Laila Howard can’t remember the exact moment she learned she was more likely to die from pregnancy-related causes than white women. Growing up in Atlanta, the 33-year-old was surrounded by black women who often spoke out about the risks that people who see her face pose during childbirth.
Black women were 2.9 times more likely to die from pregnancy-related causes than white women in 2020, according to new CDC data released Wednesday. Black mother deaths accounted for nearly a third of the total, even though Black Americans make up 13% of the population. Pregnancy-related deaths among Black people in 2020 (55.3 per 100,000 live births) have also increased significantly since 2019 (44 per 100,000).
The reasons for these racial disparities are complex, but the phenomenon of obstetric racism is well documented: Black women often have trouble getting the right diagnosis and dismiss the symptoms. Research also shows they are more likely to give birth prematurely or have an emergency C-section and are less likely to be treated for pain.
The years of dismal statistics on the health of black mothers in the US didn’t stop Howard, who is currently in her second trimester, from deciding to conceive for the first time. But they made her determined to control her grooming. And while only about 860 women died from complications during pregnancy or childbirth in the United States in 2020 (a small percentage, but much higher than in other developed nations), they and many other Black women are being forced to take precautions when planning their families.
Howard has hired a doula, a person whose only job is to support her through pregnancy and childbirth. Research shows that doulas improve pregnancy outcomes, especially for people of color. She also works with a birth center with an ethnically diverse group of midwives for her prenatal care and delivery. She feels more secure in her safety thanks to these resources, but every day she faces the terrifying reality of being a black pregnant person in the United States
The following interview has been edited and shortened for clarity.
Having children is something I’ve always wanted. My mother had many of us and that has always been a goal of mine since I was young. As I got older, I watched my sister, who had her first child at 21, and saw how difficult it was for her to be just a single mom, young, and going to college at the same time. That shifted my goals a bit. I wanted to make sure the timing was right, that I had the right partner and that I was stable enough.
It’s been a journey to understand my body. I started birth control when I was in high school and my body didn’t respond well at all, so I stopped. Since then I’ve had spotty reproductive health. It was never my wish not to have children, but this uncertainty about whether I would be able to have children.
When a person giving birth works with a doula, the outcome of the birth is more likely to be good, research has repeatedly shown. But communities of color, which have higher maternal mortality rates in the United States, often don’t have access to this type of pregnancy support. NBCLX storyteller Jalyn Henderson explains why doulas are important and the effort to make them more accessible to families in need.
The chronic infections started in college. I would go to my college clinic and tell them what’s going on. So many times I’ve been tested and they said, “Everything’s fine. You’re fine.” I went from a bacterial infection to a yeast infection, taking lots of antibiotics back and forth. I got so used to it that I changed my diet, very clean, took probiotics and figured I would counteract it. It got to a point where I was tested and they said, “You’re fine.” OK, but I know I’m bleeding, my stomach and back feel really bad, but you tell me it’s nothing. I didn’t have any black doctors back then.
The first time I felt discharged from a doctor was when I was in college and caught the flu so bad I had a fit. I shared how I was feeling and he was just very dismissive. “It just sounds like you have the flu. I can give you a flu shot.” That’s it. I knew what I had experienced, what I had lived through, and I shared that. I decided that day that I never wanted to have a white male doctor ever again.
Growing up around black women, I knew doctors saw black women as stronger and more resilient — or made up things like, “It’s not that bad.” My sister, my mother and my aunts would all tell me. I didn’t want to bother about it.
It wasn’t until after college that I actually saw Black maternal mortality statistics. That scared me because it’s not just about being a black woman in America — it’s actually that we are dying in incredible numbers.
The decision to try to conceive meant a lot of talking to God and praying about it while also seeking the right care where I felt seen and supported. I had to find women who looked like me, who knew the statistics of black maternal mortality, who would take care of me in the way I needed it. The high rates affected my delivery schedule. I wanted to make sure I was getting the best possible care and attention. I don’t want to be just another patient.
I decided I didn’t want to give birth in a hospital because I wouldn’t know the nurses and it’s possible my gynecologist is at another birth at the time. I wanted to make sure everyone around me was committed to how I wanted my child to be born.
I transferred to the maternity center whose mission is to bring that care and attention to black women in particular. They have special groups just for black women where we can talk about what we’re going through. I felt very seen and it was reassuring to know that the other women in this group can go on this journey with me and understand when I share something intimate because they have probably experienced it too.
Black people are conditioned from the moment they step foot on this planet to know that things are unfair, that we live in an unequal world and that people see and judge us. It’s frustrating to have to take those extra steps, but we live that frustration all the time. Even now, a black person can walk into a store and think, “okay, I know if I’m walking around the store trying to shop, they’ll probably stare at me.” Sure, it’s frustrating, but it’s just a part of life, honestly said.