I think this is a good thread for this article. When I was at a maternity class at Novant I spoke with another first time father, a black man, during the lunch break and he talked about how scared he was because pregnancy was dangerous for black women. I had never even considered that it was specifically different. I've read a couple of articles since then and it's harrowing
https://www.propublica.org/article/...-women-from-dying-in-pregnancy-and-childbirth
...“It’s chronic stress that just happens all the time — there is never a period where there’s rest from it, it’s everywhere, it’s in the air, it’s just affecting everything,” said Fleda Mask Jackson, an Atlanta researcher and member of the Black Mamas Matter Alliance who studies disparities in birth outcomes.
It’s a type of stress from which education and class provide no protection. “When you interview these doctors and lawyers and business executives, when you interview African-American college graduates, it’s not like their lives have been a walk in the park,” said Michael Lu, a longtime disparities researcher and former head of the Maternal and Child Health Bureau of the Health Resources and Services Administration, the main federal agency funding programs for mothers and infants. “It’s the experience of having to work harder than anybody else just to get equal pay and equal respect. It’s being followed around when you’re shopping at a nice store, or being stopped by the police when you’re driving in a nice neighborhood.”
Arline Geronimus, a professor at the University of Michigan School of Public Health, coined the term “weathering” for how this continuous stress wears away at the body. Weathering “causes a lot of different health vulnerabilities and increases susceptibility to infection,” she said, “but also early onset of chronic diseases, in particular, hypertension and diabetes” — conditions that disproportionately affect blacks at much younger ages than whites. It accelerates aging at the cellular level; in a 2010 study, Geronimus and colleagues found that the telomeres (chromosomal markers of aging) of black women in their 40s and 50s appeared 7 1/2 years older on average than those of whites.
Weathering can have particularly serious repercussions in pregnancy and childbirth, the most physiologically complex time in a woman’s life. Stress has been linked to one of the most common and consequential pregnancy complications, preterm birth. Black women are 49 percent more likelythan whites to deliver prematurely (and, closely related, black infants are twice as likely as white babies to die before their first birthday). Here again, income and education aren’t protective.
The effects on the mother’s health may also be far-reaching. Maternal age is an important risk factor for many severe pregnancy-related complications, as well as for chronic diseases that can affect pregnancy, like hypertension. “As women get older, birth outcomes get worse,” Lu said. “If that happens in the 40s for white women, it actually starts to happen for African-American women in their 30s.”
This means that for black women, the risks for pregnancy likely start at an earlier age than many clinicians — and women— realize, and the effects on their bodies may be much greater than for white women. This doesn’t mean that pregnancy should be thought of as inherently scary or dangerous for black women (or anyone). It does mean, in Geronimus’ view, that “a black woman of any social class, as early as her mid-20s, should be attended to differently” — with greater awareness of the potential challenges ahead...
...Until recently, much of the discussion about maternal mortality has focused on pregnancy and childbirth. But 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. For American women in general, postpartum care can be dangerously inadequate — often no more than a single appointment four to six weeks after going home. “If you’ve had a cesarean delivery, if you’ve had preeclampsia, if you’ve had gestational diabetes or diabetes, if you go home on an anticoagulant — all those women need to be seen significantly sooner than six weeks,” said Haywood Brown, a professor at Duke University medical school. Brown has made reforming postpartum care one of his main initiatives as president of the American Congress of Obstetricians and Gynecologists.
The dangers of sporadic postpartum care may be particularly great for black mothers. African Americans have higher rates of C-section and are more than twice as likely to be readmitted to the hospital in the month following the surgery. They have disproportionate rates of preeclampsia and peripartum cardiomyopathy (a type of heart failure), two leading killers in the days and weeks after delivery. They’re twice as likely as white women to have postpartum depression, which contributes to poor outcomes, but they are much less likely to receive mental health treatment. If they experience discrimination or disrespect during pregnancy or childbirth, they may be more likely to skip postpartum visits to check on their own health (they do keep pediatrician appointments for their babies). Lack of paid maternity leave and childcare can create additional hurdles. In one study published earlier this year, two-thirds of low-income black women never made it to their doctor visit.
Meanwhile, many providers wrongly assume that the risks end when the baby is born — and that women who came through pregnancy and delivery without problems will stay healthy. In the case of black women, providers may not understand their true biological risks or evaluate those risks in a big-picture way. “The maternal experience isn’t over right at delivery. All of the due diligence that gets applied during the prenatal period needs to continue into the postpartum period,” said Eleni Tsigas, executive director of the Preeclampsia Foundation.
It’s not just doctors and nurses who need to think differently. Like a lot of expectant mothers, Shalon had an elaborate plan for how she wanted to give birth, even including what she wanted her surgical team to talk about (nothing political) and who would announce the baby’s gender (her mother, not a doctor or nurse). But like most pregnant women, she didn’t have a postpartum care plan for herself. “It was just trusting in the system that things were gonna go okay,” Wanda said. “And that if something came up, she’d be able to handle it.”