Unwanted Epidurals, Untreated Pain: Black Women Tell Their Birth Stories

When Afrika Gupton-Jones was on bed rest in the hospital, after developing high blood pressure at 28 weeks of pregnancy, her husband was with her day and night. Yet the nurses often assumed that he was her brother, and that she was a single mother. When the doctors and nurses gave her medications or took her blood, she said, they gave her minimal explanation.

“It’s like they didn’t trust me with my own bodily decisions,” she said.

In the United States, people who have more money generally receive better health care: More expensive insurance plans usually cover more doctors, and well-off patients can afford the increasingly high out-of-pocket costs that come with medical care. But despite being upper-middle-class and privately insured, Ms. Gupton-Jones and her husband felt they were treated insensitively. Her career in marketing didn’t make a difference in how doctors and nurses saw them, she said, nor did his doctoral degree.

Earning more and being well educated generally doesn’t protect Black mothers during childbirth the same way it protects white mothers. A new study of a decade of births in California, published this year, found that the richest Black mothers and their babies were twice as likely to die from childbirth as the richest white mothers and their babies.

Missing from mortality statistics are the many stories of mistreatment and negative experiences. In interviews with Black women who responded to a request from The New York Times to share their birth stories, they described having their pain dismissed, concerns ignored and plans disregarded while giving birth. They recalled walking a fine line between speaking up for themselves but feeling nervous to push too hard.

Ms. Gupton-Jones’s son Sidney, now 8, was born at 30 weeks, and stayed in the neonatal intensive care unit for six weeks. It was filled with families of color, she said, while the health care professionals at the suburban Ohio hospital were white. They took good care of Sidney, she said, but she and her husband felt they were treated dismissively.

Though she was comfortable advocating for herself in her career, she said, she and her husband said nothing at the hospital, because they didn’t want to create conflict with the people taking care of Sidney. “You had to have a blind trust in the overnight shift that they were taking care of your child appropriately,” she said, “so you didn’t want to rock the boat.”

“It’s been maybe a generation or two since we’ve had opportunities for African Americans to move en masse into the middle class,” Professor Parker Dominguez said.

Lia Gardley, 32, had hoped to deliver her son, Jaxson, without an epidural. A construction manager, she thought that if she could make it past seven centimeters dilation, the point at which she had learned the pain peaks, she could make it all the way. Her repeated requests to the nurse to check how far she was dilated, though, were denied.

“She kept saying, ‘No, if you’re having so much trouble, you should just get the epidural,’” Ms. Gardley said.

Exhausted, and unsure how much labor she had left, she agreed to the epidural. Shortly after, a nurse checked her dilation, only to find she’d already made it past seven centimeters.

“It still bothers me when I think about it, because I had such intention and determination, and all I had needed them to do was give me all the information so I could make my informed decision,” Ms. Gardley said.

Others described being subject to stereotypes. One woman said a pediatrician assumed her baby was on Medicaid. Another described a nurse referring to her domestic partner, now husband, as a “baby daddy.” A third was accused of inappropriately seeking opioids when she repeatedly returned to the hospital after delivery because she was experiencing intense headaches and dangerously high blood pressure.

“The nurse said, ‘What is it you want? This is your third time here, what do you want, Dilaudid?’” a mother and physician in Maryland said. “I just said, ‘No thank you, I guess it’s time for me to go,’ and I didn’t go back, because clearly the nurse thought I was drug seeking. And that didn’t feel good at all.”

The physician, who did not want to use her name because of her professional connections in health care, said she and her husband decided not to have another child, in large part because of her experience after the delivery.

“I think that historically, Black people’s pain has been dismissed and under-treated,” she said. “There are all these myths. I don’t know that there’s anything sinister — just like with many things with racism and disparities in health care, a lot of it is unconscious, and your own assumptions clouding your judgment.”

Many Black mothers described walking a tightrope: wanting to make providers aware of their knowledge or even their expertise as health care workers themselves, but also to avoid being labeled difficult.

Sade Meeks worked in a neonatal intensive care unit while she was pregnant with her daughter Leilani in November 2020, two months before her due date. Ms. Meeks had a difficult, emergency C-section; she recalled fading in and out of consciousness while she was wheeled into the operating room. She was surprised and concerned when the hospital said she was ready for discharge just three days later.

“I could barely stand,” she said. “I was in so much pain but I didn’t want to make a scene. If I started yelling or making demands, I know I’d be labeled the ‘angry Black woman.’ They said things to me like, ‘You’re a woman, you’re strong, other women have been through worse.’”

In her NICU work, Ms. Meeks had seen how the hospital was more likely to involve child welfare services with Black families, a trend that holds true nationwide. She feared that pushing back too hard could have that consequence, so she reluctantly went home.

But the next day, still in terrible pain, Ms. Meeks went to another hospital’s emergency room and was diagnosed with a serious infection. She was admitted, and spent weeks there recovering while her daughter was across town in another hospital’s NICU. She tried shipping breast milk to Leilani, but the logistics proved impossible.

“It was traumatic, and I felt like I’d failed not only myself but my child,” Ms. Meeks said. “I wish I’d been more assertive with my concerns, but they kept brushing them off.”

Sahred From Source link Health

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