“I could have died,” says Nzinga Shaw, reflecting on her experience having an ectopic pregnancy (a condition wherein a fertilized egg implants itself outside the uterus). Shaw was given two methotrexate shots to stop the growth of the fertilized egg, thus terminating her pregnancy before a life-threatening internal rupture occurred.
Shaw, who now has three children, remembers the emotionally taxing experience like it was yesterday. She says she’ll also never forget the cold manner in which she was treated by her doctor. “It felt very transactional—not loving or kind,” she remembers. For her next pregnancy, Shaw says, “I made the purposeful decision to switch to a Black woman OB/GYN.”
She’s not alone. Countless Black mothers continue to feel underserved and undervalued in the healthcare system. And the statistics support this lack of care. Black women are three times more likely to die from a pregnancy-related cause than their white counterparts. And while there are multiple considerations for why this is the case, among the most prevalent are implicit bias and systemic racism.
Change Starts With Acknowledgement
Dr. Margaret Larkins-Pettigrew, an OB/GYN and the first chief clinical diversity, equality & inclusion officer for Allegheny Health Network, has made it her mission to improve outcomes for Black mothers by looking at the situation from all angles. “Intentionality is what’s going to make sure we move this needle,” she believes.
She’s identified three main areas of focus: the corporate space (to ensure women have access to optimal care by mitigating accessibility issues like insurance); the clinical space (to educate providers to treat patients and their healthcare journeys with nuance and care); and the academic space (to collect the right data in order to facilitate progress, which Larkins-Pettigrew likes to call “data justice”).
“This is not an overnight fix,” says Larkins-Pettigrew. “This is something that we have to invest in to make it sustainable. There has to be acknowledgement and awareness, then the need to be intentional. Once we understand how we got here, we move forward by looking at the behaviors that show the ugly racism that occurs—it’s in our policies and our procedures, it’s in our hiring, it’s everywhere.”
For Black Mothers, Knowledge Is Prime
Making conversations around maternity challenges less taboo should also be a priority, says Dr. Larkins-Pettigrew. She recommends expecting Black mothers seek hospitals with a Centering Pregnancy program, which provides group medical visits for pregnant women. “Those types of models where women are allowed to express themselves—come in with their authentic self, talk about the communities they live in, and some of the challenges they have—helps them get through the pregnancy process much better,” she says.
Tomasine Oliphant, who experienced postpartum depression after the birth of her daughter, agrees. “I would say it’s really important to get connected to other women, other moms,” she says. “You don’t realize how much support you need.”
For Dr. Thomishia Booker, support was found outside the hospital walls. After unpleasant and unsupportive experiences at a nearby medical center, she decided to go the route of an at-home birth with the help of a midwife. “It’s a lot of research trying to find Black midwives who are local,” says Booker. “It was about finding the right person that was going to fit with our family. Someone who had that expertise, but also someone that was going to provide that extra care, more than just helping to deliver the baby, but being able to take care of us afterwards.”
Mahmee, Wolomi and Mama Glow are among the emerging resources helping Black women find the right birthing journey for them—and sometimes, like in the case for Booker, that means bypassing the hospital. They are also helping mothers navigate the aspects of the process that aren’t discussed enough, like nursing. “When I thought about breastfeeding, I just thought it was just going to come so naturally to me—I’m a woman, this is what women do, right?” reflects Giovanna Taylor. Formula and bottle feeding were expensive, and Taylor was a young student trying to balance motherhood. “I just sort of wish I was more supported,” she adds of her experience 15 years ago. These platforms are stepping in to help.
“I’m always encouraging folks to really seek the knowledge and the wisdom of their community and of their ancestry,” says Latham Thomas, founder of Mama Glow. In addition to offering a program that trains and connects doulas with expecting mothers, Mama Glow houses videos, essays, books and articles to help Black women stay informed as they navigate their pregnancy journeys. “Part of it is conceptualizing where you are and understanding how you want to do things,” says Thomas.
Slow Progress
New York City will begin offering free access to doulas with plans to reach 500 families in the next three months, and Thomas’ Mama Glow will serve as a partnering organization. The city also plans to expand its midwifery initiative to, according to its website, “gather data on births and care with midwives; create partnerships with midwife organizations, private practices, and community members; and develop a report on midwives in New York City.”
Congresswoman Lauren Underwood, Congresswoman Alma Adams, Senator Cory Booker, along with the Black Maternal Health Caucus, have introduced the Black Maternal Health Momnibus Act of 2021, a series of 12 bills aimed at improving maternal health experiences among women of color. It’s currently awaiting a vote.
Documentaries such as Paula Eiselt and Tonya Lewis Lee’s documentary Aftershock are also bringing experiences and information to a wider audience.
Addressing the challenges Black women continue to face in their maternal journeys is going to require a lot more time, education and investment. But Thomas is hopeful that what she’s doing with Mama Glow, alongside the work of other advocates, is paving the way for better times.
“It’s about helping people create a vision for what’s possible, not just what they see happening around them,” says Thomas. She also emphasizes the need to create space for all possibilities that come with giving birth, including the joy and the triumph. “We’re envisioning a future, but we’re also designing it.”
