Issue No. 4: Black Maternal Health
Words - Tonya Abari
Illustration - Natalie Very B

The final weeks of pregnancy were the most difficult. With a brown paper bag in my left hand and a gallon of water in my right, I waddled into the midwifery clinic for the first of now weekly check-ups leading up to labor and delivery. Hyperemesis, which lingered throughout the first two trimesters, was still ever present.

In a distinct Caribbean accent the attending nurse inquired, “Is everyting okay?”

I gave an affirmative nod and lowered my head in hopes of avoiding conversation.

“Blood pressure way high and you gain lots of weight since last appointment.”

Intuition wanted me to confide in the nurse because her warm skin was radiant and inviting. A motherly figure–just like what I had imagined the midwives to be–I could tell she genuinely cared about patients’ wellbeing. However, I chose to remain silent. Perhaps this was a conversation I should have with the midwife instead, I thought.

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This place was appealing–likely because it was the only midwifery practice covered by our insurance. An onboarding pamphlet advertised the clinic to be a sanctuary for Black and brown mothers-to-be. While there wasn’t a single midwife of color, the waiting room was filled with women that looked like the mothers in the pamphlet. Situated between two abandoned buildings, the clinic was eerily similar to the traditional OBGYN office that I decided against early  in the pregnancy. I had only chosen a midwifery practice because I read online that they were generally more understanding. Without family or friends nearby, I needed nurturing. I needed compassion.

The midwives, however, worked on rotation–making it nearly impossible to develop a personal relationship with any of the women who would be delivering life from my body. I was to give birth in a hospital and whoever was on call would be the designated midwife. This less-than-ideal dynamic wasn’t exactly what I envisioned, but I didn’t have the resources to choose otherwise.

“Midwife Claire will be in to speak with you shortly.”

“Ugh, not Claire,” I mumbled.

Previous appointments had proven Claire to be the least empathetic of all the midwives. Very short and often rude. Most exchanges were approached with arrogance. Claire grabbed the notes and immediately expressed disappointment in the numbers.

In a condescending tone, she scolded, “You are going to be someone’s mother. You shouldn’t be gaining so much weight; and since high blood pressure runs in your family, you’ll likely need to take something to get it down. Have you implemented the healthy eating plan? Are you at least walking a few times per week?”

After Claire finished wagging her proverbial finger, I snapped back. “It’s not just the food or walking!”

“Then what’s wrong? As your midwife, I can’t do anything unless I know what’s really going on.”

“Well…we both just...lost our jobs...and I think I’m depressed.” Then, I burst into tears. The recent layoffs just two months shy of giving birth had shaken me to my core. I felt unprepared. I felt disappointed. I wasn’t sure how to unpack everything and still keep a level head. I was afraid to cry in fear of transferring sadness to my unborn child. Truth is, even without the tears I was internalizing anger and uncertainty for what would happen next.

In the midst of crying, Claire shockingly went on a whitesplaining tangent, trying to convince me that losing both incomes and feeling vulnerable was actually “quite normal.” But, if I needed to talk to someone about depression, I should “contact the insurance provider or research free services.” Claire then handed me two pamphlets–a generic nutrition infographic and a tri-fold explaining the dangers of high blood pressure during pregnancy.

I wiped my tears, tucked both pamphlets into the brown paper bag, and left bewildered.

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Rain tap danced across the front window as the book Expecting Better played its final chapter over my car stereo. With traffic at a standstill, I felt the front right corner of the car leaning. I got out of the car to check the tire pressure. A flat. Surely, someone would see a pregnant woman on the side of the road and stop to help. And then I remembered how Black women are rarely damsels in distress. One by one, drivers just passed me by–either refusing to recognize me at all or splashing muddy water as they sped past.

As I fiddled with the tire, I began to cry again. I wasn’t fabricating the hurt. It was there, just like the flat tire. As much as I needed help changing the tire, I also needed a trusted health care professional to recognize a depressed pregnant woman. I got neither. As for the tire, I was able to put on the spare. As for midwife Claire, she was only right about one thing: I was about to be someone’s mother.