Black Maternal Healthcare: A First-Person Perspective

Stacey-Ann Okoth, DNP, RN, NEA-BC

By Topic: Equity of Care Safety Quality By Collection: Blog


About a year ago, I began to experience what I believed were symptoms of menopause, about five years after my husband and I had unsuccessfully tried for another child. While jarred by the thought of reaching that stage of my life, I knew I had a great job, a loving family and lots of volunteer work to keep me busy. I wanted to be healthier, so I started taking care of my body through a membership at a local kickboxing gym. Faithfully, I got up at 5 a.m. every day and kicked and punched my way to losing 35 pounds. At the same time, my husband became an avid cyclist on his Peloton bike and would strive to finish in the top 10% of any class he took.

So, you can only imagine our distinct shock and surprise when we discovered that it was not menopausal symptoms but rather, at my ripe age of 44 years old, we were expecting a baby. We were so overwhelmed by the news that we checked and double-checked to make sure someone wasn’t playing a cruel joke on us. Even after three months, I was still questioning if this was real.

I was also terrified of the thought that I too would become a statistic of a Black maternal demise. I became so anxious about it that I could hardly sleep. What exacerbated my concerns was the COVID-19 pandemic. According to the Centers for Disease Control and Prevention, the pandemic increased pregnancy complications among Black women, which is 2.9 times the rate for white women. Age was also a concern. In 2020, the maternal death rate for women age 40 and over was 7.8 times higher than the rate for women under age 25.

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After my first trimester, the time came to share the news among our friends and family. We felt reluctant, however, because of the risk involved, and we knew the real danger was ahead. Everyone was happy and offered support and reassurance. Despite this comfort and the care from the wonderful healthcare providers at my organization, I was still convinced that I could become a statistic.

So, I planned. I told my husband that, if it came down to me or the baby, choose the baby. I will never forget the despair I saw on my husband's face when I made this statement, or the look of understanding after he was made aware of the statistics. I am grateful that both my husband and I work in the healthcare field and are versed in medical jargon and procedures because we were able to speak and understand the language and jargon of medical providers. In turn, we were able to communicate our needs. But why should women have to make this choice when our medical system is so advanced? Why is this conversation a must, particularly in households with Black women?

The reality is that today's healthcare providers are overwhelmed with the volume of patients and are understaffed due to the healthcare workforce shortage. This is why we must pass common sense laws that support our patients. We must hold insurance companies accountable, and we must support programs that aim to educate the community. My state has organizations committed to this effort to empower hospitals to advocate for improving community health. 

Another concern for me was work. As a female executive, there's always the pressure of having to be perfect, or at least ensuring that I am carrying my weight. I held my breath for the negative comments and the judgment, but they never came. I attempted to show my commitment by working up to the date of delivery and insisting that I only take the minimum leave required by my doctor. In retrospect, this was pure nonsense. I am glad I had a supervisor who insisted that I take the leave I needed to be with my family and supported me through my time off so I didn't have to worry. My baby was born in the hospital system where I work, and I am so fortunate and thankful to have this healthcare team for my care and a safe delivery.

I am excited to say that my daughter is doing very well. While I am anxious about heading back to work soon, I know I am one of many mothers who continue to work hard every day to ensure that their children live fulfilled lives. My recent experiences have reenergized my commitment to continue to make the U.S. healthcare space more conducive to mothers.

Stacey-Ann Okoth, DNP, RN, NEA-BC, is system senior vice president/associate chief nurse executive, Jefferson Health (Pa.), and a 2022 Thomas C. Dolan Executive Diversity Program Scholar.