevention (CDC), 84% of pregnancy-related deaths are proven to be preventable, which shows an evidentiary malfeasance for birthing people within the healthcare system.
The most frequent underlying causes of pregnancy-related death are mental health conditions (22.7%), hemorrhage (13.7%), cardiac and coronary conditions (12.8%), infection (9.2%), thrombotic embolism (8.7%), and cardiomyopathy (8.5%).
Historically and structurally, Black Americans experience multifaceted barriers in medicine, including reduced access to healthcare, implicit bias within the medical community, a lack of Black doctors, and discrimination at the intersection of race, gender, age, and class. Black pregnancies are resulting in higher rates of death because Black patients are not being listened to, and are not receiving equal care, which is why self-advocacy remains crucial.
What Should You Look For When Choosing an OB-/GYN?
Nicole Sparks, MD, an Atlanta based OB/GYN and Review Board member for Verywell Family, offers some helpful ways to find the right doctor for your pregnancy.
“Take your time and choose the right provider, whether it’s a midwife or a physician,” says Dr. Sparks. “Choose someone who listens to you and will advocate for you.”
It is important to remember that your OB/GYN is supposed to be on your team, and you should feel inherently supported and heard by them. Dr. Sparks tells her patients to research a doctor the same way they would when looking for a hotel or restaurant. “Read reviews,” she suggests. “Do you have friends who recommend this doctor? You want an OB/GYN who will listen to you and take your concerns seriously. If a provider is dismissive of your concerns, it’s time to find a new one.”
If possible, consider bringing a support person with you to your doctor appointments and to your birthing center or hospital when you’re in labor. This can be a partner, relative, or trusted friend. “Sometimes, you may get overwhelmed with the amount of information that is thrown at you and it can be helpful to have someone else present who can remind you of important things that were said,” Dr. Sparks says. Make sure that both your health care team and the people in your life are supportive and listen to your feelings and concerns.
How to Advocate for Yourself Throughout Your Pregnancy
Zora Neale Hurston once said, “If you are silent about your pain, they will kill you and say you enjoyed it.” Even if it feels challenging to speak up in the moment, it’s imperative to advocate for yourself and your family, as pregnancy and childbirth can truly be life-or-death situations.
With that, Dr. Sparks has compiled a list of ways Black birthing people can advocate for a safe and smooth experience throughout pregnancy, childbirth, and beyond.
- Ask questions. Medicine should not be a patriarchal system. Your health is a partnership. Inquire about all of your options when it comes to treatment and care.
- If something doesn’t seem right, say something. That nagging headache that won’t go away, the bleeding that is heavier than you are comfortable with—don’t dismiss any of it as “normal.” Those first few weeks after delivery can be the most dangerous for pregnant patients, so bring up your concerns to your provider right away.
- Get a second opinion. I tell patients that I never get offended when they ask for one. You can get a second opinion if you’re curious about alternative options, or if you simply want to know if another doctor is on the same page as yours. Get the information and clarification you need before proceeding with any procedure or care.
- Maintain a good support system. This is crucial after delivery as well, that way you have a team in place who can advocate for you if something seems wrong.
- Know the warning signs. This includes during pregnancy and after childbirth. You’ll want to contact your OB/GYN or healthcare provider if you experience a headache that won’t go away, difficulty breathing, heavy bleeding, and/or severe swelling, and in a medical emergency, do not hesitate to call 911.
How to Combat the Racial Disparities for Black Parents
Awareness and accountability are key in dismantling the racism Black birthing people face. It is important to speak up, both individually and as a community, so that maternal and infant fatalities don’t continue to happen.
Ask questions. Medicine should not be a patriarchal system. Your health is a partnership. Inquire about all of your options when it comes to treatment and care.
If something doesn’t seem right, say something. That nagging headache that won’t go away, the bleeding that is heavier than you are comfortable with—don’t dismiss any of it as “normal.” Those first few weeks after delivery can be the most dangerous for pregnant patients, so bring up your concerns to your provider right away.
Get a second opinion. I tell patients that I never get offended when they ask for one. You can get a second opinion if you’re curious about alternative options, or if you simply want to know if another doctor is on the same page as yours. Get the information and clarification you need before proceeding with any procedure or care.
Maintain a good support system. This is crucial after delivery as well, that way you have a team in place who can advocate for you if something seems wrong.
Know the warning signs. This includes during pregnancy and after childbirth. You’ll want to contact your OB/GYN or healthcare provider if you experience a headache that won’t go away, difficulty breathing, heavy bleeding, and/or severe swelling, and in a medical emergency, do not hesitate to call 911.
Being vocal protects you throughout your pregnancy and beyond. Approximately 31% of pregnancy-related deaths occur during pregnancy, 36% occur during labor or within the first week postpartum, and 33% occur one week to one year postpartum. All of this is why access to health care after giving birth is extremely important.
There are many national and community-based programs dedicated to reducing maternal deaths in the U.S., including the CDC’s Hear Her Campaign, Saving Mother Giving Life Initiative (SMGL), and Black Mamas Matter. All birthing people deserve to have healthy pregnancies without feeling unseen by their providers. And with the innate stress of pregnancy, people shouldn’t fear that they will experience racism or bias that can lead to physical or emotional harm.
A Word From Verywell
It is undeniable that Black birthing people face disparities that lead to a disproportionate maternal mortality rate in the United States. And while there are groups and organizations working to dismantle the systemic racial bias that contributes to these preventable deaths, knowing how to advocate for yourself is the best way to keep you and your baby safe. Your voice matters. Never remain silent if you have concerns during or after your pregnancy, and if you feel like you aren’t being heard, find a provider that will listen. The most important thing is to advocate for yourself and ensure that your support team is working to provide the safest and healthiest environment for you and your baby.
