Okay. So. All I am is a woman who has given birth three different times under three different circumstances, but a few things stick out to me about the push for doulas, midwives, and home births for Black women:
I do not think that hiring midwives and doulas, or avoiding hospital births, is an adequate response to the abysmal U.S. Black maternal mortality rates.
Black women who decide that a hospital birth w/physician is right for them (and that can take many different forms) still deserve quality, compassionate care within our medical systems.
They deserve not to die giving birth.
They deserve not to die giving birth.
I would rather put pressure on medical providers to provide decent care for all Black women rather than put the onus on Black women to avoid the system.
I say that as a woman whose first choice and plan for childbirth included:
1. A Certified Nurse Midwife
2. Several doulas
3. A carefully planned home birth
…and who still wound up in the hospital with an emergency C-Section, with uncaring physicians and staff.
1. A Certified Nurse Midwife
2. Several doulas
3. A carefully planned home birth
…and who still wound up in the hospital with an emergency C-Section, with uncaring physicians and staff.
Telling Black women to pivot to midwife, doula, home birth pretends that these medical professionals operate entirely outside of the same medical system we coach them to avoid.
In many cases, to maintain certification, these professionals must *comply* with the system.
In many cases, to maintain certification, these professionals must *comply* with the system.
For example, in GA where/when I had my first child, midwives must operate legally under the auspices of an OB/GYN. Home birth is alegal in GA and patients have to practically lie to physicians in order to do one. State regulations make it VERY hard there.
If you tell an OB you’re doing a home birth in GA, you could put the certification of your midwife at risk. I wrote articles about my failed home birth afterward and had to protect the identity of my CNM so she wouldn’t be discovered helping women plan home births.
So it’s really not as simple as telling black women about the options outside of hospital births and then assuming those options are readily accessible in a woman’s city/state/region.
Furthermore, birth is unpredictable. Most CNMs will advocate for home birth in pregnancies that are not high-risk. My pregnancy was fine, but my labor/childbirth were not.
In that case, my CNM referred me to the hospital, which was correct. BW STILL NEED ADVOCATES AT HOSPITALS.
In that case, my CNM referred me to the hospital, which was correct. BW STILL NEED ADVOCATES AT HOSPITALS.
I would have been MUCH worse off at the hospital without my midwife, doulas, and my female family members who work in the medical system.
All those advocates were with me and I still had a traumatic childbirth experience at hospital with a high fetal mortality rate.
All those advocates were with me and I still had a traumatic childbirth experience at hospital with a high fetal mortality rate.
So what I am saying, ultimately, is that YES, Black women need all the advocates they can get.
But those advocates still work with biased physicians, are often undermined by them, and have their own uphill battles to advance reproductive autonomy in their respective states.
But those advocates still work with biased physicians, are often undermined by them, and have their own uphill battles to advance reproductive autonomy in their respective states.
Hiring a midwife and doula can be helpful, but it will not solve BW’s maternity mortality rate as long as the medical system prioritizes physician authority over patient autonomy and dignity. We still must address and change the bias that kills Black women.
Oh, and for reference:
Kid 1: Planned home birth, ended up with an emergency C-Section
Kid 2: Planned VBAC, but had a high-risk pregnancy that concluded with a C-Section
Kid 3: “Automatic” third C-Section bc of risk of uterine rupture 🤷🏾♀️
