April 11-17th marks the week spotlighting Black Maternal Health in a time where Black pregnant people nationwide are still disproportionately dying in childbirth and postpartum at three times the rate of other races.
The numbers are even scarier for Texas, with Black pregnant preterm birth rates 41 percent higher than all other races. In a report by March of Dimes, Black children scored the highest in infant mortality rate, high-risk cesarean births, and inadequate prenatal care, despite Black pregnant Texans ranking third in the number of deliveries overall.
For context, preterm means babies born before their designated due date, leading to complications for the pregnant person and the child.
Many underlining issues can impact this preterm birth, including lack of quality prenatal healthcare, environmental hazards such as air pollution, contaminated water, proximity to oil and concrete plants, food deserts, transportation, housing, racial bias, cultural incompetence, and lack of empathy for Black pregnant people in the delivery room.
Equally important, Senate Bill 8, the state’s six-week abortion ban, is also disproportionately impacting Black people across the state, stripping them of abortion access and forcing them to carry out pregnancies in a healthcare system unable to support them.
As Black people get older, the scary statistics on maternal mortality and morbidity is a looming dark cloud over the head of many as they start to think about starting their own family. In reality, death in childbirth or childbearing isn’t a concern for non-minorities.
And for Black people precisely, every day, a new story breaks the airwaves showcasing a doctor’s negligence, another Black woman not being heard in the delivery room, or even complications after the birth that lead to her death.
The Center for Disease and Control also said most pregnancy-related deaths are preventable.
In the 2021 legislative session, the Texas Senate passed a minor resolution to extend postpartum coverage statewide to six months, despite the Texas Medical Association recommending 12 months to address the state’s high maternal morbidity rate.
Nevertheless, Black healthcare providers are coming up with new ways to support Black pregnant Texans different from the typical OBGYN. Alternative options such as doulas and midwives, in addition to OBGYN, give pregnant people extra support.
The Signal spoke with doulas D’Andra Willis and Qiana Arnold from the Southern Roots Doula Collective with The Afiya Center, a reproductive center based in North Texas that centers Black women on reproductive justice, supporting HIV positive women, and provides access to abortions.
For context, SR Doulas offer support for pregnant people and their families for 13 months. This means throughout the entire pregnancy, labor, and postpartum. A holistic approach, they said, protects not only the birthing person but the child too.
“The uniqueness of Southern Roots is that we serve the whole family because we understand that maternal mortality can be somewhat lower if the entire village understands what this birthing person is going through and advocates for them,” Willis said. “We have been very successful that with the folks we have, they feel supported, and when it comes time to the birth, we can sit back a little bit because we have educated the whole village. If the birthing person is having issues after the baby, you have someone apart from their village to say, ‘Oh, you need to call the doctor.’ ”
Still, in 2022, both doulas said they have clients dealing with racial stereotypes like “the angry Black woman” in the delivery room. While medical professionals will also state the morbidity rate for Black birthing people is based on preexisting conditions.
But 23-time Grand Slam winner Serena Williams’s birthing experience of her daughter Olympia showed the world that even the healthiest, wealthiest and highest status Black woman could experience negligence and complications in the delivery room.
More specifically, Arnold compared it to the criminal legal system, which frequently blames the dead Black victim instead of holding police officers accountable after a police shooting or excessive force.
“So when we go into systems, the overall weathering effect of racism within every system we function in this nation affects our body,” Arnold said. “Not only does it affect our body, the systemic racism in the healthcare system determines how we are listened to, all these preconceived notions about us, all these biases. So we are dying because we are flowing in a racist system that was never designed to keep us alive.”
So both women agree doulas play a vital role in lowering the maternal mortality and morbidity rate. Still, they fear the numbers will remain the same without significant policy and systematic changes.
“We are doulas working inside this system, and we can only advocate so much; it’s going to take policies to be changed, not only Black Maternal Health Week,” Willis said. “We need extended Medicaid. We need comprehensive sex education and medical care. We need women with HIV to be listened to and make sure they are getting the right treatments. We need full access to abortions because if parenting is not their option, they need to have an option to terminate the pregnancy.”
In the eight months since SB 8 has been in effect, Arnold said the impact has been overwhelming.
“We’ve seen women lose their jobs, and we haven’t talked about the women who are trying to get an abortion, but they’re also escaping their abusers,” Arnold said. “The downfall has been enormous. It’s been overwhelming for the women in our community. It’s been overwhelming for our staff. We have folks willing to take risks for their health and their freedom that they would never have considered taking in the past because they had some access to an abortion.”
Empowerment, self-advocacy, and education remain the top priorities for Black pregnant people to save themselves. Moreover, Shades of Blue Project Founder Kay Matthews said she’s focusing on Black pregnant Texans’ mental health while also providing basic needs like diapers, food, and water.
“It’s about putting compassion back in the healthcare system,” Matthews said. “[Black woman] the stigma of getting help knowing that you’re struggling mentally. Afraid of what someone will say. I don’t know why we have stigmatized people getting help as a sign of weakness. It’s actually a sign of strength.”
But in the end, Matthews said this has to be a collective effort, and Black women can’t be the only ones on the frontlines supporting and saving themselves.
“If we don’t address what is happening with Black women, it is going to trickle down,” Matthews said. “Hispanic women, Asian women, Native American women, it’s just going to keep going and affect everyone at some point. [Black women] have to save ourselves. Nobody is coming to save us but us. But we have to see the value in saving us too.”