ONE: MYESHIA’S STORY

Myeshia is a married, 34-year-old cis Black queer woman with a PhD. Two weeks after giving birth to her first child in a Southern California emergency room, things take a turn for the worse.

Episode Notes

In this episode we mention: 

• California cuts its maternal mortality rate in half

• CA Senator Holly J. Mitchell's bias training bill

•  California as a "global reproductive technology hub"

• Postpartum preeclampsia

• Sisters in Loss podcast

Visit www.natalstories.com to learn more about NATAL, access our resource hub, and donate to our production fund.

Follow NATAL on social media:

• www.instagram.com/natalstories

• www.twitter.com/natalstories

Join our Facebook Community to connect with other parents, birth workers, and advocates: https://www.facebook.com/groups/natalstories

NATAL is produced by You Had Me at Black and The Woodshaw. Listen to You Had Me at Black wherever you get your podcasts.

EPISODE TRANSCRIPT

Gabrielle Horton: I'm Gabrielle Horton. I'm a 29 year old millennial. I've got aunties, uncles, distant relatives, geez, even neighbors who want to know, when am I going to settle down and have a baby or two? When I was younger, I used to daydream about how many kids I might have. But for real, I'm not even gonna lie to you all, as I've gotten older and more aware of what motherhood entails, I'm nervous about going down that road. Do I know enough about parenting? Do I have enough money for childcare? Am I even ready to be responsible for the life of a child? And then there's the close calls some of my new parent friends have had while giving birth.

Y'all, I've, heard the stories, the unfortunate consequences at STEM from disparities and the care black birthing parents receive in our healthcare system. And it's appalling, and it only adds to my anxiety. And I feel like this, despite the fact that my home state, California is regarded as one of the best States to have a baby.

Between 2006 and 2013, California cut its maternal mortality  rate in half. And thanks to the passage of state Senator Holly J. Mitchell's 2019 bill, racial bias training is now required for all California perinatal healthcare providers. In this country, a law like that is a really big deal. Plus here in California, you have progressive policies that support freezing eggs and birth by surrogate and IVF, aka in vitro fertilization.

We have culturally responsive reproductive policy, cutting edge technology, medical advancements, I mean, all things considered, Cali really stands out as a hub for reproductive technology, and it also seems like a pretty damn attractive place to start a family. Right?

 Or at least it should be. But this model state is far from perfect.

California is trying to give birth to a better maternal health care system, but the facts are the facts. Black birthing parents are still experiencing complications both locally and nationally, our healthcare system is deeply fractured by racism and racial bias. Black parents are still falling through the cracks. They're still getting hurt. Sometimes, near fatally. 

And that's exactly what we're going to get into on this very first episode of NATAL.

[Musical Jingle]

Myeshia: I've always wanted to be a mother, and I think I had a separate process of whether I wanted to actually be pregnant. 

Gabrielle Horton: That's Myeshia Price-Feeney, a fellow California resident. Myeshia is 34. She has a PhD in developmental psychology, and a stable job, income, and access to quality health insurance. Myeshia is also a married, Black, queer woman.

Myeshia: I was able to disentangle those two things. Um, and so I did actually decide, okay, like I would like to carry and be pregnant also myself. And so it was interesting because I remember being sort of somewhere in my early twenties sort of having this moment of recognizing my queerness, if that makes sense.

And sort of processing that in and of itself, and how motherhood would look in that picture. Because then I had to sort of decide, okay, being a mother might look different. Right? But I think it's one of the unique experiences of being in a same sex relationship where like you're, you're not going to accidentally get pregnant, right.

You have to kind of figure out the process. It's going to happen, and you kind of need to have that conversation and have a very active role with getting pregnant. So yeah, I think it was sort of a process for me, but, I think I eventually got there and sort of like, yes, I do want to have children and I do want to have that experience of being pregnant and sort of carrying a child.

Gabrielle Horton: And they tried for about a year. On their last attempt, right as they were thinking about taking a break from the process, it worked. Myeshia's pregnancy test came back positive. They were really going to have a baby. And Myeshia's very real family history and pre-existing conditions were top of mind.

When she disclosed them to her doctor, the likelihood of them affecting her pregnancy was high. 

