I’m not sure I want any more children. When I was young, I promised my mother a bunch of grandkids. I wanted a basketball team that my future wife and I could coach through all of life’s challenges. I was idealistic, naïve, and hopeful. I didn’t know how hard raising one human—let alone multiple—could be. I didn’t know how difficult it is for many couples to even conceive and carry a child to term. I didn’t know that Black women are three times more likely than white women to die due to pregnancy-related complications. I didn’t know much. Having grown up in a home filled with people, a large family felt natural. I wanted to be surrounded by love and love my children as my mother loved me.
“Babe, can you come here for a minute? I need your help.”
Those are the words that I’ll never forget; the words that made me stop pacing our living room, hands in pockets and eyes fixed on our gray tiled floor. Those are the words that brought me down the hall, feeling the perspiration gather on my brow; the words that made me enter the bathroom unaware of what to expect. Those are the words I’ll remember, accompanied by a full, heavenly grin, and a pregnancy test with a blue plus.
“You’re pregnant! Are you serious?”
I wrapped her in my arms, suddenly unaware of what else to do with my hands. We exchanged a kiss and she asked, “Are you happy?” I ran into the hallway and jumped up and down for a full minute before her question registered. Happy couldn’t begin to describe what I was feeling.
“She’s hyperventilating. When she gets like this, it’s easier for her not to talk. Give her a minute.”
We were in the hospital. There was a complication that required additional tests and a risky procedure, and we were only four months in. The doctor kept touching Kandace, despite the recoil and the requests not to. She kept touching my wife despite seeing her withdraw into herself.
“It’s okay. We’re here together. It’ll be okay.” Kandace knew that, but I needed to voice it. She needed to hear the words.
“She doesn’t like to be touched,” I said, now directing my attention to the doctor.
It wasn’t just that doctor. It was the culmination of events, starting with the first visit when our assigned obstetrician, Dr. Z., took one look at my wife and insulted her weight and eating habits. It started then, when she diagnosed her with gestational diabetes, an issue that is very much due to hormones, and told her that she needed to stop eating.
“It’s okay if you don’t gain weight.”
“There’ll be less weight to lose when the baby comes out.”
Health was our priority, not aesthetics. Perhaps she was telling us what she believed we wanted to hear.
You’ll snap back if you do X, Y, & Z.
Here’s a guide to getting your summer body back.
Perhaps, that’s what other women want to hear, no doubt due to the ridiculous pressure that’s placed on their bodies to conform to societal standards of beauty. But Dr. Z. didn’t hear us. She didn’t hear the self-aware, educated, and highly knowledgeable Black woman in front of her.
Just days before going into labor, we talked about our worst fears. Mine was losing my wife and the little life that we created.
For years, my wife prepared for pregnancy and labor. She researched, spoke to friends in the medical field, and learned from her own family. She introduced me to preeclampsia, ectopic pregnancy, and engorgement. She quizzed me, checking the symbolic boxes within her mind before committing to creating a life together.
“Some women need help using the bathroom after. Would you help me?”
“I may have to wear a diaper. How do you feel about that?”
“If I’m too engorged, they recommend hand expressing or even having your partner suck it out…”
“Yes. Fine. And, tell me when.” I didn’t know much and whatever readiness I lacked was replaced with a willingness to do whatever it takes. I was built for this. My mother raised me not to take parenthood lightly. I was determined to make her proud and to be the father that I never had.
My wife found solace in that and grinned from ear to ear knowing that it was real. And, when she was ready, so was I.
We felt trapped. We never wanted to work with Dr. Z. or the maternal-fetal medicine team. We originally chose a new birthing practice in Downtown Brooklyn. Their space was filled with warm colors, books that could answer any of our questions, and a trauma-informed staff to match. We were greeted upon entry, receiving eye contact, a smile, and the feeling of respect people of color seldom experience in these types of institutions. We loved it and we were excited at the prospect of working with their midwives. At 10 weeks, we were given the option of learning the sex of our child. We toyed with the idea of a modern gender-reveal party where we gathered all of our family and closest friends, all to have “Gender is a construct,” written in the sky. As tempting as that was, we opted for the gender-reveal email; a PDF that took forever to load.
We must have clicked open 15 times before the screen lit up in orange and white letters that read, “It’s a girl!” We already had a name. We picked it out years before when we fantasized about having a little girl. Xiomara. We locked eyes and imagined holding little Xio in our arms.
“Gestational diabetes makes this a high-risk pregnancy and we don’t handle those here.”
