A Black Body in the Healthcare System – Brianna’s Story
I have many identities as I navigate through the world. Through observation alone you may gather that I am wife, a mother, a black woman. You may make educated guesses about my status if you take note of what I am wearing that particular day or my mode of transportation.
As I navigate my work environment in the hospital, you may view me as helpful or pleasant. You may perceive me as sure of myself, confident even. As a colleague, you may take note of my badge and give me a friendly hello or collegial head nod while passing in the halls. On some level, you gather enough information that my presence and personhood matters or at least is expected to be acknowledged in this setting.
I am quickly at risk of being a statistic according to the national maternal death rates. As a medical OB social worker, I have witnessed patients be dismissed or challenged about their pain, symptoms, laboring signs. I’ve witnessed patients treated as if they weren’t the experts on their own bodies. I never imagined that would be a part of my story.
What many know now, is that I am a survivor. A survivor of medical implicit bias, two traumatic births, two postpartum near-death experiences and perinatal mood and anxiety disorders.
I am a survivor of a black body being treated in the healthcare system.
Becoming a Mother
August 1, 2014 was life changing. I birthed my first son, David, via an emergent c-section, after laboring four days through a failed induction. As I laid shaking on the operating table, not sure what to anticipate, the first surgical cut revealed a tragic reality to me. The epidural had failed!
The hours leading up to this moment were spent laboring, lying on my left side in efforts to maintain David’s fluctuating heart rate. Unbeknownst to me, suddenly starting to feel some, but not all of the contractions, the medication from the epidural shifted with the weight of my body and settled all on the left side.
Staring at the bright lights in the operating room, the first cut on the right side of my body was accompanied with a piercing scream. My husband whispered in my ear, “Please don’t leave me”.
The trauma endured during the procedure stuck with me for years. I relived the surgery in my mind via flashbacks, and could not recount the events without a heavy heart and a lot of tears.
The hospital course was incredibly difficult. My pain was not managed well, I could barely walk and why did no one tell me about cluster feeding? Everything hurt, someone was always waking the baby, and I felt invisible. Hello Motherhood!
Cherish these moments they say…
Nothing could prepare me emotionally for the months ahead. 30 seconds after arriving home with our new bundle of joy, I had locked myself in our bedroom, called home to Michigan, and told my mom I had made a mistake by having a baby and was planning to leave my husband.
Why you ask? He forgot to get Chick Fil A Sauce to go with my chicken strips! Baby Blues much?! Or maybe it was the trauma talking? I was no match for the crashing hormones, pain, and fear that overtook me like a giant wave.
My Struggle During Postpartum
During the postpartum period, I was riddled with anxiety, fear, and an overwhelming sense of shame surrounding the resentment I felt around breastfeeding. Why do I always have to feed the baby? Why do you tell me to rest and then bring the baby to me three minutes later saying you think he is hungry?
Each morning my husband left for work, I stood in the window and counted the hours, minutes, seconds, until he returned. There were not enough phone calls in the world to make me feel like I wasn’t banished to a kingdom of isolation…hey Elsa, move over!
I smiled and joked my way through my 6 week postpartum depression screening, and assured myself, this is motherhood! It’s hard, but I must power through and learn to love every moment of it. I’ll never get this time back…right?
If I had known what I know now, especially about perinatal mood and anxiety disorders, I would know staying up all night to ensure my son didn’t pass away in his sleep from SIDS, was actually postpartum anxiety. I would know that reliving my traumatic birth experience over and over was actually postpartum PTSD. I would know feeling inadequate and constantly battling thoughts of whether I was a good mother, was postpartum depression. But, I didn’t know, what I didn’t know.
Another Baby & More Complications
Years later, we welcomed our son Elijah. A second emergent, unplanned, thankfully well medicated c-section with complications after. Who knew postpartum preeclampsia was a thing? My blood pressures were fine during pregnancy, but the weeks following Elijah’s delivery were filled with severe lower extremity swelling and headaches. I monitored my blood pressure on my home machine and feverishly recorded the astonishing numbers on a notepad before calling triage. I drove myself to the hospital and was immediately hospitalized.
All the possibilities about how things could have ended, had I not listened to my body, flooded my mind. I could not settle my racing thoughts of impending doom that were battling with the feelings of guilt that wanted the spotlight in my mind because… MY NEWBORN BABY WAS HOME WITHOUT A MOTHER! How could he bond with someone who’s not there? The first few days of his life are critical for bonding, right?
