Written by Allegra Lucas, LMFT
In Brooklyn, New York my grandmother was diagnosed with a small tumor in her abdomen. In early 1948, she discovered the mass was a pregnancy, not a tumor, when she prematurely gave birth to my father. A generation later, in September of 1980, I was born to two healthy Black parents at a hospital in Hollywood California. As the story goes, the lights were dim, jazz played in the background, and the doctor was smoking. Upon my arrival, the physician noticed my light complexion and commented, “What? Did you ‘do’ the milkman or something?” My mother was shocked — but she was also in that kind of bliss that can only be conjured by the first-time meeting of a mother and child. These stories showed me early on that Black people’s healthcare experiences, especially in pregnancy and childbirth, are often stained by racial bias.
Growing up as a young Black woman in America society taught me not to be “fast” or sexually promiscuous. By being promiscuous, I would’ve risked public shaming by my community and judgment from God. My parents were professional Black dancers in the sixties and seventies, so they were deeply embodied and very liberal but also had their first children before the age of twenty. So, the messages I received about sex were that it could bring about immense pleasure and that it could result in childbirth , which could have lifelong implications for everyone involved.
“Access to care providers you can trust is a matter of survival.”
When I was 15, my mother took me in for my first gynecological exam. The OB-GYN was Black and male. I remember that he was a rare find — intentionally selected and very trusted by my mother. Meeting with him taught me three important principles about interacting with the medical system as a Black woman:
- Representation matters.
- Medical education through a racially accurate lens is imperative.
- Access to care providers you can trust is a matter of survival.
In that first exam, I also learned that birth control and abortion would be vital tools on my path of resistance against systemic oppression. At 23 years old, I had an unplanned pregnancy which I chose to abort. I’d like to thank Roe v. Wade and the Bleeker Street Planned Parenthood in New York City for the 13 years of self discovery, academic achievement and professional development that termination afforded me. I was able to earn my Master’s degree in counseling psychology and become a clinician my community could rely on.
My first job out of school was in a nonprofit agency that served single Black mothers and their children in Oakland, California. Never before had the health disparities among Black birthing people in the United States been so pronounced to me. The people we served at the nonprofit suffered primarily from the trauma of systemic oppression and racism, resulting in extreme poverty, houselessness, physical and emotional malnourishment, community and domestic violence, depression, mental illness, alcohol and drug addiction, and chronic or long-term incarceration. Our clients had increased rates of premature births, pre-eclampsia, babies born with substances in their blood, and C-sections. Our primary role as therapists was to humanize our clients, to treat them with love, care, respect, and dignity, and to help them bond with their children.
“It also reinforced what I already knew about single Black mothers — that they are resilient, resourceful, and strong, but that sometimes this resiliency comes at the sacrifice of mental health and emotional well-being.”
My early professional experience showed me firsthand how systemic racism erodes the Black community at its core by isolating birthing parents, the shepherds and guardians of the next generation of Black children. If Black mothers aren’t healthy and supported, the community collapses from the inside out. It also reinforced what I already knew about single Black mothers — that they are resilient, resourceful, and strong, but that sometimes this resiliency comes at the sacrifice of mental health and emotional well-being.
A few short years after that internship, I became pregnant and decided that I was ready to become a mother myself. I was unmarried — and at the time, it was unclear what role the father would play in raising the child. As I faced my own experience of Black single motherhood, I thought of my clients at the nonprofit. I had supportive family members, education, and some money, but there were certain pitfalls even these privileges couldn’t protect me from. Money couldn’t buy me out of systemic oppression, a family impacted by mental illness and addiction, and the resulting personal challenges with self-esteem and identity.
“What this meant to me was not that I would have to do this alone, but that I would have to intentionally build a community of support around me.”
At the time I became a mother, I was estranged from my own mother — a fact I attribute to the transgenerational trauma that can be passed along in families like mine or the families of the clients I worked with at the nonprofit. The symptoms associated with systemic oppression can make it very difficult for Black families to remain intact. As such, Black birthing parents may not have the familial support that would be ideal during the process of pregnancy and birth.