The news felt like a punch to the throat. I don’t know if you’ve ever been punched in the neck before, but imagine getting a devastating blow to the gut; the kind that makes you double over and writhe, hoping for any kind of relief. Got it? Okay, the neck is worse.
We were transferred to the hospital that our birthing center partnered with. That meant new nurses, new doctors, and fewer smiling receptionists. Despite the setback, we were determined to give it a chance. Besides, transferring so late into pregnancy was difficult and no one wanted to take on a “high-risk” patient at that point. We were stuck and we knew it, even though we kept trying to transfer.
The first thing we noticed was the doctor’s quick delivery. We wondered if she was performing an assessment or auctioning us off. The first visit was terse, unfriendly, and sterile. We left wondering if she heard a word either of us said, yet provided excuses for her behavior.
Maybe she had a lot of patients that day.
Maybe that’s just how she talks. It could be cultural.
We’ll see how it goes next time.
The next time was more of the same, as was the time after that.
“Oh no, your diabetes is out of control! Look at these numbers! You need to fix what you’re eating. I’m increasing your insulin.”
So, she increased it and increased it, and increased it. My wife protested, developed spreadsheets detailing what she was eating when she was eating it, and even hired a dietitian to work with her on a custom health plan. The dietician completely disagreed with Dr. Z. Her numbers weren’t out of control; quite the opposite, actually. And, she wasn’t eating enough. By the time my wife was six months pregnant, she had still not gained any weight. The doctors continued to increase the insulin, fearing that our baby would be big or unhealthy. When we discussed our birthing preferences, they scoffed at the idea of vaginal birth. Dr. Z. was convinced my wife would require a C-Section. Despite our saying we did not have forceps in our birthing plan, Dr. Z. took that as an opportunity to brag about how well she was trained in the use of forceps.
Good for her.
“Babe. Babe, wake up. Kandace, wake up!”
My wife’s overnight dose of insulin was too high and she was having trouble waking in the morning. We told Dr. Z. and she wasn’t concerned. She was more concerned about the big baby that we were bound to have and made jokes about inducing labor early.
“If you’re bored, we could induce at 32 weeks,” she said with a smile. We weren’t smiling, nor did we find that funny. We were at our breaking point. The boundaries that were established were pushed far enough for them to be distant memories. Our wishes for a healthy mom and baby were disregarded for the doctor’s intense need to be right.
“I don’t want to end up in a coma,” said Kandace, a realistic result of taking too much insulin. “This woman is going to kill me.”
We spoke to the head of the maternal-fetal medicine team. If we couldn’t get through to our assigned obstetrician, then we were bound to make some headway with her boss.
Race is not a predisposition. It is not a cause of high mortality rates or complications. Racism is the cause. If we spent more time listening to what Black women have to say, we’d have the solutions.
“Well, you know, I trust her implicitly. She delivered my daughter’s baby, but it’s up to you. If you want to leave, it’s up to you.”
The boss was a white woman in her sixties with graying brown hair and wrinkles around her eyes. We’d liked her in our few interactions and really thought our talk could make a difference.
“No, we’re not saying that we want to leave,” I said.
“We just want to switch to another doctor on the team,” my wife continued.
“Oh,” said the department head. “Well, you can. You’d just need to change the days that you’re coming in. She’s here on Tuesdays and Thursdays. But, I really think that you should just talk to her. She’ll understand all the race stuff and I really think that it would be good for her to learn."
We already tried talking to her; teaching this woman how to treat people of color wasn’t our responsibility. We moved forward with changing providers and things got better. He lowered the insulin, stating how surprised he was that it was that high and agreeing that my wife’s gestational diabetes was in complete control. He gave us their patented speech on the fear of a big baby, but promised not to hound us about a C-Section or induction unless medically necessary.
It was never medically necessary.
“Jay, I think I’m feeling contractions,” were the first words that I heard at the start of week 39. It was officially go-time. We packed the bags with our last-minute items, did the massaging and all of the comfort measures, and most of all, we rested. We called the doula and let her know to be on standby because we were going to meet little Xio sometime soon. Fifteen hours later, at 3 in the morning, we arrived at the hospital, and my wife was six centimeters dilated. The nurses complimented her for showing up in active labor and everyone was convinced that we’d meet our little one within a few hours. But they didn’t account for the trauma. They didn’t account for the bright lights, the sterility, and the unpleasant, overworked, and brisk staff. They didn’t account for my wife’s discomfort or the reminders of every negative encounter she’d had since becoming a patient at the hospital. They didn’t account for the worst happening.
