Three years ago, I got pregnant. It wasn’t exactly planned. So by the time I’d gotten used to the idea that I was going to be a mom, I was done with surprises.
I borrowed stacks of pregnancy books from the library. I scrolled through pregnancy message boards late at night when sleeping was too uncomfortable, clicking on any delightfully specific questions about all the weird things that can happen to your body while gestating. I polled friends who were pregnant or had kids. I took the expensive birthing classes. By the time those last few weeks of pregnancy rolled around, I was able to recount to anyone the signs and stages of labor and exactly what I wanted to do once admitted to the hospital to give birth. I felt armed with knowledge.
The thing about having a baby, however, is that there’s no way to know exactly how things will go. I was fortunate to have had an easy time conceiving and an uncomplicated pregnancy, but that’s not always the case for many. And while some people experience the exact labor they envisioned, whether that be home water birth or epidural-assisted hospital stay, others are thrust into disorienting experiences, sometimes with devastating outcomes. This, of course, can happen to any pregnant person, but the risks increase for women of color, and especially for black women.
I’m an editor at a health media brand; I always knew in theory that pregnancy was dangerous, but it never occurred to me that it was something that I needed to think about more than my white peers. When I went to the hospital to deliver my daughter, I didn’t really think that I would end up having an emergency C-section. And I definitely didn’t consider the possibility that, after that emergency C-section, I would remain in the hospital for 10 days while my health-care team tried to determine what was going on with me (it turned out that I’d contracted a bacterial infection during or shortly after giving birth). I had no idea that black and Asian infants have the highest rates of C-section delivery in the United States (incidentally, I identify as both those races). And I certainly didn’t know that, as a black woman, I had been at an increased risk for developing other complications like preeclampsia and heart failure all along.
That was at the end of 2016. What I know now has been widely written about in the last two years thanks to stellar investigative reports by outlets like ProPublica and The New York Times. Even so, the stats—sobering, eye-opening, hard to believe—bear repeating: The United States has one of the highest maternal mortality rates among wealthy countries, and is the only industrialized country where the rate is getting worse. Women of all races are affected, but black and Native American mothers are dying at a much higher rate than others. Black women, in fact, are three to four times more likely to die in childbirth than white and Hispanic women in the United States.
I know, too, some of the reasons why. I know, for example, that black moms are more likely to be uninsured after pregnancy, when many complications manifest, once their prenatal Medicaid coverage runs out. I know that black women are more likely to deliver in lower-quality hospitals. I know that researchers have posited that racism plays a role in why black moms die—either directly, when it comes to how they are treated in delivery and operating rooms, or indirectly, since racism has been shown to have a negative effect on the health of people of color, which can increase a pregnant person’s risk of developing complications during or after childbirth (a consequence that researchers refer to as “weathering”)—since the mortality rate crosses socioeconomic lines.
About a year after my emergency C-section and post-birth complications, I read Serena Williams’s account in Vogue about her own harrowing birthing experience with a mixture of shock and comfort—there, in the back of my mind, had been the tiny feeling of failure, of wondering why it took me so long to recover from birth when others seemed to treat it like a stop at the baby store. Learning that a black woman who embodies strength, who had all the resources you could imagine at her disposal, had also been terrifyingly incapicated from giving birth helped me understand that I was blindsided by something that I couldn’t have foreseen. Learning about Beyoncé’s similarly scary experience helped me feel less alone as well. This drove home for me that the more we talk about our experiences and share outcomes, the better it is for us all.
So now I know. Some of you know, too. But this is a reality that everyone should know.
Today, SELF is launching a new editorial series examining what we know about black maternal mortality and morbidity, and where we go from here. Every piece is a must-read for any black person who is pregnant or thinking about becoming pregnant. The aim for this series is to arm black mothers-to-be with as much information as possible before they find themselves in the labor and delivery room.
We’re launching the series with three pieces, to start, and a promise to continue hammering on this topic over and over again, for as long as it remains a public health crisis.
The first of those three pieces is our July cover story, a profile of sprinter and Olympian Allyson Felix. Felix, the most decorated female track and field athlete in U.S. history, had her own life-threatening experience in childbirth last year—at 32 weeks pregnant, two months before her due date, she learned that she had severe preeclampsia and was told she needed to have her baby that day. She had an emergency C-section. Her daughter, Camryn Grace, spent the next month in the NICU. Now, Felix—someone who also had no idea that anything like this could have happened to her—is speaking out so that other black moms, in her words, “have all the tools to be able to face whatever comes at them.” I spoke with her last month about all of that and more; you can read the entire profile here.
The second piece in this series focuses on politics and policies. Because while education and awareness are essential, the onus is not only on us to save our own lives. We deserve systemic change that will directly reduce black maternal deaths. That means electing lawmakers who rightfully recognize that this is a major public health crisis, and who have plans to do something about it by addressing black maternal mortality specifically. It’s important we push them to go further than implementing (still important) general maternal mortality policies. Case in point: California recently standardized emergency maternity care and in doing so cut its maternal death rate in half, and yet the death rate stubbornly remains higher for black women in California than for white women. So it’s clear that the problem here isn’t going to be solved purely with a race-blind solution. Which is why we asked every single presidential candidate what they plan to do to address the black maternal mortality crisis specifically—you can see their responses (or lack of responses) here. If this is an issue that is important to you, the wide range of answers may help you determine who to support as we move closer to 2020.
The third piece in our series launch is an informational service piece to help you navigate the pregnancy, delivery, and postpartum period with eyes wide open: 11 Conditions You Should Know About If You’re Black and Pregnant lists the most common conditions that you’re at risk for and what signs and symptoms you should be aware of.
We’ll be covering black maternal mortality and morbidity on an ongoing basis this year and beyond; the goal, as I said, is to explore this very important aspect of life as a black mother-to-be in the United States. Over the next few months, look out for profiles of doulas helping to save black mothers’ lives; what pregnant people should know about weathering; the policies and procedures that have actually worked to reduce black maternal deaths; and more. The objective isn’t to scare you, but rather to help us all understand what we are working against—and in so doing, maybe help each other out a little bit. Because there’s strength in our numbers, and this public health crisis needs all the attention it can get.
Leta Shy is SELF’s digital director.