We have begun to discuss the horrifying state of affairs regarding Black maternal health in the United States as a wider group. From higher rates of death to undiagnosed but preventable complications, there are many fatal and dangerous issues that are disproportionately impacting the lives of Black birthing people. The problem is impacting the lives of poor and wealthy Black birthing people alike, as we’ve learned from the recent traumatic birth stories of Beyoncé and Serena Williams. All across the country, Black birthing people have shared their testimonies complete with the fears, frustrations, worries, pain, and struggles, but it’s crucial that as we sift through our trauma we also offer solutions and plans for navigating this stark reality.
The recent launch of the U.S. Black Maternal Health Caucus is a welcome development, though it will take time for things to change at the structural and institutional levels. So what can be done now to positively impact our lives as Black, birthing people who deserve better birth outcomes? What can be done to address the maternal mortality rate for Black people, which is three times that of white women, per CDC data? What can be done to address the disparities in mortality and morbidity of Black infants admitted to NICUs over their white counterparts?
“The United States is a country where the healthcare system is killing Black bodies during laboring/birth and in their postpartum period,” says Luar Adonis Wolf, a certified breastfeeding consultant and trained birth and postpartum doula. And this “symptom of medical racism” needs to be met with advocacy, awareness, and education.
I was struggling to find a birth partner with my nonexistent income.
Luar became a doula following their involvement in reproductive justice work and working in reproductive healthcare and wanted to respond to the system’s need for change. The system, they say, needs to “be dismantled to better serve and take care of pregnant people no matter their outcome of the pregnancy.” They go on to explain that doulas “uphold the pregnant/birthing person’s self autonomy and agency over their own bodies, reminding them there are options and that they have rights and help them feel empowered.”
“I will always credit my doula, Whitney McWilliams” for a positive birth experience, says Shaira, an Afro-Latinx mother, artist, and activist living in the Bronx. McWilliams runs Want to Be Well, a childbirth collective. “I was struggling to find a birth partner with my nonexistent income,” says Shaira, “from the weeks leading to my birth and the birth itself, [McWilliams] kept me grounded, listened to my fears and anxieties, and was my advocate on so many levels.” Her experience fits with the existing research. “Doula-assisted mothers were four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding,” concluded a 2013 study published in the Journal of Perinatal Education.
Shaira adds that another way to support Black pregnant and birthing people is to “check in and not just when we admit we're having a hard time, but do it often and intentionally. Come over with food, volunteer to help us clean, hell, take us out for dinner or brunch. Don't forget we're still the same people you know, regardless of this major life change... and postnatal hormonal shifts.”
Another mom, Kris, comments that her “village” was made up of family, friends, and her doula who came “equipped with food, laughs, and shoulders to lean on when it was too heavy to carry alone.” When her dad helped her realize she needed help for postpartum depression — Black women have a higher risk of experiencing a perinatal mood or anxiety disorder (affecting as many as 44 percent of Black women per the Icahn School of Medicine at Mount Sinai), but are less likely to seek help for those conditions — she talks about how he would come over to spend time with her daughter so that she could get some extra sleep. “More people need to be open and honest about this, we need to talk about the experiences and maternal welfare of families of color,” Kris says.
After a traumatic birth, I myself was thankful to have helpful friends who would text or call to ask if I needed anything.
In addition to being a mother, Kris is a certified parent coach and birth & postpartum doula who, after “bearing witness to firsthand abuse from medical professionals to laboring and new mothers,” enjoys “giving the gift of ‘let me make you dinner, hold your baby while you poop and shower without fear’ to new moms.”
Like Kris and Shaira, I can also attest to the importance of help from visitors willing to show up and help. Whether it’s bringing meals, offering to clean, watching the baby while I take a shower, or just sporadically checking in to offer assistance, it means a lot to feel supported in some way. After a traumatic birth, I myself was thankful to have helpful friends who would text or call to ask if I needed anything, in addition to a caring doula who held space for me.
Be that as it may, it is important to keep in mind that these issues plaguing our community are systemic and historical in nature. A 1992 paper in Ethnicity & Disease posited that the deterioration in infant health outcomes as the age of a Black mother increases could be explained by the concept of weathering: “namely, that the health of African-American women may begin to deteriorate in early adulthood as a physical consequence of cumulative socioeconomic disadvantage” wrote researcher A.T. Geronimus at the time. We cannot erase our collective history, and not everyone has the privilege of access to a ready-to-help village or family who can come over with meals. And certainly we cannot wait for governmental solutions.
On a community level, you can support Black birth organizations dedicated to advocacy for reproductive and birth justice, as Kris urges. Organizations like SeSe Doula Services, Ancient Song Doula Services, Sista Midwife Productions, Birth Nerd Doula Services, and resources like Black Mamas Matter can offer options for new and soon-to-be parents. States have different regional non-profits committed to bridging the gaps between parents and culturally competent care. Pushing your local representative to support these initiatives is crucial to expand the reach of these services. Luar recommends that parents seek the help of organizations like The Doula Project, Carriage House Birth, Get Boober, La Leche League, and the regional LLL Chocolate Milk Cafe in NYC.
And remember, though these issues are systemic, much of the progress has been made by individuals. Shaira laments that she wished capitalism didn't “make new parents feel like they needed to choose between their children and their careers.” She explains that state programs often treat low-income parents like they’re less than. To add insult to injury, Shaira continues, “Black scholars and organizers have dedicated their lives to exposing the abuses and disparities Black mothers face in treatment from the U.S. healthcare system” and government officials often take credit for that work.
“Black Maternal Health Week is intended to be a week of awareness, activism, and community building,” says Kris, emphasizing the importance of listening to Black, birthing people and birthworkers who know the reality of these issues firsthand.
“As a doula,” remarks Kris, “I’ve come to realize support means something different for everyone. While one person may need more hugs and warm baths, some may need more advocacy and healing. I challenge families to intentionally listen to birthing people — give them space to speak their truths, ask questions, grieve, and celebrate.” She says we need to shift the narrative, culture, and research to even more diverse and inclusive standards with respect to reproductive justice and care for pregnant and birthing people.
Black scholars and organizers have dedicated their lives to exposing the abuses and disparities Black mothers face in treatment from the U.S. healthcare system.
There are many recent examples of initiatives that governments can implement to increase access to help for Black moms. From efforts to make sure more that moms have doulas if they want them to updating standards of care for pregnant people in hospitals, there are changes being made that can help improve birth outcomes. It will take more than that to improve the quality of life for Black moms, though, when it comes to a holistic approach to health and wellness.
Kris suggests that people gift doula services to their friends, family, and community members, because doulas “fill in the spaces for support; they’re empathetic listeners with the right advocacy tools and language that other birth partners may not have.”
“This is a great week,” Luar says, “to give a spotlight for those who are at the forefront, doing the work of tackling Black Maternal Health issues.” It’s also the perfect time to reflect on ways we can offer help to the Black birthing people in our lives.
Black people of all genders are experiencing pregnancy, birth, and postpartum transformations and are disproportionately impacted by often fatal complications. Whether it’s bringing meals and laughs, offering a shoulder to cry on, gifting a doula, or reaching out to ask exactly what we need, it’s important to be an active part of the solution. Especially given the time it will take for change to come to the structural and institutional levels. As bell hooks said, “love is an action, never simply a feeling.”
If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.