Myeshia: Yeah. So before I got pregnant, actually one of the things that I was aware of was preeclampsia. I have sisters who are twins and they are a year older than me, and they were born three months early because my mom had preeclampsia and had to deliver them. My doctor and I talked about it at the, towards the very beginning of my, um, visits with her and she said, "I am very familiar with this. I worked in," I feel like she said, Baltimore. "I worked around a lot of Black women. I'm familiar with this condition. I, um, know the signs of it." And it was a conversation very early on about like, what to look for, what to be ready for while you're pregnant.

Gabrielle Horton: Preeclampsia is a pregnancy related condition that causes the body's blood pressure to rise dramatically. It can result in brain injury, it can impair kidney and liver function, and it can cause blood clotting, fluid in the lungs, and even seizures. If untreated and severe forms. It can also lead to maternal and infant death.

The rate of preeclampsia and eclampsia for Black women is 61% higher than it is for white women, and 50% higher than for women overall, according to the US Department of Health and Human Services. Basically, for us, this is not a rare condition.

Throughout this episode, I'm going to be using an abbreviated name, Dr. B, to refer to Myeshia's physician.

Because of my use family history with preeclampsia plus two of her own pre-existing conditions, dr B, her obstetrician, sometimes called an OB for short, categorize her as a high risk pregnancy case. Despite Myeshia's rheumatoid arthritis and a predisposition to blood clotting, her pregnancy went well. It went even better than Myeshia expected. Her rheumatoid arthritis pretty much went away. 

Myeshia: I actually had a relatively easy pregnancy and I was like, some way through it just kind of already like plotting. Like, let me see, I will straight up carry so many people's babies for them. I will do so many surrogacies if I get to feel like this for it? Like that's how easy it was for me. 

Gabrielle Horton: Really, the only major issue was her baby's position. He was breached, meaning he was flipped in an awkward position inside her. His head was at the top of Myeshia's, uterus presenting a challenge to her plan for a vaginal delivery. Even though she really didn't want to have a C-section,  Myeshia's doctor told her she had no choice.

During labor. She was administered an epidural, basically a shot to the spine with the big ass needle. While anesthesia is an elective medication for vaginal deliveries in hospitals, it's practically required for C-sections and epidurals are common procedure for parents embarking on this abdominal surgery.

We got into the groove of things like the whole pattern of like, feed, change, diaper, put back to sleep, like newborns have a pattern. And we were sleeping when he was sleeping, and then we were up and we were like, okay, what are we going to do all day? And so by the time my two week appointment happened, we had established this pattern. We were good to go. He was fine, we were fine. Um, and I remember at my appointment with my OB, I remember mentioning that I had some swelling going on. And she went to go like feel my legs and feet, and she felt both of them and she was like, "No," she's like, "It feels like even swelling." And she was like, "I think you're fine. It's very even. It's both sides. Your blood pressure's good." All throughout my pregnancy, my blood pressure was actually lower than the typical 120/80. At this two week checkup, it was normal. 

Myeshia remembers everything being super chill at her appointment. She and her doctor joked around and basically had a kiki for half the appointment.

But in the two days following her first postpartum checkup, Myeshia began to feel a little bit off. In her words, she was feeling brain fog. She didn't think much of it, chalking it up to hormones. She just had a baby, after all. But as a fogginess progressed, so did the pain. It started to feel more like the beginning of a migraine, another ailment she also had a history of. 

Myeshia: As that day progressed, I started getting a headache and then, the next day the headache got worse. I'm getting a migraine, and I'm thinking, of course like it makes sense to get a migraine. I'm not the kind of person who is just like, something's wrong with me. I need medical attention.

Like I, I tend to try to like rationalize things before I go there. The thing that I thought was, I had a lot of hormones going through my body. Obviously if I have a history of migraines, I feel like coming off of whatever hormones were going on when I was pregnant, it would make sense that this could trigger a migraine.

And I remember being upset and crying because I thought, I'm already having health issues and this kid is two weeks old, like I want to be able to take care of him and not have health issues going on. 

Gabrielle Horton: At this point. My issues, pain was almost debilitating. She tried sleeping and natural remedies, but nothing seemed to work.

