Birthing While Black: Medical Racism and Self-Protection

The problem isn’t race. It’s racism.

Let’s be real. Talking about Black maternal health means talking about racism in health care. Are the greater health risks that Black women face during pregnancy, birth, and postpartum because Black bodies are sicker or less able to have healthy births than white bodies? No. The reasons why Black women experience more pregnancy-related health issues are rooted in structural racism. This is true whatever your income level, your education, or your social status. Racist attitudes in health care and false beliefs about Black bodies continue to cause physical and emotional harm to women and babies. As a pregnant person of color, these are scary things to think about. You might be anxious about keeping yourself and your baby safe. You’re not overreacting. And you’re not alone. You can have a birth support resource, like a doula, to be your advocate and ally, helping you to resist medical racism and prevent it from impacting your birth.

What is medical racism?

The reality is that lots of healthcare providers have unconscious biases. What does that look like? It might be attitudes toward you that are rude or disrespectful. It might mean that you feel invisible or ignored. It could be labeling you as “aggressive” when you ask questions. It might be pressuring you about treatments or procedures, touching your body without permission, or minimizing your pain. It could be making false assumptions about you or your partner. It might be not taking your symptoms seriously and refusing to take action. None of this is okay. And all of it violates your rights as a patient.

How can you protect yourself?

Whether you’re planning to give birth in a hospital, a birth center, or at home, there are steps you can take to keep your maternity care as respectful and compassionate as possible.

  • Knowledge is power. Learn about pregnancy, labor, and birth, and what to expect during each stage, so you can clearly state your preferences. Be aware of complications and the warning signs of serious conditions. Stay in tune with your body and trust your gut if something feels wrong. Yes, health care providers have medical knowledge and experience, but you know your own body best. Ask for a second opinion if you feel pressured or unheard. Demand help when you need it.
  • Explore your options. Depending on your location and insurance, you might have just a few or lots of choices about your provider and birth setting. Check out the available hospitals, birth centers, obstetricians, and midwives. Look for online reviews. Ask providers about their C-section rates, their views on un-medicated birth (if you want one), vaginal birth after cesarean (if you want one), induction, and other interventions. Ask if they welcome doula support. Ask all your questions and watch their response. Do they listen? Do they treat you with respect? If you feel rushed or dismissed, choose another provider.
  • Bring back up. If possible, bring someone you trust to your prenatal visits and your labor/delivery as an advocate. Having a witness in the room can motivate providers to watch how they act. Your advocate can also remind you about questions, help get clear answers, and talk through options. Research shows that doulas can be especially useful for women of color, helping them claim their power in health care situations.
  • Make a plan. Create a plan with all your birth preferences. Share it with your provider and make sure they are on board. Remember to also plan for the postpartum period or fourth trimester. Complications can show up after delivery, so it’s important to have support from family or a postpartum doula.

Remember that plans change. Birth can be unpredictable, so you might find yourself needing care from providers you didn’t choose. No matter what, no one has the right to treat you disrespectfully, or to bring bias or racism into your birth.

To find out more about how care advocates like doulas can support you in combating medical racism, schedule your free 15-minute consultation on Mae.