How Medical Racism Robs Black Families of Joyous Birth Experiences

by Chamidae Ford

(This article is published in recognition of Black Maternal Health Week, which takes place every year from April 11—17. The week is intended to deepen the national conversation about Black maternal health in the US; amplify community-driven policy, research, and care solutions; and center the voices of Black mamas, women, femmes, families, and stakeholders.)

Childbirth is often thought to be the most magical experience one can have. But for Black women, the road to motherhood can often be paved with horror due to the racism they face in the medical field.

Shayla Akande gave birth to a baby girl on January 24, 2021. Although her story ends with a happy and healthy baby, the birthing process wasn't the smooth transition she had been hoping for.

In the United States, Black women are three times more likely to die in childbirth than white women. Many researchers believe the deep, structural racism embedded in so many aspects of Black women's lives, as well as in the medical care they receive, is the most significant factor. Conscious of these statistics, Akande worked to create an environment that recognized her Blackness and supported her in every way.

"I chose to do a waterbirth; based on everything that's going on with Black women in the maternal community, it just seemed like the safest thing," Akande said. "I wanted a calm environment to birth in. I've also heard a lot of benefits about giving birth in the water."

Akande and her husband chose a local birthing center, Seattle Home Maternity, in Columbia City. Akande sought out both a midwife and a doula for her daughter's birth. She wanted to be able to get to know the people who would be delivering her baby. The saving grace of her experience would be her doula, who she found through The Perfect Push.

At 4 a.m., Akande's water broke. By 8:30 a.m., she was at the birthing center. Everything was going smoothly for both Akande and her baby until she began to deliver.

"It was a shift in energy in the room," Akande said. "It went from, 'Hey, baby's coming, baby's coming,' to the breath being taken out of the room."

This was the moment when things began to take a turn. The baby was born with the cord wrapped around her neck, cutting off her oxygen. She needed immediate attention. When Akande heard the midwife ask for scissors, she knew something was wrong. They had begun to veer off her birth plan, which meant things were not going as expected. Akande had intended to cut the cord with her husband.

Akande's mother, Bridgette Hempstead, stressed the helplessness she felt in those moments.

"My whole heart is broken because the room went from excitement, anticipation, to sheer terror," Hempstead said. "I start praying. I'm praying for my son-in-law, my daughter. And I don't have time to be scared. I just have to do what I can in a situation I can't put my hands on."

An ambulance was called because the baby was still not breathing well and Akande was bleeding profusely. Six EMTs rushed into the birthing room, adding a level of chaos and fear into the space that had once been filled with excitement and love.

"All of them rushing into the room … I have no clothes on. I'm bleeding out. I am completely vulnerable," Akande said. "I'm out of it. I just gave birth. Eight hours of labor, I'm out of it. I don't really know exactly what's going on."

She does remember, however, the moment when the EMTs decided they'd leave the baby behind and only transfer Akande to the hospital, despite the baby not receiving oxygen for some time.

"One of the head medics said, 'It seems that [the baby] is fine now, so we're not going to take her,'" Akande said. "I remember in that moment Heather, [my midwife], looking like her head was going to explode for a second, and saying, 'No, you need to take her. We're not a facility that has the proper instruments to handle this type of thing.'"

Akande and her baby were transferred to Swedish Hospital where Akande would stay for four days and her baby would stay for five. The first few days were filled with uncertainty and a lack of information. "The Swedish emergency room feels like the place that you're going to go to die," Akande said. "It was cold. It was kind of grungy. It was like we were in the corner of the hospital that everybody forgot about."

In the emergency room, the gravity of the situation began to hit Akande.

"I don't even have the energy to talk or to say anything. And I think that's the moment where it kind of just hit," Akande said. "I just started to cry because I had no idea what was going on. I just delivered this baby, but I don't know what's going on with her. I barely really know what she looks like. All I remember was that she was blue and I'm asking the nurse, 'Where's my kid? What's going on with her? The nurse that was in my room didn't have access to [my daughter's] file. So for at least four hours we were left in the dark completely and had no idea what was going on.'"

The two of them were separated upon arrival, the baby going to the NICU and Akande being transferred to a different floor where she was admitted and given two blood transfusions. Akande remembers being told she would need blood transfusions, but credits her doula for explaining the medical information in a digestible way. Without her, Akande might have felt very lost and confused.

"My doula, she was really good at explaining everything to me and making sure that I understood everything that I was signing while being out of it," Akande said. "She also made sure that I had a pump. As soon as we got there, she was like, 'Okay, these are the things that we're going to need.'"

Akande's doula acted as her voice and advocate throughout this experience. Due to COVID-19 restrictions, only one person was able to stay with Akande. She and her husband, Olu, opted for her doula to be the one by her side because she has a proper understanding of maternal health and the medical field.

"We chose at that moment to have my doula stay with me because advocacy is key when I'm completely out of it, and I needed an ally, period," Akande said. "[My husband] has no idea what's going on with the birthing world. I don't have any idea what's going on. Medical terms are flying at me and I need the best advocate and ally in the room with me. So my doula stayed with me and then Olu had [the baby's] other wristbands so he [could] go and see her in the NICU at any time."