A timely phone call and some advice from another mommy friend to get her blood pressure checked was ultimately a game changer.

Throughout this season, we're highlighting different podcasts that explored various facets of the black birthing experience. Sisters and loss podcast spotlights, faith-filled black women who share their grief and loss stories and testimonies. If you or a loved one has experienced a miscarriage, infant loss, stillbirth or infertility sisters, a loss, a resource for you, find it and listen wherever you get your podcasts.

Follow sisters and loss on Twitter, Facebook, and Instagram, and be sure to visit their website@sistersandloss.com

Myeshia called Dr. B and left a message with the details of the ongoing headache. A nurse called her back and told Myeshia the doctor anted her to go to the emergency room immediately, but the nurse didn't give her a reason why. All Myeshia was told was that she needed to go, so she did. But she really thought it was going to be a quick in and out kind of thing.

Even though she was feeling a headache like no other she'd had before. Myeshia convinced a reluctant, Beth to just drop her off alone at urgent care. Again, trying to rationalize things and thinking she could handle the situation on her own, Myeshia wanted Beth at home with Langston. Her baby was vulnerable, understandably, she didn't want him in a germy emergency room.

Finally, at the emergency room check-in, Myeshia told the attendant on duty how she was feeling. The woman gave her an intake form and told her to sit and wait. But according to my Aisha, the woman didn't seem to register the urgency of the situation despite being in an emergency room.

Myeshia: And I remember just sitting there thinking like, please, please, like please. So then she finally calls me back up there. I go up there and she's like, okay, your chief complaint. And so the person who does the triaging, I assume is what this is called, is literally sitting right behind her and there's a chair right there.

So she's like, okay, "Go walk around here." And so again, no one is in here. So I walk around and sit in the chair and he takes my vitals. And takes my temperature. Puts the little thing on my finger, important stuff here, takes my blood pressure, takes my blood pressure again, we stand up and he walks me back.

Why? Because there's nobody here, and he's like, okay, if you just right here, somebody will be with you soon. I sat down, so then, the next person who comes in to talk to me about my symptoms, is like, "Okay, so your chief complaint is a headache." And I'm like, "I just had a baby." I let her know. I let him know also, by the way, that I had just had a baby because I don't know how these things are tied together.

Um, and so she's like, "Okay."

And then I start crying and she's like, "Why are you crying?"

And I'm like, "because my head is hurting so bad."

And she's like, "Is that it? Are you sure that's all, the only reason you're crying?"

And I'm like, "yeah, why else would I be crying? My head is killing me." 

Like it seemed to surprise her so much that I be crying because I'm in pain. Like the idea that I'd be hurting that bad just totally threw her off. 

Gabrielle Horton: Again, for a second time, Myeshia was told sit tight, someone would be around to see her shortly. While she waited, she managed to text Beth a few updates. But Myeshia still didn't have a diagnosis. She waited, she waited, she waited.

Myeshia: And then there was someone who wasn't someone I had even come in contact with, but saw me laying in bed and so much pain and stopped the doctor and was like, "Hey, are you going to see her?"

And he was like, "I don't know, soon." Like kind of dismissive. In that moment, not only am I in pain, but I'm separated from my newborn, I'm alone, and I still have to process, what is this young white doctor gonna think of me as a Black woman in the emergency room, right?

Am I going to get a lecture on how I need to go see my primary care physician first? Because there's an assumption that I don't know that already?

Am I going to be perceived as not being in as much pain as I'm saying I am? You know, like all these things are coming into play. How do I make sure that I convey what's happening to me? How do I let him know? Like, yes, I have a history of migraines, but I don't think this is a migraine anymore.

I didn't come to the ER thinking this is a migraine and please fix my migraine. Like this is different. And so that's why I specifically chose to tell him this is the worst headache I've ever felt in my life. I chose those words very specifically, just to get his attention. 

Gabrielle Horton: Finally, the doctor was one-on-one with Myeshia.

Myeshia: And he was like, okay, kind of like, why are you taking up my time? Like this is an ER and I, so then I rephrase it. "My head is hurting. This is the worst headache I've ever had in my life." Let me get dramatic with you if that's what you need. And so he's like, "well, if this is the worst headache you've ever had, then I'm going to give you a spinal tap."

