♥ Black Birth Matters ♥

“According to the CDC, black mothers in the U.S. die at three to four times the rate of white mothers, one of the widest of all racial disparities in women’s health.” ¹

We Need Change

I am calling on my followers to learn more about the abysmal treatment of black women and transfolks in pregnancy, birth, and postpartum, and what you can do to help.

“There is much evidence to document the impact that generations of imperialism, colonialism, racism and white supremacy has had on African people in general—and on Black women in particular… Black mothers, children and families… are unseen and unheard in a health system driven by the remnants and realities of institutionalized racism.” ²

According to the most recent CDC data, more than half of maternal deaths occur in the postpartum period, and one-third happen seven or more days after delivery. The majority of initial postpartum appointments don’t happen until four-to-six weeks after birth. These are also frequently the only postpartum appointments that occur. Anyone that has had a c-section, pre-eclampsia, depression, or is taking anticoagulants needs to be seen sooner than four weeks after birth. Black women and transfolk are far more likely to experience all of these things, sometimes more than twice as likely as white women. In one study published in 2017, two-thirds of low-income black women never made it to their doctor visit.

The high risk of death surrounding black birth spans all income and education levels. It happened to Shalon Irving. It almost happened to Serena Williams. Their education and money did not change the way that their providers brushed off their concerns and ignored them. This shows that the problem does not stem from race, but from racism.



All of this was even before COVID-19 came along and highlighted the disparities even more.

 

What Can You Do?

  • If you are a black mother or a care provider, read this guide for how to acknowledge and address racism in prenatal and postnatal care.
  • If you are a care provider, pay attention to your unconscious biases that may arise when serving black women and transfolks. Work hard to be mindful and overcome them. Talk about them with others in your field, to help them give voice to their own unconscious biases, which is the first step to removing them.
  • Support the NAABB in their mission to “combat the effects of structural racism within maternal and infant health to advance black birth outcomes.”
  • Check out the resources offered by and support Black Women Birthing Justice.
  • Speak up and speak out. Raising awareness of black maternal mortality rates helps inspire policy changes, targeted funding, additional training for providers, and other solutions. Vote for candidates that support these solutions. Talk about these issues with your friends.
  • Share the IRTH app with your black birthing friends and acquaintances, so that they know about this resource for reading and sharing reviews of black care providers. This helps black birthing people make informed decisions when choosing their care providers.
  • Have a look at the anti-racist reading list and other black maternal health resources offered by Every Mother Counts, an organization working for equality in maternal health care around the world.
  • Support National Advocates for Pregnant Women, an organization working protect constitutional and human rights for women of all races, but primarily focused on black and low-income pregnant and parenting women. They provide legal defense and advocacy services.
  • If you are black and have a passion for helping pregnant women and babies, consider becoming an OB/GYN, midwife, pediatrician or other medical specialist, or doula. Currently, only 4% of doctors are POC. According to a review in 2019, the mortality rate is cut in half when black babies are cared for after their birth by doctors of the same race.

Remember to Share Positivity

It’s easy to share the scary articles and statistics surrounding black birthing women and transfolks. But sharing and celebrating the positive stories is just as important. There are lots of beautiful, peaceful, relaxed, and/or powerful black births that happen every day, and they deserve to be recognized, too. Black birthing people need to see the happy stories and know that they can have those kind of stories themselves. The media likes to share things to scare everyone into believing there is no happiness or joy in the world anymore. Even Google brings up only horror stories and dismal statistics when searching “black birth”. That means it’s up to us to prove them wrong.

 

  • You can tune into the podcast Birthright for inspirational black birth stories.
  • The podcast NATAL Stories also provides positive black birth stories alongside empowering ones that tell of overcoming the issues that black women face.
  • Homecoming Podcast is a podcast focused on black home birth, working to dispel the myths that hospital birth is safer than homebirth and that black people don’t birth at home.

