By Elizabeth Dawes Gay, MPH
We’re all familiar with the African proverb, “It takes a village to raise a child.” When it comes to Black maternal health in the United States, let’s adapt that to create a new African-American proverb, “It takes a village to save Black moms.” The maternal mortality rate in the U.S. is rising and Black women bear the brunt of it, but that’s not where our story ends. We all have the power to create a new narrative by supporting new and expecting moms.
In the U.S., Black women are three to four times more likely to die from pregnancy-related causes than white women, even when education and income are accounted for, and are also more likely to experience pregnancy complications. The issues affect people across socioeconomic status and all walks of life; two of the world’s biggest stars, Beyoncé Knowles-Carter and Serena Williams, both shared how they survived life-threatening complications and, in doing so, helped spark important public conversations about what’s happening to Black moms in the U.S.
Beyoncé first spoke about her experience giving birth to twins Rumi and Sir and postpartum self-care in her interview for the September 2018 issue of Vogue. On April 17, 2019, the last day of Black Maternal Health Week, the singer released her documentary film Homecoming in which she further details her experience recovering from preeclampsia — a condition characterized by high blood pressure that can become life-threatening if left untreated — and an emergency C-section to protect the wellbeing of her twins.
When it comes to improving Black maternal health, people often point to the health care system for intervention, and rightly so — it’s a system where Black patients receive differential treatment. After giving birth to her daughter, Olympia, Serena had to demand treatment for a blood clot, literally fighting for her life. The tennis star’s story was so disturbing in part because those medical practitioners who were supposed to be caring for her didn’t listen to her pleas. Research by Dr. Monica McLemore and colleagues finds that women of color experienced racism, discrimination, disrespect, and stressful encounters during prenatal care.
These experiences aren’t rare, but they could be. In fact, they harken back to the United States’ troubled history of ignoring Black women’s pain; modern medicine was founded through the forced experimentation on Black and brown bodies and the medical system perpetuated segregation and discrimination. Even now, our healthcare system still privileges wealthy and white individuals.
Black moms certainly need high-quality, holistic, and attentive care free from racial discrimination, along with access to community-based services that meet all their needs. And though health care providers are uniquely positioned to change the Black maternal health crisis by providing better care and support, the rest of us also have an important role to play. You don’t have to be a doctor, midwife, nurse, or doula to make a difference.
Evidence shows that moms and babies do better when moms have social support. This may be even more important for Black women, who report receiving less support than usual from their families and community when they become pregnant. Not having enough social support from your family, network, and community can increase stress, a factor that is strongly linked to poor pregnancy outcomes for both moms and babies. For Black women, societal stress from racism, microaggression, interactions with oppressive systems, and challenges navigating systems that touch our daily lives are compounded with lack of support from family and community. Thus, it may come as no surprise that Black moms are also more likely to experience depression during pregnancy than white moms.
During and after pregnancy, Black moms need more support from their loved ones and social networks, not less. Many moms might find their village online through discussion boards, Facebook, or even Instagram, but there’s a debate about whether support through social media is enough. Offering encouragement and advice online is helpful to some moms at certain points in time, but the best thing we might be able to do is take our love and support into the real world. Dr. Loretta Jones, who founded Healthy African American Families in Los Angeles, California, developed One Hundred Intentional Acts of Kindness Toward a Pregnant Woman, a resource that was informed by Black women who shared exactly what their village could do for them. Moms might need help around the house or someone to watch the kids, a ride to an appointment, help finding housing, or someone to massage their feet. Or a mom might need you to be there when they give birth, especially if their partner or family can’t.
In their Vogue interviews, both Beyoncé and Serena shared that they had a support system to help them through pregnancy and postpartum challenges. All moms deserve the same. When we’re attentive to the pregnant people and new moms in our lives, we may notice that they may not be feeling well or be their usual selves. That’s critical because we could help recognize warning signs such as chest pain, persistent headache, or depressive symptoms that require immediate medical attention. Three in five maternal deaths are preventable – your intervention could save a life.
The ways we can offer support are numerous and varied, but it starts with checking in on someone while they’re pregnant and after they’ve given birth. We are the village the new and expecting moms in our lives so desperately need. You have the power to create change. Are you willing to do what it takes?