Pregnant with a black/mixed race (with black) baby

[Sugarintheplum]

Dear All,

I am a pregnant black woman, not for the first time, and I'm just wondering about other people's experiences.

I've had some very different experiences, some quite stark. In one pregnancy it never really seemed to come up beyond booking and the sickle cell test etc. In another my midwife talked quite openly and a lot about the differences in black and white women's anatomy and how this might impact pregnancy and labour (she herself was European, Italian, I believe). At first,I found it a little disconcerting, my blackness being referenced, but at the same time I appreciated the personalisation and attention to the needs of black women. Ultimately, I was grateful. Oh, and there was the Other time when during a sweep the midwife commented on my baby's lovely black curly hair and I was there, legs open thinking 'seriously, you're ALREADY touching my baby's hair now?!'

She told me, for example, that babies of African-descent typically have a shorter gestation period (around 39 weeks) so she'd keep an eye on me if i went overdue (as in 40+ weeks) because in fact my baby would be more overdue than non-black babies and need to be monitored more carefully. Do all midwives even know this? Ad other things like, for example, our pelvis is shaped differently so the baby's exit is different (though the NHS does not accommodate for that in their utensils and tools).

So, I'm wondering what other women's experiences are if you are not a white woman, but the NHS and maternity care is modelled on that of white women, and if your baby is not white, but the NHS maternity care is modelled on white babies.

Hopefully we ca share some experiences and empower ourselves or others we know when we or they become pregnant in future!

Hi OP, thanks for starting this thread - it's really interesting and informative. It reminds me of how research for things like heart attacks is done mainly on men (partly due to numbers of available test subjects) and then just extrapolated to women despite it turning out that women often present very different symptoms, as it turns out.

I wonder whether part of the reason for the general ignorance, and/or lack of mentioning of potential differences is a fear from researchers and HCPs that addressing these things based on race (even if warranted by the data they have) could be seen as racist or uncomfortably singling some mothers out? Maybe misguided and ultimately unhelpful but I could understand the apprehension. Do you think this might be the case, and if so do you have any thoughts about how that might be overcome?

I don't mean to derail the thread if that's not what you want it to be about, but you got me thinking!

@MarleneandBoycie It's hard not to interpret your incredulity as an invalidation of my experience, but i'm trying!

What I wrote is a faithful account of what happened. It was my due date or one or two days after. I was a little dilated, but nothing to get me excited (baby ended up 10 days overdue, and is two now and still prefers Mummy to all else, so i'm no longer complaining!) and the midwife was sweeping and feeling around and narrating what she felt which was very 'curly', 'lovely', 'afro hair'. She told me how much she loved feeling black babies' hair and that my baby had a lot of it.

I liked that midwife very much and would have been very happy had she attended the birth. As it goes I got a midwife whom I loved EVEN MORE.

But it did happen and I'd be really grateful not to be told it didn't, again.

Thanks!

@AxeOfKindness Yeah, that's just what I was trying to convey in my original post. I was certainly grateful of teh information, but I wonder whether it showed on my face that I was initially terrified of where the conversation would go once she mentioned 'black' mums or mums of african descent. Many black people will attest that we kinda hold our breath when blackness is mentioned, steeling ourselves from some social gaffe or casual racism. It never came and I am entirely grateful. But maybe other midwives who know this stuff, shy away from discussing it?

They SHOULD have training on how to raise these issues sensitively, if they are trained on it at all. I work in a clinical function in the NHS and i can tell you a lot of what I know about working with and treatments for BAME communities is from my own extra curricular research. I imagine midwifery is similar? Maybe some midwives can help us out here.

I know that midwives are not even taught about perineal trauma as part of core part of their training. I learned that when, after my episiotomy, I incorrect parts of skin were stitched up together. Wonky fanny as a result, and an infection. Went to a specialist clinic in West London and midwife there told me hardly any midwives actually receive training on how to stitch up after tears and episiotomies - when most of us need it! I was flabbergasted, but it is what it is.

Yes, that is a true story, too!