Dr. Z. came barreling into the room. Her tone was loud and tense, her eyes erratic. This was nothing like the calm environment we had at home and we were anything but calm. I can only imagine that was going through Kandace’s mind upon seeing her—upon hearing her voice. Just days before going into labor, we talked about our worst fears. Mine was losing my wife and the little life that we created. She felt the same but added one more. “I really just don’t want her there. I can’t do this with her there.” And, she was right.
“Oh, my God! How are you? Ready to have this baby?”
She stood there with her hands on her hips, waiting for a warm welcome, which she never received. Kandace was frozen and breathing slowly, trying not to hyperventilate. She stared at the ceiling, as the tears streamed down her cheeks. I intercepted the doctor and said whatever it took for her to leave. Then our doula went into the hallway and requested that she not come back in, but the damage was already done.
Labor was delayed and the doctors didn’t understand why. Contractions stopped and our morale plummeted. We needed to recover and we asked for some space, but they kept coming in every 15 minutes. They wanted to break her water, but she said no. She repeatedly said no, but they weren’t hearing her. So, I said it and our doula said it. Still, they asked.
Then the nurse, Elizabeth, a veteran by her account, who’d seen “thousands of births” ignored our every wish.
“Turn this way.”
“Let me adjust this pillow.”
“I need to press here.”
“No, let me do it.”
Over and over again, she kept touching my wife, and over and over again we each protested.
“She doesn’t like being touched. I got that,” I said.
“I’ll hold her hand” offered our doula, in an attempt to get this woman away from us.
She didn’t get it until my wife said, “I know you want me to get into that position, but it’s not going to happen. I’m comfortable here.”
Elizabeth replied, “Fine, I’ll just do some paperwork!” in a tone that was too snarky for our liking.
Kandace and I stared into each other’s eyes for what felt like forever. “It’s going to be okay,” I reassured her. At the moment, I wasn’t sure if I was saying it for her or myself.”
“Okay, we’re seeing decels on the monitor,” said the doctor. “So, we’re going to have to start pushing.”
Xio’s heart rate was slowing down, the result of 40-plus hours of labor and constant pressure from medical staff to consent to interventions that would make their lives easier. However, pushing wasn’t a problem. Kandace told them she could get to 10 centimeters on her own and she did. Now, it was time.
I held her hand and looked into her eyes, repeating “I love you” and “You’re doing it.” She needed to hear the words and so did I. My mind drifted to stories of my own birth. The complications and doctors that wouldn’t listen. My mom’s only words to the doctor when he said that he could only save one of us. “Save my baby. If you have to choose, save him.” I was determined not to repeat those words.
This isn’t a tragedy. This is a love letter to the Black woman that I married. It’s a love letter to the Black woman that raised me. It’s a love letter to every Black person that has, will, or wants to experience giving birth. Kandace and Xio both lived. As I write this, they’re napping just a few feet away. I’m lucky. We’re lucky.
I won’t talk about the days after birth. The postpartum preeclampsia, hospital staff that ignored us, or being placed in a room without heat and improperly insulated windows. I won’t talk about needing to bring the baby to the bathroom, with hot water running, to allow the steam to keep her from freezing. I won’t talk about the hospital staff that left my wife on meds for far longer than necessary and the doctors that never returned to check on her. I definitely won’t talk about the nurse that assumed my wife did drugs and put that in her chart or the tech who assumed we were on Medicaid and thus shouldn’t have a problem with additional tests and procedures because they would be free. And, I won’t talk about feeling helpless and unsure of how to protect my wife. Those who know the full story want us to sue and maybe we will, but we’re still frozen. Others have suggested therapy and that’s still in the cards. But this—writing this is therapeutic.
This is for the Black women and birthing people who are dying because of the color of their skin and their family members who love them. I see you. Since the birth of my daughter, I’ve been motivated to do something. Black women are more likely to die from pregnancy-related issues than any other race and all solutions seem to blame them for the problem. Race is not a predisposition. It is not a cause of high mortality rates or complications. Racism is the cause. If we spent more time listening to what Black women have to say, we’d have the solutions. If we understood the impact of trauma on individuals, especially within institutions that never meant to serve them, we’d have the solutions. And, if we truly believed that Black Lives Matter, we’d spend more time trying to save those who create Black lives.
Until then, I’m not sure that I want any more children because you almost killed my wife.
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