Motherly Collective

For every 100,000 live births by Black women in the U.S., there are 69.9 deaths—a rate nearly three times higher than the mortality rate in childbirth for white women. In 21st century America, this should not be our reality. But the statistics don’t lie.   

The numbers became personal for me when my former nursing student—and her baby—died in childbirth. People are often quick to stereotype the women that meet this fate, seeing them as uneducated, financially unstable or holding myriad other cruel biases. My student debunked all these myths. She was a highly intelligent, middle-class individual educated about her own health, and studying to become a nurse. And still, both she and her baby died. 

It is unacceptable that a healthy, young Black woman would die in childbirth in the U.S. today. But it happens every day—and it doesn’t have to. More than 80% of US fatalities due to pregnancy could have been prevented. 

While the statistics paint a bleak picture themselves, it’s these personal encounters with the grim reality of US healthcare, especially for Black women, that sound the alarm. Losing my former student drove my need to advocate for something better—so I turned to my research. 

Through my qualitative study, which I began in 2019, I wanted to uncover how Black women feel about their pregnancy and birthing process in the U.S. healthcare system. One of the main themes I identified from my conversations was fear—these women had not even given birth yet, and they were still so afraid to do so. Terrified of not only the birthing process, but also of what would come after—particularly for Black women expecting a son. They feared they would not be able to protect them from a world that is rarely kind to Black males. Such strong anxiety during pregnancy is dangerous both from a mental and physical health perspective. 

Another theme I noticed was that these women did not feel heard. They expressed the frustration that accompanies the feeling of someone not listening to you, but also the grief that follows an experience of being ignored. These emotions are not ones anyone should ever feel from their healthcare provider—someone whose sole job is to ensure their health, safety and well-being. And most tragic of all is the fact that if these women had doctors who truly listened to their concerns, rather than viewing themselves as the know-all experts, many deaths may not even occur. 

So how can Black women protect themselves—and their babies—while going through their pregnancy? 

Some strategies I recommend include talking with your doctor openly about your concerns. Patients can ask their physicians directly if they are aware of the Black maternal mortality crisis in the U.S., and what that might mean for their care. And if something feels off, tell your provider, and keep a record of it. 

But while I can’t stress enough the importance of advocating for ourselves as Black women in the US healthcare system, especially when going through a pregnancy, this burden should not fall on expectant mothers. 

It is the duty of all healthcare providers to become cognizant of their own implicit biases and take the necessary steps to educate themselves. 

Unconscious biases in healthcare include marginalization, racial discrimination, and financial barriers like not being insured or not having provider’s preferred insurance. Healthcare providers need to understand their biases and how they influence patient interactions. 

All healthcare providers are also responsible for knowing their patients and their individual needs, as well as listening to them when they raise any concerns, rather than writing them off as nothing or not a major issue. This should be obvious and should not have to be said—and yet, we cannot be silent when Black mothers are dying. 

Through my research, I hope to continue the conversations about Black maternal mortality in the US. And while discussion is good, it means nothing without action. We need to work on policy, increasing funding for community health clinics in underserved areas, ensuring all healthcare providers undergo cultural competency and anti-bias training and addressing contributing systemic factors like food deserts. 

I have faith in the next generation of healthcare providers to be the doctors and nurses we all deserve. I see this in my own Walden University students, studying so they can become providers who truly care for their patients and listen to their concerns. We have a long way to go, but with care and action—including healthcare providers doing their part to raise awareness—there is hope in seeing real change.

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