When I found out I was pregnant with our second child, excitement quickly turned to fear. It had been nearly six years since the birth of our first child – but after a tumultuous pregnancy and aftermath, I was sure I wanted a completely different experience this time around.
First of all, I wanted to be fully supported and heard. During my first pregnancy, I went from an OB-GYN to a rotating team of midwives at the hospital in the third trimester. Both my husband and I were unexpectedly laid off and lost our health insurance. I never really had the opportunity to interact with my doctors on a personal level, and I felt like nothing more than a number.
This time, I wanted a vaginal home birth after a cesarean (HBAC). I longed for a learning environment where my young daughter could also share in the experience. In a hospital, I would be limited in the number of people I could have in the delivery room – and since I would not have additional childcare, giving birth at home was the best option for me.
One of my biggest desires was to have an experience free of microaggressions. During my first pregnancy, I struggled with an unhealthy and unnecessary fatphobia. When I wondered why I was suffering from hyperemesis gravidarum, severe vomiting, and nausea during pregnancy, I will never forget being falsely accused of “drinking too much soda and eating donuts.” According to my doctor, the reason I was vomiting excessively every day was simply because I was fat.
What I wanted most was a birth team that fully understood the seriousness of the Black maternal health crisis in America; people who would advocate vigorously for me and my family, and who would make physical autonomy and flexibility a top priority in our birth plan.
According to the Centers for Disease Control, Black mothers are three times more likely to die from pregnancy-related causes than white women. There are numerous factors that contribute to these disparities in obstetric care, including access to quality health care, unrecognized or misdiagnosed underlying conditions, racism, and implicit bias.
After several weeks of research, I was finally connected with a midwife who was willing to take me on as a patient. She drove nearly an hour in the rain to our home to perform a physical exam and pre-natal interview, where I talked at length about my previous pregnancies and birth. There were difficult parts of this conversation, but her strong maternal presence and deep caring comforted me as she wiped tears from my eyes. As a 60-year-old former nurse who had four children and six grandchildren—whom she had helped deliver—she was able to empathize with me because she had heard my story so many times.
At each subsequent appointment, I felt heard. I was not rushed. Sometimes a session with my midwife (and her trainee) lasted several hours. My doula, my husband and my 6-year-old child were also welcomed with open arms at all of my appointments.
Without making any assumptions, our midwife recommended a low-cost nutritionist nearby to help with development and helped us with suggestions to help ease the symptoms I had experienced in my previous pregnancy.
Most of the time, the birth team led the birth and I followed along. However, one piece of advice that I kept ignoring came back to haunt me after the birth. “Are you wearing your compression stockings?” I was asked at every appointment. They were expensive and uncomfortable, but in hindsight I should have listened to them.
On the morning of labor and delivery, my doula came with a team: a doula trainee, a birth photographer, and a therapist. I had never heard of anyone having a birth therapist, but I understood the trauma I was going through with My During my first birth, my doula intuitively provided the necessary psychological support.
They took turns holding my hands during labor. They sang to me. They made a playlist of my favorite songs. They recited affirmations with me. “I am strong. I am amazing. I am capable.” They decorated my spartan bedroom with family photos and artwork. They brought coloring books and activities for my six-year-old. They helped me in and out of the tub. They made meals for me and my family and went shopping for things we had forgotten.
In the middle of the contractions, we laughed loudly and heartily. As a hyper-independent guy who carries the whole world on his shoulders, this treatment was not something I was used to. But it felt so good. It felt so natural. This feeling? It’s a birthright that everyone a person giving birth deserves.
While labor and delivery went smoothly, two weeks after birth, serious complications arose. When we returned to our normal routine, my doula and midwife continued to check in with me and make surprise visits. But I secretly had severe leg pain. At first, I didn’t tell anyone, not even my husband. Since I was suffering from postpartum depression, I didn’t want to be a burden and was afraid of being separated from my newborn. In the middle of the night, I sent my doula and midwife pictures of my swollen leg. Within minutes, both of them, along with my husband, were urging me to go to the emergency room.
In the emergency room, the gynecologist on call, who was also a black woman, held my hand as she told me that my leg pain was actually a blood clot and that I had suffered a mild stroke. As they took me back to the operating room for an emergency thrombectomy, I remember her praying for me with a group of nurses as I was being prepped for surgery. She didn’t have to, but she called my husband and birth team from her personal cell phone, asking for the help I needed and keeping them updated on what was happening at the hospital.
“I know you’re scared, but you did the right thing by coming here. We will take care of you,” she said.
It is not always guaranteed, but Research shows that short- and long-term racial congruence can have positive health effects. The significance of an all-black birth team did not dawn on me until long after the surgery.
I often think back to that day and the weeks and months of recovery that followed. I think about how the women in my family rarely talk about childbirth and how I inadvertently gave my daughter the opportunity to experience what real community care and support for women in labor looks like. And finally, I think a lot about the team that carried me through one of the most beautiful and dangerous moments of my life. It could have turned out differently, but it didn’t. And I’m truly grateful.