I remember telling my father the news of my pregnancy. Even in the context of a loving relationship, I felt so much shame: that I wasn’t doing this right, that I had made poor choices, that I was yet another single black mother in America. But I was certain of one thing — that I wanted to keep the child. I will never forget my father’s words, spoken only as a man raised by a single mother could: “Then you are going to have to do this on your own.” What this meant to me was not that I would have to do this alone, but that I would have to intentionally build a community of support around me. For me, this included selecting a care team that could guide me through all of the twists and turns of pregnancy, birth, and the postpartum phase.
“I chose the midwifery model because I believe in the wisdom and teachings that have supported childbirth for centuries before the hospitalization of the industry.”
Because of my professional and educational background, I was already aware of the increased mortality rates for Black women and children. In addition I had two negative experiences at the hospital where I was receiving prenatal care. There was one instance where I was delivered inaccurate genetic test results and another where an anatomy scan was conducted incorrectly. Both experiences generated a great deal of unnecessary distress during my pregnancy. So with all the data from my research and experiences I determined that the traditional maternity model of care was not for me and that I would have my babies at home.
Learning about midwifery opened my eyes to the perspective that I could have a healthy, supported pregnancy and birth experience with limited medical intervention. While I knew how valuable medical intervention could be when dealing with fertility challenges or in emergency situations, I realized that pregnancy isn’t inherently an emergency. It’s a natural metamorphosis that’s been occurring since the beginning of time. I chose the midwifery model because I believe in the wisdom and teachings that have supported childbirth for centuries before the hospitalization of the industry.
My home-birth team was made up of a midwife, her assistant, two doulas, and my best friend (who also happened to be a midwife). They collaborated with the staff at the hospital where I had my prenatal appointments so they could form a solid plan in the event that a transfer would be necessary. In addition to their collaborative nature, my midwives placed my somatic intelligence at the center of my experience. What I felt physically, emotionally, and spiritually all played a role in how they helped me prepare for giving birth.
“Understanding exactly what was happening with my body during the most radical transformation of my life was the greatest gift I could’ve received.”
The educational element of midwifery care really empowered me during the experience of giving birth. Understanding exactly what was happening with my body during the most radical transformation of my life was the greatest gift I could’ve received. Sometimes it was emotional and sometimes, especially during my second birth, I just needed someone to help me fold laundry and nest. After my second pregnancy, having a postpartum doula in addition to my home-birth care team was a game-changer in my healing process.
My psychotherapist also played a vital role in the success of both of my births. I was diagnosed with prenatal depression and postpartum anxiety. Ongoing therapy provided me with the space I needed to explore all of the uncharted emotional territory that comes with becoming a mother. My singlehood at the time felt like grief some days and like a superpower on others. My therapist provided me with useful coping strategies, served as a surrogate matriarchal presence and guide in my life, and helped me consider and explore potential psychopharmacological interventions when necessary.
“I selected a team of birth-work and mental health professionals who listened to me, who made me feel seen, and who were not afraid to engage in a discussion about my experience as it pertains to my race and identity.”
When I set out to write this article, I would have loved to have said that as a Black birthing person I selected an all-Black birthing team to meet my needs. But the reality is that there aren’t enough Black reproductive healthcare professionals. So, I selected a team of birth-work and mental health professionals who listened to me, who made me feel seen, and who were not afraid to engage in a discussion about my experience as it pertains to my race and identity. Following this path culminated in the birth of two healthy daughters, whom I raise with their father. It has impacted me so profoundly that I began facilitating support groups and designing retreats to help pregnant and postpartum people create their own communities.
We don’t have control over the systemic forces that bring distress or pull families apart. But we do have control over who we invite onto our care teams. Whether you birth at home, in a birthing center, or in a hospital, I believe that the care team you choose will go a long way in shaping the kind of experience you have. Build a team that encourages you to trust your body, listens to what you say, and lends a helping hand when you need support. Entrusting a team with so much may feel like the deepest vulnerability, but that vulnerability will grow into your greatest strength as a new parent.