This piece is part of our Empowered Birth series, highlighting ways Black women can have birth experiences that leave them and their families feeling safe and respected. Click here for more stories.
Over the past few years we’ve seen a rise in traumatic birth stories, especially for Black women.
It’s clear that pregnant Black women are more likely to experience poor treatment by the medical establishment than other races. It’s why there has been a push for home births.
But due to insurance, various health needs, and differing living situations, not everyone can birth at home. So how do you have an empowering birth when you have to stay in the hospital?
These four tips can help Black women have better hospital births.
1. Educate yourself.
Don’t just assume what your insurance will and won’t cover. Look up your plan online to find out what the basic services are, as well as what doctors and hospitals are in your network, if you are not already familiar.
Although websites are usually very good at giving basic information, giving the insurance company a call and asking directly about what benefits are covered for pregnant and birthing people will let you know right away what your options are. Most insurance plans won’t cover midwives, but you may be able to have one if they work for the hospital.
Thanks to the Affordable Care Act, many prenatal care needs are covered—but there are still things you need to check into. At the very least, you’ll want to ask your insurance company about deductibles and policy limits. Also check in about which hospitals and doctors work in your insurance network, including specialists. We all hope for healthy babies and pregnancies, but if you need additional care, you’ll need to know which doctors will be available to you.
As Black women, it’s really important to know what sort of interventions and care are available to us.
This is also a good time to find out which OBGYN offices are in your network, if you do not already have a stable doctor, and where they have hospital privileges. Each hospital is different when it comes to the care options they offer. For example, did you know that some hospitals have birthing pools available? Some are family first and create a more home-like environment in the delivery room where siblings and partners can comfortably stay. Others are much more clinical. Some keep the baby in the room the entire time with the parent, others have a nursery.
See what’s available to you and make a choice based on what’s the most comfortable for you. You can schedule tours at most hospitals so you can see up close what they’re like, long before you give birth. Keep in mind that your insurance may not cover all of these options, or may only cover a partial amount, so keeping on top of contacting them, early and often, is the best practice.
As Black women, it’s really important to know what sort of interventions and care are available to us. Talk to your family about their medical and birthing history to learn if you have family members who had health issues or complications. If there are any health problems that can be screened for, then asking about coverage for screening and intervention during your pregnancy should be a priority. Unfortunately, we have to very proactive in our care.
We need to be extra vigilant in educating and advocating for ourselves, says Shannon “Nola” Solomon of Doula Nola in Orlando, Florida.
“Completely understand your medical circumstances,” Shannon says. “If you have preeclampsia, you may need more intermittent monitoring and be on a ‘countdown.’ Know how you handle certain medications. If you get nauseous when you get pain meds, if they offer you morphine it’s not a good option for you.”
Also understand your rights as a patient, and have a plan in mind for how you’d want any potential emergencies to be handled—Babble has a helpful guide to get you started.
2. Build your support network.
This is so important, especially if you’re having a hospital birth. While you are giving birth, your focus is on your body. It is exhausting. Having people you trust with you can help you get through this process—and they can advocate for you when you’re too tired to advocate for yourself. There’s a lot happening in the press of having a baby, and these people can speak to doctors and nurses who are being too pushy or help bring their attention back if they dismiss something that worries you.
When you’re doing your hospital tours, ask how many people can be in the room with you and decide beforehand who makes the list. You can then appoint someone—a partner, friend, or family member—to be the main person who advocates for you.
You’re allowed to ask questions, you’re allowed to get a second opinion, you’re allowed to make choices for yourself.
Your support network isn’t just who will be in the hospital with you. It’s also the people on the outside who are caring for your other children if you have them, or taking care of the major and minor parts of your day-to-day life so that you can concentrate on getting through labor and delivery. They’re people who make sure your trash gets taken out so you don’t come home to a stinky house or wait for the cable guy because your baby came a week early. The people who give your partner a break or keep you company during the recovery period.
Having these folx around will help you feel more confident, especially if the doctors you’re seeing start pushing for treatment that you don’t want. Having a second (or even third) voice will help you advocate for yourself. Solomon adds that making sure everyone is on the same page will really help you remember your plan and keep you focused as your labor progresses.
3. Write a birth plan and give it to someone else to hold.
Having a birth plan before you go into a hospital is a great idea. Many people discuss theirs with their doctors before they go into labor so that, hopefully, everyone is on the same page.
But in the heat of the moment, this doesn’t always work out. Laying out what you do and don’t want right from the jump helps.
“Send in your birth plan to the hospital beforehand,” says Solomon. “Be very specific. And then carry a copy in with you in the big day. “
This plan can include the treatments you want, who is allowed in the room with you, if you want music or would prefer silence, as well as a number of other specifics you would like to ensure during your time in the labor and delivery. (Here’s a great template to help you get started.)
Let someone else hold it though! While you’re in the midst of labor, your mind is very focused and the birth plan will likely not be at the top of your thoughts. Having someone else who is familiar with it will help ensure that your desires are addressed, as much as possible.
4. Remember that you can say no to anything.
Once you enter a hospital, many people feel like they have to “follow the doctor’s orders” and that they are no longer in control of their own bodies.
But this is one of the major things that contributes to an unsatisfying birthing experience. You don’t have to say yes to anything, you are allowed to say, “No, I don’t want this.” You’re allowed to ask questions, you’re allowed to get a second opinion, you’re allowed to make choices for yourself.
This remains true even if you are in the midst of having a baby! You are still a patient, you are still important, and you are allowed to say, “This is what I want and this is what I don’t want.” In fact, taking this stance may help you avoid medically unnecessary interventions altogether.
Although so much of what we want can be out of our control in a hospital setting, it is still our birthing experience. By taking these small steps, you can help create a hospital birthing experience that is just as empowering and joyous as birthing in your own home.
Donyae Coles is a healing justice writer. She has been published on Splinter News, Vox, and Wear Your Voice. You can follow her work @okokno on Twitter.