 

sources:

1. https://www.npr.org/2017/12/07/568948782/black-mothers-keep-dying-after-giving-birth-shalon-irvings-story-explains-why
2. https://thenaabb.org/advocacy/

3. http://www.ajog.org/article/S0002-9378(17)30368-X/fulltext

4. https://theeverymom.com/black-mothers-are-dying-at-an-alarming-rate-how-to-be-an-ally/
5. https://www.nytimes.com/article/black-mothers-birth.html
6. https://thenaabb.org/
7. https://www.blackwomenbirthingjustice.com/
8. https://irthapp.com/
9. https://everymothercounts.org/anti-racist-reading/?gclid=Cj0KCQjw5auGBhDEARIsAFyNm9F3mczdvIMSeK4uWb5pb03WdxsoQfICIvx9Z5HLJPb0vLxEw2qtvpYaAuhTEALw_wcB
10. https://www.nationaladvocatesforpregnantwomen.org/
11. https://1410c6d1-d135-4b4a-a0cf-5e7e63a95a5c.filesusr.com/ugd/c11158_150b03cf5fbb484bbdf1a7e0aabc54fb.pdf
12. https://birthrightpodcast.com/
13. https://www.natalstories.com/
14. https://www.instagram.com/homecomingpodcast/

 

♥ Preeclampsia in Pregnancy ♥

 

 

Today is preeclampsia day. This is something that is very important to know about during pregnancy and the postpartum period. 

 

What is Preeclampsia?

Preeclampsia.org summarizes it like this: “Preeclampsia is persistent high blood pressure that develops during pregnancy or the postpartum period and is often associated with high levels of protein in the urine OR the new development of decreased blood platelets, trouble with the kidneys or liver, fluid in the lungs, or signs of brain trouble such as seizures and/or visual disturbances.”

This is a very basic description of it, but there is a lot more to know about it, and you can learn more from their website. Here are some key things that I think everyone should be aware of about preeclampsia in pregnancy:

Preeclampsia can be life-threatening during pregnancy, and for baby as well. Medical professionals no longer require the detection of protein in the urine to diagnose it, as research has shown that organ trouble can occur without the development of protein in the urine. Symptoms to watch out for include headaches, abdominal pain, shortness of breath or burning behind the sternum, nausea and vomiting, confusion, heightened state of anxiety, and/or visual disturbances such as oversensitivity to light, blurred vision, seeing flashing spots or auras, or swelling in the limbs, face, or genitals.

 

How Common is Preeclampsia?

I don’t mean to alarm you. Chances are, it won’t even happen to you. Preeclampsia and related hypertensive disorders of pregnancy impact 5-10% of all pregnancies. Let’s flip that to a more positive way of thinking. That’s a 90-95% chance you won’t have preeclampsia in pregnancy. So your odds are good, but with so many pregnancies per year, that’s still a lot of people affected by it!

But remember, most people with preeclampsia in pregnancy will deliver healthy babies and fully recover.

 

What Causes Preeclampsia in Pregnancy?

The abovementioned website has a great chart with a listing of basic summaries of theories of what causes preeclampsia, though no one knows for certain what actually causes it. This is fairly common in conditions of pregnancy, due to a lack of research and subsequent lack of full understanding of how having the DNA of two different people inside of one body really affects the body. Preeclampsia.org’s chart covers things like nutrition, genetics, injury, and random malfunctions of the human body. One theory that was not well-specified in that chart is the partner’s contribution. Partners who have contributed to one pre-eclamptic pregnancy are twice as likely to contribute to another pregnancy with a different person. It is also more likely to happen with limited sperm exposure from the same partner prior to conception. The reason for these statistics is currently unknown.

 

How is Preeclampsia Treated?

There are various treatments for the condition, ranging from medications to supplements to diets. Intravenous magnesium sulfate can be used to help lower blood pressure and decrease the likelihood of seizures. A high-protein diet is another commonly used treatment, which has shown great results.

 

What’s My Story?

Most people don’t even realize that it can occur in the postpartum period. It is less common, but definitely still happens. In fact, it happened to me!

I developed preeclampsia a few days after I went home from the hospital when I had a C-section with my oldest daughter. I had many of the classic symptoms mentioned above. I had actually experienced many of those symptoms during my pregnancy as well, and was suspected to be developing preeclampsia several weeks before birth. My blood pressure went back down below the threshhold of what my doctor considered “too dangerous”, however, and they didn’t look into it any further.

When I called my doctor’s office and informed them of my concerns, asking to move up my appointment scheduled two weeks out, my doctor declined to bring me in any sooner. He brushed off my concerns and treated me as though I knew nothing about my own body (just as he had tried to do when I came to the hospital, telling him that something was wrong with my baby, leading to my emergency c-section).

