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In 2018 I walked into my doctor’s office, newly pregnant and excited to hear my baby’s heartbeat for the first time. I left feeling ashamed of my body.
The doctor didn’t ask about my medical history, my lifestyle or my goals for birth. She didn’t even take blood tests. Instead, she looked me up and down and said I would probably develop gestational diabetes and high blood pressure and would likely end up needing a C-section.
None of these predictions were based on facts — only on how I looked. (I’m a Black woman with a smaller than average build.) What should have been one of the most joyous milestones of my life was replaced with fear, sadness and disappointment.
As a medical social worker, I knew her words didn’t have to become my story. But I couldn’t shake the thought: How many other women — especially women who look like me — walk out of medical offices believing those words and internalizing fear and shame, because the doctor is considered the expert?
Too many women — especially Black women — enter pregnancy carrying fear.
We read the statistics: In California, a woman dies every five days on average, either during or after childbirth, but Black mothers are nearly four times more likely to die than others. African Americans account for 5% of pregnancies but 21% of pregnancy-related deaths.
Black women also have heard stories about celebrities like Serena Williams nearly dying after childbirth because her concerns weren’t taken seriously. We wonder: If they didn’t listen to her, why would they listen to me?
That’s why alternatives like midwifery and doula care aren’t just “nice extras” for well-off expectant parents. They are lifesaving, cost-effective health care options that should be covered and accessible to every woman, especially Black women, who could use some peace of mind.
My search for better pregnancy care
My fears came early in my pregnancy. I used to tell myself that if I died in childbirth, at least I made it to 30. It sounds dramatic, but for many women of color it feels like reality. That first obstetrics appointment only reinforced those fears.
I turned away from traditional obstetric care, and my husband and I researched alternatives and chose a midwifery birth center. That meant paying $9,000 out-of-pocket, when my insurance would have covered hospital care for free. But for me, safety meant being respected, listened to and cared for as a whole person.
The difference was transformative. The midwives never rushed me. They invited questions and explained every option, they prioritized my voice and they prepared me and my husband through prenatal classes.
The research is clear: When women have access to midwives and doulas, outcomes improve. There are fewer unnecessary interventions, fewer complications and more positive birth experiences.
Hospitals will always have an important role in maternity care, but birth should not be limited to them. For women who are good candidates for out-of-hospital birth, midwifery and doula care should be encouraged and supported by our health system.
Erica Moore-Smith is a therapist and licensed clinical social worker in Riverside County.
CalMatters is a nonpartisan and nonprofit news organization bringing Californians stories that probe, explain and explore solutions to quality of life issues while holding our leaders accountable.
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