Understanding the Specialty
In light of all of the stories in the news media regarding worrisome birth outcomes and experiences of Black women in the United States, you might be wondering or even fearful of how your own birthing experience will turn out. Part of family planning will include finding an OB/gyn that meets your personal needs. Most often, your obstetrics practitioner will be the gynecologist you are already seeing as the speciality usually crosses. Many large OB/Gyn practices will have practitioners who specialize in general gynecology, family planning, obstetrics, high-risk pregnancies and gynecological surgery.
While all gynecologists are trained in obstetrics (the study of pregnancy, childbirth and postpartum), not all gynecologists will specialize in high risk pregnancies.
Knowing your Risk Catagory
Understanding where you fall on the spectrum of risks (high or low) is going to be instrumental in finding a doctor who can properly manage your pregnancy. Probably the number one pestilence during pregnancy is diabetes and hypertension. Black women are already at an increased risk of having diabetes and hypertension as a baseline before pregnancy. Therefore, the disease processes (diabetes and hypertension) that can arise during a normal pregnancy may already be underway in some Black women before becoming pregnant.
According to CDC.gov, if you already have hypertension before pregnancy you should develop a care plan for before, during and after your pregnancy.
Most of the time we are under the assumption that we can manage our health albeit diabetes or hypertension. However, this could not be further from the truth for a pregnant woman of color statistically. If pregnancy occurs after the onset of prehypertension, hypertension, pre-diabetes, diabetes, heart disease, blood disorders, and any other health issues, specialized care from a physician to manage your pregnancy is critical. Click the links below to learn more about hypertension:
The following links will be a helpful resource for your labor/delivery and postpartum care plan and self care:
- https://www.cdc.gov/hearher/maternal-warning-signs/index.html
- https://www.cdc.gov/hearher/index.html *highly recommend bookmarking this link* This is the homepage for the HEAR HER® Campaign. Please familiarize yourself with this page as it has plenty of information that can help keep you safe.
- https://www.cdc.gov/hearher/quiz/index.htm This quiz may be helpful to you in identifying any warning signs of complications.
- https://www.cdc.gov/hearher/personal-stories/index.html This link includes YouTube video testimonials regarding pregancy-related complications.
Birthing Location
Choosing where you want to give birth is a major part of your birthing plan and will also impact your personal birthing team, see Choosing Your Birthing Team. Surprisingly, the number of women choosing to deliver at home using midwifery has increased. Although giving birth is a very natural and normal undertaking for women that has been taking place for thousands of years, the advancement of medicine and increase of chronic disease needs to be considered. Giving birth in a controlled setting at a hospital still remains the safest way to give birth. There are many life-threatening situations that can arise for the mother and baby where immediate access to highly trained medical teams, specialists, and birthing rooms can mean the matter of life or death. Hundreds of years ago we did not have a choice of where to give birth, but now that we have better access to care we do better. There are plenty of hospitals that offer many birthing options and settings that offer a holistic birthing experience at the hospital. Many hospitals now have birthing suites that have highly skilled nursing care and specialists trained in high risk labor and delivery.
Lastly, despite the latest childbirth trends impacting women of color are troubling, the hospital still remains my top recommendation as a place to deliver your baby. By choosing an OB/Gyn who aligns with your health goals/needs during pregnancy, a hospital with a good maternity track record, high maternity patient satisfaction scores, and focusing on your physical and mental health you will be prepared to deliver your baby safely.
Links
https://www.cdc.gov/hearher/maternal-warning-signs/index.html
https://www.cdc.gov/bloodpressure/about.htm
https://www.cdc.gov/bloodpressure/facts.htm
https://www.cdc.gov/hearher/maternal-warning-signs/index.html
https://www.cdc.gov/hearher/index.html
The Maternal Health & Safety Awareness Post 
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