Black birthing people in the U.S. are three to four times more likely to die in childbirth than their white counterparts. In New York City, that number is a staggering 9.4 times higher. Why is this happening in modern American medicine, and what can be done to protect Black mothers?
In this powerful and essential episode, Dr. Carolyn Coker Ross is joined by Dr. Ashanda Saint Jean, a board-certified OB/GYN with over 25 years of experience on the frontlines of the Black maternal health crisis. Dr. St. Jean breaks down how medical racism, historical trauma, and systemic blind spots have created a deadly “two-tiered system” of care.
Drawing from her professional expertise, her lived experience as a Black woman in medicine, and the stories of her patients, Dr. St. Jean provides a searing look at the problem and a powerful toolkit for advocacy, empowerment, and reclaiming the joy in motherhood.
Dr. Ashanda Saint Jean is a board-certified Obstetrician and Gynecologist specializing in women’s health and health equity. She is a recognized leader in addressing maternal mortality and racial disparities, holding key roles with the New York State and City Maternal Mortality Review Boards, the American College of Gynecology’s National DEI delegation, and the New York State Coalition for Doula Access. She is also a contributing author to the book, Antiblackness and the Stories of Authentic Allies.
- Unpacking the Statistics: A breakdown of the shocking maternal mortality rates for Black birthing people nationally, in New York State, and in New York City.
- Beyond Socioeconomics: Why wealth and education, as seen in Serena Williams’ story, do not protect Black women from being ignored by the medical system.
- A Toolkit for Empowerment: Actionable advice for expectant parents to protect themselves, including how to choose a provider, the vital role of a doula, and the power of a birth plan.
Guest Links:
Instagram AshandaStJeanMD
LinkedIn AshandaStJeanMD
Dr Carolyn’s Links
Linkedin: https://www.linkedin.com/in/carolyn-coker-ross-md-mph-ceds-c-7b81176/
TEDxPleasantGrove talk: https://youtu.be/ljdFLCc3RtM
To buy “Antiblackness and the Stories of Authentic Allies” – bit.ly/3ZuSp1T
Dr. Carolyn Coker Ross: Hi everybody and welcome to the show. Today I have a wonderful new guest with me who is also. As I’ve mentioned many times before, one of the authors of our book, Anti-Blackness and the stories of authentic Allies, lived experiences in the fight against institutionalized racism. So her name is Dr. Ashanda St. Jean, and she’s a board certified obstetrician and gynecologist with over 25 years of experience. Specializing in women’s health and health equity, Dr. St. Jean is recognized for her leadership in addressing maternal mortality, racial disparities in access to care, holding key roles with the New York State and city maternal.
Mortality review boards, uh, the American College of Gynecology, national DEI delegation, and the New York State Coalition for Doula Access. Her career is dedicated to advancing comprehensive patient-centered care for underrepresented women in New York. Welcome to the show.
Dr. Ashanda Saint Jean: Thank you so much for having me.
Dr. Carolyn Coker Ross: You’re very welcome. Um, her chapter is amazing and I hope you have gotten the book, and if not, you can see the link in the show notes to purchase the book, but I. You, you’re gonna wanna read this one. So can I call you Ashanda? So in your chapter I’m gonna quote you wrote, black birthing people are three to four times more likely to die in childbirth than their white counterparts in the United States.
In New York state, the pregnancy mortality rate for black birthing people is. Five to six times higher than it is for whites. And in New York City it’s 9.4 times higher than the national average, despite black births representing only 15% of total births. So how can you help listeners understand those horrific statistics?
What’s happening with black birthing mothers?
Dr. Ashanda Saint Jean: You know, it’s something that truly impacts me personally and professionally as being a woman of color and understanding that many of my patients seek me out specifically because I’m a black woman. And so there has been studies that show that the cultural concordance.
And congruency of care is applicable when you are mirror image to your provider. And so understanding these stats and this data, it’s terribly troubling and it completely removes the joy outta motherhood. You know, there is nothing I can say to explain away these numbers, but what I can say is that it is a public health crisis.
And although we see that in the latest data that the numbers are improving for white, non-Hispanic, for Asian and Hispanic, the number for black women and black birthing people continues to rise. So this should be unacceptable for everyone.
