Photo: courtesy of Alicia Lue
Most women go into their hospital delivery rooms heavy with baby—and anxiety. Giving birth is one of nature’s great marvels, but there is always an element of "what if?" no matter how many times you’ve done it before. I was feeling this anxiety after I went into labour with my third son, only mine teetered toward fear. I knew that statistics were against me: I was at a higher risk for complications during delivery, and I had a higher chance of me or my baby dying during birth. Not because of any health conditions, but because I am Black.
My labour progressed rapidly, unlike the two previous times. Within 90 minutes of checking in at the triage desk and with no time for an epidural, I was screaming in excruciating pain, which sent my delivery room into a flurry of activity. I became increasingly panicked with each push that did not move my baby down the birth canal. My doctor confirmed that my baby was not moving and told me that she would need to use a vacuum to try to help me. I felt like I was losing what little control I had over the birthing process.
The vacuum didn’t help, and my baby’s heart rate was starting to drop. I was terrified. Though my partner was comforting me as best he could, I looked around the room frantically, asking for reassurance that everything was going to be alright. The doctor then told me that I had one final push to try to move him down, otherwise I was going to be rushed into an OR for an emergency c-section. They announced a "code lavender," which I later found out signaled a neonatal emergency, such as an unresponsive infant.
I don’t know if it was out of pain or fear, but I started screaming hysterically. The sole Black face in the room belonged to a nurse who made me think of my grandmother—firm but gentle at the same time. She locked eyes with mine as she told me, “You and your baby are going to be O.K.” She encouraged me to push really hard with the next contraction, so I did.
Two pushes later, my perfectly healthy baby boy was delivered. I still feel lucky—lucky that my beautiful, healthy baby was safe in my arms, and lucky to have someone that looked like me at my side.
Giving birth under the very best of conditions is stressful, but it is a sad truth that Black expectant mothers go into delivery already at a deficit. When labour becomes complicated, the usual stress compounds exponentially for Black women. Not only do we have to worry about the outcome as a result of the labour complication, but we also worry that our birth outcome—and the care we receive—is dependent on our race.
Problems for expectant Black mothers do not start in the delivery room. In fact, the disparity between Black women and their white counterparts begins with the prenatal care they may, or may not, have access to. Though statistics on maternal complications and mortality rates based on race in Canada remain woefully unavailable, a 2015 study revealed that Black women have a higher rate of premature births, mirroring the disparity in the U.S. Numerous studies carried out in the U.S. reveal that Black women are three to four times more likely than white women to die of pregnancy-related complications. In the U.K., they are five times more likely.
There are a myriad of factors that influence these stark contrasts, such as cultural and socioeconomic backgrounds, but the Centers for Disease Control and Prevention (CDC) reported in 2019 that “sixty percent of all pregnancy-related deaths can be prevented with better health care, communication and support.” In other words, most Black maternal deaths are easily preventable.
Perhaps the answer to addressing the glaring disparity lies in the very people administering healthcare during pregnancy and delivery. A recent report revealed that, while Black newborns are three times more likely to die than white newborns, that number was almost cut in half when the doctor of record was also Black. Additionally, the correlation between Black infant survival and the race of their doctor becomes even more evident in complicated deliveries.
While there is clearly a dire need for more Black medical professionals, the pipeline from school to practice is practically dry. In the U.S. only 4 per cent of doctors are Black, and in Canada only 2.3 per cent are. The findings are troubling on many levels, and emphasize just how pervasive and pernicious systemic racism is, sparing not even the most vulnerable—our newborn babies.
In recent years, as more Black women open up about their experiences, there has been an increased awareness of how the medical system continues to fail them. Some recount horrifying instances of being denied pain management, while others speak about having their complaints repeatedly ignored. Tennis superstar Serena Williams famously spoke out about her experience after giving birth to daughter Olympia in 2017. It was her own self-advocacy that ultimately pushed doctors to test for blood clots, revealing that she had, in fact, been experiencing pulmonary embolism, which could have been fatal if it hadn’t been detected and treated in time.
Too many Black women, however, are not so lucky. Last October, media outlets covered the tragic story of Dr. Chaniece Wallace, the chief resident at Riley Hospital for Children in Indianapolis, who succumbed to postpartum complications just four days after giving birth. These women are further proof that wealth and education do not preclude Black women from the fallout of discrimination in the healthcare system.
It's such a dire issue that in the U.S., members of congress formed the Black Maternal Health Caucus and introduced the Black Maternal Health "Momnibus" Act of 2021, with a goal of growing and diversifying the "perinatal workforce to ensure that every mom in America receives culturally congruent maternity care and support."
While I feel that the team that assisted me during my own labour was 100 per cent instrumental in the ultimate success of my delivery, the bottom line is that I entered my delivery room fearful, and that singular fear of what might happen because of my race is not one that any woman in labour should have to grapple with. My Black nurse was the only one who saw my frantic, searching eyes and understood, intrinsically, how I felt. She was the only one able to communicate effectively enough for me to snap out of my panic. Maybe because she was just a highly skilled healthcare practitioner. Maybe because she too knows all too well the crippling fear a Black woman feels when she enters a delivery room full of faces that don't look like your own.