Luckily for me, he broke his arm while on the vacation he didn’t tell me about (presumably the reason he didn’t want me in the office any sooner), and the office brought in his son in to cover for him. His son had more up-to-date training and knowledge, and had worked all over the world. He told me to come into the office immediately when I called again, voicing my concerns which had then turned to fear. He examined me, reviewed my symptoms, and did some bloodwork. He determined that I had indeed developed preeclampsia, however it seemed to be resolving on its own at this point, which is a rare but happy occurrence. I told him that I had discovered the Brewer diet, and been trying to follow it, while also taking extra magnesium supplements. He told me that this was spot-on and commended me for doing my own research, while also apologizing for his father’s failure to listen to me. He told me to keep listening to my instincts and hinted that I may want to find another doctor once his father returned and he set back off on his international adventures.

I was lucky, not only because I had been empowered to listen to my instincts by my own previous life experiences, and I had the education and resources to do my own research, but because I got to meet a doctor that so thoroughly embodied the essence of what a doctor should be, and what a good doctor is.

 

Lastly…

I wish everyone could be as lucky as I was, but unfortunately, many are not. This is why I am here. This is why I do what I do. By sharing my knowledge and my stories, I can help to empower and educate others who may otherwise never find their power or learn the things they need to know. If you would like to gain more education and empowerment, please follow my page, and join the growing Baby Led Enlightenment Support Village on facebook. We are a community dedicated to supporting and empowering each other to make informed decisions so that we can have happy, healthy pregnancies, and raise happy, healthy, emotionally intelligent children. I hope to see you there!

 

 

Join the Baby Led Enlightenment Support Village

 

Sources:

Preeclampsia.org, Sanford Health, Dr Brewer Pregnancy Diet

♥ SPD – Symphysis Pubis Dysfunction ♥

This is something important for all women to know about. It is a lot more common than you might think, despite the fact that most doctors in the US don’t know about it, or don’t believe it exists. Don’t ever let your doctor tell you that excruciating pain is “normal” or tell you to “just deal with it”. If you are experiencing a large amount of pain, you have every right to adequate treatment of the cause, not just of the pain! If you suspect you may have SPD, and your doctor refuses to refer you to a specialist, find another doctor. SPD can cause permanent, sometimes debilitatingly severe damage if not handled properly. Please see the warning about labor and delivery near the end of this post for more information on this.

 

 

What is SPD?

 

SPD stands for Symphysis Pubis Dysfunction. It is also sometimes referred to as pelvic girdle pain, or PGP. It affects pregnant women, but can persist beyond pregnancy in a rare few very unlucky ladies. In simple terms, SPD is a misalignment of your pelvic bones, caused by your body producing too much of a hormone called relaxin during pregnancy. Relaxin is what helps your spine realign to make room for Baby, your hips to expand, and your pelvic bones to separate to allow Baby to be born. It’s a good thing — in proper amounts. When your body produces too much of it, the joints in your body become extra flexible, and much more prone to misalignment. In some women, this doesn’t become a problem unless they have some kind of trauma occur, such as a car accident or a fall. We don’t exactly have the best of balance when we’re carrying an extra 20+ pounds in front of us and our joints are soft, do we? When we fall, especially if we land on our hands and knees (which of course is much better than our bellies) the pelvis can easily become misaligned. In my case, my right hip became tilted backward. The body does not naturally realign itself without proper guidance, so the misalignment, if not corrected, can cause excruciating pain that lasts for a very long time, and only gets worse. In some women, however, SPD can occur without any kind of trauma. The hypermobility in the joints caused by the excess hormone can make it easy for the symphysis pubis to work itself into misalignment over time.

How is SPD Diagnosed?

It cannot be 100% diagnosed “officially” until pregnancy is over, by doing an x-ray to see if the symphysis pubis is misaligned. It’s not that difficult for a good chiropractor to recognize it, though. For one thing, most people that have SPD have one leg slightly longer than the other, due to the misalignment of the pelvis. 

How Can You Tell if You Have SPD?