Dr. Carolyn Coker Ross: And so I, I’ve also seen, I read about Serena Williams’ story. I think she wrote about it in Vogue or Vanity Fair, which was shocking.I mean, she’s a. Wealthy woman and in her first, uh, childbirth experience, she almost died because the doctor just wasn’t listening to her. I think she has a history of blood clots to the lungs. She knew the symptoms, she knew what was needed to diagnose it, and she told the doctors over and over and yet they ignored her and did, did whatever they thought they should do.
Dr. Ashanda Saint Jean: A lot of studies that have been done, and what they have found is that when you adjust for financial wealth, right? For education, yeah, for socioeconomic status, for insurance type, and even where you deliver black educated or even graduate level Women and birthing people, they still die at a higher rate than white non-Hispanic women who have not even received a high school diploma.
Dr. Carolyn Coker Ross: Yeah. So why do you think that is? What’s happening? For those women or what’s not happening for those women, that’s happening for other, for white women and non-Hispanic people,
Dr. Ashanda Saint Jean: I, I think it’s the impact of medical racism. Structural, interpersonal, and also systemic. ’cause there’s no biological difference. There’s no biological difference. Remember, race is a social construct. It’s not a biological construct. So there is no difference in our bodies. Someone else’s bodies. But if we listen to these tragic stories about maternal deaths, and when we speak to the families or the partners, one of the things they say is that they didn’t listen.
There was no validation of their concerns. There was no kind of elevation of what they were saying. And often women of color and women, uh, birthing people of color, they will tell you, I don’t feel they’re listening to me. They’re not validating. I’ve had patients travel two hours just to see me because they know I will listen to them.
You know, typically I get two types of patients, one who are already pregnant. They’re scared of dying having their baby. Or the second is, I don’t wanna get pregnant because I don’t wanna die.
Dr. Carolyn Coker Ross: Doing something that’s so beautiful as having your first or your 10th baby, that shouldn’t be part of the metric. Uh, in your book you talk about the origins of obstetrics and gynecology and the Dr. Sims, who’s considered to be the father of O-B-G-Y-N. Can you tell us a little bit about that history?
Dr. Ashanda Saint Jean: Yeah, so what people don’t realize is that this lack of trust that has happened with people of color with medicine is not something that’s a nonsense.
This is something that has been around for ages and what we know with Dr. J Marion Sims, and again, he has many instruments named after him and procedures and physicians named after him. What he did was he practiced and actually fine tuned his surgical technique on enslaved women. And he was doing that often without anesthesia, right?
There was Betsy, Lucy, and Anarcha, and those are the ones we know the most, but sometimes they were then instructed to then practice on other enslaved women, right? And Anarcha sometimes had multiple surgeries in one day with no anesthesia. So. When we think about it in that framework, right? There’s a long history dating a back to the trans-Atlantic slave trade to enslaved women coming to this country.
Then we can talk about Henrietta Lacks, and that was in the 1950s where this was a black woman who went to John Hopkins because of vaginal bleeding. All the time and was diagnosed with cervical cancer and they took her cells, name them HeLa cells, which are still used today for medical research, for vaccinations.
And it wasn’t until 2024 that her family was rightly financially compensated for her contribution to medicine.
Dr. Carolyn Coker Ross: So they took, but they took her cells without her permission or even telling her. Right?
Dr. Ashanda Saint Jean: Right. Yeah. They took it without her consent. And they still use it to this day.
Dr. Carolyn Coker Ross: Amazing. Yeah, so that, I mean, it’s almost like it’s baked into our DNA after it’s, it’s a form of intergenerational trauma in a way.
Not to mention the other trauma that happened to black women during slavery, which. It could be lo loss of children having to go back into the fields when they’ve just given birth. You know, all of those things must have been passed down to some degree in, in our DNA if, if we’re descendants from those women, I.
Dr. Ashanda Saint Jean: And then, I mean, I think also if you think about how we used to, first of all, enslaved women. Enslaved black women were breeders, right? Yeah. ’cause at one point, slavery stopped, right? They stopped bringing people over from Africa, but they still wanted to have slaves. And so they were expected to have 10 and 12 and 13 babies and still work in the plantations, work in the fields, pick cotton.
But I think in addition to that, what we have removed in terms of. Traditional kind of delivery patterns is having the obstetrician, you know, it’s a very sterile environment. If we go back to how deliveries were done in villages, in Africa, or even in enslaved times, it was a communal.
Dr. Carolyn Coker Ross: Yeah, they were midwives.
