They call them “near misses,” women who almost died while giving birth. It is a harrowing experience that, over time, sinks below the surface but never disappears. Nearly every Black woman I spoke to about their hospital birth could relate. Few described a peaceful, emotionally beautiful miracle like the birthing center experience documented in the groundbreaking film, “Aftershock.”
The most important thing that Black women can do to empower themselves to have a positive and healthy birthing process is to proactively educate themselves well before delivery, according to labor and delivery nurse Lynnell Day. (Note: Day’s name has been changed to protect her identity.) Day has helped hundreds of women give birth in a hospital setting, but when it comes time for her to have a child, she plans to engage a midwife.
“It’s important to realize that modern obstetrics was built on a racist past where doctors experimented on the bodies of enslaved women in order to take over an area where other women, midwives, had been the experts for thousands of years,” she explained. Racism impacts the field today, notwithstanding Black OB/GYNs.
The assumption that women don’t know their own bodies, worry needlessly and therefore don’t need to be listened to, permeates the medical field. The current medical insurance model perpetuates that. “Selecting the right person to help you deliver your baby is crucial,” Day said.
Atlanta-based OB/GYN Dr. Melinda Miller-Thrasher agrees. “Doctors are people, too,” she said. After 35 years of delivering thousands of healthy babies to satisfied mothers, Miller-Thrasher – who is Black – is in high demand; the doctor is beloved for her nurturing and respectful demeanor. “Unfortunately, that means without training, we bring our unconscious biases to work just like everyone else. My job is to ensure a safe birth for mother and child, with the mother guiding the process. It’s her body, her baby, her birth experience.”
Not every doctor feels that way. Often, unnecessary interventions like breaking the water or administering Pitocin can lead inexorably to C-sections, a major surgery that most healthy women do not need and one that can cause dangerous complications during birth. Many women don’t want that kind of intervention, but it is common. That’s where having a doula throughout pregnancy can make a measurable, positive difference in the birthing experience.
“As a doula, I nurture not only the birthing person, but their family as well, helping to develop and advocate for the birthing person’s vision of what they want their birth to be, whether that is at home, at a birthing center, or in a hospital,” Ilexis Lindsey says.
Engaging a doula as an advocate who knows what the birthing person wants and who will intervene when it is appropriate helps ensure a more positive experience. “Not everyone is able to have a home birth or birth center delivery; high-risk pregnancies should be attended to in a hospital, but for those who can, it’s a beautiful experience.”
When looking at data comparing the U.S. to other developed countries, the U.S. has the highest rates of maternal death and the lowest utilization of midwives and doulas. This nation has overly medicalized the birth process. Black and Brown women, poor and rural women without access to midwives and compassionate healthcare are dying as a result.
I had a midwife and a doula, but after days of hard-but-beautiful labor – in and out of the inflatable pool we had installed in my living room, walking endless loops around my favorite park, and surrounded by people I love – my son’s cord wrapped around his neck causing distress. I ended up in the hospital after all, needing an emergency C-section. But the midwife knew the doctors on-call and requested one – a Black man – who listened carefully, explained everything to my satisfaction, and allowed the midwife and doula to stay in the room during the surgery.
The women arranged for me to have a private room and called a couple of my friends who brought my own blankets, pj’s, music and decorations to make me feel at home during the unplanned hospital stay. My doula and best friend, Taliba, alerted the nurses in the middle of the night when there was more blood than there should have been and dismissed a rude nurse, asking for another with more compassion as we struggled through the crisis. It wasn’t the home birth I’d planned, but I felt empowered thanks to the women at my side, a flexible birthing plan and a compassionate doctor who really listened to me even during what could have been a tragic ending.
Why are Black women still dying at higher rates than anyone else during childbirth and the days and weeks after giving birth? It’s complicated. But these are our sisters, daughters and friends who are at risk; it is us. The first step to turning the tragedy around is to arm ourselves with knowledge. I can’t think of a better way to start that process than watching “Aftershock,” and making sure everyone connected with Black women watches it too. It just might save someone’s life.
A mother’s love lives on
Soleil Irving is a vivacious, gorgeous 5-year-old whose eyes, personality and flashing smile echo the mother who died before she was a month old.
“Soleil is so much like Shalon – smart, curious, loving, kind, determined, and fearless,” Wanda Irving said, comparing her granddaughter to the daughter she lost to a preventable postpartum death. “She loves her gymnastics, cooking, creative drama and karate classes. I can see Shalon in her eyes. Soleil has her mother’s love of life, and she lives each day to the fullest. But in the quiet times, she so misses her mother.”
Dr. Shalon Irving was an epidemiologist at the Centers for Disease Control and Prevention and a lieutenant commander in the US Public Health Service Commissioned Corps who worked fiercely to eliminate the health disparities caused by structural racism, limited healthcare options, trauma and violence.
“I see inequity wherever it exists, call it by name, and work to eliminate it. I vow to create a better earth!” Shalon declared in her social media bio. She was considered a brilliant researcher, making history at age 25 when she earned the first dual Ph.D. in sociology and gerontology from Purdue University.
Shalon understood the many underlying factors that lead to poor outcomes and used her voice and position to speak out on behalf of those who couldn’t advocate for themselves. None of her knowledge, accomplishments or passion helped when doctors ignored her distress and concern. She was a Black woman in America who died on January 28, 2017, just 21 days after giving birth to Soleil.
Shalon’s family, many friends and coworkers were stunned and devastated. They gathered, transformed their grief into action and created an organization to keep Shalon’s legacy and work alive. Dr. Shalon’s Maternal Action Project partners with philanthropists, leading public health organizations, policymakers, legislators, and advocacy groups around the country to reduce maternal mortality rates, specifically in Georgia. They have developed two initiatives, “Knowledge is Power” and the Believe Her app that are beginning to have an impact.
“’Knowledge is Power’ advances the birth justice agenda by focusing on high-risk Black women and birthing people, as well as providers, to improve community health awareness, education and empowerment and reduce systematic health inequities,” DSMAP board member Dr. Ndidiamaka Amutah-Onukagha says. “We’re working to empower black families with the skills and knowledge to navigate racist healthcare systems and ‘doctor-speak’ to obtain the best outcomes for themselves.”
DSMAP’s Believe Her app, which can be downloaded through Apple Store and Google Play, empower women in their healthcare journey by teaching them appropriate phrases when they are trying to get their doctors to listen and believe them.
Wanda Irving has surrounded Soleil with images and stories of her mother. The 5-year-old has a loving village of Shalon’s friends and family to help raise and guide her, but the loss of a mother she will never know is a deep wound and may always be.
Her grandmother is determined that she will thrive despite the pain they both share.
“My heart breaks when Soleil says that she wants to die so that she can be with her mommy in heaven,” Irving says. “She tells me daily how much she misses and loves her mom. It truly concerns me that this loving, sweet child will never ever get the chance to know her mommy. And we’ll both live with the trauma of losing Shalon. Soleil will carry the pain throughout her life and potentially to the next generation.”
But Soleil is her mother’s child, Irving says. “She wants to be a doctor so she can help save Black women.”