Melanie McKnight went into labor for the first time nine months ago. When her son, Messiah, was born, the entire University of Pennsylvania hospital room fell silent.
McKnight’s umbilical cord was wrapped around Messiah’s neck, and he couldn’t breathe.
“I knew something was wrong,” said McKnight, a 21-year-old single mother from Brewerytown. “Nobody was saying anything. We were just waiting for him to take a gasp of air or something. He just didn’t.”
Remembering that moment still brings McKnight to tears. Fortunately for the young mother, Messiah turned out to be healthy. He finally took his first breath after the doctors cleared his lungs.
Her scare was not without precedent, especially for a Black woman in Philly.
Though infant mortality rates are dropping nationally, they’re still higher here than the rest of the country. Maternal mortality rates are even more abysmal — especially for women of color in this city.
According to data from Penn, Philadelphia’s maternal mortality rate is 53 percent higher than the national rate.
From 2010 to 2012, 55 people out of 100,000 died due to complications with birth, compared to 17.9 nationally. All of the Philadelphians who died were living below the poverty line, and three-quarters were African American.
Racism in the delivery room
Giving birth can be understandably stressful. But for women of color, the stress experienced during childbirth can be compounded by their race.
According to Tori Jennings, who leads the Southeastern Pa. chapter of the International Cesarean Awareness Network (ICAN), black women experience issues with their pregnancies and birth experiences at a disproportionately high rate. They are prone to hypertension and cardiac problems during pregnancy, and they are more likely to have premature births and babies at low birth weights.
Issues often arise, Jennings said, when white doctors aren’t aware that Black women are prone to certain health risks, so they don’t know to look out for those during childbirth.
“We have also heard stories that their complaints aren’t taken as seriously for pain management,” she added, “which can delay care and lead to death.”
For the past couple months, in partnership with Georgia-based Black Mamas Matter, ICAN has worked to gather stories about the experiences people of color face during pregnancy and childbirth. Many of those will be presented anonymously to the public this week, which has been dubbed Black Maternal Health Week to raise awareness of the issue.
How extensive is the issue? Studies show doctors are less likely to listen to Black women when they voice their concerns or express their pain. This can turn their childbirth into a traumatic experience — one that has ripple effects on the rest of their lives.
“We’ve seen women who are in tears at the idea of having another child again because of the trauma they’ve experienced with a healthcare provider,” said Hillary Donaghy, another local chapter leader at ICAN. “How can they go on to even mother that child when they’re really experiencing PTSD?”
A statewide solution
Pennsylvania’s legislature has begun to recognize maternal mortality as a statewide issue. In December, the state House unanimously approved House Bill 1869, which would create a statewide Maternal Mortality Review Committee. If established, the committee would better study pregnancy related-deaths.
The bill was proposed by state Rep. Ryan Mackenzie, a Republican from Lehigh county, after a group of local OBGYNs presented him with data about the worsening national maternal mortality rate. The bill currently sits in Senate Appropriations.
Philly established its own Maternal Mortality Review Board in 2010. A statewide review committee, Jennings said, would be a positive step.
“As I understand it,” she said, “it would identify pregnancy-related death and figure out ways to prevent it.”
“You have a woman walking through those doors and expected to be treated with dignity and respect, and then she feels like her body is no longer her own,” Donaghy added. “There’s a need for a greater sensitivity to that.”
Saving dignity, and lives
For McKnight, the birth of her first child was a “scary experience.”
She saw countless strangers rushing in and out of her hospital room, and none of them seemed willing to answer her questions. They wouldn’t let her use the restroom, and by the time her anesthesiologist checked in on her, she was already crowning — it was far too late for an epidural.
Above all else, McKnight wishes that the nurses in her hospital room had slowed down to answer her questions.
“I was like, am I not important? Are they not paying attention to me?” McKnight said. “In the moment, I was so upset.”
It’s these experiences, ICAN’s Donaghy said, that can strip a mother of her dignity — and in some cases, her life. She hopes ICAN’s local advocacy, along with new statewide public policy, can help change this.