Released home, only to return to the hospital a few days later for ongoing blood pressure issues, I convinced myself that Elijah was not going to be aware of who his mother was. I felt defeated, and I made passive aggressive jokes to my husband about how Elijah would think my husband was his mother, since he had been the only one that had been there consistently for him since his birth. My untreated postpartum anxiety continued.
When I returned home and got into the swing of things caring for Elijah, it was everything BUT amazing. Try terrifying! Each day I battled intrusive thoughts about Elijah’s demise. There were no imminent threats, but the stories I created in my mind left me watching him like a hawk 24/7.
Sleep when the baby sleeps? No way! In between checking his breathing, I frequently examined him from head to toe. I created a narrative that there was “something I was going to miss” and that was going to cost him BIG. Where did this thought come from?
My first born had food allergies that were missed, as they developed early on. He was tested shortly after his first birthday after struggles with severe eczema. He was literally allergic to everything I had fed him during his first year of life. Egg, wheat, MEAT -of all things! I ruminated on how the simple act of love and feeding my little one was causing harm.
The seeds planted during that experience were in full bloom when I was learning to care for Elijah. I called my husband at work several times a day trying to solve a mystery diagnosis that simply did not exist. Was he presenting with a specific symptom that served as evidence to my worry? No, BUT I vowed to myself, “I won’t “miss” things this time around so the excessive worry and searching continued. In my mind, it made me a great mom that I was observant. Looking back, my worries choked the joy out of my bonding experience with my sweet boy.
My Pride, Their Prejudice
I was ecstatic when I found out we were pregnant with Elijah. It was not a planned pregnancy, but very much desired. I will never forget my first appointment when I saw his heart flutter on the ultrasound and was overjoyed. I was in a specialized clinic that had dietary counseling for plus sized moms, and I was excited for the support as I had been working with a health coach over the last few months and looked forward to continuing the path of wellness.
The dietitian sat across from me during our first meeting and shamed me about my weight. She fired off questions about why I had not lost weight before becoming pregnancy. I went from feeling on top of the world to wanting to sink into a hole and hide.
She instructed me not to gain any weight during my pregnancy and to try to lose any weight that I could. She then handed me literature suggesting that my weight would result in delivering a stillborn baby. I left the office feeling crushed and defeated.
The fat-shaming during that appointment caused me to obsess about my weight the entire pregnancy and feel as if I was harming my baby every time I succumbed to a pregnancy craving. I felt anger, disgust, guilt. I never expected body shaming to be incorporated into my prenatal care.
Working in the healthcare system, I somehow thought I would be exempt from experiencing the slights that I witness every day to people of color. As a medical social worker, I have witnessed patients be dismissed or challenged about their pain or symptoms. I’ve witnessed patients treated as if they weren’t the experts on their own bodies. But that was them….this will be different…right?
Fighting for Help
The first time I presented to triage during my pregnancy with Elijah, it was for what I thought was fluid leakage. My work pants were saturated, which in my opinion was a good enough cause to get examined. The doctor who performed the exam seemed annoyed and gave the impression my response of coming in was overkill. I left triage feeling embarrassed, questioning and second guessing my actions.
A few weeks later, I felt like was leaking fluid again. I wrestled with the thought of going in to triage again, but the interaction I had with the doctor during my prior visit replayed in my mind, and I decided against going in.
A few hours later the fluid leakage worsened. By this time, I was not feeling much movement of the baby. I called my husband emergently and headed to the hospital. The entire ride was filled with panic, as I had thought our baby boy had died due to the lack of movement, but for some reason, I was still afraid of being wrong and made to feel like my response in coming in for an evaluation was disproportionate to the circumstances.
As the nurse examined me, she had difficulty locating a heartbeat. The doctors determined Elijah was breach, which explained the lack of movement. They assured me my fluid was “probably fine” and informed me I would be likely discharged after they ran a few tests on the fluid. I settled into the thought of returning home and was abruptly met by an anesthesiologist who came to consent me for anesthesia for an emergency c-section. Apparently, my water HAD broken, therefore, I would not be discharged as discussed and I would be welcoming my baby 5 weeks early.
I was grateful I had decided to come into the hospital, as looking back, it saved Elijah’s life. However, the fact that I battled with whether my concerns were valid based upon a previous interaction with a care provider should have never been a deterrent to begin with.
Perception is Everything
Providers, the concerns of a mother should never be minimized or trivialized. If a mom feels something is not right, meet her where she is. The comfort, support, and validation impacts the way she chooses to engage going forward. See her. Hear her. Protect her.
