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Being a Black woman and giving birth. What to know?

Being a Black woman and giving birth. What to know?

When Serena Williams shared her birth story in a 2017 interview with Vogue, it seemed like confirmation to the growing body of research on the disparities that plague Black women. In the cover story Serena recounts having to insist on critical life-saving treatment just a day after giving birth. Due to her history of blood clots, she had asked the nurse and her medical team for a CT scan and blood thinner, which was not immediately granted to her, however, they relented after she insisted.

Sadly, systemic and societal racism which transcends socioeconomic factors is expressed in prevalent racial bias in the health care system — this manifests in dismissal of legitimate concerns and symptoms even in black women with most advantages. Essence magazine reported that doctors may overlook red flags in educated, middle-class or affluent Black women since they classify them as low risk. This is not to say that concerns from poor Black women are acted upon. It may be worse for them. Disparities encountered by Black women mean that they are 243 percent — or three to four times likely to die of childbirth than White women according to the Centers for Disease Control and Prevention (CDC).

Pregnancy-related deaths occur even up to a year postpartum with a prevalence of 33 percent, and at 36 percent at delivery or in the week after. But there is great news, 60 percent of those deaths are preventable. Here is what you need to know during labor, delivery and the post-partum period. 

Trust your intuition and speak up if something seems off

At the point of your delivery, you might want to have established some rapport with your delivery attendant. Hopefully, you had shopped around for the best fit of a healthcare facility and interviewed potential providers, and have already chosen the practice suited to your needs — cesarean birth, normal birth, maybe you don’t want an episiotomy (surgical cut to the perineum that can be used to get the baby out). Ensure you discuss all your options and preferences with your birth attendant prior to the delivery. This will perhaps ease some of the pressure or anxiety knowing that your attendant is aware of your needs. 

As with Serena, you too know your body maybe even better than anyone else. Tell your birth attendant when you feel like something is wrong. You might need to repeat it more than once. One of the best ways to get their attention would be to try holding their hand, ask them to look directly at you and tell them what your concerns are. Try and be calm, when they seem not to be listening. Doctors so often have very heavy schedules, hence they tend to stick to the conventional and sometimes operate in default. That’s why it is important to have established a relationship with your attendant prior for them to understand how you communicate. If you have a support person, this could be your doula, partner or family member, ask them prior to act as your advocate during the birthing process. 

Seek community support

You’ve had a safe delivery, baby/babies is/are healthy and doing great, you still need to be cautious though. Your body is still healing itself, you may be perturbed by the kind of mental and emotional toil a new baby/babies brings on. Don’t despair. This is the time to lean on the community around you, be they family, friends, church folk, neighbors, let them know they are welcome to help. In the African culture, the child belongs to the community and is nurtured by the community, which cultivates a healthy experience for the mother and child.

In the Vogue interview, Serena’s mum, Oracene Price is said to have moved to Florida to help out. Serena also acknowledges the support she received from her colleagues. It is really important at this time to be vocal about how you want to be cared for by your support group. In addition, you still need to voice out any concerns. Your support team can help you call your doctor and/or have you go in for an evaluation. Also consider joining support groups within your area and link up with people who can understand the process.

Visit a health facility for your postpartum checkups 

The weeks following birth are critical for you and your infant, setting precedence for long-term health and well-being, since a lot of maternal deaths happen in the postpartum period. Hence, postpartum care should be an ongoing process, rather than a single encounter. The first meeting with your gynecologists or other obstetric care providers should be within the first 3 weeks postpartum. It is recommended that this initial assessment be followed up with ongoing care as needed, leading to a comprehensive postpartum visit no later than 12 weeks after birth.

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Ensure that the comprehensive postpartum visit includes a full assessment of physical, social, and psychological well-being: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance.

By no means are these tips exhaustive, but they act as a means of introducing you to what you need to know if Black and giving birth. I hope your journey will be a safe and fulfilling one.

Trust your intuition and speak up if something seems off

At the point of your delivery, you might want to have established some rapport with your delivery attendant. Hopefully, you had shopped around for the best fit of a health care facility and interviewed potential providers, and have already chosen the practice suited to your needs — cesarean birth, normal birth, maybe you don’t want an episiotomy (surgical cut to the perineum that can be used to get the baby out). Ensure you discuss all your options and preferences with your birth attendant prior to the delivery. This will perhaps ease some of the pressure or anxiety knowing that your attendant is aware of your needs.  As with Serena, you too know your body maybe even better than anyone else. Tell your birth attendant when you feel like something is wrong. You might need to repeat it more than once. One of the best ways to get their attention would be to try hold their hand, ask them to look directly at you and tell them what your concerns are. Try and be calm, when they seem not to be listening. Doctors so often have very heavy schedules, hence they tend to stick to the conventional and sometimes operate in default. That’s why it is important to have established a relationship with your attendant prior for them to understand how you communicate. If you have a support person, this could be your doula, partner or family member ask them prior to act as your advocate during the birthing process.

Seek community support

You’ve had a safe delivery, baby/babies is/are healthy and doing great, you still need to be cautious though. Your body is still healing itself, you may be perturbed by the kind of mental and emotional toil a new baby/babies brings on. Don’t despair. This is the time to lean on the community around you, be they family, friends, church folk, neighbors, let them know they are welcome to help. In the African culture, the child belongs to the community and is nurtured by the community, which cultivates a health experience for the mother and child. In the Vogue interview, Serena’s mum, Oracene Price is said to have moved to Florida to help out. Serena also acknowledges the support she received from her colleagues. It is really important at this time to be vocal about how you want to be cared for by your support group. In addition, you still need to voice out any concerns. Your support team can help you call your doctor and/or have you go in for an evaluation. Also consider joining support groups within your area and link up with people who can understand the process.

Visit a health facility for your postpartum checkups 

The weeks following birth are critical for you and your infant, setting precedence for long-term health and well-being, since a lot of maternal deaths happen in the postpartum period. Hence, postpartum care should be an ongoing process, rather than a single encounter. The first meeting with your gynecologists or other obstetric care providers should be within the first 3 weeks postpartum. It is recommended that this initial assessment be followed up with ongoing care as needed, leading to a comprehensive postpartum visit no later than 12 weeks after birth. Ensure that the comprehensive postpartum visit includes a full assessment of physical, social, and psychological well-being: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance. By no means are these tips exhaustive, but they act as a means of introducing you to what you need to know if Black and giving birth. I hope your journey will be a safe and fulfilling one.

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