Dr. Ashanda Saint Jean: Midwives. If we go back, I mean, I, I’m gonna date myself, sorry, the listeners, please, um, bear with me. But if you ever watch Roots. Yeah, there is a scene where Cicely Tyson is giving birth, right? Mm-hmm. And she’s in a hut. And the actually the father is outside. Yeah. While all women are surrounding her and supporting her and coaching her and loving on her.
Right. And one of those women is Maya Angelou. If you go back, go watch the the scene.
Dr. Carolyn Coker Ross: Oh my goodness. I didn’t realize that.
Dr. Ashanda Saint Jean: And you think about it, and you look at these stars, right? And you think about this is how. We used to deliver back then, whereas now someone’s telling you who can be in the room, who can’t be in the room, you can’t get up, you can’t move around, you gotta stay in the bed.
You know, there’s so many things that are taken away. From our birthing people now that removes the joy of that maternal journey.
Dr. Carolyn Coker Ross: Yeah, it’s so true. With the statistics being so much higher in New York City, for example, compared even to New York State, what’s the explanation for that?
Dr. Ashanda Saint Jean: Well, I think first and foremost, we know that black women and black birthing people are experiencing these numbers at a higher rate, right?
And if we look at the distribution of the, the demographic distribution of black people, right? There’s more in the five boroughs, right? And so that’s probably why there’s a distortion of those numbers. And if we even went more granular, Brooklyn has the highest delivery numbers of black people. Um, and that includes African American, Caribbean, American, African as well.
And so what we look at the data in the five boroughs in New York City, Brooklyn has the highest number. So they have the highest number of black births, okay? The highest mortality as well.
Dr. Carolyn Coker Ross: Oh, so sad. Yeah. And I would imagine, I mean, I’ve read stories about that. If you lose a child that way, it’s extremely traumatic and makes it very hard to recover and you know, have another child or e even being, but,
Dr. Ashanda Saint Jean: but we’re talking about losing the mother, right?
And so, yeah, when you lose the mother, so the data that I just said is maternal deaths. So we have the highest number of, of births by black women or black birthing people in Brooklyn and they have the highest maternal deaths.
Dr. Carolyn Coker Ross: Yeah, so, so if you lose a mother, that’s even more impactful ’cause you have lo lost the caregiver for the family.
Dr. Ashanda Saint Jean: But not only that, the spouse. The partner, the, the family, the community. So everyone suffers. It’s not something that only impacts, it’s not a nuclear impact. It’s expanded. And you know, I think that one of the, kind of how I ground myself in this work, I went into OB because I wanted to be a part of the best day of someone’s life.
When I first saw my first birth, I’m one of six children. Oh. And I remember when I was a medical student and my first day on the OB rotation and I saw a vaginal birth and I called my mother and I said, you did this six times. I, I was, I was fascinated. Right. ’cause you can’t believe that baby came out of that belly.
And again, I’m 27 years in, I’ve delivered over 5,000 baby. Well, I stopped counting after 5,000. And I can tell you this, I am still amazed. Every time I do a delivery, because I cannot believe that baby wasn’t there. And so imagine after training in Connecticut, coming back to New York City and Connecticut again, I had more, um, I did not have the same demographic population that I took care of New York City.
You know, when I was in Connecticut, the biggest thing we worried about were redheads. Redheads always bled. So we’d be like, get four units of blood because she’s redhead. Right? But when I came to New York and. I was at one of one hospital in Queens for three years. We had five maternal deaths. Hmm. And so with that, I was like, I cannot believe that this is not the best day of someone’s life.
This is actually the worst day. And so then I was just like, I didn’t even believe that this is possible. I mean, of course you know you’re a doctor, but I had never seen it. And until you see it and you are like, oh my gosh, this changes the whole trajectory of why I am doing this. And I remember. Just thinking about the family, seeing the, the partner ’cause again, I wasn’t involved in that particular incident, but I was on call, right? Yeah. And it never kind of went away from me. And I said, well, what can I do? To give a voice to the voiceless, right? How can I turn this trauma? Because of course my trauma is only like second victim trauma, right? Yeah.
Dr. Carolyn Coker Ross: Secondary trauma. Yeah.
Dr. Ashanda Saint Jean: It’s not like what the family’s feeling, but how can I turn this into my purpose and my path? And that’s when I started really doing the work of maternal mortality. Because I think that if we can. Address this. And as we look at these numbers and they’re horrible, right? And we only have the numbers from like 2018, right?
