Breaking the Silence: Black Maternal Health, Health Equity and Self CARE

Breaking the Silence: Black Maternal Health, Health Equity and Self CARE By Renada Bey

Trigger Warning: Pregnancy Loss

Explore pregnancy and black maternal health, highlighting support and building circles of care during Black Maternal Health Week. Find insights for self-care and advocacy. Black Maternal Health Week is April 11-17, 2024.

My Story

“The pregnancy implanted in your tube.”

I watched the screen intently, following the small cursor on the screen. The ultrasound finally came to an end as my OB removed the wand and slid his chair back. He began to explain exactly what that meant and voiced his concern with more of a sense of urgency than I expected.

“I’m going to let you get dressed, and we’ll talk outside.”

I wasn’t sure whether to be relieved or worried. Weeks of back and forth, from my OB to the lab and back to the OB, culminated in a feeling of gravity I hadn’t felt as a wife and mom until that moment.

It had been a month since my initial concern of a miscarriage had finally been confirmed as an ectopic pregnancy implanted in my left Fallopian tube. I’d been working to navigate all the “news” in my life, and the weight of my health was not only inconvenient, but it also added yet another level of stress to being the mom of a 6-month-old, a two-year-old and still a newlywed.

As my husband and I listened to the doctor lay out the emergent situation of the embryo growing in my tube, his calm was a welcomed relief. He clearly laid out my options to remove the pregnancy: surgery or medication. I appreciated how matter-of-fact he was in explaining the options. He was transparent as he detailed the efficacy of each option.

Even more, I appreciated my husband’s presence. He held and stroked my hand with his thumb as I asked my questions. His follow up questions, a show of support and advocacy, I didn’t realize I needed in the moment.

Throughout our conversation, my OB’s honesty helped to fill in the gaps of the unknowns and gave me as much understanding as possible, given the emergent situation I was facing. My husband and I discussed settling on the greater efficacy of surgery, understanding it would be immediate, given the growth and size of the pregnancy.

After we spoke, I called my mom, who was watching the kids and explained the situation. She instantly went into mom/nurse mode; her knowledge from years of nursing was a welcomed confirmation that I’d asked the right questions. As usual, she went through our doctor/pre-procedure conversational checklist. “Did you tell them you have hemoglobin C trait, did you make sure they know you’re allergic to iodine, did you tell them you have a sensitivity to anesthesia?” Her intention was both a comfort and a boost to my confidence at that moment.

As my husband and I walked the adjoining sky bridge toward the hospital, my mind raced less, and my heart felt lighter. I couldn’t help but feel grateful that I’d trusted my intuition and made sure I voiced my concerns and questions with my OB. In the busyness of motherhood, there were times when I questioned whether another trip for labs or a missed nap time for an appointment was worth it.

My husband held me and prayed over me before I was prepped for surgery. I sat on the operating table and went back through my pre-procedure checklist, making sure they knew I was allergic to iodine, had a sensitivity to anesthesia, and had hemoglobin C trait. I faded into the quiet and still.

It took years for me to fully process the true seriousness and significance of my experience. Before it happened, I’d never heard of an ectopic pregnancy or had really given much thought to the traumatic or adverse outcomes of maternity. Recent events and headlines over the past couple of years of maternal deaths and botched deliveries have brought an immense sense of awareness and gratitude for my own pregnancy-related emergency and outcome.

One of the major takeaways I’ve held on to is the importance of practicing self CARE when it comes to health and health-related situations. In retrospect, I believe this was a major part of how I helped my OB to provide responsive and effective care that kept my well-being as the focus of treatment for my health.

Ownership of your health is your absolute right! It can be intimidating to voice your concerns or take an assertive stance in your healthcare, but self CARE is a way that creates space and opportunity to build community around your health to support successful outcomes.

Practice self CARE with these four principles:

C- Consider all your options. In planning your medical care or having a procedure, consider what you’ll need now and later. Select a provider based on your needs and what will serve your best interests. Does the provider have other patients that look like you? Do you know anyone who’s been a patient? What has the practice/staff been rated on patient review sites (Health grades, Rate MDs, Vitals, Real Self, Zoc Doc, or even your insurance provider site)? What hospital(s) does the doctor have privileges at, and what are the reviews and quality star ratings of the hospital(s)? Use resources like Google and Yelp reviews or even the Care Compare tool on the Medicare website to find a facility that you feel comfortable with. It’s absolutely worth the time it takes to research and evaluate your options; your provider and hospital selection can be the difference between life and death.

It’s important to know if you’re choosing a facility that’s birthing friendly, baby friendly and honors their patient bill of rights. It’s also important to consider who’s in your circle of care. You need a community around you regardless of whether you’re married or single. Your partner, family, friends, doulas, patient advocates, patient organizations, or even online groups are all great ways to create community around your care and can help you to consider important aspects of your care.

A- Advocate for yourself. Ask ALL the questions you can and share what you know. Asking and sharing is one of the best ways to help your doctor provide all the information you need and even help to best care for you.

Remembering things you may have a sensitivity to, reminding about allergies, sharing any previous surgeries and challenges with recovery and even voicing your concerns can improve the communication between you and the people involved in your care. How you communicate can also help to alleviate any fears you might have. Arm yourself with as much information as you can so that you can make the best decisions for yourself. Advocating can look different for each of us, but some of the easiest ways are using the “5 Ws and H’’

  1. Who is going to be involved in my delivery? Who is responsible for my care after my delivery? Who do I contact if I have immediate concerns or an emergency?
  2. What should I expect during and after my delivery or procedure? What are some potential risks or side effects I should be aware of?
  3. When is the usual expected recovery timeframe? When should I return to my normal daily activities?
  4. Where can I go to get more information about the side effects or impact on my health?
  5. Why choose this medication over a more natural solution? Why this procedure; is it medically necessary?
  6. How can I best prepare for recovery? How will I know if I’m healing properly?

R- Resource gathering. Having a safe and supportive space to recover after childbirth is crucial to your mental health. One important way to honor your mental and physical needs after birthing is by resource gathering. A great starting point is asking and researching what types of resources and supports your insurance offers. Both state and private insurance have support resources you’re eligible for as a new mom. Finding spaces, places, and groups in your community that can provide support in the form of peer connection, nutrition and meals, in-home check-ins, and even lactation support can help lighten the load of motherhood. Having a list of resources can make it easier to communicate your needs and get support in real-time. There are lots of great community, postpartum, and family support organizations like Postpartum Support International that can help in building mental and physical wellness after birth.

E- Engage with kindness. Unexpected things can happen, and sometimes our plans don’t pan out. When challenges arise during your pregnancy, labor, or delivery, it’s important to remember that the best way for the medical professionals, your circle of care, and for yourself to ensure healthy outcomes is to communicate what you need or don’t know. Be gracious as information is provided, and ask for clarity where you don’t understand. Share your concerns and advocate for you and your baby. It doesn’t matter if you’re a first or fifth-time mom; pregnancy, labor, and recovery are challenging. Be kind to yourself, recognize the signals your body is sending, and allow yourself space to meet your needs in healthy ways. Resist the urge to put yourself last and let your healing have its place.

Motherhood is a beautiful and challenging gift. My hope in sharing my story is to make space for each of us to practice self CARE where our health is considered. Be empowered to know regardless of your age, race, education, income or type of insurance, you have options, and ownership in your healthcare is your right!

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About the Author

Renada Bey

Renada Bey

Renada Bey is a dynamic educator, published author, speaker and advocate for equity in education, mental health, and maternal wellness. Through her organization, Love Worth Work, she offers empowering mental health coaching and support.

Follow her journey on Medium: Renada Bey.