Closing the health care disparity gap for Black people who are pregnant

Pregnancy can be a source of fear and uncertainty, particularly for Black people. The prevalence of racial prejudice within the health care system, in addition to various other obstacles to good health, places us at a greater risk of experiencing life-threatening complications.

A lot of Black patients seek me out because I’m an OB/GYN who looks like them. But I can’t be there for everyone. So I’m hoping this article will help.

Complications to Watch Out For

If you’re pregnant, hopefully everything will go smoothly. But some complications can put you and your baby at risk, including:

• High blood pressure during pregnancy, a.k.a. pregnancy-induced hypertension, gestational hypertension, pre-eclampsia, eclampsia
• Diabetes during pregnancy, a.k.a. gestational diabetes
• Bleeding — it doesn’t always mean there’s a problem, but it can be a sign of a miscarriage, placenta previa, placenta abruption, or hemorrhage after delivery

You’re at especially high risk if you’re:

• Older than 35
• In your first pregnancy
• Obese
• Pregnant within six months of having a baby
• Have a history of previous pregnancy complications

You need to know about these risks so you can get help if they happen. I encourage you to read each of the linked articles above.

Symptoms You Shouldn’t Ignore

If you notice any of these symptoms, it might not be anything serious. But just in case, tell your doctor as soon as possible if you’re having:

• Bad headache(s) that won’t go away
• Chest pain (more than just heartburn)
• Leg swelling that doesn’t improve overnight
• Blurry vision, which can be a sign of diabetes or preeclampsia
• Not feeling well for any reason
• A sudden, lasting decrease in your baby’s movement
• Pain under your right breast, which can signal preeclampsia

Don’t just try to tough it out. A lot of stillbirths, deaths, and near-deaths happen to folks who put off going the hospital. If something doesn’t feel right, call your doctor.

More Important Tips

Choose an OB/GYN You Trust

It’s important to have a doctor you trust, who listens to you and takes you seriously. So, how do you find the right fit?

I recommend asking other parents who they’ve used and checking online reviews. If other people had a good experience with a particular doctor, there’s a decent chance you will, too.

Once You Trust Your Doctor…Listen to Them

There’s a lot of advice out there about pregnancy and delivery that has no basis in medical fact. It can be very dangerous. It’s much smarter to listen to someone who has real medical training.

If you’re not sure about something your doctor is telling you, get a second opinion. If two different providers are both saying the same thing, there’s a pretty good chance they’re right.

Go to All Your Checkups

Some people only go to the doctor when they think something’s wrong. That’s a serious mistake. An OB/GYN can spot some problems long before you may notice anything. And the earlier they’re caught, the easier they usually are to solve.

Ask Questions

No matter how much you trust your doctor, be inquisitive at your visits. Ask these questions at every decision point:

• What are the risks, benefits, and alternatives to what you’re recommending?
• What symptoms should I watch out for?
• What can I do to support my pregnancy, help prevent problems, and keep my baby as healthy as possible?

Always make sure you understand your options.

Have a Birth Plan…And Share it Early

Giving birth can be profound and magical. It can also be stressful and terrifying. A birth plan lets you spell out what would make you feel most comfortable and supported when your time comes.

Start thinking about it in your second trimester. Who do you want there with you? What music do you want to hear? Do you want pain medication? What medical interventions are you open to and what would you like to avoid if possible?

Make sure your medical team is aware of your birth plan…and give them some advance notice. Have it written down or printed out. Review the details together before labor so you are all on the same page. Ask them to put it in your chart, so no matter who’s there on the big day, they’ll all know what it says.

But remember, childbirth can be unpredictable. Things don’t always go exactly as planned.

Postpartum Complications

A lot of things can still go wrong for you after your baby arrives, especially in the first two weeks. Black people have a higher risk of this happening, given our high maternal complication rates. So it’s crucial to attend your postpartum appointment. The timeframe of this appointment may vary depending on your situation, but can be as early as one week after delivery.

Independence Blue Cross also covers a nurse home visit, which is another checkpoint to make sure you and your baby are doing okay. And if anything feels “off,” any time over the whole next year , call your doctor’s office right away.

Postpartum Depression

It’s very common to experience depression after giving birth, especially for Black people. And social stigma sometimes makes it hard for us to discuss mental health. If we start feeling depressed, we often just try to ride it out.

But postpartum depression isn’t something you should just ignore. It’s caused by hormonal changes in your body after you’ve had a baby. You deserve to get treatment for it, just like you would for any other health issue. That can provide the support you need to take good care of yourself and your child. So please tell your doctor right away.

You’ve Got This

You deserve the same chance for a healthy pregnancy, delivery, and postpartum period as anyone else. That’s why I’m trying to give you the information you need to make the right decisions.

Trust your gut. Listen to your body. Get a good doctor on your side, and let them help you.

Independence Blue Cross members have access to resources that may also be helpful, including the Baby BluePrints® program, as well as Registered Nurse Health Coaches, who are available to members 24/7 by calling 1-800-ASK-BLUE (1-800-275-2583 TTY/TDD: 711).

This article was originally published on IBX Insights.

About Kerry-Anne Perkins, DO

Kerry-Anne Perkins, DO, is a board-certified OBGYN who is clinically proficient in minimally invasive surgery for treatment of diseases of the female reproductive tract. She has comprehensive expertise in high-risk pregnancies and contraceptive care.

Dr. Perkins received her bachelor of science degree from Temple University, her master of science degree from the Philadelphia College of Osteopathic Medicine, and her executive master of business administration degree from Saint Joseph’s University. Her medical doctorate degree was received from PCOM as well.

In addition to her practices in medicine, she is a major in the United States Army Reserves. Dr. Perkins has notable honors and awards for her contributions to the medical research community. She is a member of the American College of Obstetricians and Gynecologists, the American College of Osteopathic Obstetricians and Gynecologists, the American Medical Association, and American Osteopathic Association.