ENDANGERED: Hospital systems ‘don’t take our pain seriously,’ say Black Iowans

Part two of a 3-part series about Black maternal mortality featured in the fall edition of the Black Iowa Newspaper.

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Come on, come on!” the doctor screamed. ”You’re moving too much.”

Twenty-two hours of hard labor. The doctor Lori Young barely knew, stitched her up after the birth of her son. He ordered the college senior to stop shivering uncontrollably. When she couldn’t, he threatened her.

“We’re going to have to do it again,” he said, before removing her stitches and starting over.

No warm blanket, no kindness from the doctor or the nurses who dashed about.

“They don’t take our pain seriously,” said the Des Moines mother of two and now grandmother of four, who experienced preeclampsia during her pregnancy in 1987. “I don’t think white society at large even looks at us as humans.”

Black Iowa women said anti-Blackness is rampant in the sixth whitest state in the nation.

Studies show medical professionals who are trained to preserve life routinely discriminate against Black people — jeopardizing the lives of Black babies and parents. It’s happening globally and in Iowa.

“You have to scream to be seen,” Young said.

The American Medical Association has acknowledged systemic, structural, institutional and interpersonal forms of racism as an urgent threat to public health. Racism is a key driver of the national Black maternal mortality crisis, which has doubled in the past 20 years, experts have said.

Black Iowa women said they barely survived some of their children’s births in predominantly white and unwelcoming hospital systems because nurses and doctors ignored them, refused to follow their birth plans, rushed them in and out of critical appointments and treated them like numbers.

“I think doctors and nurses and anybody that’s going to come in contact with a woman during pregnancy and delivery needs some cultural competency,” Young said. “They need to understand the Black American culture: how we talk, what birth means to us.”

A survey by the Centers for Disease Control and Prevention in August found that 30% of Black respondents reported mistreatment during pregnancy and delivery care, compared to 20% of white respondents. Forty percent of Black respondents reported the highest rates of racial discrimination. According to the report, respondents who didn’t have any insurance or used public insurance at the time of delivery reported more mistreatment during maternity care than women with private insurance.

‘There was a fear I wasn’t going to make it’

After a grueling breech birth began at her home in Florida, where she was living at the time, Jacqueline Hunter arrived at the hospital and told the nurse something was wrong.

“You had a hard delivery,” the nurse told her, offering nothing more.

When blood gushed from Hunter, medical professionals sped into the small room. In the chaos, she overheard someone ask if she was a donor.

“There was a fear I wasn’t going to make it,” said the former educator, who is now a doula in Dubuque and owns Centering Joy Doula Services. “All of those fears women have, those were there.”

The married mother of four had never wanted to give birth in a hospital, but after her midwife wasn’t able to turn her son from the breech position, the midwife bypassed the closest hospitals to take Hunter to the one where the midwife’s daughter worked, about 30 minutes away.

The hospital staff told Hunter’s husband they thought she was on drugs, she said.

“They see you as just a Black girl: ‘Let’s deliver this baby and be gone,’” Hunter said.

The experience tarnished the birth of her son, who weighed just 4 pounds and 3 ounces, delaying their bonding time and ultimately jeopardizing her life.

“Doctors and nurses treat birth as routine,” Hunter said. “But that was me bringing my son into the world. They didn’t see my humanity.”

According to the CDC report, the most common mistreatment birthing people experience during delivery includes:

• Receiving no response to requests for help
• Being shouted at or scolded
• Not having their physical privacy protected
• Being threatened with withholding treatment or made to accept unwanted treatment

‘I don’t feel like he listened to me”

Carrie Romo, a middle school principal in Des Moines, met her husband when she was a senior in college. He was from Mexico, she could speak Spanish, and they bonded. The couple has four children.

“I had a team of doctors, and I must admit that I never quite felt comfortable with any of them,” she said. “One doctor in particular who I had most often, I don’t feel like he listened to me.”

She had expected to see a rotating slate of doctors.

“I always got the practitioner and hardly ever got the doctor,” she said.

She said historically, Black people, particularly Black women, have been used in gynecological and other medical experiments.

“And so having a less qualified individual always see me, I felt some type of way about that,” she said.

At 38 weeks pregnant with her first child 12 years ago, Romo checked into the hospital on a Friday night. Her blood pressure, a problem throughout her pregnancy with her son, was high. In labor for 36 hours, she asked for an epidural at “hour 12 or 13,” but that did not go well, she said.

Later, the lactation nurse pushed her to breastfeed.

“She was being very forceful, and I didn’t like her at all,” she said. “I just felt she was trying to push that on me and kind of told me I wasn’t doing it right.”

Medical staff had also dismissed her husband.

“Then it was time for me to give birth, the nurse, all of these people just swarmed in the room. I didn’t even know who people were, and my husband’s kind of pushed to the side,” she said.

She felt rushed, shuffled about like a number. As her family grew, Romo conducted her own research. She selected a midwife and learned about and applied essential oils. She also remained at home longer to shorten her labor at the hospital.

“I knew what I needed, and I got better at vocalizing my needs,” she said.

Even so, the medical establishment had already repeatedly let her down, she said. During the birth of her third child, an ultrasound tech asked her if anyone had talked to the couple about Down’s Syndrome, but when she asked if there was something wrong, the tech said no.

But, her son was born with the condition, she said.

“I feel like there was information that was not shared with us when there was an awareness or some things that they knew but decided not to tell us,” she said.

She said knowing earlier would have allowed the family to prepare and access resources.

Doctors have also dismissed her contention that lingering sciatic nerve pain in her right leg resulted from the epidural, she said.

“I kept verbalizing that it felt funny and didn’t quite take,” she said.

Hospital staff ignored her.

“They never really addressed it,” she said. “They were just trying to get me to have the baby.”

‘Please don’t let me die’

“This is my fifth baby. I cannot die. I can’t die,” Ebonie Bailey pleaded as the hospital staff prepped her for emergency surgery after she experienced a potentially dangerous precipitous birth, marked by labor that began too quickly.

Bailey had hemorrhaged, needed to be resuscitated and received a blood transfusion. Even so, she breastfed her newborn before her first surgery. Her doctor prayed with her.

“And when I woke up . . . She said, ‘You’re here. You’re alive,’” Bailey said.

Bailey remains grateful for her home birth midwife. She said her husband and doula “stood in the gaps” during the crisis, with her doula caring for her other children at home. 

Bailey’s story had a happy ending, defying the odds. Today, as executive director of the Iowa Black Doula Collective, she stands in the gap for others: training doulas, empowering parents and holding providers to account.

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The 3-part ENDANGERED series about Black maternal health in Iowa was supported by the Journalism and Women Symposium Health Journalism Fellowship, with the support of The Commonwealth Fund.

Cover photo: Getty Images.