Change the Narrative

You CAN change the Narrative

The data is heartbreakingly clear: Black women in America have more than a three times higher risk of death related to pregnancy and childbirth than their white peers. This is regardless of factors like higher education and financial means, and for women over 30, the risk is as much as five times higher.

While the recent national dialogue created in response to the data has been a critical leap forward, it has also brought up a lot of fear and questions from Black women about how we can prevent these outcomes.

Step 1: Acknowledge Race and Racism In The Room

If you feel comfortable, you can share your fears through the lens of statistics about race and its impact on maternal care with your care provider. The following sample language could help: “I recently read that Black women like me have a much higher chance of death related to pregnancy and childbirth than white women. That’s really scary. What do you think about these statistics, and how we can work together to prevent that from happening?”

Step 2: Create a Care Plan Anticipating That Racism May Impact Pregnancy

Do whatever you need to do to feel safe and supported. For appointments, bringing a support person or hiring a birth doula to accompany you can bring a sense of community to the experience, and provide you with someone knowledgeable to reflect with afterward.

Mental health support through connecting with a therapist or faith leader, as well as physical support through acupuncture, massage or regular low-impact exercise like walking and yoga, can also help to alleviate daily stress.

Have your blood pressure regularly monitored before, during and after pregnancy. The first few weeks following delivery are particularly important as up to 65 percent of maternal deaths from high blood pressure, including pre-eclampsia, occur 10-426 days postpartum. The following sample language could help: “I know that Black women like me are more likely to have problems related to blood pressure in pregnancy. How are we going to monitor my blood pressure so that I am safe?”

Be aware of the symptoms of heart and blood pressure problems in pregnancy. Report to your provider if you experience any of the following: severe headache, vision changes, shortness of breath, asthma not responsive to your usual medications, more difficulty breathing when you lay down flat, heart palpitations, chest pain or increased swelling, particularly in the hands, face and feet. These symptoms could also be signs of pre-eclampsia, which affects up to 15 percent of pregnancies worldwide. When Black women have pre-eclampsia, it often presents earlier and is more likely to be more severe than with white women.

Step 3: Identify How Racism May Impact Labor

Take a birthing class to learn about the basics of labor and delivery, and what options are available to you.

Talk to your doctor about why she would advise you to have a cesarean birth and how it would be performed. The following sample language could help: “I am concerned about data showing that Black women like me have higher rates of cesarean delivery. What is your cesarean delivery rate, and why would you advise me to have one?”

Create a birth preferences document, and work with your support team to help you decide what options might be best for you.