Over 30 years ago, a young Afro-Jamaican woman who was eight months pregnant walked into a Brooklyn hospital complaining of vomiting and a severe headache. She was examined briefly by the doctors and subsequently discharged. As the woman was being discharged, a triage nurse checked her vitals. The nurse was alarmed at the woman’s high blood pressure reading, and at that very moment, the woman lost consciousness and collapsed.
That young woman was my pregnant mother, and she was having an eclamptic seizure, a life-threatening obstetrical emergency. She was rushed to the operating room, and an emergency c-section was performed, which not only saved her life but mine as well. Throughout my life, this story has been relayed countless times. However, I remain in awe of my mother and am eternally grateful for the doctors and nurses that night.
My mother’s traumatic birth experience resonated with me and was a major factor in my desire to become a doctor. During my Obstetrics and Gynecology rotation as a medical student in the Midwest, I always felt connected to the women I encountered, especially young Black women. As a physician working in various clinics and hospital settings, I witnessed the profound impact of systemic racism and implicit bias on my patients. I have seen colleagues being dismissive of pregnant Black women complaining of pain, only for some of them to return to the hospital with obstetrical emergencies like cervical insufficiency, preterm birth and sepsis. Implicit bias is dangerous and can result in delays in care, long-term complications and even death. I became an OB/GYN to advocate for underserved women, most of whom looked like me.
Upon completing medical school, I returned to New York City, eager to start residency in my chosen discipline. Sadly, I was in for a rude awakening as I quickly learned the harsh realities of the healthcare system. As a resident physician, I witnessed two Black maternal deaths that rocked me to my core. I can still recall a young father falling to his knees when he was informed that his wife had passed away during the delivery. That could have been my father’s story. Unfortunately, not much has changed. In fact, over the past two decades, the Black maternal mortality rate in the U.S. has been increasing. In New York City, Black women are currently nine times more likely to die from pregnancy-related causes in comparison to their white counterparts.
I have been confronted with these alarming statistics not only as a physician but during my own pregnancies. My first son was born during the height of the COVID-19 pandemic; during my second pregnancy, I was diagnosed with preeclampsia. Despite being a skilled practitioner, I struggled with immense fear of having preeclampsia as I contemplated all possible outcomes. I told my husband that I did not want to die, leaving him and our baby Noah behind. I wonder if my mother experienced the same torrent of emotions when she woke up in a recovery room after an emergency c-section with a premature baby in the NICU. I am certain this is the same type of fear that many Black mothers across the country feel every day. This lingering fear often intensifies during labor when things do not go according to plan. This fear is heightened by multigenerational medical trauma, as our mistrust in the healthcare system often stems from the experiences of the previous generation.
I have turned this fear into my life’s purpose, fiercely advocating for every patient I encounter. Despite the days wrought with uncertainty, I would choose this specialty of ushering life into the world again and again. I show up to work as my authentic self and give patients the grace they need to let down their guard and express their concerns. During prenatal visits, I provide patients with evidence-based information to prepare them for pregnancy, delivery and postpartum. My goal is to equip patients with the knowledge and confidence needed to advocate for themselves. In my clinical practice, I am hypervigilant regarding every aspect of patient care. Administratively, I have served on committees geared toward improving outcomes for Black mothers. I will continue to advocate for my patients in and outside of the hospital until birthing in America is safe for every Black woman.
While the frequent headlines highlighting the Black maternal health crisis have been disheartening, I am hopeful for the future. A movement is developing: utilizing activism, tech, social media, collaboration and innovation to decrease Black maternal mortality. With the allocation of adequate resources to prepare Black families for childbirth and postpartum, the implementation of rigorous anti-racist training programs, collaborative care models and funding for doulas—I am confident we will start to see a decline in Black maternal mortality rates.
Rhonia Brooks-Gordon, MD, FACOG is an Obstetrician and Gynecologist based in New York. She is also the Associate Medical Director at Oula Health in Downtown Manhattan.