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Black Maternal Health must be a priority to all of us, as we lose approximately 700 Black mothers during childbirth and 50,000 experience severe and long-term complications. In addition, many Black babies are born prematurely and don’t live to see their first birthdays. Most of these deaths are preventable.

We know that political and social determinants of health play a role in these challenges, but structural racism and decisions made by health care providers may contribute to these poor outcomes and even deaths. Lack of access to care remains for some due to no or limited health care coverage. Even with appropriate health care coverage, lack of intentional time, investment in inpatient/clinician partnerships, and lack of dignity and respect results in many women choosing not to access needed care during pre-pregnancy, pregnancy and postpartum periods.

Pre-pregnancy is the critical time that women must decide whether they are prepared for a pregnancy. In 2021, pregnancy is a choice. There is the occasional “mistake,” but this is extremely rare. Black women must decide that their bodies are valuable and an asset to the lives of a man who sees the value in loving and caring for them. This is the time to be selfish and focus on self-preservation. Birth control has been made available and condoms also work when used regularly. Choosing to become pregnant should be a planned event filled with the physical, psychological, emotional, spiritual and economic tools to handle it.

Pregnancy requires a village — support that fills us as Black women with the affirmation that we are beautiful, Black vessels carrying future Black leaders who need cultivation in the womb. Mothers need a social wellness network that adds joy versus unwanted tension to the pregnancy. They need to step away from all who dare to strip them from self-affirmation, self-esteem and a self-image that reflects maternal beauty. This includes mothers, fathers, siblings and friends who create drama in their lives. Surrounding themselves with allies, including the use of doulas, social workers, community health workers and clinicians (physicians and midwives) that listen and treat them with dignity and respect, is a great start.

Reading, being informed and preparing questions that strive to protect both mom and her baby is one of the fundamental roles of a great mother. Know the benefits and risks of considering home births and tub births without the trappings of the “it looks so cool” mentality. The wisdom and support of other mothers during this critical time, such as centering pregnancy care, is one method of fulfilling this goal. Knowing, understanding, and advocating for the right to be heard and treated respectfully at all times is a clear investment in rejecting perceived racist decisions or treatment that may lead to poor maternal and birth outcomes.

Lastly, but most importantly, is what we clinicians call postpartum or the fourth trimester. This is the time after delivery when mothers are sent home with their newborns to start parenting. Parenting requires the continuation and presence of the village; it’s the period when mothers need help caring for their newborns, but also help caring for themselves. This is the time when lack of sleep, caring for other children, depression, anxiety and the energy to be self-affirming can be drained. Black women must be reminded of the legacy of strength and beauty they embody. Shower mom with gifts of perfumes and clothing that will help them feel feminine and beautiful. We are all responsible for contributing to the total health of Black women.

Navigating the beauty of birthing healthy Black babies in an often unkind and unhealthy medical system can be done. Challenging the political and social determinants of health that stem from the systematic structural racism practices will remain the biggest challenge to reducing the death of Black mothers and their babies in this country.

Dr. Margaret Larkins-Pettigrew

Writing since February 2022 · 1 story contributed