By Paige Giffon
Jessica Lipscomb, 29, was washing dishes when she felt a large contraction. She had been having contractions for a couple days but this one was different. Her husband, Matt, quickly rushed her, not to a hospital as they had with their first child, but to the Charleston Birth Place to have a water birth, where she spent the final stages of labor in a birthing pool and delivered into the water.
Women, particularly women of color, are increasingly opting out of hospital births and choosing alternative options like giving birth at home with doulas or midwives to help. The main reason is that black women are three to four times more likely to die from pregnancy-related issues than white women, according to the Center for Disease Control.
While Lipscomb had no major issues when she gave birth to her first child in a hospital, she became familiar with the statistics and wanted a more natural experience with her second child. In 2014, 98.5% of births in the United States were in a hospital.
"Women's bodies were made to do this without intervention," Lipscomb said.
The United States is one of 13 countries where the maternal mortality rate is worse than it was 25 years ago. Maternal mortality is when a mother dies during pregnancy, childbirth, or in the immediate postpartum month as a result of complications from pregnancy or birth.
Pre-eclampsia is a condition characterized by high blood pressure that can damage the organs, lead to seizures and harm the baby. Black women are 60% more likely than white women to have the condition, according to the Department of Health and Human Services. This condition can be caused by continual physical and toxic stress to the body, the very kinds of stresses experienced by black women.
Richard Davis, a neonatologist at the University of Illinois of Chicago, has studied the correlation of black mothers and mortality rates for decades. He has found that racial discrimination is a key factor.
"It's hard to find any aspect of life that's not impacted by racial discrimination," he said. "Whether you're talking about applying for a job, purchasing a car, finding housing, getting an education, earning the same amount of money...If you're black, you tend to get less pay."
Lipscomb says she has experienced prejudice and discrimination based on her skin color. The first time, she was about 12 years old training for a cross-country meet in her neighborhood when a white man drove by in a truck and shouted "nigger."
This kind of atmosphere of systematic racism and sexism results in "weathering," a process in which women's bodies are physically worn down by constant stress, according to Dr. Arline Geronimus of the University of Michigan.
"When controlling for income and education, African-American women had the highest measurement of stress-associated body chemicals, higher than white women and black men," Geronimus concluded in a 2006 study.
This discrimination spills over into maternity care, where a third of black women report some level of discrimination from doctors, nurses, and hospital staff, according to a 2017 NPR article titled How Racism may cause Black Mothers to Suffer the Death of Their Infants.
Even after birth, the stresses continue.
"We feel the need to be everything for everyone and forget about ourselves," Lipscomb said.
"Particularly in the postpartum part of parenthood, when we're giving all of our energy to this one new soul. No one is taking care of us."
Reducing stress during the birth has a calming effect that resonates through the postpartum period, Lipscomb said. She said a water birth was far better than giving birth in a hospital.
During the hospital birth of her first child, Lipscomb felt doctors were more focused on the baby. Three out of four times doctors came to her room, they were there to check on the baby, not her, said Lipscomb, who believes maternity care is just as important as the physical health of the baby.
"Our mental state, our physical state, our emotional state are not being taken seriously and I blame hospitals for that," she said. "Midwives are there to support both the mother and child, and doulas are specifically there for the mother."
Lipscomb had two midwives, trained medical professionals who focus on promoting natural birth. Doulas are birthing coaches, there mainly to give emotional and physical support to mothers. Doulas tend to extend their care, sometimes for weeks after the birth. Mothers form strong bonds with these caregivers.
"Women are simply not aware of their options," she said. "They take the word of the hospital and go with that."
Lipscomb's labor lasted eleven hours and thirty minutes before she gave birth to her second boy via water birth. There were with no complications and she felt much more comfortable and "more liberated."
When she gets pregnant with her third child, she plans a home birth. She also wants to become a doula herself. Until then she wants to spread the word about options for expecting mothers.
"Until the system changes to protect us," she said, "We have to protect ourselves."