Expectant mothers tend to spend time fine-tuning their baby registries and decorating their nurseries. I did some of that, but also spent time getting my blood pressure checked and drafting a will with an estate lawyer.
As a Black woman, I embody the high risk of dying during or soon after giving birth. As a Black OB-GYN, I know that Black women in the U.S. are three to four times more likely to die from pregnancy-related causes than white women.
But even beyond that statistic, I was afraid for my life because of what I see every day as a physician: Black women’s pain treated as inconsequential, their heavy bleeding regarded as non-emergencies, their high fevers deemed nominal, their high blood pressure neglected. I routinely witness health disparities in maternal health while fighting on the frontlines for dignified care.
Three years ago, I rushed to the bedside of my friend Dr. Monique Smith, with whom I co-founded a startup called Culture Care, during her labor at a California hospital. She had called me saying she did not feel right. I walked into her room to find her blood pressure dangerously high blood and her baby showing distress on the monitor with not a single doctor on the unit. She was another neglected Black woman whose medical degree did not distinguish her — even in the hospital where she worked two floors down.
Serena Williams’ celebrity and her public medical history of a pulmonary embolism in 2011 did not prompt nurses to listen when she experienced the pain of another clot wedged in her lung after giving birth to her daughter in 2018.
In my work, I regularly hear Black women share how they are ignored and disparaged by medical staff. On rounds, my patients find solace in my dark brown skin, sharing accounts of treatment by my colleagues and sordid histories of previous births at neighboring hospitals.
As a physician, I’m not shocked at how commonplace these occurrences are. As an expectant mother, though, I was positively terrified.
My work tempered my joy as I prepared for my own baby. According to the Centers for Disease Control and Prevention, a Black woman with a college degree or higher is more likely to die a pregnancy-related death than a white woman who dropped out of high school. The disparity of maternal health outcomes between Black women and white women points to racism — not race — as the true risk factor for that disparity.
My degrees from an Ivy League university and a historically Black medical school can’t save me from racism. Nor can my socioeconomic class or ZIP code. Even living in the state with the lowest maternal mortality rate in the U.S. does not protect a Black woman like me from having four times the maternal death rate of other races. California has created medical interventions to make pregnancy safer for some women, but not me.
I realized that I needed to engineer my personal survival kit. Anonymity in a hospital is not safe for a Black woman. Who is in the room with her making decisions matters. I first secured a Black obstetrician to minimize bias in my care, but then realized that in most practices today it is physician roulette as to who would be on call the day I walked into labor and delivery.
As my delivery date neared, I thought about how best to ensure I had advocates in my corner and pivoted my plan to focus on an environment where I could count on a holistic team committed to my survival. So I made plans to fly across the country to have my baby in the hospital “where everyone knows my name” — the medical center where I did my residency training for four years. The staff knew me well, from the doctors and nurses to the environmental services staff. It was in that obstetrics unit where my humanity as a person and a patient would be fully recognized, something many Black moms-to-be are never afforded.
The choice I made was arguably extravagant — involving plane flights and extended time away from work to allow for Covid-related quarantining. And while this unorthodox plan may seem dramatic or far beyond reasonable to those who have not experienced the systemic racism in the U.S. health care system, it made sense to me as I thought of Dr. Chaniece Wallace, a pediatric chief resident with significantly elevated blood pressure — just like me — who died two days after giving birth.
Black women across the country are electing unusual and creative birth plans to ensure their survival, the survival of their babies, and the health of their families in ways never before imagined. I joined this trend, using my privilege and connections to craft my team and create a beautiful delivery surrounded by Black clinicians I knew and trusted. I did this to secure my daughter’s safe passage into the world with a mom by her side who will support, love, and fight for her every day.
That’s what every mom wants to be able to do for their child. It shouldn’t take privilege or connections to make it happen.
Joy Cooper is an OB-GYN in California and co-founder of Culture Care, a telemedicine startup connecting Black women to Black doctors throughout California.