Do I Need Fiber or an Obstetrician?
“I think they forgot about you,” my husband said while bouncing our restless two-year-old on his knee. I looked at my phone. It was past the clinic’s posted closing time. “Maybe you should check to see what’s going on,” I replied.
We had made a trip to urgent care because I was 13 weeks pregnant and on day two of a stomachache. It was nothing serious, but our recent cross-country move had left me without an OB/GYN. The only way I could get medical advice on a Saturday evening was to go to urgent care. Since I was pregnant and complaining of abdominal pain, the attending physician ordered blood work and an ultrasound.
At this point, we knew that the baby was doing well. All signs pointed to a bad case of constipation (because pregnancy is very glamorous), but we needed the lab results to rule out anything more serious. We had been told to wait in the exam room because my lab results wouldn’t take long, yet there we were a half-hour later.
I could hear surprised voices as my husband approached the nurses’ station. Moments later, he returned with a nurse who apologized profusely. They had forgotten that I was still waiting. She told us that all the tests were normal, so we went home.
Invisible, Forgotten and Ignored
On the list of things that can go wrong during pregnancy, being left to wait in an exam room while the clinic is closing rates as a minor inconvenience. It could even make for a funny story. But I’m not laughing.
This incident is symbolic of what many pregnant black women experience as we interact with many healthcare providers: we are invisible, forgotten and ignored. [1]
Racism in Prenatal Care
A 2013 study[2] found that black women are more likely to enter prenatal care after their sixth month of pregnancy if they receive prenatal care at all. The hesitancy to enter into prenatal care may be rooted in “the avoidance of racialized experiences among less empowered women when faced with discrimination.” In other words, black women, particularly those with fewer resources, are less likely to receive prenatal care because they want to avoid discrimination.
A study conducted in 2012[3] indicates that such concerns may not be unfounded. In this study, a group of minority women reported their various experiences with personally-mediated and systemic racism while seeking prenatal care. These women regularly encountered the perception that because they were African-American, it was assumed that they were on medical assistance, unmarried, or used drugs.
Avoiding prenatal care can have tragic results[4]. Women who enter prenatal care during their third trimester or not at all are more likely to have babies with health problems. Women who receive no prenatal care are three times more likely to have a baby with a low birth weight. That child is five times more likely to die.
A Far-reaching Problem
The problems that pregnant black women face extend far beyond prenatal care. Black women are subject to dangerous, even fatal, issues during labor, delivery, and postpartum. There are disparities in our birthing experiences and outcomes. We are often not believed when we highlight and report these issues. Studies have found that not only do racial disparities in health outcomes exist, but racial disparities in the quality of health care received also exist, specifically citing racism as a factor in these disparities.
I wish that I could say that being left in an exam room was the worst thing that I’ve experienced, but it isn’t. I have two happy and healthy girls, and so I’ve treated the negative aspects of my birthing and postpartum experiences as water under the bridge.
In this series, I will reflect on my labor, delivery, and postpartum experiences and connect my experiences to the much larger issue the dangers of childbirth when you’re a black woman. I hope that my experiences help someone know they are not alone. I hope this series saves a life.
[1] http://thehill.com/blogs/pundits-blog/healthcare/322874-for-women-of-color-the-healthcare-gap-is-real-and-deadly
[4] https://www.childtrends.org/indicators/late-or-no-prenatal-care/