Not taught about perineal trauma as part of core training?! Right-o, then I definitely don't hold out much hope that potential differences are covered!

I'm horrified to hear that happened to you and hope it has all been sorted out now.

I'm rapidly gathering that antenatal and postnatal care is so hit and miss that it purely comes down to the individual you get and how interested/informed/sensitive they've personally taken the trouble to be. Not ideal.

I read something in Rebecca Fett’s book about vitamin D and pre term birth - there is a potential link drawn between the fact that black people are more likely to be vit d deficient in general, and black babies tend to be born earlier. Might be worth looking into and checking vit d levels if you are a black pregnant lady :). I’m white but taking a vitamin d supplement anyway based on some reading ive done.

Short extract:

“Researchers were originally suspicious that vitamin D deficiency could play a role in preterm birth because of the racial disparity in preterm birth statistics: black infants are 60 percent more likely to be born preterm than white infants. We also know that individuals with darker skin tones need significantly more UV exposure to produce the same amount of vitamin D, so they are much more likely to become deficient. One study of pregnant women in Pittsburgh found that black women were six times more likely to have a severe vitamin D deficiency than white women were.”

@MarleneandBoycie,

To your further disavowal of my experience despite my request for you to refrain from doing that, I believe the purpose of the sweep was to stimulate my cervix and to trigger labour. I don't think the midwife literally made connection with my baby's hair as there is, of course, the amniotic sac protecting my baby from that. (sigh...)

Now, out of respect I want to make you aware that, should you post again again, I will not respond. Not because I am ignoring the content of your post, but because I just won't have read it.

I truly wish you a good week.

@Sugarintheplum I have very little to add to this thread except that you write so very much like a dear friend of mine - particularly in your eloquently caustic yet gentle put-down of the naysaying Marlene - and my dear friend is marvellous so by extension you are also marvellous.
I am also mouth agape at everything to do with race impacting pregnancy and birth. I’m shaking my head at my own ignorance. Thank you for this thread.

But the BCG isn’t race-related as such, surely — it’s area-dependent, if you live in an area with higher rates of TB, or have a parent or grandparent from a country with high rates of TB. DS (white child of white Irish parents) was given it at six weeks in north-east London, but when we moved to rural England when he was a few months old, no one recognised the mark, and the HV, rather to my shock, asked about ‘that burn on his arm’!

I watched something a while back, was about how different countries have different birth tip or differences such as labouring in certain positions due to typical baby sizes and mum pelvic sizes.
I'm sure there was a bit about midwives in some countries encourage mum to be on all fours more and are experts at rotating the baby during birth due to shoulders.
But cant for the life of me find the clip.

Read this recently from Spinning Babies might be of interest

@MarleneandBoycie, the midwife was able to feel my baby's hair when doing an internal. I also could too when they encouraged me to touch top of her head whilst still in me to give me more motivation to keep pushing.

Why do you find it hard to believe?

@Gallivespian
Both of mine had the BCG, though it ran out for a few months with one of them. I thought somewhere in the back of my head it was because of higher incidence of TB among (sub-Indian continent) Asian communities, but I never understood why that might be. I must have just picked it up somewhere. Maybe it's a stereotype.

@Savingshoes yes, this also rings bells. My midwives have always encouraged walking around different positions, and NOT to lie on the back. I wanted a birth centre delivery for my first but meconium in the waters meant I had to go to a labour ward and they did kind of push me on the bed and I ended up giving birth on my side. The second one I had at home. Kept walking about etc and gave birth standing up (much better). So maybe culturally the medicalisation of childbirth seeps in or even takes over in the UK whenever it gets a chance and we end up on our backs or close to it?

I was overdue with the second one by 10 days and as induction was approaching I went on youtube in desperation and found a woman instructing a pregnant woman to bend forwards and make sweeping figure 8s with her hips. You kinda need someone behind you to dip your hips enough so you stay steady and don't fall, though I did try it myself quite a bit that night. REALLY didn't want to be induced. Baby did move from back to back to front to back and labour started the next morning. Marginally escaped induction, but got loads of stretch marks!