Pregnancy and childbirth can be an incredibly joyful experience, but for some women, it can cause fear about possible complications.
Doctors say maternal deaths are three times higher for Black women and more than half of these deaths are preventable. Detroit Medical Center obstetrics specialists recognize the disparity in pregnancy-related complications in Black versus white women and have made complex pregnancies a high priority every day.
Dr. Rebecca Jameson, an obstetrician gynecologist with the DMC, said there are many factors that come into play when we talk about the disparity in pregnancy-related complications in Black women.
“There can be huge differences in access to quality care and higher likelihood of chronic diseases due to family history and genetics,” she said. “(There are) other social factors like lack of insurance and health care, lack of transportation, housing, and lack of quality food in some neighborhoods.”
Some of the chronic diseases that can increase the risk of pregnancy-related complications are hypertension, cardiovascular disease, obesity and diabetes, all of which are seen more commonly in Black women.
Reducing the risk
While many social factors beg for structural and societal change, there are ways women can reduce their individual risks right now, according to Jameson.
“These are getting regular preventive visits -- prior to pregnancy -- with a gynecologist or a primary care provider and managing any chronic diseases with lifestyle changes or medication prescribed by a physician,” she said.
Jameson said one unique thing obstetricians need to do more of is have a patient schedule an appointment for preconception counseling.
“We can talk about their individual risks, how that would impact their pregnancy and help create goals to improve their health prior to pregnancy,” she said.
During pregnancy, women should have regular prenatal visits with a nurse midwife, an obstetrician or a maternal-fetal medicine (high-risk OB) doctor. They should make sure before they deliver that they choose a facility that will meet their needs.
“For some women, the hospitals closest to their homes may not have the resources to manage some of these high-risk conditions, so they will want to make sure with their doctor or midwife that the facility will be able to manage their obstetrical care,” Jameson said.
Deciding on a doula
Doulas are non-clinical professional caregivers that provide emotional and physical support before, during and after delivery.
Jameson said while doulas do not provide medical advice, they can be crucial advocates during pregnancy and postpartum care. They can provide many benefits to patients to make it safer for moms and babies.
“Some of the benefits we see are fewer C-sections, less anxiety and depression, better pain relief during labor, and better communication between the pregnant patient and their providers,” Jameson said. “Having a doula means women are two times less likely to have a birth complication, four times less likely to have a low birthweight baby, more likely to breastfeed, and more likely to be satisfied with the care they received.”
Most insurance plans, including Medicaid, cover doula services. Women should call their insurance provider to find out which groups are covered.
Making a birth plan
Jameson said making a birth plan can be a great jumping off point for women.
“We use them a lot,” she said. “Ask your provider if they have a birth plan form that outlines what is offered at their facility. Go over this plan in the office so that you can talk about which things are safe. This helps us to know what the environment should be in the labor room, identify any support persons you would like present, pain control options, monitoring options, and physical movement during labor.”
The most important thing, Jameson said, is to be flexible with the plan, because things can change very quickly in the delivery room. She said the goal, above all, is to have a healthy mom and baby.
“Make sure you have a provider you can trust so they can discuss how things are changing and what that means for your baby and your care,” Jameson said.
To learn more about the DMC birthing centers or to find an OB-GYN that will meet your needs, click or tap here.