by Rudy Johnson
How many of you have hopes and dreams? And I am not talking about flying to the moon or visiting Mars, but practical down to earth dreams. When young, our dreams are more outlandish. As an adult, practicality hits, as does the drive to live a purposeful life. Here in the United States, we’re given the chance to dream. As a citizen of this “developed” nation, we’re taught to shoot for the stars, and to grab a piece of the proverbial pie. For most, the goals would be to raise a family, and gain financial success. But this fairy tale life is just that for too many of the “citizens” of this great nation. For minorities, getting to the family part can literally result in death.
Specifically when you look at the disturbing gaps between the care we seek for pregnancy/childbirth and the care we actually get. For people of color, that disparity occurs at a staggeringly higher percentage.
Why Choose Birth Work?
Knowing why you choose this realm or profession may start the process of how you work within the job. Birth work is innate, deeply rooted, yet has been crowded by overconfident credentials and pervasive thinking. We now overshadow the wisdom that was once passed down from person to person, the village mentality or passing of the baton. Doulas, Midwives, OBGYN’s, you should re-frame your thoughts regarding pregnancy. Mary Poppins comes to mind with her magical satchel. Anything you needed, either unspoken or verbalized, she would materialize, and she did so without judgement. We could all be holistic Mary Poppins, respecting parent’s birth plans, listening, toting essential oils, suggesting healthy foods, utilizing non-western medicine (such as crystals, implementing yoga, and incorporating meditation).
You want the future family, that is both partners, to visualize a calmer future, where they are content with becoming someone’s parents. They should be echoing your positive affirmations, be totally trusting in your bond. All their fears dissipating, along with their distrust of the birth process.
Being Black & Pregnant is Revolutionary
Being a part of something you know, when going in, could very well result in your death is a revolutionary act. So when a person of color elects a system, or even more specific a provider, that doesn’t desire to treat them is immensely brave in and of itself. There is a sort of unspoken racism that is occurring before a patient even steps into an actual clinical encounter. The specific model or construct in which healthcare was built upon is steeped in racism, both implicit and structural.
Some structural instances that have weaved maternal care to what it is today would be: Gynecologic surgery on enslaved women in the mid-1800s, the use of high dose birth control in the 1950’s on Puerto Rican women, and the most recently in the early 2000’s unlawful sterilization of women in California prisons without consent.
The cards are stacked against minorities. Just imagine you’re pregnant, and at your most vulnerable state. You’re worried about not only your health, but also the safety of the baby as well. You are already aware of the deep rooted, structural racism which cannot be dismantled until we really take a look at the implicit racism or biases that occur. We, as people, are a product of our upbringing, our environments, our experiences, our family and friends. All of these different influences shape us to be the person we are today. So this is where the term high risk pregnancy typically comes in due to a clinician’s implicit biases. These aren’t always in your face, or blatant. Some are noticeable, but many are subconscious. The subconscious is the bias that really affects how the clinician treats their patient. The course of the pregnancy depends on that clinician patient relationship.
It’s been noted that people of color are given the term “high risk” during their pregnancies more so then their non-minority counterparts. They’re counseled differently from treatment options (such as being induced) to having birth plan, birth control after delivery, and so on. Diving deeper into the waters of birth and postpartum and biases (well this really goes for all professions): Passion, do you have it? Not just the letters that follow your name, but are you committed to each person’s passage to parenthood and the blessing to journey alongside. Also if there isn’t a fit and you notice that you are not meshing well with a patient fully, understand that you can inform all parties this may not be a good fit for the best outcome.
This racial diss cannot be overlooked (nor reversed) without addressing racial bias, both implicit and explicit. We have to acknowledge that it exists. If you are a marginalized patient, acknowledge the historical context from which this power dynamic has stemmed from but take control. You have options of what type of birth worker you may want to use. Studies have shown that having a birth doula present before, during, and after birth have an increase of positive outcomes. Many are concerned with the cost, but by researching early, contacting your insurance, or using word of mouth you may be able to afford a doula.
Maternal outcomes should be the goal, and mortality hurts both the family and greater communities as a whole. Let’s become a village. What you need to do this work is within you, but the only way to truly blossom is by shedding the skin of doubt and fear where biases feast. Use your upbringing as lesson, but not as a manual. Focus on the individual making sure they’re seen, heard, and accepted. Make sure you’re truly and purely present for any one of them. As you continue on this journey, you will transform into the unmatched birth worker you were intended to be.
Rudy Johnson is a freelance writer from Philadelphia, Pennsylvania. Full time mom/ part time blogger. As an maternal rights advocate she publishes cutting-edge articles that seek to take a look at the disparities in healthcare systems, lactation and breastfeeding, and fertility. Aspiring doula, breastfeeding ally, and holistic hippie. This is her first article with The Birth Mag.