An Open Letter to Black Moms During Black Maternal Health Week

After her birth experience left her feeling judged and alone, maternal health advocate Christine Michel Carter became committed to making sure other Black birthing people don't have to go through the same thing.

High angle view Of pregnant Black woman lying on bed holding her belly
Photo: Getty Images

I had a scheduled cesarean delivery when I gave birth to my son West in 2015. However, when he was removed from my body, my heart rate shot up to 230 beats per minute. I whispered "help" to my OB-GYN, but he was already working to address it.

Days later, when I was in the maternity ward, my OB-GYN ordered me to receive a CT scan assessed by a neurologist. After evaluating the results, the neurologist spoke with me privately in my hospital room: "I can't confirm the reason for your high heart rate during delivery, but I'm led to believe that your age played a factor. A woman of your age should consider the challenges of giving birth at this stage of your life, and perhaps should be done with pregnancy."

Before that conversation, I wanted to have five children, and this neurologist was putting an end to that plan. I felt judged and ashamed.

But perhaps what felt the most heartbreaking was that I was alone. My then-husband was not in the room to console me, nor was my OB-GYN, whom I'd befriended after the birth of my first child, Maya. I couldn't even wait for the neurologist to leave the room; the tears ran down my face. Sadly, my back caved into the mattress, and my head sank.

Hours later, my OB-GYN returned to check in on me, and I told him what had happened. He dismissed the advice: "Christine, first of all, you're 29 years old. You still have many more years to have kids if you want. Second, he is not an OB-GYN; he is a neurologist. Third, as a Black woman, you, unfortunately, are subject to discrimination and a lower quality of care from healthcare providers. Ignore him."

Reflecting on that experience, I know it was then I realized the fragility of maternal mortality, maternal mental health, and quality of care. Moreover, I know it was then I discovered the importance of Black maternal advocates.

How can I put this in a way which comforts the few yet does not alienate the many?

It is not you, Black mama. It is them. You undoubtedly have it harder, and you are not going crazy.

The "them" I refer to are those who marginalize your mental health through societal expectations or employment and government policies. Those who stereotype you. Those who do not understand the Black mom's right to a positive and fulfilling pregnancy, childbirth, or postpartum experience.

I grow tired of talking to "the many." So today, in honor of Black Maternal Health Week, I am directly talking to you, Black mama. My friends at Black Mamas Matter Alliance are fighting "them" for you, claiming your right to live and thrive- despite racism, poverty, and structural policies that affect your access to quality and equitable reproductive health care. The CDC, National Black Midwives Alliance, The African American Wellness Project, and Shades of Blue are fighting for you too.

It is unacceptable that you are more likely to suffer from perinatal mood and anxiety disorders in silence because you think your situation with your clinician will never improve. You should not have to return to work after giving birth before you're physically or mentally ready. In addition, Black maternal health support should not come with the risk of losing your child due to improper social agency evaluation, racial bias, or discrimination.

That's why as an executive committee member of Mom Congress—an organization addressing the most pressing policy issues of motherhood, including the "motherload" of stress that U.S. mothers carry—I, and other activist groups, are deepening the national conversation about Black maternal health in America, amplifying community-driven policy, research, and care solutions.

Better treating Black maternal health conditions is crucial, but America has to look at systemic issues and how we can prevent maternal health issues in the first place. At the societal and employer level, it's time we look upstream. Because make no mistake: Black maternal health is your employer's responsibility.

Case in point: Black mothers, in particular, sustain an array of essential industries from food service to public transit to nursing homes. Yet, they are traditionally underpaid and overworked—last to get hired and first to be fired in times of crisis. Also, finding professional success often involves significant compromising, overworking, and discrimination.

You can handle it; you are probably motivated, ambitious, educated, and resilient. But you don't have Imposter Syndrome. You often just don't belong. That disconnection and lack of ambient belonging can deteriorate maternal health.

Related, it's time for the phrase "social determinants of health" to become widely adopted because the places in which we work, live, eat and age determine 50% of a person's health outcomes. But, unfortunately, your social determinants of health are inconsistent at best, Black mama, and even outside of work, your maternal health is constantly challenged by racial and financial inequalities.

I challenge the government to do its part and put protections in place to give you (and Black moms to be) the peace of mind needed to flourish at home and work. We need lawmakers to pass more legislation addressing maternal health. If policies like the Pregnant Workers Fairness Act (PWFA) became law, Black pregnant and postpartum workers would receive accommodations in the workplace and move the needle. If the Moms Matter Act under the Black Maternal Health Momnibus passed into law, it would exponentially transform the maternal health crisis in America by providing equitable access to mental health and substance use disorder services. The TRIUMPH for New Moms Act will help federal agencies coordinate maternal mental health programs if passed. The Into The Light Act would provide you with permanent mental health resources, from a 24/7 voice and text hotline to improved screening and treatment programs.

Because, quite frankly, we should all be striving to end Black maternal mortality.

My postpartum experience was disheartening, but it prepared me to serve and support other Black women through their maternal journey. If I can make a tangible impact in your life, I want you to know one thing: You. Are. Not. Alone. At this moment, as lonely as you might feel, as scared as you may be, as unfair as America is to you, we are connected.

I may not know you personally, but I am fighting for you. I just need you to keep fighting for yourself and your babies.

Editor's Note: Though "women" and "moms" appears throughout, we acknowledge that not all people who give birth are women or identify as moms.

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