When I discovered that I was pregnant with our second child, excitement quickly turned into anxiety. Nearly six years had passed since we had our first child — but with a tumultuous pregnancy and postpartum period, I was certain that I wanted a completely different experience this time around.
For starters, I wanted to be fully supported and heard. During my first pregnancy, I switched from an OB-GYN to a rotating hospital midwifery team in my third trimester. Both my husband and I were unexpectedly laid off and lost our health insurance. I never really had the chance to interact with my providers on a personal level, and I felt like nothing more than a number.
This time, I wanted a vaginal home birth after cesarean (HBAC). I craved an environment of learning, and one where my young daughter could share in the experience as well. I’d be limited in who I could have in the delivery room at a hospital — and with no additional child care support, birthing at home was the best option for me.
One of my biggest requests included having a microaggression-free experience. I dealt with an unhealthy and unnecessary amount of fatphobia throughout my first pregnancy. When questioning why I suffered from hyperemesis gravidarum, severe vomiting and nausea during pregnancy, I’ll never forget being falsely accused of “drinking too much soda and eating donuts.” According to my doctor, the reason I was excessively puking every day was simply because I was fat.
What I craved most of all was a birth team that was fully aware of the seriousness of America’s Black maternal health crisis; people who would be fierce advocates for me and my family, prioritizing bodily autonomy and flexibility in our birthing plan.
According to the Centers for Disease Control, Black mothers are three times more likely to die from pregnancy-related causes than white women. There are numerous factors that contribute to these disparities in birthing care, including access to quality health care, undetected or misdiagnosed underlying conditions, racism and implicit bias.
After a few weeks of research, I was finally connected with a midwife who was interested in taking me on as a client. She drove nearly an hour in the rain to our home to administer a physical exam and pre-onboarding survey, in which I extensively discussed my previous pregnancies and birth. There were tough parts of that conversation, but I was comforted by her strong maternal presence and deep care as she rubbed tears from my eyes. As a 60-year-old former nurse who had four children and six grandchildren — whom she helped deliver — she empathized with me because she had heard my story so many times before.
At every subsequent appointment, I felt heard. I was not rushed. Sometimes, a session with my midwife (and her apprentice) lasted for hours. My doula, husband, and 6-year-old were also welcomed with open arms to all my appointments, too.
Without making assumptions, our midwife recommended a local, low-cost nutritionist to support development and assisted with suggestions to help ease symptoms that I had in my previous pregnancy.
For the most part, the birth team led, and I followed. Although one piece of advice I kept ignoring came to bite me in the rear end, postpartum. “Are you wearing your compression stockings?” I was asked at every appointment. They were expensive and uncomfortable, but in hindsight, I should have listened.
On the morning of labor and delivery, my doula arrived with a crew: a doula apprentice, birth photographer and therapist. I’d never heard of anyone having a labor and delivery therapist before, but understanding the trauma that I had experienced with my first birth, my doula intuitively provided necessary mental health support.
They took turns holding my hands through contractions. They sang to me. They organized a playlist with my favorite songs. They recited affirmations with me. “I am strong. I am magnificent. I am capable.” They beautified my spartan bedroom with family photos and artwork. They brought coloring books and activities for my 6-year-old. They helped me into and out of the tub. They prepared meals for me and my family and made store runs to grab items that we had forgotten.
In the midst of contractions, we shared deep belly laughs. As a hyper-independent, put-the-whole-world-on-my-shoulders type, this treatment was not something that I was used to. But it felt so good. It felt so natural. That feeling? It’s a birthright that every birthing person deserves to have.
While labor and delivery went smoothly, I experienced severe complications two weeks postpartum. As we returned to our normal day-to-day, my doula and midwife continued to check in, making surprise visits. But I had been silently experiencing intense leg pain. At first, I didn’t tell anyone, not even my husband. With postpartum depression firmly in place, I did not want to be a burden and worried about being away from my newborn. In the middle of the night, I sent pictures of my swollen leg to my doula and midwife. Within minutes, both of them, along with my husband, urged me to go to the ER.
At the emergency room, the attending OB, who was also a Black woman, held my hand as she told me that my leg pain was actually a blood clot and that I was experiencing a mild stroke. As they rushed me back to the operating room for an emergency thrombectomy, I recall her praying for me with a group of nurses while I was getting prepped for surgery. She didn’t have to do it, but she called my husband and my birth team from her personal cell phone, requesting the help that I needed and keeping them abreast of what was happening in the hospital.
“I know you’re scared, but you did the right thing by coming in. We are going to take care of you,” she said.
It’s not always guaranteed, but research shows that short- and long-term racial concordance can positively affect health outcomes. The gravity of having an all-Black birth team didn’t even hit me until long after the surgery.
I often think about that day and the weeks and months of recovery that followed. I think about how the women in my family rarely talk about childbirth and how, inadvertently, I’ve gifted my daughter the opportunity to witness what true community care and support looks like for birthing people. Finally, I think a lot about the team of people who carried me through one of the most beautiful and dangerous moments of my life. It could have gone another way, but it didn’t. And I am truly grateful.
