I almost died giving birth to my first child. 

The attending doctor ignored my concerns, and implied that the 30 hours I had spent suffering did not deserve his immediate attention. He refused to heed the medical necessity of a Caesarian section, which was the recommendation of my primary obstetrician gynecologist. It was maddening. I felt like a child subject to the whims of a parent who was putting me in danger, but speaking up had also ensured that I was ignored, furthering the physician’s agenda. Nothing I did mattered and wouldn’t until I was likely in an emergency situation with no positive outcome.

My near-death experience in childbirth was determined by racism and misogyny, which unfortunately is commonplace for Black women in the United States. We have higher maternal mortality rates than white women because of inherent prejudices that riddle the American health care system. Black women such as myself are three to four times more likely to die from pregnancy-related factors than white women. This is reflective of race-based disparities in the U.S. health care system that provide non-whites with lower-quality care. 

Black women such as myself are three to four times more likely to die from pregnancy-related factors than white women.

DW McKinney

I carried the weight of almost dying—of my child almost dying—with me into my second pregnancy. I spent the first trimester thinking through hypothetical problems and situations—strategizing how to work against systemic inequalities and prejudices that appeared on my delivery day. I never devised an absolute solution because every plan I concocted required that I confidently believe that the hospital staff would be aware of their prejudices and provide me with the best care. Sadly, I could only muster faint hope in their abilities. 

The anxiety of having a healthy, safe pregnancy compounded as my family and I prepared to relocate. In addition to the stressors and responsibilities associated with an out-of-state move, I had to find a new ob-gyn.

I would be transferring my care in the third trimester, where I would be considered a late-term pregnancy and, thus, an at-risk patient for any doctor who accepted my care. Compounded with my medical history—an emergency C-section as a result of an obstinate doctor—this would make finding a new doctor even more challenging.

The process of advocating for my rights meant refusing to cower to respectability politics.

DW McKinney

The prospect of being in physical turmoil again gently tugged at the back of my mind. My pregnancy hormones manifested stress dreams regularly. I woke up one morning overwhelming weighed down by my anxiety and burgeoning depression. I broke the spell of this emotional malaise by remembering a promise I made to myself after I gave birth to my first child: I would use my voice to advocate for my rights and for the life of the child in my womb.

I first started by establishing my medical and birth plan preferences and by educating myself on the spectrum of birth options, instead of solely relying on information from medical professionals. I would not let my experience be limited by their convenience. I also endeavored to find a physician who I was most comfortable with. Among my preferences, the physician had to be a woman, would respect my concerns, and would have an active interest in me as a patient such that I felt comfortable putting my trust in them. 

The specificity of my desires reduced the available options, but they also helped me establish authoritative control. 

It is not just disappointing that I have to fight for my life under the umbrella of the American health care system, it’s horrifying.

DW McKinney

Once I found a doctor I liked, I made a promise to myself to exercise the full extent of my rights as a patient. I was not going to diminish my feelings in order to be seen as low-maintenance or a non-hysterical woman. I would convey my knowledge and not allow my doctor to dismiss my legitimate concerns. My overall objective: establish the value and respect from my doctor that I deserved. 

The process of advocating for my rights meant refusing to cower to respectability politics. Women are often taught to lower themselves. We are taught not to be complicated or loud, to be complicit with what is happening to us. We learn these social rules at a young age when we begin apologizing for things we did not do or for things that don’t even require an apology.

This burden is great for women, but greater for women of color. We must fight destructive stereotypes. We are told to police ourselves so we adhere to the dominant (white) social standards. In medical situations, this means abdicating our authority and subjecting ourselves to whatever level of care is offered—often at the expense of our lives.

It is not just disappointing that I have to fight for my life under the umbrella of the American health care system, it’s horrifying. Speaking up did not guarantee that my life would be saved, but being completely passive meant increasing my chances of death.

I would not be quiet.

Speaking up did not guarantee that my life would be saved, but being completely passive meant increasing my chances of death.

DW McKinney

When I arrived to the hospital for my second birth, I was suffering from inflammation in my left nipple. It radiated stabbing pain throughout my breast. For a week I had been sleeping awkwardly to accommodate the pain, refusing physical touch from my husband and my daughter. I massaged it at home to induce lactation and relieve the pain, but it did not work. When I asked my attending nurse about it, she said didn’t have any idea what it was. She also chose not to examine it.

With the possibility of this being an infection or other ailment, I exercised my rights as a patient until I received a solution. I asked every doctor and nurse that came into my room about it. Disregarding how vulnerable I felt in the moment, I whipped out my nipple at every opportunity so they were forced to examine it. After all, wasn’t their job to heal people?

When it was time for the C-section, a bevy of nurses escorted my husband and me down the hallway to the surgery room. There was a mix up in the schedule and they couldn’t contact the anesthesiologist. Everyone was hurried and stressed. 

Once the anesthesiologist arrived and asked me if I had any questions, I could sense that everyone wanted to get started, and the polite thing for me to do was to say, “No.” I instead asked every question on my mind, not to be arrogant, but because I was genuinely concerned. I wanted assurance that this childbirth experience was going to be different from the first one.

This time, I felt seen and heard by the hospital staff. I felt more confident in their ability to care for me, which created a childbirth experience that was affirming and life-giving. 

Throughout my care, I learned all of the nurses’ and doctors’ names and had established a rapport with them. The surgery room felt like being in a room with people who genuinely cared about me. My favorite moment was when Moe, one of the nurses, turned to ask me, “What music would you like to listen to?” 

Without hesitation, I asked for Missy Elliott. I bobbed my head and shimmied my shoulders to “Sock It 2 Me” from her album Supa Dupa Fly as I lay on the operating table. It was only fitting that the first CD that helped me embrace my identity as a young girl was now helping me exert my autonomy as a woman, patient, and mother.

Lying there with my husband beside me, my favorite artist pumping through the speakers, and my life and my daughter entrusted into skilled hands, my childbirth experience finally felt like a celebration.