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Expectant mothers tend to spend time fine-tuning their baby registries and decorating their nurseries. I did some of that, but also spent time getting my blood pressure checked and drafting a will with an estate lawyer.

As a Black woman, I embody the high risk of dying during or soon after giving birth. As a Black OB-GYN, I know that Black women in the U.S. are three to four times more likely to die from pregnancy-related causes than white women.

But even beyond that statistic, I was afraid for my life because of what I see every day as a physician: Black women’s pain treated as inconsequential, their heavy bleeding regarded as non-emergencies, their high fevers deemed nominal, their high blood pressure neglected. I routinely witness health disparities in maternal health while fighting on the frontlines for dignified care.

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Three years ago, I rushed to the bedside of my friend Dr. Monique Smith, with whom I co-founded a startup called Culture Care, during her labor at a California hospital. She had called me saying she did not feel right. I walked into her room to find her blood pressure dangerously high blood and her baby showing distress on the monitor with not a single doctor on the unit. She was another neglected Black woman whose medical degree did not distinguish her — even in the hospital where she worked two floors down.

Serena Williams’ celebrity and her public medical history of a pulmonary embolism in 2011 did not prompt nurses to listen when she experienced the pain of another clot wedged in her lung after giving birth to her daughter in 2018.

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In my work, I regularly hear Black women share how they are ignored and disparaged by medical staff. On rounds, my patients find solace in my dark brown skin, sharing accounts of treatment by my colleagues and sordid histories of previous births at neighboring hospitals.

As a physician, I’m not shocked at how commonplace these occurrences are. As an expectant mother, though, I was positively terrified.

My work tempered my joy as I prepared for my own baby. According to the Centers for Disease Control and Prevention, a Black woman with a college degree or higher is more likely to die a pregnancy-related death than a white woman who dropped out of high school. The disparity of maternal health outcomes between Black women and white women points to racism — not race — as the true risk factor for that disparity.

My degrees from an Ivy League university and a historically Black medical school can’t save me from racism. Nor can my socioeconomic class or ZIP code. Even living in the state with the lowest maternal mortality rate in the U.S. does not protect a Black woman like me from having four times the maternal death rate of other races. California has created medical interventions to make pregnancy safer for some women, but not me.

I realized that I needed to engineer my personal survival kit. Anonymity in a hospital is not safe for a Black woman. Who is in the room with her making decisions matters. I first secured a Black obstetrician to minimize bias in my care, but then realized that in most practices today it is physician roulette as to who would be on call the day I walked into labor and delivery.

As my delivery date neared, I thought about how best to ensure I had advocates in my corner and pivoted my plan to focus on an environment where I could count on a holistic team committed to my survival. So I made plans to fly across the country to have my baby in the hospital “where everyone knows my name” — the medical center where I did my residency training for four years. The staff knew me well, from the doctors and nurses to the environmental services staff. It was in that obstetrics unit where my humanity as a person and a patient would be fully recognized, something many Black moms-to-be are never afforded.

The choice I made was arguably extravagant — involving plane flights and extended time away from work to allow for Covid-related quarantining. And while this unorthodox plan may seem dramatic or far beyond reasonable to those who have not experienced the systemic racism in the U.S. health care system, it made sense to me as I thought of Dr. Chaniece Wallace, a pediatric chief resident with significantly elevated blood pressure — just like me — who died two days after giving birth.

Black women across the country are electing unusual and creative birth plans to ensure their survival, the survival of their babies, and the health of their families in ways never before imagined. I joined this trend, using my privilege and connections to craft my team and create a beautiful delivery surrounded by Black clinicians I knew and trusted. I did this to secure my daughter’s safe passage into the world with a mom by her side who will support, love, and fight for her every day.

That’s what every mom wants to be able to do for their child. It shouldn’t take privilege or connections to make it happen.

Joy Cooper is an OB-GYN in California and co-founder of Culture Care, a telemedicine startup connecting Black women to Black doctors throughout California.

