Maternity Care Issues

Women of Color Deserve Respectful Obstetrical Treatment

The first time the author was able to touch her baby daughter. | Credit: Courtesy

Given recent conversations about the state of obstetrical care in Santa Barbara, I feel compelled to share my experiences and perspective about what is lacking and what could be improved for birthing people in our community. My daughter was delivered via emergency C-section at Cottage Hospital when I was 25 weeks pregnant. She weighed less than two pounds and spent nearly four months in the NICU.

As a Black woman in this country, my story is unfortunately not unique. Preterm birth and low birth weight are the second leading cause of infant mortality in the U.S. and the leading cause of death for Black babies. Black women are three times as likely to die during pregnancy or childbirth than white women and 60 percent more likely to give birth prematurely. These statistics are devastating but hardly surprising, given the way structural racism impacts health outcomes.

The history of reproductive violence against women of color is a long one: forced sterilization, mass sexual assault and violence, and the systematic separation of babies and children from their families. Black and Native women in particular have struggled for autonomy over their reproductive lives and ability to mother their children for most of U.S. history. The continuation of this struggle is reflected in the reproductive health disparities that exist today. These disparities will surely be exacerbated by the overturning of Roe vs. Wade.

I began my prenatal care with a group of midwives, hoping to give birth at home and avoid a hospital setting that I knew could be disproportionately dangerous for Black women. When I began experiencing concerning symptoms, I reached out to the midwives, but my concerns were dismissed. After advocating for myself with a number of medical professionals, I was diagnosed with cervical insufficiency, drastically increasing my risk of preterm labor. I sought care with an OB in town who I had seen early on in my pregnancy. She had a reputation of being one of the most progressive doctors in town, and I immediately felt comforted by her warmth and kindness.

She acknowledged the difficulty of being a woman of color seeking obstetrical care and also recognized that my race put me at a higher risk for preterm birth. I had never had a doctor acknowledge these realities. She assured me that while she could not guarantee any specific birth outcome, she could promise that I would be listened to. I was on modified bed rest for about two weeks before my daughter arrived 15 weeks early.

Having a child in the NICU, especially a micro-preemie, is terrifying. For me, this trauma was compounded by both the medical neglect I experienced and the COVID-19 restrictions that limited the time I could spend with my baby.

When I went into preterm labor, I was sent home from the hospital. The nurse who cared for me dismissed my concerns and insisted that my pain was a normal part of the second trimester. My doctor came to speak with me briefly, and while she was very kind, she did not examine me. Despite describing my excruciating pain and the increasing intensity of my contractions, I was instructed to go home and take ibuprofen.

I returned hours later when the pain became unbearable. I could barely walk but waited nearly 20 minutes in the lobby of Cottage before someone from Labor & Delivery came down for me. I was not offered a wheelchair or assistance getting to the elevator or through the halls, despite contractions writhing through my body. It wasn’t until my daughter’s foot was coming out of my vagina that I was taken seriously. I was rushed into surgery. From across the room, I saw my daughter for just several seconds after she was resuscitated, before she was taken to the NICU.

I cannot help but wonder if my experience would have been different if I were someone else. Black women and their babies die as a result of not being believed about their pain or symptoms. This is well-documented. My life and my child’s life are not less important than anyone else’s. Just like every other pregnant and birthing person, I deserve respectful maternity care.

My partner and I are very lucky that our baby survived. We are deeply grateful to the neonatologists, respiratory therapists, nurses, speech pathologists, and physical and occupational therapists who took wonderful care of her. Still, I think back to my doctor’s promise that I would be listened to. I wish that had been true; being listened to would have meant being believed about the pain I was experiencing, not being sent home with ibuprofen. I understand that preterm birth cannot always be prevented, but I wish I could say with confidence that those who treated me did everything they could to prevent that outcome.

I am not denying that many women have had wonderful experiences with the doctor who delivered my baby. I am pointing out that all experiences are not equal. Even with progressive, feminist doctors and midwives available, Black women and babies still suffer.

Megan Spencer is a PhD candidate in Feminist Studies at UC Santa Barbara.


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