How to Advocate for Your Health as a Black Mother

The unfortunate truth in health care is that the treatment you receive will vary depending on where you live, how you pay for it—and your racial identity. Data shows that Black and Native American moms over the age of 30 are four to five times more likely to die from a pregnancy-related cause than white moms. In order to tackle this issue, we need to pass legislation, increase insurance coverage, and empower patients to stand up for themselves. That includes asking for a second opinion.

Any time a health care provider recommends a certain course of treatment—that includes any medications, procedures, waiting periods—you can ask for a second opinion. That means giving a second health care provider all the information about what’s going on, and asking what they would recommend. During pregnancy and delivery, you might want to ask for a second opinion on anything from lab results to a recommended cesarean delivery.

That said, asking a physician to clarify something or offer other treatment options can feel really overwhelming. Here’s exactly how to do it.

Listen to your gut.

“You should switch doctors when you do not feel comfortable with the way you are being treated or if you feel that you are not being heard,” says Dr. Octavia Cannon, D.O., a board-certified osteopathic obstetrician and gynecologist,and co-owner of Arboretum Obstetrics and Gynecology in Charlotte, North Carolina.

Hehe Stewart, a birth and postpartum doula and founder of Tranquility by Hehe Maternity Concierge, says: “You should not have to fight for your birth goals. Your provider’s job is to be an expert that you consult with during this process, not a dictator that tells you what, how, and when things will happen.”

A supportive provider will listen to your wants and needs and try to manage those as best as they can. When alternatives are necessary, they’ll patiently explain why one recommendation is preferred over another. Your emotions shouldn’t feel dismissed during this process. Good healthcare is collaborative.

Learn as much as you can.

Knowing what’s considered “normal” versus what’s unusual during pregnancy and delivery can help frame your situation. Learn what you can about pregnancy conditions, especially anything you’re at a high risk for (for example, if you’ve had gestational diabetes or a preterm birth before, you’re more likely to have it again). Find out the rules and regulations at your delivery hospital, like how many support people can be with you during birth.

“Understand your hospital policies and the research surrounding maternal health practices,” Stewart says. “Know the normal variables and variations of labor so you also know what is concerning. Explore your options so thoroughly that you are confident in the choices you have made for yourself and can have an informed conversation with your provider about your choices.”

Bring in an advocate.

“If you feel apprehensive about speaking up when you don’t feel heard, then enlist the help of an advocate,” Dr. Cannon says. “This can be your partner, a friend, or a family member. If there are restrictions regarding bringing someone with you to the appointments due to Covid-19, then ask the provider whether you can include someone in the visit via telephone or FaceTime.”

Try not to feel intimidated.

Medical jargon can be really confusing, and it can also feel scary to push back against trained medical professionals. “Hospitals and healthcare systems can seem intimidating,” says Aisha Allen, DNP, CRNA, a Nurse Anesthetist. “They can also take away a lot of our autonomy. You know your body more than any because you live in it, so advocate for yourself.”

If you’re not familiar with a certain phrase or word your provider is using, ask them to clarify. You can also take notes at every appointment (a smartphone is great for this) so you can research any recommendations later.

Ask to look at your chart.

Your doctors will have a medical chart for you, consisting of notes from appointments and the results of any tests they ran. You have a right to review your medical information, and Allen says this can be helpful when you’re discussing treatment options.

“By reviewing your charts you can see the information that is being utilized to make decisions,” she says. “You can then do some research to understand terminology a bit better, and therefore be more informed in your decisions.” You can also make sure that all of your information is being accurately reported. If something is misnoted, it could lead to a recommendation that doesn’t always make sense for you.

Try a script.

Stewart offers the following script:

“I understand your recommendation, thank you for sharing my options with me. Right now I’d like to do some more research before making a decision. Can you refer me to a colleague for a second opinion?”

The bottom line.

You can ask for a second opinion any time you want to, for a variety of reasons: Because you feel dismissed or unhear, because you feel unsafe, because your provider can’t explain their rationale, because you want to confirm that their suggestion is the best path, or simply because you feel like it. The only time it’s not in your best interest to ask for a second opinion is in an emergency situation—if you or your baby are in medical distress, there is not always time to contemplate the next course of action. The relationship you’ve built with your provider thus far should put you at ease that they have your best interest at heart.