Birthing a human, pt. 2: Race & Class

There’s a quiet crisis in American childbirth currently: Black women die in childbirth in disproportionately large numbers. In Texas, Black women make up around 11% of births but over 28% of maternal deaths. Numbers are similar around the nation, and activists and media have recently been drawing attention to these numbers. While the rate of maternal death is still overall extremely low in the United States, rates have been increasing since the 1970s. (read more here & here).

The tone of this blog post seems to be in stark contrast to the tone of my last blog post about birth. I argued in the last blog post that women need to cultivate positive, affirming narratives/images of pregnancy and birth in their lives—that anxiety and fear don’t need to be the primary emotions of childbirth and pregnancy. I stand by that message.

But that perspective is clearly one positioned in race and class privilege. In my last blog post, I wrote “I felt in control” and “my doctor…respected me.” I grew up surrounded by physicians. My mother is a doctor. Many of our closest family friends are doctors. I have aunts that are nurses and physicians. Now, as an adult, my husband is a doctor. I grew up with familiarity of the medical system and a deeply held belief that it was there to help me and to heal me. I know these to be truths. For me.

But the medical field has a history of both malicious maltreatment and neglect towards more marginalized communities, so it is unsurprising that there is such a large racial disparity in childbirth mortality for Black women. There are millions of Black women who have had positive and affirming childbirth experiences both inside and outside of the medical institutions of the US. Of course, many Black women make their own positive and affirming pregnancy and childbirth experiences, and there are medical providers that support them.

But I want to take time to reflect on moments in my hospital stay when my class or race changed how I was treated (of course, it’s hard to just pick discrete moments–many times race and class privilege changes the underlying tone of interactions. Plus, the fact that my privilege got me into one of the fanciest hospitals in the region…):

1. When I mentioned to my labor nurse that my husband was an MD/PhD student, she got so nervous that she had to bring the more experienced nurse on shift to do my I.V.
2. When I was about to get my epidural at 1 a.m., the night nurse told us that my husband would have to stand in front of me so he couldn’t see the procedure, but the anesthesiologist let my husband watch.
3. My OB offered me a mirror to watch the pushing stage and advocated for me so a nurse went to go get one.
4. I’m sure there are dozens more…

My privileged experiences is directly related to someone’s discriminatory/damaging experience. Maternal mortality is obviously the extreme and incredibly rare end of the spectrum. But subtle discrimination can have smaller but nonetheless insidious impacts of women of color.

I want there to be a call to action in this blog post—a tangible thing I could do to promote racial justice in childbirth & pregnancy in some small way. I’m not sure what that is honestly though…Any suggestions, as always, are welcome!