Blog
Last week, I did an interview about pregnancy and fertility. I was asked :“What is the one thing most women worry about in pregnancy that we don’t freely talk about ?” My answer : “Many women worry that they may not survive their pregnancy “And it’s not an irrational fear.
For years, I received skeptical looks when I performed a high risk work-up on every single pregnant patient that came through my practice. I have long been of the opinion that being pregnant and giving birth in the United States is, by default, a high risk condition.Think about it. Our country historically does not prioritize the health of its female citizens :
-There are scarce resources for uninsured or underinsured women to optimize their health prior to pregnancy
- Concrete physical complaints of female patients are often dismissed as emotional or behavioral problems.
- Most women are expected to work FULL TIME outside of the home up until the day they deliver. When they ask for reduced hours or early maternity leave to physically prepare for the rigors of delivery, they are often harrassed, ridiculed and not supported. They are threatened with decreased time at home with their infant after delivery.
- And let’s talk about that ridiculous standard of 6 week maternity leave. The body is physically adjusting to a HUGE cardiovascular, hormonal and musculoskeletal shift. Not to mention the mental drain of trying to care for the physical and emotional needs of other humans. How is 6 weeks sufficient time to heal and adjust when WWIII is going on inside your body and your home ?
- Insurance reimbursement for women’s services is among the lowest in all specialities which has caused a tsunami wave of closures of obstetrical units across the country. Meanwhile, fewer and fewer clinicians are choosing OB/GYN or midwifery training because of this poor reimbursement and the ever present threat of litigation.
I can only imagine the fear and anxiety in the minds of anyone who is pregnant right now or even thinking about becoming pregnant in the near future. The recent news of Olympian Torie Bowie’s untimely death due to pregnancy complications and the ruptured aneurysm of influencer Jackie Miller James less than a week before her due date has likely left you wondering if you are safe.
Take some time at your next appointment with your OB or Midwife to discuss these cases. Ask them if you have any risk factors that could compromise your health. Approach your next appointment as if it is a class assignment and IMPLORE your clinician to TAKE. THE.TIME. To TEACH you about your pregnancy and potential dangers that you may face.
HIRE A DOULA or a trained birth advocate who can accompany you to your appointments either physically or virtually to help you ask the right questions and digest and implement the information that is provided to you. Sometimes, we clinicians throw a ton of data at you and it’s difficult to absorb by yourself.
Until the U. S. takes maternal health seriously, we have to take care of ourselves. Every woman deserves a joyful birth story.
Sending Prayers for the Bowie and the James family.
#TorieBowie #JackieMillerJames
Tools to Improve Maternal Health
WHO? WHAT? WHEN? AND WHERE?
Many of you know the statistics that Black women are 3 times more likely to die during pregnancy, childbirth and in the post partum period.
I am sure that this is frightening to hear. Especially frightening, if you or your loved one is currently pregnant, considering pregnancy or just delivered. As an OB/GYN who is dedicated to seeing the statistic change, I want to arm you with some tools to protect you and those you love.
WHO?
WHO will take care of you or your loved one this pregnancy?
Are they a culturally competent provider? Are they someone who acknowledges the health disparity secondary to your race and recognize that there are nuances to your care that must be addressed to keep you safe?
WHO will be your support person THROUGHOUT your pregnancy?
WHO will accompany you to your prenatal visits and help you communicate with your physician/midwife about your pregnancy as it progresses?
WHO will be at your bedside throughout your labor or your c-section?
WHO will serve as your voice to express your physical and emotional needs as you give birth?
WHO will be with you after delivery to ensure your recovery is going smoothly?
WHO is willing to insist that your physician/midwife/nurse care team addresses your needs when you don't feel as if they are being heard?
WHAT?
Ask your provider to see YOU as a unique and special individual. WHAT about YOUR pregnancy needs to be viewed differently?
We are not robots. The inner workings of our bodies differ from person to person. What about you, your history, your family history is being considered from visit to visit? Make sure your physician or midwife to truly consider everything about YOU before addressing your concerns.
WHEN?
Know WHEN to start your prenatal care.
- Some offices will wait until you are 6 weeks or further along to see you for your first visit. If you are at an increased risk for pregnancy complications, you may need to be seen sooner to start therapies to ensure a healthy pregnancy.
- WHEN do you start childbirth preparation courses?
- Seek out courses that will provide guidance and knowledge through ALL three trimesters of pregnancy and post partum period (not just classes for childbirth)
- WHEN are symptoms considered concerning?
- Make sure your physician or midwife is educating you at EACH visit about concerning signs and symptoms to look out for THROUGHOUT the pregnancy, childbirth and post-partum period.