So we don’t have really numbers data before that because we didn’t calculate it. So we don’t really know what it was before that. And so again, I feel that it is, my purpose in this field is to help kind of address this, hopefully eradicate it, but also to give hope and joy back to people of color.
So that they can have a joyful birthing and motherhood and maternal journey that they so rightly deserve.
Dr. Carolyn Coker Ross: Absolutely. So break down some of the individual factors that we, you know, we put under the umbrella of racism, but one of them is maybe under being underinsured or uninsured. What are some of the other factors that black birthing people are experiencing that may lead to that higher mortality rate.
Dr. Ashanda Saint Jean: I think a collection of of those things in totality are called social determinants of health, right? These are non-medical factors, right? That impact outcome. So they could be healthcare access. Healthcare availability. They could be transportation.
They can be racism, they can be redlining, they can be food insecurity, they can be health literacy. Sometimes patients don’t really understand what you’re telling them. Right? Right. Are they receiving care with a trauma-informed lens? Because we know about generational trauma. We know about weathering.
Dr. Carolyn Coker Ross: you’re gonna have to explain that term because not everybody listening may know about weathering.
Dr. Ashanda Saint Jean: Okay, so weathering is the impact of racism, discrimination over generations that impact your health conditions. So it can, you know, when some people say, well, I have hypertension, high blood pressure, because you know, often they think there are certain medical conditions that are caused.
By the impact of stress, of racism and discrimination, and this is over years.
Dr. Carolyn Coker Ross: Yeah. So it’s kind of a wear and tear effect over not just years in your life, but generations. And those, you know, can be passed from one generation to the next.
Dr. Ashanda Saint Jean: From the womb to the tomb. They sometimes say,
Dr. Carolyn Coker Ross: yeah, epigenetics. That’s a whole nother program, but we’ll just mention it here. So those social determinants of health really describe the impact of racism and how it particularly impacts. Birthing people as you’re saying, the, the new term, and those, those are things that maybe the woman herself may not have control over, you know, may not have control over her ability to get better insurance or to live in a better neighborhood where she has more access or to avoid being in a food desert.
You know, so she could have better nutrition,
Dr. Ashanda Saint Jean: even healthy food options, right? We’re we could be in right here in New York City and there are no supermarkets, right? They go to the bodega, right? Or they don’t have the money to afford the organic things at Whole Foods, or they don’t have farmer’s markets, right?
And one of the things I had tried to do when I was in New York City is to get green dollars. So my patients, my clinic patients could then shop at the, at the farmer’s markets, right? You know, many affluent neighborhoods. They have co-ops and they have food co-ops, and they get fresh produce
Dr. Carolyn Coker Ross: and there’s a Whole Foods right in soho. I found out when I visited my son right there in the middle of the city.
Dr. Ashanda Saint Jean: But you can go to some places in Harlem and there’s no supermarket. People go to the bodega. And so when we think about kind of what the impact of RA redlining, right? And then also kind of food deserts. Food deserts are not only a rural thing, it can happen in the urban settings as well, right?
So we wanna be very kind of introspective of what is happening. Also, when we talk about quality healthcare, right, we know that when you have a provider that mirrors your cultural identity, right? There are things that are more understandable. Right? And then we never talk about the impact of maternal mental health.
P meds, uh, perinatal mood and anxiety disorders. Black women and black birthing people are 40% impacted by, um, anxiety and depression during their pregnancy. But again, they’re often weaponized against them and their shame and stigma. So they will not tell you they’re anxious, right? They’ll just be anxious the whole pregnancy because they thinking you’re gonna call ACS.
Or some sort of child protective service, or you’re gonna think they’re crazy, right? Because we still haven’t normalized mental health in this country.
Dr. Carolyn Coker Ross: And there are a whole, a lot of reasons why there’s a big stigma on mental against mental health, getting mental health care in the black community as well, and we don’t, we’ve talked about that in a previous podcast with Dr. Wigfalls. So if you’re interested in learning more about that, really refer to that podcast. But let me ask you another. Uh, question, uh, you said in your chapter, racism impacts the birthing journey and it’s a significant barrier to equitable healthcare, quality of healthcare and overall healthcare access.
So do you have any specific examples from your 5,000. Birthing experiences that can help people really get a sense of what this is like because we talk about concepts all the time, but when you break it down to an individual patient not asking you to, you know, say anything that’s confidential, but just give some scenarios, some.
