There is unequivocally a crisis in maternal and infant mortality in the United States — and it is disproportionately affecting Black and Indigenous birthing people. Stories from this crisis trickle in month-to-month, accounts of mothers with perfectly healthy pregnancies experiencing traumatic births and, in the worst cases, end tragically with death of the parent or the baby.
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According to the World Health Organization (WHO), “between 1990 and 2013, the maternal mortality ratio for the USA more than doubled from an estimated 12 to 28 maternal deaths per 100,000 births and the country has now a higher ratio than those reported for most high-income countries and the Islamic Republic of Iran, Libya and Turkey” and more than half of these deaths are considered preventable. For Black people giving birth, they are three times as likely to die than their white counterparts.
Actress and advocate Tatyana Ali, who experienced her own deeply traumatic and life-threatening birth, closed out BlogHer Health 2021 in conversation with Sugaberry Founder Thai Randolph about this very crisis — and shared how connecting with other Black parents, midwives, doulas and maternal health advocates have helped them better understand the role of systemic medical racism in these horrifying numbers and how to advocate for the care all mothers deserve.
“I lived a very privileged life,” Ali said, citing her background as a Harvard-educated former child actor. “The birth of my son and my pregnancy was really my first interaction with a type of racism that could kill me and affect the health of my child.” Yet, she said the experience of her first birth going so wrong and being so dehumanizing opened her eyes to the way her privilege didn’t protect her from the systemic racism in the medical community.
She detailed the traumatic moments from her first birthing story — experiences of being ignored, coerced and traumatized at such a vulnerable moment that resulted in an emergency C-section and her newborn spending the first few days of his life in the NICU.
“When we left the hospital it felt like we were running,” Ali said.
It wasn’t until she was really able to connect and talk with people in the reproductive justice space — in her case, a lactation consultant — that she says it fully clicked how valid her feelings of trauma and violation were.
“When we were healing our wounds the best we could, not even knowing our story fit neatly in the statistics, a lactation consultant asked what happened,” Ali said. “When I told her, the look on her face let me know that what I was feeling was real — and that something needlessly horrible had happened.”
And it was from there that Ali started to connect with other organizations in the reproductive justice space — like Black Mamas Matter — and she said “the paradigm shift started to take place.”
“The guilt is something I carried with me for a very long time, until I started to hear similar stories and realized there’s something bigger happening,” Ali said. “That my story is one piece of it. And it didn’t have to be that way.”
Reclaiming joy for Black mothers
In her next pregnancy, Ali said she felt more empowered and more prepared to really take control of the experience — for her safety and the safety of her child. She knew she wanted to write about her experience (which she did in her powerful essay “Birthright” for Essence) and that she was moved to dive into the reproductive justice work, but a small part of her also hoped that she would find her midwife. Someone who could provide the culturally competent care and help her reclaim birthing and pregnancy from the trauma.
“I wanted a black midwife who I felt connected to,” Ali said. “[Finding her] was not easy to do and there are historical reasons for that and there are corrections for that too.”
She shares how her experience with her midwife could be summed up with this one stark difference between her experience with her OBGYN.
“At my OBGYN I had a pelvic exam every time, he was always in it,” she said. “My midwife asked me ‘can I touch you? can I touch your belly?’ She always asked. If I didn’t need a pelvic exam, she didn’t give me a pelvic exam.”
“My midwife asked me ‘can I touch you? can I touch your belly?’ She always asked.”
She added that her midwife also came prepared to work with her to psychologically prepare for birth again (fully aware of how her previous experience might influence it) and to assist with postpartum care in a compassionate and fully understanding way.
“It’s a shift in care,” Ali said, adding that her midwife even came to her house and cooked her family a South African peanut stew to help keep her strength up.
And this second birth? It was exactly the experience she wanted and needed: “My second birth, for both my husband and I, it completely changed, it cleared up the trauma.”
To other birthing people who are scared about their pregnancies or processing their own trauma from birth inequality, Ali urges them to feel empowered to take charge of their and to reclaim the joy of giving birth and being a new parent.
“Share your story, share it, share it, do not stop digging. You can have the type of birth that you want, the kind of support that you want. We are often talked about as a needy community, that we have more needs than anyone else,” she said. “Any mother of any ethnicity knows, we need community, we need support, we need help when things go wrong. Unfortunately our systems are such that some people get those needs met and some don’t. Remember that and let that empower you to get what you need.”
You can watch the full BlogHer Health event encore over at BlogHer.
And before you go, check out these awesome books that center Black women’s mental and physical health:
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