 

A tearing feeling in the middle of your pubic bone and/or perineum is a pretty strong clue. I’m not talking about the odd twinge here and there caused by stretching during pregnancy. This tearing feeling is different. It feels like you are being ripped in half. While the pain may subside quickly in the beginning, over time (if left untreated), it becomes more constant, and spikes with every movement, rather than just walking. It may hurt when rolling over in bed, or when sitting in a bad position. The pain usually subsides for the most part when sitting or lying down, at least until the condition progresses very far. Taking long strides when walking, going up and down stairs, and standing or walking for very long also cause great pain. This pain can also be felt in the hips, usually one side more than the other, or only on one side. The pain can be in different areas for different women, and may feel a bit different because everyone perceives pain differently, and the misalignment can go in various directions and affect different places. 
Clicking, cracking, and popping noises and feelings in the pelvic region and hips are also very common when you have SPD. Sometimes they can be so loud that others hear them, and sometimes they just feel like they are. Sometimes these pops can bring relief, other times they can make the pain worse. It just depends on whether or not your body is adjusting itself in the right direction.

How is SPD Treated?

There is no one-size-fits-all treatment. A combination of stabilization exercises, ice, positioning, and manual therapy is the most effective. Stabilization exercises reduce stress on the joint and improve stability. Stabilization exercises include strengthening the abdominals, pelvic floor, gluteals, latissimus dorsi and hip adductors. Chiropractic care is the most highly recommended component of treatment by those that have tried it. It is certainly what I recommend over anything else. Physical therapy is common in the UK, and sometimes attempted in the US, as well. Swimming is a good option, especially in conjunction with aquatic therapy if you can find a therapist trained in treating SPD. 
Many doctors will simply tell women to take acetaminophen (also known as Tylenol or paracetamol), and if the pain gets bad enough, give them crutches, or in rare cases, a wheelchair. This isn’t really treating the problem, however, only the symptoms. There are also a couple of different types of surgery that can be performed to try to repair it if it persists after delivery, but they have very low success rates, and sometimes can actually make the pain worse. One type involves fusing the pubis together with a metal plate. Another involves binding it with something else, like thread or ligaments from a donor (like a pig) or another part of your body. These surgeries also make future pregnancies highly inadvisable, since they immobilize the pubis, and make future vaginal delivery impossible. They can also come undone if you do become pregnant again because it will try to separate anyway to make room for Baby. I do not personally recommend these procedures at all, based on their outcomes, unless everything else has failed and you are desperate enough to risk it.

What Can You do to Minimize the Pain of SPD?

If you have SPD, or think you might have SPD, always be mindful of the following:
♥ When getting in and out of a car or getting up from a chair or bed, keep your knees together.
♥ Do NOT do extreme stretches, especially one-sided ones. DON’T do lunges or squats. These kinds of stretches have the ability to cause irreparable damage to the symphysis pubis that simple chiropractic care or physical therapy cannot fix, and then your only hope left would be the dismal chance of successful surgery. It is important that any stretching you do be symmetrical, to avoid exacerbating the misalignment, and that it be done while sitting or lying down, to avoid pressure on the pubis. 
♥ Sleeping with a pillow between your knees helps to stabilize the pubis at night.
♥ Sleep with your knees in a symmetrical position. Do not sleep with one knee drawn upward and the other leg straight, as this can worsen the misalignment and cause you much more pain, despite potentially being comfier for sleeping. It might take some getting used to and a lot of training yourself to be able to sleep in a different position, but it is well worth it. 
♥ Sit down to put on socks, shoes, underwear, and pants. 
♥ Take stairs one step at a time if you cannot avoid them altogether. A good phrase to remember is “up with the good foot, down with the bad foot,” meaning that you lead with your least painful side when going up steps, and your most painful when going down. 
♥ Take small strides when walking, trying to keep your knees as close together as possible, and don’t walk for too long at a time. 
♥ Rest frequently. 
♥ Do not cross your legs while sitting.
♥ Limping actually makes the misalignment, and thus the pain, worse, so try to avoid it if at all possible. 
♥ Keep your knees together when rolling over in bed, or with the pillow still between them. 
♥ Try sitting in a tall chair if you do the dishes or cook. 
♥ Anything you can do to take pressure off of your pelvis will help. 
♥ Change positions and shift your weight frequently when standing. Try not to favor one side when doing this, as this helps further the misalignment.

What Should You Do if You Think you Might Have SPD?

