How to Advocate for Yourself as a Pregnant Black Woman

If you’re feeling pressured into a treatment decision or don’t quite understand what the physician is asking you to agree to, ask whether there’s an alternative course of treatment and what the risks of that course of treatment are. 

When the situation is slightly more urgent, “part of the discussion needs to be, ‘How quickly do I need to make this decision? How urgent is this? What are the risks to myself and what are the risks of the pregnancy if I need to take an hour to think about this?’” says Dr. McDonald-Mosley. 

Know that you can change doctors.

“There is no rule that says any birthing human has to remain in the care of a provider they do not feel safe with,” Hawkins says. “If the provider recommends something that makes you feel scared or unsafe, get a second opinion. You are not locked into a contract, and you are free to leave your provider at any time during your pregnancy.”

Perkins says it’s perfectly reasonable to stop seeing a provider “if you ever feel unsure or uncomfortable for any reason—whether that’s medical or even just energy or vibe related.”

Prep your delivery partner.

“If you’re in pain, going through a difficult situation, or in labor, it can be hard to advocate for yourself,” says McDonald-Mosley. This is why many people choose to hire a doula—a birth worker who can advocate for you in the delivery room. But if that’s not in your budget, or you can have only one person with you due to COVID-19 restrictions, “it’s critically important to have someone by your side, if possible, to help to advocate for you, whether that’s a trained doula, a sister or an auntie, or a partner,” McDonald-Mosley says.  

Educating yourself and your birth partner is really important. Research things like induction protocols, epidurals, and cesarean births to know what questions to ask and what alternative options there might be. Make sure your partner knows about anything really important to you, like having skin-to-skin contact with the baby directly after birth. While you’re in active labor, your birth partner can help advocate for you.

“I also recommend using the nurses,” adds McDonald-Mosley. “Part of their role, especially in inpatient care, is to advocate for their patients.”

Stay vigilant during the postpartum period.

Common postbirth complications include hemorrhage, blood clots, and hypertension. “People need to be looking out for things like a severe headache, having pain in your leg, difficulty breathing, and, of course, heavy bleeding,” says McDonald-Mosley. “Those are all huge warning signs.” 

“With cardiovascular disease, the postpartum period is a very high-risk period,” says Jennifer Haythe, M.D., a cardiologist and codirector of the Women’s Center for Cardiovascular Health at Columbia University in New York City. “Sometimes people forget that.” After delivery, look out for chest pressure, palpitations, shortness of breath, and swelling.

It’s also crucial to keep an eye on your mental health. Perkins experienced postpartum depression four months after her daughter’s birth, and she recommends that everyone in your household brush up on potential symptoms. “Educate your team, your partner, your mother, your nanny—whoever is helping you with the baby,” she says. Signs of postpartum depression to look out for include fatigue, a low mood, crying, low appetite, feeling more irritable than normal, and showing little or no interest in the baby.

If you are going back to the hospital with postpartum complications, bring someone with you who can help advocate for you. 

Approach your health care as a team effort—your expertise is crucial.

“Remember, a physician comes to the discussion with medical knowledge,” Perkins says, “and you come to the discussion with how your body is feeling along with your own research, so that together as a team, you can make a fully informed decision.”

Advocate. 

It bears reiterating that the onus should not be on birthing people to fight for the right to a birth that’s joyful instead of life-threatening—we need to fix the system. “Advocate for system change and holding our health systems accountable for how they’re paid, who’s leading them, and whether they are making this a priority,” says McDonald-Mosley. 

The National Birth Equity Collaborative and the Black Mamas Matter Alliance are great places to start. 

Nina Bahadur is a health and culture writer in New York City.