When I struggled with my blood pressure after Elijah, I called the triage line to seek advice, as I was concerned about high the numbers were. The doctor on the phone listened as I read off the numbers. When I finished sharing my record, the phone line filled with silence.
He did not respond. Hello? He acknowledged that he was still on the line. I then directed the conversation as I realized he was not going to initiate problem solving solutions. Should I come in? Should I call my OB? He responded in a very unconcerned tone, “You can come in if you want”.
He demonstrated no concern which led me to think, maybe I’m overthinking this. I struggled with these thoughts for a while and decided I should go in anyway. I had enough medical knowledge and insight to know something was amiss.
After a few incredibly high readings, and six liters of fluid coming off my body, the same doctor greeted me stating, “I’m glad you came in, you could have had a stroke and died”. All I could think about is, if I had no medical knowledge and made my next decisions about my care based on the phone conversation alone, I would have assumed the concern was not emergent and would have been home with my baby alone, possibly dead.
With magnesium running through my veins for 24 hours making me tired and flushed, a Foley in place, and a poorly placed IV, I still managed to pump milk for Elijah. I felt miserable, but felt I was doing what I could to care for my baby who was home with family. A nurse who was caring for me introduced herself at the beginning of her shift and rudely questioned why my baby wasn’t with me in the hospital. The way she questioned me made me feel as if she thought I was “vacationing” without my baby.
Her attitude changed when she saw that I was pumping. I guess that assured her I cared about my baby and wasn’t “hiding out”. She noted my ring and was able to deduce the baby was with my husband. I shared I was a social worker at the hospital, and immediately my care improved.
When I felt the most vulnerable, I felt the need to provide I was worthy of respect and support.
My journey of struggles and triumphs in becoming a mother birthed a beautiful passion. I left a career as an oncology social worker after almost 7 years, followed my heart, and pursued a career caring for moms and babies.
As social workers, I truly believe we return to fill the gaps in care we have personally experienced. Where we’ve experienced injustices, hurt, disappointments. As you can imagine, these experiences have had a significant impact on my life and I want to stand in the gap for others mothers in the hopes their care and support will be better.
Black People Pray & We Certainly Don’t Go To Therapy or Take Meds!
Growing up in a Christian home where attending 3 church services on Sunday was the norm, I guess it would not take you by surprise that when the world began to fall down all around me, my go to answer was to pray and wait. This will get better…right, Lord?
My first few weeks in working in postpartum care, almost a year after the birth of Elijah, my coworker asked permission to give me feedback about how I was navigating my new role. She strung all the complimentary pleasantries together, boosting my ego, before hitting me with the “zinger”:
“Your anxiety has anxiety”.
“You work really hard, but I am noticing a pattern of anxiety”.
I immediately grabbed a postpartum screening tool off of the shelf and started to take a self-inventory. It turns out every symptom I checked off aligned ever so perfectly with postpartum anxiety. I am here to help other women, what do you mean I have anxiety?
She recommended seeing a therapist after learning of my unprocessed trauma and anxious thoughts. I thanked her and assured her I was fine. In my mind I was considering, what will my mom and husband think? Black people don’t go to therapy.
Several months later, sitting across from the therapist, she looked alarmed as she witnessed how my thoughts spiraled around and around gaining momentum with each new intrusion introducing a new thing to perseverate on. May I suggest medication?, she asked. I blankly stared….
I barely came to see you, now you want me to take medication?
Another internal struggled ensued. Would medication make me less of myself? Do black girls take medications? Will my husband think I incapable of self-regulating my emotions?
I worked up the courage to engage my husband in my decision to try medication. He was very supportive. When my mother visited, I casually slid my pill bottle into her view and hoped she would break the ice about the observation. I decided in that moment to own my truth, my struggle, my journey, my day to day triumph in my battle with anxiety.
As time passed, I abandoned shame and embraced the beautiful transformation that had taken place. Self-care, reflection, practicing gentleness and grace with myself, improving my self-talk, taking my medication, being vulnerable in therapy…all the work is no small feat.
Now, I champion normalizing mental health treatment. I share my story to hopefully free others. I was fortunate to find a therapist who “looked like me” to hold space with me while I explored issues around my birth experience particularly when I processed feelings surround how I perceived race impacted my experience.
My therapist was not particularly trained in perinatal mental health, but held space, normalized and validated my expressions. I was most comforted by the fact that I did not have to educate her on the black experience and the context of being a black body being treated in the healthcare system.