If your insurance will cover it, or you can afford it, don’t wait for the pain to become unbearable. Get an adjustment from a knowledgeable chiropractor at the first sign of trouble and see a physical therapist to instruct you in stabilization if at all possible. This makes it much easier to treat, and increases your chances of a full recovery.The longer you wait, the worse the damage becomes.Many chiropractors have a self-pay option for $25-50 per visit, and some give discounts for those on Medicaid or who are uninsured or have low or no income. Reach out in your local community and ask for help. If you are in the US, call 211 to ask for referrals to resources that may be able to help. Start a GoFundMe. Do whatever you can to take care of yourself. Don’t let yourself suffer.

 

What is Good to Keep in Mind During Delivery if you have SPD?

 
The best position for delivery if you have SPD (and one of the best for everyone during labor in general) is on all fours. It is the most natural, and allows more room for the pelvis to expand, while actually taking pressure off of the pubis. In this position, the tailbone has room to move to make more space in the birth canal. It is much more comfortable during contractions for most women, as well.
Squatting has been recommended by some providers. I have not heard any accounts from people that have SPD that have delivered in this position, though, and since it still puts so much pressure on the pelvis, and stretches it so much, I would personally be a bit hesitant to try it, but I would definitely try it before the lithotomy position if I needed an alternative to being on all fours. A supported squat using a birthing stool or sitting on the toilet may help decrease the chances of injury with squatting.
Waterbirth is also a really good choice. This is when you actually deliver Baby in a pool or tub of water. It helps to decrease tearing of the perineum, and decreases the pain of contractions, as well. This is not always possible, but is becoming an increasingly more available option across the world. It is most common in birthing centers, but some hospitals do offer it. Homebirth with a midwife or freebirth (without any medical professional in attendance) also make this possible. 

What is the Most Important Thing to Know About Having SPD?

 

You have to be careful during delivery when you have SPD. If Baby is in a funny position, such as with their arm up by their head, during delivery, most doctors/nurses will forcefully grab your legs and push them up to your shoulders. This is one of the absolute worst things that can be done to someone with SPD, and almost always results in irreparable damage to the symphysis pubis, which can cause extreme pain for the rest of their life. Like with the stretching I warned against, this can actually cause severe tearing of the ligaments and in some cases, the muscles around the pubis. 

The lithotomy position (lying on your back on a bed or table during delivery) is the worst possible position for anyone to give birth in. Not just anyone with SPD, but anyone at all. The World Health Organization cautions against this position. Despite the fact that the US uses this position almost exclusively, it has been banned in many countries. It compresses the birth canal and slows labor. It also increases the chances and degree of tearing that may occur during birth. It may even increase the chances of needing an emergency C-section and the use of other interventions, such as forceps or venthouse. The common use of stirrups in this position is one of the dangers to people that have SPD, as it can also cause tearing of the ligaments in the pubis.
Having an epidural or spinal block also increases your chances of permanent damage due to SPD. Because it numbs you, your body can’t tell you when you are in a position that is putting too much stress on the pubis. You won’t be able to feel if your ligaments or muscles do begin to tear. If you can’t feel it, you can’t stop it.
It is very important that you make sure the doctor/nurses/midwife present at your delivery know that you have SPD, and know not to force your legs apart or to put you in stirrups. Some doctors will try to tell you that you cannot have a vaginal delivery if you have SPD. This is simply untrue. While there may be more risks to the pubis with a vaginal delivery than with a C-section, there are still more risks in general with a C-section, so it is still no more advisable over a vaginal delivery for someone with SPD than someone without it, unless there are other issues present that make a C-section a safer option.
Again, don’t ever let a doctor blow you off if you are having extreme pain. Trust your body. If something doesn’t feel right, then it probably isn’t. You know your body better than anyone else. Doctors may have lots of knowledge about lots of things, but they are not omniscient. They do not know everything. The best doctor can admit that sometimes the patient does know better than they do. If your doctor is unwilling to listen to your complaints, or is refusing to investigate your symptoms, please don’t hesitate to find another doctor that will listen to you and CARE. Many doctors think of patients as just numbers — money in their pocketbook. A truly good doctor will actually care about you as a person.

Where Can You Find More Information on Treating SPD?

You can find further information on:

 
 But the best information by far that I have come across in my research came from