Black Mothers Matter

April 15, usually known as tax day, launches a new awareness this year of 2018: the first Black Maternal Health Week. To have a week dedicated to explore black mothers’ health means that their health has historically been ignored, which is nothing “new” in America. To have a week dedicated to explore this topic means that the data exists for us to figure out how we can help improve black mothers’ health before pregnancy, during pregnancy and in the postpartum period. One week out of the year may be just enough to get the dialogue going and is definitely not enough to establish corrective measures to address the systemic issues that confront expectant black mothers, namely societal racism that affects black mothers and their babies. In the spirit of Black Maternal Health Week, let us explore some of the health disparities that exist for black mothers in America today.

According to a recent New York Times article, the United States has collected data on infant mortality since 1850, when many families often restrained themselves from naming their children before their first birthdays in case these children did not live that long. At that time, the black infant mortality rate was 340 per 1000; the white infant mortality rate was 217 per 1000. That is about a 3:2 ratio; for every 3 black infant deaths, there were 2 white infant deaths. These days, despite advances in medicine that reduced the number of babies dying per year, the ratio has become more drastic: 11.3 per 1000 black babies die every year, compared to 4.9 per 1000 white babies dying. In essence, black babies are more than twice as likely to die as their white counterparts. Black mothers, even with advanced degrees and higher pay, still experience higher infant mortality rates than their poorer and less educated white counterparts.

Research and anecdotal reports examining the prenatal and postpartum treatment of African American mothers point to these factors that impact their health:

  • Societal and systemic racism produce physiological stress hormones that result in high risk pregnancies, which include hypertension and pre-eclampsia
  • Prejudice and preconceived notions about black mothers (e.g., nerve endings being tougher and their blood more able to coagulate) can lead to disregarded concerns, dismissed symptoms, and deaths or near-deaths of mother and/or baby
  • Childbirth education, birth doula and postpartum doula services, and lactation support provided by racially diverse professional companions that reflect the experience of these black mothers significantly reduce the death rates of mother and baby

Of the three factors listed above, the most significant one is the support given from one black mother to another to help turn the tide of black infant mortality. Nothing replaces the lived wisdom and experience of being black and female in America. Who else but our sisters can we turn to when no one takes our concerns seriously? Who else but our mothers can we turn to with lady problems we have not experienced before? Who else but our daughters-to-be can we dream for and strive for?

Black mothers deserve to be seen and heard. They deserve to be treated with honor and respect. They deserve a compassionate ear, an understanding heart, an expansive space to let go of the stress and sink into their own inner knowing that every mother instinctually possesses. Black mothers deserve to feel safe, happy, and hopeful for the future--our collective future. Black Mothers Matter.

Contributing author Gloria Ng is a homebirth mom of three who edited and anthologized works in New Moms, New Families: Priceless Gifts of Wisdom and Practical Advice from Mama Experts for the Fourth Trimester and First Year Postpartum. If not squeezing words into haiku these days, she can be found scratching her head piecing together "transferrable skills" to step into new industries. Follow her adventures here.

Informed Decision Making

Are you pregnant?  Chances are your OB or Midwife will have forms for you to fill out and papers to sign.  Imagine you are in labor, arriving at your hospital triage and you still have papers to sign, even if you preregistered!  What are you putting your name on?  What are you agreeing to?  Did anyone go over this with you in a way you can actually understand? 

It is the responsibility of our care providers to afford their patients what is call Informed Consent. In the medical field, Doctors, Midwives, Nurses and Nurse Practitioners, and various Clinicians are familiar with Informed Consent and can be held accountable to include this in their practices.

In pregnancy, we mothers are most open and sensitive to receiving information.  Even the usage of the term Informed Consent implies that we will *agree* to move forward with whatever proposed measure that may be mentioned by our trusted care provider.  Some may not necessarily be so trusting and would rather approach this process with the mindset of Informed Refusal.  Both are valid, and to be neutral, nonjudgmental and unbiased, this Doula prefers the term Informed Decision Making.  

When navigating our way through choices regarding our health, it helps to gather our thoughts in an organized way so that we clearly understand our priorities.  As your Doula, I use a simple acronym to guide this thought process.  BRAIN

Benefits: what are the benefits of any proposed measure or intervention?

Risks: tell me the drawbacks and potential risks also.

Alternatives: what other options do we have in this situation?

Intuition: given the above information, my gut is telling me...

Need more time? or do Nothing: take your time!  it may not be necessary to decide now.

We are definitely conditioned to sign consent forms and liability waivers when interacting with care providers, and we often do this without question... but inquiring minds want to know what exactly is expected of us when we put our signature on those papers, and how we and our babies may be affected by our decisions.  Using our BRAIN gives us power in this decision making.  And it's no inconvenience to engage with your OB or Midwife in this way.  By exercising Informed Decision Making, you're taking control of your choices and building a trusting relationship with your birth team.  Tell me more!  NO guessing, NO assumptions, YES please and NO thank you.  It's YOUR birth & YOUR baby, the power is YOURS. 

Wax and gold

I recall when I was first welcomed to the tribe of motherhood.  

I was quite young, by today's standards.  And it was such a delight when another mother reached out to me while I was expecting, giving me the wisdom I didn't yet understand, but somehow already knew deep in my bones.  It was the excitement of a lifelong journey, with hints of what's to come that would resonate without ceasing, still.  It's funny, I repeat the very words that were spoken to me, time and time again, when I encounter expecting parents.  Naturally, my curiosity compels me to pick the brain of a woman holding her future legacy in her womb.  I cannot help but incite that intuition which will be her driving force throughout her stewardship of this precious gift.  When I see this path unfold, I am encouraged that the next generation will be able to access the wisdom of their ancestors, receive the strength of their roots, grow with nourishment from their present community support and take the best of these to guide them in their journey.  

Throughout the history of humankind, women have provided support to one another in times of transition, initiation into adulthood, childbearing, motherhood, childrearing and companionship.  Over the past century, the culture surrounding childbirth has changed drastically, to the point where we will most likely enter childbirth without ever having been in the company of a birthing woman, neither as an observer nor support person.  I've often compared it to being placed at the wheel of a vehicle without being informed of the functions of machinery, without ever seeing another person drive, yet we must navigate ourselves to the optimal destination.  Here's the flaw with that comparison: Our bodies and babies know exactly what needs to happen and will do the work involuntarily in almost every instance.  Our ignorance to the happenings surrounding childbirth may be completely irrelevant, if our minds did not have so much power.  There is great hope in that the role of the timeless support person has resurfaced in a professional way, the Doula.

The presence of a trained professional childbirth support person is invaluable to the birthing mother at various levels.  When I begin a relationship with clients, I am heavily invested in the goals of this particular family.  Birth is not one-size-fits-all, and we all come into it with our unique backgrounds, expectations and preferences.  It is my delight to get to know a family during this time.  What an honor to accompany any individual(s) in these precious months, so short, yet powerful in the making of new family bonds.  I think about the family non-stop for weeks, soaking up the relationship the mother has with her primary support person (often a partner), gaining a deep understanding of her priorities for this particular situation, providing relevant and fact-based information, facilitating time-tested comfort measures according to the needs of her body and baby, and affirming the choices of parents as they do what is best for their growing families.  This is the formula for building a foundation to parent with confidence, as it is the most challenging and fulfilling experience an individual may undergo in their lifetime. 

With gratitude and reverence, I am humbled by the many families who have invited me into their intimate space.  It is awe inspiring to see the intuitive decisiveness with which women trust their bodies, accepting every turn on their path with grace, and embracing their new responsibilities in a most gentle way, knowing this gift was meant for them.