24 May 2022

How to feel more empowered as a black pregnant person

24 May 2022

Advocating for yourself in a medical setting can be tricky, particularly if you feel like your voice isn’t being heard.

“Everyone should be entitled to optimal maternity care no matter their race,” says Dr Lauren Hamilton, a mother-of-one who works in A&E for the NHS, and is also a cosmetic doctor (victorandgarth.co.uk).

“There is no place for discrimination, microaggression nor systemic racism when it comes to maternity care – as in each case, there is not just one life at stake, but two.”

In January 2021, a report from MBRRACE-UK (which examines deaths among pregnant women, new mothers and babies), found maternal death rates among women from black ethnic backgrounds were more than four times higher than for white women.

This spurred a year-long investigation, hearing from over 300 people with lived and professional experience of racial injustice in maternity care. It recently wrapped up, finding that “systemic racism” is experienced by black, Asian and mixed ethnicity women.

Charity Birthrights said the findings included evidence of a lack of physical and psychological safety; experiences of being ignored and disbelieved; dehumanisation; coercion and a lack of choice and consent.

Sonah Paton, co-founder of Black Mothers Matter (blackmothersmatter.org), says: “I didn’t know the statistics when I went into any of my pregnancies, and I’m very glad I didn’t.

“I don’t think knowing the statistics is particularly helpful. There are certain things you could do to mitigate the risk, but ultimately the onus is on the people caring for us, caring for black women and black birthers.

“I don’t like to say, ‘Black women can do this to protect themselves’, because it’s healthcare professionals and birth workers that need to do most of the work.”

However, if you’re a black person navigating pregnancy and birth, you might want to take some steps to feel more empowered throughout your journey…

Prepare as much as possible

For Paton, one of the most empowering things you can do is “as much preparation as you’re able to, education about the physiology of birth and the process of the system you’re working in”.

She recommends seeking out education “that’s put together with you in mind”, saying: “Our organisation produces and shares a very short pamphlet that’s got some information written for black birthers. So, for example, tips on healthy eating with a more culturally diverse diet, or ways of exercising safely that are a bit more considered for black women.

“As well, if you have a birthing partner – whoever that might be – educating them, or encouraging them to educate themselves on the system you’re going into.”

(Alamy/PA)

Have a script ready

Paton’s advice is to “potentially have some lines ready, or some scripts in your head to be able to challenge things you’re told or suggested”, she says. “So often things are presented as critical or an emergency, but having something already in your subconscious that questions that is really helpful. So, ‘Can I have 10 minutes to think about that?’ Or, ‘If I don’t do that immediately, what are my other options?'”

Hamilton recommends taking the advice of the Royal College of Obstetricians and Gynaecologists, who champion the use of ‘Ask three questions’:

1. What are my options?2. What are the pros and cons of each option for me?3. How do I get support to help me make a decision that is right for me?

“These questions acknowledge the importance of individualised maternity care,” explains Hamilton.

Connect with others

Paton recommends “connecting with other people within your community that have had similar experiences, or been through the same thing. It’s really helpful to be able to validate your thoughts and feelings”.

Hamilton broadens this advice, saying: “It could also be useful to talk with friends and family and share experiences, keeping in mind that everyone’s experience is unique to them.”

Document your journey

“Capturing what you’ve heard at appointments, rather than relying on your maternity notes, can be really helpful – so you can go back and clarify or remind yourself,” Paton suggests.

Speak up if you feel able to

Rochelle Fryer is training to be a midwife, and has volunteered to be a Maternity Mate – a scheme set up by East London charity Women’s Health and Family Services (whfs.org.uk) to make sure every woman is supported and empowered during their pregnancy, birth and afterwards.

Reflecting on the negative experience she had during the birth of her second child, Fryer says: “For me, the lesson I learned from that experience is not to allow yourself to be silenced. If you know something doesn’t feel right, speak up and don’t allow anyone to make you feel ashamed or embarrassed for doing so.”

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