How Black Parents-to-Be Can Take Back the Birthing Experience
As Black Maternal Health Week comes to a close, we proudly reflect back on this year’s theme, “Our Bodies Belong to Us: Restoring Black Autonomy and Joy!” This is a powerful and important call-to-action for Black birthing individuals and healthcare professionals, as the rates of Black maternal mortality have continued to rise, undeniably bringing focus to systemic racism and adding to significant fears for Black birthing people everywhere. While the statistics are still staggering, this year we’ve intentionally focused on empowerment and bringing the joy back to what should be an inherently joyous time in one’s life.
Birth is a time of transition; it brings about growth in a family and new opportunities, and is the continuation of a community. This is a joyous event, but sometimes processes, procedures and outside factors can steal our joy. So what can we – as expectant parents and as clinicians – do to change that?
Planning Your Birth
Let’s educate ourselves and our loved ones and our birthing team about how we want our birth experience to go, including anything and everything, from the music we want played to who we want in the room. Of course, discussions about common disorders such as preeclampsia and other pregnancy-related complications are important to be had as well. This is all part of your birth plan!
A birth plan is a guide that is completed during pregnancy with detailed decisions on how you would like things to go during your labor and delivery. Despite the name, it is important to understand that things may not go exactly as you plan, as delivery can be unpredictable. However, your birth plan can be a valuable starting point for a conversation with your medical team, provide guidance to decisions that may need to be made, and help avoid franticly making important decisions on the spot. Some things to consider include: who you want in the delivery room to support you, whether you will have a doula, plans for pain management, and even whether or not you want your baby to remain with you rather than going to the nursery.
Filling out a birth plan (such as this one), not only provides detail for yourself, your loved ones and your medical team, but it also helps you consider what options you have. Discussing your plan with your doctor can help you to feel empowered, informed, and aware of what choices you have in the birthing process. And it helps the birthing team support your autonomy too.
We encourage healthcare providers to invite their patients to complete their own birth plan, or be prepared for – and receptive to – your empowered patient when they show up with their own.
Screening for Mental Health Concerns
A patient’s medical team is the first line of defense when it comes to detecting mental health issues. If you are a provider (e.g., OB/GYN, certified nurse-midwife, nurse practitioner, etc.), take that extra step to screen your patients during pregnancy and ensure that you are hearing their concerns while addressing them and not being dismissive. Seleni’s 30-minute primer, Screening for Perinatal Emotional Distress, is designed for healthcare professionals who do not specialize in mental health, but who are often the first to see patients and can refer them for additional support.
If you, the patient, are experiencing any symptoms that concern you, including anxiety or persistent depression, be sure to voice them during your prenatal visits. Remember, your provider may be an expert in the field of medicine, but you are an expert at understanding your own body. You may not know what is considered “normal” when it comes to your physical and emotional health and changes during pregnancy, but you know what is and is not normal for you.
Understand that you have a right to speak up about your concerns. Sometimes it helps to write down all of the symptoms you are experiencing and things you want to cover before you meet with your provider so you do not forget or get distracted by the things they plan to discuss. If you have questions or want to discuss options, include those in your list. Remember, this is your body and your health. Being prepared and using your voice helps you make informed decisions about your care. While it can be difficult to speak up about your concerns, remember that the more open and honest you are about your situation, the better your birthing team will be able to serve you.
Flip the Script
The reality remains that Black birthing people are now three times more likely to die in pregnancy or while giving birth than their White counterparts. This fact alone can steal one’s joy before even getting pregnant. Health care providers, public health agencies, patients, families, and the community need to join as a united front, to work on closing the various racial gaps that exist and be intentional about protecting Black birthing people.
This can be best achieved with a focus on the goal of autonomy of the birthing parent and birthing family, recalling that people have successfully given birth since the beginning of time and did so surrounded by loved ones, song, and celebration, long before the existence of teams of medical providers, medical facilities or emergent medical procedures. A return to the respectful consideration of the knowledge of our bodies, the beauty and joy of birth, and the recognition – by ourselves and others – that our bodies belong to us is long overdue.
References:
Centers for Disease Control and Prevention (2023) Pregnancy Mortality Surveillance System.
ACOG (2022) Sample Birth Plan Template.
https://www.acog.org/womens-health/health-tools/sample-birth-plan