Paint a picture for us of what it might be like for a black woman or black birthing.
Dr. Ashanda Saint Jean: Yeah. I’ll give you one example. I had a patient come in with her partner. You know, they had a little disagreement about whether, you know, they should bring the suitcase in or not, right? Because they didn’t know if they were staying right?
Well, their discord was witnessed and all of a sudden she was asked multiple times if she had domestic violence. Then they wanted to get a social worker, right? And it, it just kept escalating because then she got angrier because they kept asking her the same things over and over. And I said to the whole team, I said, if that was a Caucasian couple who argued about the same thing right.
Would they have gotten the same response? Yeah. You know, there have been times when I moved upstate, I started working in a more of a rural hospital. Okay. There was not many people that looked like me. Okay. During COVID, there were certain restrictions. And one of the restrictions is you had to stay with your partner the whole time, right?
Uh, or if you left the hospital, you couldn’t return, right? That was just one of their rules. We had an instance where most of the couples were Caucasian, right? Mm-hmm. And the husband’s like, I gotta just go for a smoke. I’m gonna, no problem. Go for a smoke. Whereas when I had black couples, if you leave, you’re not coming back.
You understand? So there is a different type of of care. I can give you another example. I had a patient, I will tell you in my experience, if a baby talks positive for cocaine, that baby’s not going home with the parent. Okay. In New York City, if a baby talks positive for marijuana, there’s a chance they’re not going to, especially if they’re a person of color.
When I went upstate, I had babies that talk positive for cocaine amphetamines, but their parents were Caucasian and they went home with their parents.
Dr. Carolyn Coker Ross: Wow.
Dr. Ashanda Saint Jean: Okay. So again, it’s not weaponized against them, you know? And I had Pat, I had a patient one time, she had no prenatal care. She had an extramural delivery, meaning that she delivered at home and the placenta was still in.
So she came and we delivered the placenta. The baby talks positive. She did crystal meth and the baby tax positive for amphetamines. And she was like, I wanna go home because she wanted to smoke or do whatever she does. And I said, well, listen. Just stay the night. ’cause she was ready to sign out a MA and leave the baby.
And I said, just do me this favor. I just want to repeat your blood work, make sure you’re stable, what we call hemodynamically stable. You know, I don’t, I don’t discharge babies. I’m an obstetrician. And so she decided, she agreed to stay and I said, I promise you I will arrive at five in the morning so that you can leave early.
And so when we made that agreement right, she said, okay, I’ll stay. And then the, the partner came and I think something happened because all of a sudden she was okay. You know, she was different. She wasn’t exhibiting behavior that would be consistent with withdrawal. Okay. And so she told me, I’m leaving with my baby.
And I said, oh, okay. I said, again, I don’t, I don’t make those decisions. I’m not a pediatrician. Can I tell you? She went home that the next morning the baby stayed. ACS was called. Hmm uh, or Child Protective Services, what? What they call upstate. And do you know, two days later, the baby was cleared to go home and she looked me dead in the eye.
Not anyone else. Not all the other Caucasian people looked me dead in the eye. And she said, see, I told you I was gonna take my baby home.
Dr. Carolyn Coker Ross: So the rules, you’re saying basically the rules are different for black women and their partners, or black birthing people and their partners?
Dr. Ashanda Saint Jean: What I have witnessed, so I dunno, you’ve witnessed rules of difference, but the implementation of the rules, right.
The enforcement. I have seen a two-tiered system.
Dr. Carolyn Coker Ross: Yeah. What about your own personal lived experience? Because you know, in the book we try to include a lot of the professional experts mm-hmm. Their expert opinion, but also their lived experience so people can get a sense of like, what, what’s it like for you to be, uh, well, I know you have multiple identities here in terms of right.
You’ll have to say what they are. ’cause I don’t remember.
Dr. Ashanda Saint Jean: I. ’cause I always wanna honor my mother and my father. Um, my mother is Dominican. She’s very fair. My father is from Alabama and he is very dark. Okay. Oh wow. Okay. And so I’m in the mix. They had six children. They met in the sixth grade. They were married 49 years.
My dad has passed for the past 10 years. What I will say to you as a doctor, you know, training in Connecticut, there were times where I had a patient one time. You know, I was a very fast and a very skillful surgeon and so sometimes when the privates would come in, they wanted me to operate with them so they can quickly finish and perhaps go back to their office.
