Self-advocacy is crucial when it comes to combatting the Black maternal health crisis

I hate to say it because we’ve all heard it before, but knowledge really is power. This became very evident last year as I worked with Tomi Akitunde of mater mea and nurse/doula Ebony Harvey to do what we could to end the Black maternal health crisis.

As the person in the group that knew the least about pregnancy (I run a mobile hair styling service and site for Black hair), I quickly learned that understanding pregnancy and understanding how hospitals work in America are two different things, but one can be critical to the other. 

“Overdue: A Pregnancy Guide for Us“, the resource we created for Black moms-to-be with the support of Gerber, addresses just that. 

During our weekly Zoom calls in the months we spent developing “Overdue,” one thing that kept coming up was the clinical protocols used at hospitals. Hospitals generally diagnose and treat patients based on procedures that are created to fit most situations and patients—not all. 

There are clear benefits to using these protocols and efficiencies that come from them, but there are also downsides—especially when the doctor-patient relationship is more dictatorial than collaborative.

It’s easy to go into any medical situation and relinquish all power to your medical provider because they’re the one that spent years studying medicine and you assume they know more than you do. While they most likely do have more medical information, no amount of studies or on-the-job experience can teach any medical provider everything there is to know about you specifically—which is why you have to play an active role in your care. And that’s one of the most important takeaways from “Overdue.”

In creating this resource, I learned just how much choice you have as a patient, what you can say no to, and what’s mandatory. I also learned what to look out for in providers, what questions to ask when building a team, how to feel comfortable asking those questions, and what to do if you feel something is going wrong. All of that is key to working with your medical provider to create a birthing experience that fits you. 

During one of our pre-production calls, Tomi gave the example of one of her site readers sharing that they didn’t know they could have XYZ during birth or could turn down ABC. Tomi shared how she would love to not hear any more stories like that, any more “I-didn’t-knows.”

In a better world, we wouldn’t need a resource like “Overdue” because anyone would be able to walk into a hospital without the fear of not making it out alive or worry about not being listened to.

During the casting process of one of our recent video series, Mom Cuts, we asked those applying to share their birth stories. When we were reviewing submissions, my sister, who was helping me with casting, asked if I specifically asked for women who’d had bad experiences. I told her no, that it just so happened to turn out that way. Most of the people who had applied had a negative experience, such as Victoria:

“The hardest part about my birthing experience was feeling as if no one was advocating for what my husband and I wanted. At 28 weeks, our doctor discovered that my daughter’s belly was sizing below the 10th percentile and she suspected that my placenta was not working properly. In order to lower the chances of Zahara being stillborn, I was at the hospital twice a week, every week, being monitored.” 

“Those visits were unbearable. A few times, her heart rate took a dip and conversations about emergency C-Sections came up. During one visit, a doctor tried to convince me to sign a waiver for an emergency C-Section by telling me, ‘Well, you wouldn’t want her to die right?’”

“Despite making it clear that my desire was to have a natural birth and allow my body to go into labor naturally, our doctors kept warning us that an induction was in our future. The first time I brought up my birth plan to a doctor, I was told, ‘Well those things probably won’t apply to you because you’re likely going to have an induction.’ She still offered to look at the birth plan, but we were already disturbed by how casually she dismissed the document I had spent hours preparing that detailed our wishes.”  

“We were pressured into having the induction and we were pressured into breaking my water. When the induction was unsuccessful, I had reached the point where my only safe option was to have a C-Section. Overall, we felt like our doctors had an agenda and in the end, they prioritized that agenda over what we wanted.”

That kind of language is exactly what Ebony flags in our videos. It’s the kind of language that leaves parents feeling disenfranchised and frightened. Ebony also talks about how if during your pregnancy there are complications or you are labeled high risk, you can still have a birth that feels like yours versus what the doctors are thrusting upon you. 

Knowing that you can push back on certain recommendations and knowing that you can find doctors that will work with you is a proverbial (and perhaps literal) life preserver in a crisis awash with bias, socio-economic inequalities and institutional failings. 

In a better world, we wouldn’t need a resource like “Overdue” because anyone would be able to walk into a hospital without the fear of not making it out alive or worry about not being listened to. Unfortunately, we don’t live in that world yet, so “Overdue” is a resource that Black women can use to navigate the reality that we’re living in now.

A version of this story was originally published on Jan. 15, 2023. It has been updated.