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[quote=Anonymous][quote=Anonymous]A few tips. 
1. Remember that the stats nytimes etc are old.  Looking from 2011-2014.  Ask your doctor straight up, how many maternal deaths has the hospital had since 2014.  
2009 and 2010 were left out and a large portion of black women died during this time because of h1n1.  Get your flu shot. 
2. Find out if both their L&D and pp units are meeting appropriate staffing guidelines.  You should be 1:1-2 on LD and 1:3-4 on pp. If a nurse had too many patients they can not give you enough attention. Spread too thin. 
3. Learn about preeclampsia and hemorrhage.  Get a bp cuff and learn to use it.  If you are diagnosed with preeclampsia, you should be monitored for 72 hours post delivery. Don’t fight get out sooner.  Make a 1 week bp check if you have elevated bps.
4. Let them put and iv in...so if you start bleeding you can get fluid and blood.
5. Black women are notoriously anemic...ask your doc if you are and what you can do to build up your stores before delivery.
6. Breastfeed right after delivery to prevent pph.  
7. Ask about what the hospital does to ensure you don’t hemorrhage...do they have a obh score, what level trauma center are they? Trauma 1 has the most amount of blood units on hold. 
8. Do they  have a hemorrhage cart, IR available, do they have an icu. 
9. If you have preexisting conditions, diabetes/obesity etc ...get it under control as fast as possible 
10. Doulas are great but they don’t give medical advice 
11. Midwifery is great however they deal with very low risk patients
12. Ask if your doctor is in house 24 hours a day...avoid practices where the doc takes home call.  
13. Get involved- dc govt is creating a peer review board to evaluate every case of maternal death in the district.  Hospitals also have patient counsels if you think there is better way to be heard join the counsel.

Good luck. 
Hope this helps. [/quote]

I’m 34 AA and just delivered two months ago and was very very worried about all the news coverage on black maternal mortality rates. This is a really useful list. Especially the bit about really educating yourself about symptoms of serious complications so that you can identify serious issues before they become deadly.

I think the team of people you work with is also essential. I used the midwives at WHC and would highly, highly recommend their practice. I felt like I was working with people who were actively committed to providing high quality medical care and a positive birth experience to women/women of color/low-income women/people from typically marginalized groups. That was especially true of the L+D nurses at WHC (who I found can choose their patients, and likeminded L+D nurses chose to work with the midwives). I truly can’t say enough wonderful things about the L+D nurses we had. Unlike other midwife practices, they don’t only work with low-risk pregnancies, and WHC has the trauma facilities in place in case something comes up. Plus WHC is a teaching hospital which means they practice up to date, scientifically supported medicine. It’s my understanding that it’s impossible to prevent the very serious complications that lead to abysmal maternal morbidity rates for AA women, but the excellent prenatal care I got with the midwives made a huge difference in reassuring me that I was doing the things I could do for a positive outcome.[/quote]

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