Despite that advocacy and support, Akande and her family felt disrespected. During their stay at the hospital, they experienced repeated microaggressions and macroaggressions from staff. These ranged from inappropriate conversations about Akande's faux locs, to a nurse sharing a story about the darkness of a family member's skin, to a doctor suggesting they cut corners to make their stay less expensive.

"What I heard [the doctor say] was, 'I don't want you to have a huge medical bill because this is really expensive, so we'll probably just keep you overnight and discharge you,'" Hempstead said. "So I immediately said, 'Insurance is not a problem. [Olu said] the same thing. And I just couldn't believe that the doctor would say that… Would [they] say that to a white couple that's having a baby?"

And while their story has a happy ending, the trauma of the experience leaves deep scars. Olu, Akande's husband, was faced with the reality that he may lose them both.

"Witnessing my daughter coming out with this lifeless body, and seeing her blue face and already thinking, 'Wow, is she not even alive right now?'" Olu Akande said. "Then on the other side of the room, seeing Shayla bleeding out in front of me. In my head I'm already like, 'I may end this night by myself,' and that is a lot to kind of handle and process in the moment."

For Olu Akande, it took a while to finally feel hopeful and excited about the future.

"Call it what you may, as far as protecting my heart, [but I'd] already run through this scenario of, you know, my child not making it and my wife potentially not making it," Olu Akande said "So I almost found myself not wanting to get too attached. There's so much up in the air. I wasn't able to hold [my daughter] or anything like that. She was hooked up and she's still all bruised in the face and I was like I'm not trying to get too attached to this baby because I don't even know if she is ready to meet me, you know? It wasn't until they started giving us good news, that things are going well, she's looking great — I think that's when my guard was finally starting to drop. … By the time we got home, I think I was ready to let in the love, per se, I was ready to have the 'Wow, this is my daughter, this is my child. This [baby] came from Shayla and me. All those things that people talk about, the joy of childbirth."

That joy did come, but it was belated. Even now, when Shayla Akande goes through the medical bills and reads through all the charges, it brings back terrifying memories.

"I had a really hard time looking at the bills because you see these line items that just bring the trauma back," Akande said. "The thing that puts my heart back in the pit of my stomach was seeing a bill that said 'resuscitation' on it, and being like, 'Oh my gosh, this is a complete miracle.' … I'm a Black woman. And the odds are already stacked against me. And just how many things had to go right in order for us to both make it out."

The reality of their situation was if they had not created such a strong support system, if they had not prioritized finding someone who could advocate for Akande and her daughter, their story could have been much different.

"[My doula] was basically saying, like, 'I will kick down the door if you need me to,'" Akande said. "The reality is, when you're getting ready to give birth, you don't know how vulnerable you are going to be. You don't know how fragile you're going to be. You don't know what voice you're going to have. I am, by nature, a very strong-willed, strong-minded, very verbal [person]. But in a moment where you feel like you can lose your life in a moment, where you feel like your child can lose their life in a moment, when our family looked like it was getting ready to completely crumble …" that experience changes things. Akande's doula became that necessary voice. She "put on a different hat for us … saying, 'She needs to use the bathroom. You guys aren't doing your job. She needs to be by her kid. You need to make sure that baby is sitting on top of her because they need the skin to skin.' Her telling doctors, 'She needs a minute, give her a minute. She just got here,' because I didn't have the mind to do that. My voice was gone. I was vulnerable. Olu wasn't there. My family wasn't there because of COVID."

The reality of the medical field and the racism within it, says Akande, is that change is slow-moving. She believes, especially for Black mothers, that the best way to protect yourself from mistreatment is by creating a team of people who can fight for you.

"Make sure that you have the knowledge — the advocacy — to have someone in your corner that can fight for you if you're not able to fight for yourself," Akande said. "Have a team of fighters, because Black maternal health is the issue that we're raising. The issue that we're raising for Black mothers and Black babies is that, at times, going to the hospital can be detrimental because the doctors are not listening to what's going on with you. They're not willing to take those tests that could save your life. Our healthcare system is broken and [your advocates are] going to have to step up to save you on behalf of Black families."

Research shows that the trauma the Akande family went through is not an isolated experience. In Washington State, for example, infant mortality rates have been shown to be twice as high for Black and Native communities compared to rates for white and Asian infants.

"I wanted to bring light to this because how many other Black mothers and Black fathers are going through this, in this city, in Seattle?" said Akande's mother, Bridgette Hempstead. "We're not talking about a rural area. We're talking about right here in Seattle, how we have to fight for our families, our Black families, our Black mothers, our Black babies. My terror feeling is how many Black families don't have [a happy ending]? And how many Black mothers don't come home with their families? How many Black fathers come home with only a baby or only the mother of their child? Or did he come home with no one at all?"

Akande and her family are sharing their story in order to bring awareness to the fact that Black women are not always receiving the care they deserve. They may need to create support systems that allow them to experience the miracle of childbirth, the way it should be.

"The birth of a child should be something that should be joyous," Hempstead said. "It's painful, but it should — at the end of the day, it should be joyous. And how many times are we losing Black mothers or Black children over something that's supposed to be natural?"

Bridgette Hempstead is on the Emerald's Board of Directors.

Featured image: Bridgette Hempstead with her grandchild Sade. (Photo: Susan Fried)