I remember being pregnant for the first time.
I was excited, awe-struck, and slightly in disbelief because my husband and I had tried, but had been unsuccessful over the course of the last year.
When it did sink in, and I finally felt comfortable and excited enough to share it with family, friends, and co-workers, a common spirit of fear hovered over and haunted my preparation process for the natural, home-birth labor I intended to have.
Stories of unplanned c-sections, painful labors, mind-altering drug intake, unauthorized procedures, infant disfigurement, near-death experiences…the list went on and sometimes the stories were the same only the teller was different—but they were all black women. I will be honest, though, I never encountered a white woman so I don’t know what her experience might have sounded like.
What I did know, though, was that as a black woman birthing in the United States, I had generational, cultural, and systematic odds stacked against me. At the time (2015) we lived in Memphis, Tennessee. There were no black homebirth midwives, and there may have been 2 white ones in the entire area. What we did find, was the (then) 1 black student midwife in the entire state of Mississippi. She just so happened to be studying with the Farm Midwives in the Memphis, TN area so we synchronized our schedules to accommodate each other.
In the end, I was able to achieve an all-natural home birth with her assistance, but I labored for 5 days. During a labor preparation session with my doula for my 2nd home birth, my doula encouraged me to reevaluate my thoughts and feelings during my 1st labor.
In doing that, I discovered that while I:
- had a spiritual foundation that established my faith, resilience, and fortitude;
- had undergone nutritional coaching;
- had trained as a Shafia Monroe doula and studied evidence-based books for non-medicated labor and delivery;
- had a trusted care provider who listened to me and assisted me in setting my goals;
- was surrounded by emotional support from my husband and his family;
- had limited use of drugs and interventions during labor…
I was missing one extremely important protective factor for my positive birth experience:
- mental support for traumas I had endured in life even up until the point of labor.
The most present trauma at the time was the replacement of positive support from my own family, with antagonism from them on the heels of accepting my husband’s marriage proposal. As his and my relationship progressed, the antagonism escalated and eventually was, after unsuccessful in its attempts to ruin our relationship, replaced with desertion after our pregnancy announcement; leaving me to navigate the highs and the lows of this first-time experience alone.
My mother lamented at my news of pregnancy, while she, my aunts, and my cousins refused to attend my mother’s blessing that they also refused to help plan. I, fortunately, had one of several cousins offer to plan and execute the celebration. I was grateful, but the silence from everyone else; the nasty comments and snide remarks; and having the women who raised me deprioritize sharing this milestone with me left a nagging feeling that I was doing something wrong. A moment in life that should have been covered in blessings was, instead, clouded in shame.
Added to the projected shame I battled, was the projected fear that by choosing homebirth I was choosing a riskier option. On top of the media’s depressing narratives of black birth outcomes was the personal terrorism I encountered. My grandfather phoned to express his fear that I might die if I didn’t birth in a hospital (even though his mother had successfully birthed him and 10 other children at home). I was asked consistently if I was sure I didn’t want to birth in a hospital “just in case” because there was no way to be sure that “something” wouldn’t go wrong.
Heeding some of these warnings I tried to do what I thought was the responsible thing and enlist an OBGYN as a “back-up” provider just in case I needed to transfer to a hospital. However, after just one appointment with 2 different providers, I realized there was no way I could ever accomplish a homebirth if I kept either of them on my team. The first provider, a well-credentialed black woman touted in local publications for her community work with black pregnant women had, because of her work, developed a savior complex. She was convinced I knew nothing and that nothing I knew was sufficient enough for me to have autonomy in what the process of pregnancy or birth looked like for me. She interrupted me when I spoke and very matter-of-factly asserted that she maintained control in the relationship with the patients she served. When I shared that I wanted a homebirth and was looking to hire her as a backup in the case of an emergency, she all but scoffed in offense and gave me a book to read as she politely showed me out of the room. Neither of us said anything but I think we both silently resigned never to see each other again.
Situated in a free public clinic, the second provider I visited—also a black woman—did a better job of listening to me and respecting my wishes. However, I had to make a hard pass when she too quickly suggested that her “too small” measurement of my fundal height was cause for concern that I might be gestationally diabetic. While this made no sense because gestational diabetic babies tend to measure larger than average, the suggestion added to the type of doubt I was determined to reject. She was very knowledgeable about gestational diabetes and had I been formally diagnosed with the condition she would have been the perfect provider. However, because she so quickly jumped to such an alarming conclusion on our first meeting, it was apparent to me that she operated out of the same anxiety that so many providers serving black women display. It was the type of anxiety I was determined to reject.
After laboring for 5 days, I birthed my first baby at home in Columbus, Mississippi, with stitches from a vaginal tear being the only incident. I reveled in our victory over all of the doubt but still struggled to deal with the isolation from my family and my friends. While some of them sent cards and gifts, others did not so much as call. It took me 5 weeks to get my mother and one aunt to finally visit and when my sister finally showed her stay was minimal because she “didn’t like to take off work”. After a few months of back and forth begging for visitors and enduring tumultuous encounters with family, my husband and I moved to Tempe, Arizona, and birthed 3 more babies. For 3 of the 5 years living in Arizona, I served birthing women as both a Health Connect One Community Doula trainee and as a South Phoenix Healthy Start Community Doula where in both instances I supported women of color. I’ve spent the last few years chronically the birth stories of black women across the country in the form of a blog entitled Black Birth Story Blog and I’ve filmed these conversations in a series of YouTube interviews entitled “Listening to Black Women“. In my personal experience and in my work across different states one truth is consistently present:
There is a stigma on black birthing women. When hospital providers encounter us, they anticipate we will develop the worse problems so they choose not to treat us unless we will completely relinquish our decision-making and place our pregnant and laboring bodies completely under their control. This ultimatum we’re given demoralizes us and traumatizes us into believing that our pregnancy and labor journey–one very much lacking institutional-encouraged and community-encouraged autonomy–is an inferior one when compared to white women’s.
Because the Mississippi Delta has some of the worst birthing outcomes for black women, I believe some of the worst inferiority messaging and maternal mental health exist there as well. Through the stories of birthing black women in the Mississippi Delta and the providers who serve them, I hope to contribute to the Mississippi Free Press Inequity and Resilience Project by:
- clearly outlining community and institutional inferiority messaging specifically aimed at birthing black women in the Mississippi Delta;
- exploring how this messaging negatively impacts black mental health during pregnancy, labor, and birth; and
- highlighting how the COVID-19 pandemic has magnified already existing disparities in mental health support services for pregnant and birthing black women in the Mississippi Delta.
Through investigative storytelling and Mississippi Delta informed solution circles, I not only seek to assess the damage of inferiority messaging on birthing black women, but also to discover how outside of-hospital births, the midwifery model of care, and unassisted birthing, counter the messaging of black birthing inferiority in hopes of outlining actionable steps that can work in counties across the state.
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