  • “Stop whining” I am fairly sure you are very grateful for the 1964 Civil Rights Act and the 1965 Immigration Reform Act. Both acts were largely the result of the efforts
    of Black American descendants of slavery, among others. Thank you.

  • Yes!! This is a sorry state of affairs for Black American maternity, among other concerns.
    I would argue that the lack of caring proficient medical providers dates back to the so called Flexner report where 5 of 7 Black American medical institions were closed in an effort to standardize American and Canadian medical education. No one can argue against such an effort, but the secondary effects narrowed Black American medical education to Howard University and Meharry Medical schools for scores of years since 1910. We are still hampered by this reporr until today and counting.
    https://www.medpagetoday.com/publichealthpolicy/medicaleducation/87171.

  • I use to sympathize with Black. But the repetitive whining coming from the Black community, and they seems to be the only race in the US that keeps on whining, desensitize me. You can only whine so much until people become desensitize.

    A little bit of toning done the whining as if the Black are the only victims in this world will helps a lot. Isn’t the Black the one attacking the Asian American now. So please stop whining, being Black does not makes you a victim.

    And author, stop removing comments that you are not happy about.

    • Please understand that this article was not whining; it was a battle cry. Thank you for reminding me of the lack of empathy that stifles America and keeps us stagnant. You have only charged me onward in my pursuits for my people.

    • Funny thing is “Stop whining” is the the attacks against Asian Americans have been carried out by all races, gender and ethnicities. Based on your answer to it is to be solely anti-Black. Smart!

    • Joy Cooper, you have gain my respect for replying instead of removing comments. There are to many articles in Statnews that is divisive by race.

      You should also stop saying “my people”. We are all one people. When you start saying “my people” you already create a wall around “your people” and yourself. Only in looking at other as a human being instead of Black, Brown, White, Yellow, etc, can we unite as humanity. I am not lacking in empathy but I want unity not division by race. If you look at other countries, this kind of division can lead to civil war or conflicts. So stop looking at yourself as Black but as fellow human being.

      Of course if one is looking at it in a medical point of view since each race can be more predispose toward a given disease, that than is fine. But other than science base, there is no reason to classify and divide people by race.

    • George A. Dawson, how did you get an MD when you have poor reading comprehension? Nowhere in StopWhining statement it says that it is purely Black that attack the Asian American. But to clarify your ignorance, it is mostly Black and it is not all races doing the Asian American hate crime. There were Whites and Hispanics but majority of the attacker are Black, according to news. Stop creating races hatred.

      I am glad that you are retired or force to retired. I won’t want an MD like you treating me, I might get misdiagnosed since you seems to have a reading comprehension problem and only see what you want to see.

      And what is the point of putting MD in your name. Ms. Joy Cooper did not put one after her name which shows her class, but you have to flaunt your MD.

    • Sarah, you and your racism surpasses “Stop whining” and his.
      Get a life!!!
      As to the MD you referred to, it really got your goat, huh?
      We did NOT invent race and racism. But will fight it tooth and nail!!!

    • George A. Dawson, I think Sarah was probably on the point that you only see what you are want to see. You are most probably force to retire with this attitude of yours.

      I have relatives, friends, and in-laws with MD, but they don’t put MD after their name unless for business purposes. You must be one insecure poor soul. You need to flaunt your MD. In life, what I observed the real brilliant people tend to be more humble and the insecure and not so good one tend to boast more of what they have. I feel sorry for you, maybe counseling will help. You are too angry.

    • Willful. Deliberate. Especially triggering to racist and or knitwits.
      Like honey and its ability to attract flies.
      Mission accomplished.

  • I know all about the delivery room. I was in the delivery 2 times. Different experience each time. 2nd time, 3wks. False labor every other day. Finally delivered baby weighed 2lbs and 7oz. That is one rm. I swore never to enter again. I didn’t have a will or Mother. I know you know that you are truly bless. Your baby is so sweet. You are going to have that picture forever and you are going to tell her the story of that picture. Happy first Mother’s Day.

  • This is very important and should not be necessary, but is there evidence that the “unusual and creative birth plans” actually provide safer experiences?

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