Advocating for Your Health During Pregnancy: A Guide for Women of Color

The maternal health crisis affecting women of color—particularly Black women—is one of the most pressing health equity issues of our time. Black women are 3 to 4 times more likely to die from pregnancy-related complications than white women, regardless of income or education level. This disparity reflects systemic racism in healthcare and underscores the urgent need for self-advocacy during pregnancy.

Understanding the Maternal Health Crisis

The statistics are sobering: Black women experience higher rates of preeclampsia, gestational diabetes, preterm birth, and maternal mortality. These disparities persist across all socioeconomic levels—even college-educated Black women have worse outcomes than white women who didn't finish high school.

Research shows that chronic stress from experiencing racism contributes to adverse pregnancy outcomes through weathering—the accelerated deterioration of health from cumulative exposure to discrimination. Medical racism and implicit bias in healthcare settings compound these risks.

Recognizing Bias in Medical Settings

Medical bias can be subtle or overt. Warning signs include:

• •Dismissing your concerns or symptoms as anxiety or overreaction
• •Providing less thorough explanations about your care compared to other patients
• •Failing to take your pain seriously or suggesting you have a higher pain tolerance
• •Making assumptions about your lifestyle, compliance, or education level
• •Rushing through appointments without addressing your questions
• •Attributing symptoms to weight without proper investigation
• •Not offering the same treatment options as other patients

Trust your instincts. If something feels dismissive or discriminatory, it likely is.

Essential Questions to Ask Your Provider

Empowered advocacy starts with asking the right questions:

At Your First Prenatal Appointment:

• •What is your approach to prenatal care for women of color?
• •How familiar are you with health disparities in maternal health?
• •What are your protocols for preeclampsia screening and prevention?
• •How do you handle patient concerns that seem minor but could be serious?
• •What is your C-section rate, and does it vary by race?

Throughout Your Pregnancy:

• •What are the normal ranges for [specific test result], and where do I fall?
• •What warning signs should I watch for between appointments?
• •Can you explain why you're recommending this intervention?
• •Are there alternative approaches we could consider?
• •What happens if I disagree with your recommendation?

When Reporting Symptoms:

• •I'm experiencing [symptom]. What could be causing this?
• •How can we rule out serious conditions?
• •What tests or monitoring would you recommend?
• •When should I follow up if symptoms continue or worsen?
• •What emergency signs should prompt me to go to the hospital?

Documentation Strategies

Keep detailed records throughout your pregnancy:

• •Medical journal: Record all symptoms, when they occur, severity, and any triggers
• •Appointment notes: Write down everything discussed, recommendations, and questions answered
• •Test results: Request copies of all lab work and imaging
• •Vital signs: Track your own blood pressure and weight at home
• •Communication log: Save all emails, messages, and phone call summaries with your provider

This documentation serves multiple purposes: it helps you track patterns, provides evidence if you need to advocate for care, and creates a record if you need to file a complaint or seek legal recourse.

Building Your Healthcare Team

Your care team should respect you, listen to you, and treat you as an equal partner in your care:

Choosing a Provider

• •Research providers who specialize in high-risk pregnancies or health equity
• •Ask other women of color in your community for recommendations
• •Interview potential providers before committing
• •Don't be afraid to switch providers if you're not getting quality care

Consider a Doula

Doulas provide continuous support during pregnancy, labor, and postpartum. Research shows that doula support reduces C-section rates, preterm births, and improves overall birth satisfaction. Birth workers of color bring cultural understanding and can help navigate bias in hospital settings.

Organizations like Black Mamas Matter Alliance and National Black Doulas Association can connect you with doulas in your area.

Bring Support to Appointments

Having a partner, family member, or friend accompany you to appointments provides:

• •An additional witness to conversations
• •Support in asking questions and advocating
• •Help remembering information and instructions
• •Emotional support during difficult news

When to Seek a Second Opinion

Don't hesitate to seek another opinion if:

• •Your concerns are repeatedly dismissed
• •You're not given clear explanations for recommendations
• •Your provider seems uncomfortable discussing race and health
• •You feel disrespected or discriminated against
• •Your symptoms worsen but your provider isn't concerned
• •You're told "everything is fine" but your instincts say otherwise

Your life and your baby's life are too important to compromise.

Emergency Warning Signs

Seek immediate medical care for:

• •Severe headaches that don't go away
• •Vision changes (blurriness, seeing spots, light sensitivity)
• •Severe abdominal pain or right shoulder pain
• •Sudden swelling of face, hands, or feet
• •Decreased fetal movement (less than 10 movements in 2 hours)
• •Vaginal bleeding or fluid leaking
• •Chest pain or difficulty breathing
• •Severe nausea and vomiting that prevents eating or drinking

If hospital staff dismiss your concerns, explicitly state: "I am a Black woman experiencing [symptom]. Black women are at higher risk for pregnancy complications. I need to be evaluated immediately."

Postpartum Vigilance

Most maternal deaths occur in the postpartum period, with 60% happening after hospital discharge. Continue advocating for yourself after birth:

• •Attend all postpartum appointments
• •Report any concerning symptoms immediately
• •Monitor for signs of postpartum preeclampsia (can occur up to 6 weeks after birth)
• •Watch for symptoms of blood clots (leg pain, swelling, chest pain, shortness of breath)
• •Seek mental health support for postpartum depression or anxiety

Resources and Support Organizations

• •Black Mamas Matter Alliance: Advocacy and resources for Black maternal health
• •Ancient Song Doula Services: Doula training and support
• •National Birth Equity Collaborative: Research and advocacy
• •SisterSong: Reproductive justice organization
• •The Afiya Center: Black women's health and wellness

Your Rights as a Patient

Remember:

• •You have the right to informed consent for all procedures
• •You have the right to refuse any treatment
• •You have the right to request a different provider
• •You have the right to access your medical records
• •You have the right to file complaints about discrimination

Your voice matters. Your concerns are valid. Your life is precious. Advocate fiercely for yourself and your baby—you deserve the highest quality care.