Patient-centered contraceptive care is at the core of our work. That means recognizing that every patient has different goals and desires related to contraception and pregnancy. And it means that every patient deserves access to their preferred contraceptive method – one critical step towards improving maternal health. This is particularly important for Black women in the United States who are more likely to experience complications – and even death – as a result of pregnancy or childbirth than white women.
Held annually April 11-17, Black Maternal Health Week (BMHW) is a week-long campaign founded and led by the Black Mamas Matter Alliance to raise awareness, activism, and community-building to amplify the voices, perspectives and lived experiences of Black Mamas and birthing people. For our part, Upstream intends to elevate stories on our blog such as Nicole’s article from 2021 and Ellen’s in 2022.
Along with organizations, tools and resources to support Black maternal health, this year we are sharing Danielle’s story, which like many other stories, touch on components of this year’s BMHW theme, Our Bodies Belong to Us: Restoring Black Autonomy and Joy!, and underscores the need to support Black women at all stages of their reproductive health.
Danielle’s Birth Story
I’ve always had a deep interest in childbirth, dating back to my teenage years. I knew that when the time came, I wanted to give birth in a way that resembled and honored my family, who’s originally from Guyana, and those who came before me. My plan included a natural birth at a birthing center—no hospital and no excessive medication. People all over the world are having children and yet they don’t contend with the same high maternal mortality rates as the U.S. The only difference that I could tell is that they weren’t going to hospitals as often, so I chose a similar path.
When I found out I was pregnant with my first child in 2019, I began looking for a midwife, doula, and postpartum doula. I was living in Seattle at the time, far away from my family in New York and Texas, and I knew I needed a community to support me during this journey. In addition to those three women, I wanted an elder—my grandmother—and my close friend, who was studying apothecary, at my side during the birth. If it takes a village to raise a child, I wanted to welcome mine into the world with one as well.
It was during one of my last weekly check-ins with my midwives that they noticed my blood pressure was charting higher than it had been during my pregnancy. Since we were close to my due date, they sent me to a hospital for a few tests, just to make sure everything was okay. I wasn’t feeling bad and there were no signs of preeclampsia, but when my blood pressure didn’t go back down, the hospital decided to keep me overnight. That night turned into a week and ultimately I gave birth there.
Every day at the hospital I felt like I was fighting to be heard. My reality was constantly distorted by doctors and nurses who would then use that distortion against me. One of the doctors on rotation insisted on performing vaginal checks, which I told him were unnecessary and caused my blood pressure to rise each time. Instead of acknowledging the correlation, he and the nurses used the spikes to try and pressure me into a c-section. They insisted I take a water pill to flush my system of a painful medication, even when I voiced concerns about the possible swelling that would occur. They dismissed my concerns, and when my feet did in fact swell, they pointed to it as a sign of preeclampsia—yet another reason for a c-section. They only saw what they needed to see and never considered the effects of their actions.
When my labor began, they sent in a nurse I had never met before called “The Pusher,” whose name speaks for itself. Her methods were aggressive. She came in around 1 a.m. on February 15 and I didn’t give birth until 9 p.m. that evening, so I was pushing on and off for hours. And all the while, I was still facing resistance in adhering to my birth plan, which resulted in getting an epidural and giving birth sitting up instead of laying down. Unfortunately my midwife wasn’t there for much of the labor because she had another birth, but my grandmother, doula and friend were there for support.
After the birth, I overheard the doctor talking to one of the nurses about sewing me up. I asked if I needed to press the epidural button as I could feel the stitching—no response. My friend, who is a white woman, repeated the question and he replied that I had teared. How much did I tear, to what degree? Three. Aren’t there four degrees? Yes. This was information I had to know to ask for instead of being told. At one point in our conversation, he actually asked my friend, “Is she always like this?”
I left the hospital a few days later and was finally able to start focusing on myself, my healing, and this new life I had brought into the world. My midwife and doulas visited me at home and prioritized my care, creating a safe and comfortable space for me and my child. Luckily, I healed well, both physically and emotionally.
Looking back on my experience, I’m grateful for how I handled things in the moment. But during a time when I should’ve been focused on myself and my baby, I was fighting to be heard. I was in a room full of knowledgeable professionals, but I was not recognized as the expert of my own body. My lifelong interest in childbirth equipped me with the language I needed to advocate for myself, but that isn’t the case for all mothers nor should it have to be.
Links & Resources: Black Maternal Health
Black Mamas Matter Alliance (BMMA)
The BMMA is a Black women-led cross-sectoral alliance that centers Black mamas and birthing people to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice. BMHW was founded in 2021 by BMMA and they continue to lead and build awareness, activism, and community-building to amplify the voices, perspectives and lived experiences of Black Mamas and birthing people.
National Association to Advance Black Birth (NAABB)
The NAABB is working to advocate for Black maternal-infant health through advocacy, research, educational programming, activism and policy change. They work to equip birth workers (doulas, midwives, nurses, and doctors) and maternity institutions with the practical tools and education they need to improve outcomes for Black women and persons.
Equity Before Birth (EBB)
EBB’s mission is to save the lives of Black and Brown birthing people by increasing access to critical services and support. They are pioneering an innovative approach to fill critical gaps and bring pre-existing silos together to wrap individual Black families in support.
Black Maternal Health Resources
Black Birthing Bill of Rights
The Black Birthing Bill of Rights serves as a resource for individuals to become knowledgeable of their rights as a Black person in need of maternal care. It also serves as guidance to engage hospitals, health providers, government health agencies and others to change/improve their ethic, policies, and delivery approach to serving Black women and persons throughout the birthing process.
Antiracist Prenatal & Postnatal Care Preferences Guide
Access this guide as a potential tool to address the impact of racism on you care as a pregnant Black woman/person and these are ways for your care provider to support you and make you feel safe.
NY Times Article: Protecting Your Birth: A Guide For Black Mothers
How racism can impact your pre- and postnatal care — and advice for speaking to your Ob-Gyn about it.
Midwives Alliance of North America
Learn more about Midwifery by reviewing MANA’s core documents and resources. Their essential documents describe the core competencies for basic midwifery practice, as well as the standards, qualifications and ethics necessary to provide high-quality, evidence-based services to women, newborns and childbearing families.
Ask the Midwife
Access this patient information article about midwifery from the Journal of Midwifery & Women’s Health to learn the basics about midwifery.
CDC’s Hear Her Campaign
Many people die each year in this country from problems related to pregnancy or delivery complications. The CDC’s Hear Her campaign supports their efforts to prevent pregnancy-related deaths by sharing potentially life-saving messages about urgent warning signs.
ACOG Immediate Postpartum Contraception (IPPC) FAQ
If you are not using a birth control method, it is possible to get pregnant very soon after having a baby. Using a birth control method in the weeks after you have a baby (the postpartum period) helps you avoid an unintended pregnancy and lets you plan your family. Review this FAQ for more information on IPPC.