OP-ED: Four C-sections Later, I Wish I Had Known About Choices

Lawmaker questions whether procedure is overused and sees hope for change in pending legislative package

Assemblywoman Shanique Speight
Like most mothers, my children bring me indescribable joy. Just hearing them walk through the door and yelling out, “Mommy,” when they arrive home can erase the challenges of any rough day. While they do test my patience with the carefree nature of their youth, a smile or hug from my daughter or one of my three sons makes me melt. I adore them.

With each of my four children, I had healthy pregnancies. Morning sickness was not really an issue, and my weight gain was typical. Despite these uneventful pregnancies, I had a cesarean-section with not one, but all of my children.

I am not entirely certain, clinically or otherwise, as to why vaginal birth was not an option for me. As a new expectant mom giving birth in Newark, I wasn’t well versed in C-sections and their risks such as increased probability of blood clots, cardiac complications, infections and pelvic pain. Providing me with a clear and thorough explanation was evidently not a priority for my healthcare professional at the time.

For the most part, I was told that my babies were large, and I needed to have C-sections. I took their word for it, and despite the risks, proceeded with C-sections for each delivery. During one of them, I actually felt the doctors cut my stomach. I also lost a dangerous amount of blood.

While I am grateful that my complications from the C-sections were not detrimental, I often wonder if I had been a white woman delivering in a suburban community, would I have been given more options beyond C-sections. Was there any type of implicit bias shown toward me because of my race and where I delivered? Some would argue yes.

Such biases coupled with rising C-section rates — the Centers for Disease Control reports that C-section delivery rates increased to 32 percent in 2017 — heighten the risks for women when pregnant. What’s more frightening is that as a black woman giving birth in New Jersey, I am roughly four times more likely than a white woman to die during delivery. Four times more likely? In America? In 2019?

Yes, it is true. Yet there is hope.

Disparity in maternal mortality rates

As part of a statewide effort to address such disparities in maternal mortality rates between African-American and white women, and to reverse the trend that ranks New Jersey 47th among the states in maternal mortality with 37.3 deaths per 100,000 live births, a maternal health package is moving through the New Jersey General Assembly.

The bills specifically address the issue of black women and why they are at such higher risk of dying from pregnancy complications than white women. During 2011-2014, the CDC found alarming racial disparities in maternal infant-mortality deaths nationwide: 12.4 deaths per 100,000 live births for white women compared to a staggering 40 deaths per 100,000 live births for black women.

These measures seek a collaborative effort among a broad array of stakeholders — mothers, fathers, health professionals, medical educators and experts, legislators, health agencies, doulas, community advocates and others — to help women have a healthy pregnancy and safe delivery.

Comprehensive, resource-driven and action-oriented, these maternal health measures cover a wide array of issues and include legislation to develop a set of standards for respectful care at birth and to conduct a public-outreach initiative.

I really wish there had been the type of education being proposed in this bill-package when I delivered my children. If I had been made fully aware of the various maternal health and delivery options, maybe I could have experienced at least one vaginal birth. Four C-sections later, I wish I had known.