And there was a big time executive’s wife who came in and we did the surgery, went very well. You know, we, you know, the baby did very well. And when I went into, you know, round on her, do a post-op check, she asked me what was I doing in there and I could take the garbage. I. I said, no, no, no, I’m not housekeeping, because there’s nothing wrong with being a housekeeping.
Okay. No, I said, I said I’m not housekeeping, I’m, you know, I’m doctor.
Dr. Carolyn Coker Ross: It’s the assumption. That’s offensive.
Dr. Ashanda Saint Jean: Oh no, absolutely. Yeah. And so then I said, no, no, I’m doctor. At that time I was Dr. Phillips and you know, I was the doctor who operated on you. And she goes, no, you didn’t.
Dr. Carolyn Coker Ross: Oh my, okay.
Dr. Ashanda Saint Jean: She goes, she goes, I don’t want you in my room.
Dr. Carolyn Coker Ross: Whoa.
Dr. Ashanda Saint Jean: And I left the room, and then the next day there was a note on my locker saying, do not round on her. And then I was told that she doesn’t want me, so that’s not unusual. I purposely have every scrub embroidered, all of my white jackets are embroidered. Nobody ever thinks that I’m the doctor.
Dr. Carolyn Coker Ross: With your name, you’re saying with your name and my name.
Dr. Ashanda Saint Jean: MD St. John md. F-A-C-O-G. Okay. Because nobody, I mean, I would tell you I’m the, I was the chair in my department and I was walking in to do a C-section at seven o’clock in the morning. It was scheduled for seven 30. And in this rural hospital upstate, I had security said, where the hell do you think you’re going?
And I said, I’m Dr. Saint Jean and I’m here to perform a C-section. And I’m the chair of the department there. And now mind you, scrubs are embroidered, white jacket’s embroidered ID is is showing. Okay. There’s many times I may go in with a white medical student, especially if it’s a white male medical student.
Patients will say, well, I want him to do the surgery. I’m like, well, if you look at your bracelet, that’s my name. I’m Ashanda. He’s, he’s not Ashanda and he’s student. There’s been times I, I had a time one, one time where, you know, ’cause for me, in addition to the racism and prejudice on what I look like, I also appear young.
And so I had one time where, when I was running six clinics for a major medical center in New York City, I had a patient one time said I would like a doctor who’s more experienced. It was nobody more experienced than me. And so, but I said, you know what? I don’t listen, I, you learn to have thick skin, and it shouldn’t be that way.
But what happened is. Then she saw a white female doctor who had a lot of salt and pepper hair. And the day of her surgery for her C-section, I was actually called in because she was hemorrhaging and had what we call uterine acne where her uterus wouldn’t contract down after the delivery of the baby and the placenta.
And I literally had to go in and do a special type of, um, procedure technique to save her uterus. After that the doctor said, you know, Ashanda, I’m gonna tell her that you came in and, and saved her life or whatever. And I said, no, don’t do that. And I said, you know why? Because I don’t do it for that reason.
My purpose is more than that. So I don’t need any accolades from anyone. You know what I do is. Of a higher calling and a higher reason. And so I will always help others because I think that I have been blessed with this, this gift, this talent. But I think also I have been on assignment to help other black women and birthing people.
And that that’s what I try to do.
Dr. Carolyn Coker Ross: That’s beautiful. I love that. Just as a last question before we end, I wanted to just ask you, do you think that, ’cause I know you’re involved in the state, at the state and the local level in New York on this topic, do you expect that the changes in the administration in Washington will have a better impact?
No impact, worse impact on maternal uh, health than before?
Dr. Ashanda Saint Jean: What I will say is I will always remain hopeful that each day we will strive towards improving the quality and the access and the availability to all birthing people so that everyone can experience joy during their maternal journey.
Dr. Carolyn Coker Ross: Are you seeing that hope come to fruition, though?
Dr. Ashanda Saint Jean: It’s hard to say, right? And it’s, it’s hard to know just yet. I will always look at the glass half full and remain positive, and I’m just hopeful that humanity will always win.
Dr. Carolyn Coker Ross: What kind of advice can you give to birthing people, you know, people who are planning to have a baby, who have that fear inside of them, or people who are already pregnant.
What advice can you give to them so that they can get the best care for themselves?
Dr. Ashanda Saint Jean: I always think of a toolkit, right? So before I even talk about the components of the toolkit, first I will say is you deserve to be heard. You deserve to be listened to, and you deserve to be valued. So that’s at the, at the bedrock of everything.
What I would say is. Start planning your pregnancy. You know, 50% of pregnancies in this country are unplanned, right? So as much as you can plan, I would say start taking your prenatal vitamins three months before you conceive those things. I would say research and select your provider and the provider can look so many different ways.
You can have a midwife, a nurse practitioner, you can have a family medicine doc, or you can have an ob. Um, there’s a wonderful app called the IRTH App. Take B out of it, an IRTH app, and it has a lot of providers of color and they have kind of a, a, a scale and those type of things and, and actual responses from people.
So I would say pick your provider, make sure they have shared decision making, make sure they have a trauma-informed lens. Make sure they value you. I would also say if you can select your hospital, visit the L and D.
Go there, look at the room, see if you, your vibe. See a feeling, see how you feel being there. I would say also get a.
Dr. Carolyn Coker Ross: Tell people what a doula is ’cause it’s
Dr. Ashanda Saint Jean: doula is a nonclinical support person during labor, but they can also be intrapartum. So they can come to your prenatal visits with you and they can be coming to you afterwards in postpartum.
But what they are trained and skillful at is emotional, physical, um, support. During your birthing journey. And they’re also an opportunity for advocacy and empowerment as well. And sometimes they translate what we’re saying. You know, I love this one story where I had this patient and everybody was happy and we’re all excited and she has her doula.
And then I went to my office, I came back, I go in the room, everyone’s angry. I was like, what’s going on? And you know what we do in this, in this country is how you doing? Fine. Everyone says, fine, but you know, they’re not fine. And what I did was I asked the doula, they can come outside the room and can I talk to them?
So she comes out and I was like, what, what’s going on? What, what happened? Like the whole mood changed. And she said she doesn’t like the birth, the, the blood pressure cuff. I was like, that’s it. Like, well, the nurse said she can’t take it off and it’s, it’s bothering her arm and it’s just, and I said, okay, that’s, I said they check her blood pressure every half hour, so the nurse will come in, put it back on, and.
And she goes, well, no, the nurse said no. And I said, it’s okay. Let me take care of it from here. And so we took off the blood pressure cuff and then immediately it was a whole different vibe. And, and, and, and just, you could palpate the tension before. And now she was smiling again, laughing, and, you know, and those are the things.
Dr. Carolyn Coker Ross: Now what, was it really the blood pressure cuff? Or was, was it just the sense that. Someone wasn’t listening to her and that she wasn’t being heard about her feelings.
Dr. Ashanda Saint Jean: I think it was both, I think. And the third thing was she felt that she didn’t have any power.
Dr. Carolyn Coker Ross: Yeah. So there you go. So how do we, how do we do that?
Dr. Ashanda Saint Jean: And so when I tell you doulas are incredible, you know, and I go back to that scene and roots, right? Mm-hmm. We’re used to birthing with a community around us, right?
Dr. Carolyn Coker Ross: A support community around us. So, and that’s what doulas do, and they’re actually incredible. So that’s another thing. I would also say, get a birth plan.
Dr. Ashanda Saint Jean: I provide a skeletonized birth plan so that. Number one, I can go over education about what’s gonna happen in the moment. Right, right. To kinda, because we always fear the unknown. We all do this, right? So this is not something new for birthing people. But having that skeletonized birth plan, I know that you may wanna put lipstick on before the baby delivers for for the pictures, that’s fine.
You may want delayed cord clamping. You may want so and so to cut the cord. You may want someone to cut half another one. I don’t know that. And in the moment you’re not gonna be able to tell me that. So I love birth plans. I would say also, please attend childbirth classes as much as you can. You know, a lot of these classes are now virtual and you’re able to commune with people around the same gestational age and you get to talk to each other, right?
Because you’re not what you’re feeling, you know? So those are the things that I would prescribe as a toolkit for patients. Some of those things, if not all of them, will help you return that joy into your motherhood journey.
Dr. Carolyn Coker Ross: Very good advice. Thank you so much, Dr. Saint Jean, it’s been a pleasure to talk with you.
Appreciate you being on the show.
Dr. Ashanda Saint Jean: Likewise. Thank you for having me.
Dr. Carolyn Coker Ross: You are welcome.
Thanks for listening. Please subscribe to the Inclusive Minds Podcast so we can let you know when the next great guest comes on. The link to subscribe is in the caption below.