I think he was trying to comment on my bluff. I think he thought, I will offer you something super dramatic, super invasive to get you to say, your head isn't hurting that bad. And I said, "I'm not having a spinal tap. I'm not letting you give me a spinal tap, because I just had a baby and I just had an epidural. I don't want something else and my spine."

And so when I told him he wasn't giving me a spinal tap, he had this perplexed look on his face, like, whoa, like I can't believe he just said that. And then he basically like turned around and was like, "All right, I'll give you some pain medicine then," but not like anything that would actually treat my pain.

It was like, I'll give you a few Tylenol. As he was walking away, I asked him what was my blood pressure, and I asked because of my friend. He said, I don't know, and I was like, okay, can you find out? And he was like, still very irritated with me for asking something pretty basic as far as I was concerned.

So he asked the nurse who'd been in there asking me why I was crying, what was my blood pressure? She said, "I don't know." He sent her to go find out my blood pressure and he left because he was done with me. He was going to give me some Tylenol and then they came rushing back in there. He got really close to me and he's like, "Your blood pressure is at critical levels. How did you know?"

And I said, "I didn't know."

And he was like, "Well, why are you asking?"

And I said, "Because my friend suggested that I get my blood pressure checked." And that's when they decided to start getting into gear of like trying to get my blood pressure under control.

Gabrielle Horton:  It was a full 90 minutes between the time Myeshia checked into urgent care and the moment emergency staff realized she was in a critical state.

At that point, she'd encountered four different people, the front desk person, the physician's assistant who checked her vitals, including her blood pressure, the nurse who asked why she was even crying, and finally the doctor. There was clearly a breakdown of communication or protocol in an emergency room that wasn't even busy at the time.

Myeshia, in a crisis, had to be her own advocate. The doctors quickly gave her medicine to lower her blood pressure, and while they were prepping my Aisha for a CT scan, she started losing control. 

Myeshia: I felt my left foot crunch up and then I sorta just felt like all of my left body was twisting up. And then the last thing I remember is I felt like, and I don't know if I did, but I felt like I turned over onto my right side.

And, and that was it. Like I woke up, I don't know how much time had passed. I kind of have a sense of it because I was texting with my wife. When I woke up, it was the same nurse who was like, why are you crying? And she was just like, "You had a seizure, we're going to move you to ICU."

And I remember looking at my phone and my wife was like, "Hello?" Like, you know, are you okay? What's going on? And I'm like kind of the worst, and I just text back like, "Hey, I just had a seizure." Those are like infamous words and I relationship now.

Gabrielle Horton: On April 12th, 2018 seventeen days after she gave birth, my Aisha ended up alone in a California emergency room fighting for her life. All through her pregnancy, she was so mindful of the signs of preeclampsia, but what she didn't know and what the urgent care staff in their haste didn't realize was that my issue was suffering from postpartum eclampsia. Post eclampsia has all the same symptoms as preeclampsia. The only difference is that it occurs postpartum or after childbirth, typically within the first six weeks.

So what happened? Myeshia had swelling during her first postpartum checkup, but the post eclampsia symptoms weren't very pronounced at that point. Dr B. assured my issue that she knew the signs of eclampsia. After all, she'd worked with so many Black women in Baltimore. But if this care provider had operated as if my ischium might develop post eclampsia, Myeshia might not have ended up alone, seizing in the emergency room. If it hadn't been for her friend's blood pressure advice, nudging from her wife, shout out Beth, and Myeshia advocating  for herself, things might've turned out differently. 

Myeshia: After the seizure happened, I had recurring dreams where somebody was having a seizure. Um, I remember one time there was someone having a seizure. They were driving a van I was in, and we crashed. I've had several gyms where Langston was having seizures.

I got a blood pressure machine in my house. I pulled it out and took my blood pressure. I still am like, what if it's that again? I always want to rule out blood pressure, headache, seizure. You know, when I think about my experiences with Langston and with Beth, I think, this could be happening without me. You know, like I could be only existing in his life as people explaining who I was to him.

And even like, in terms of like, him being biracial, like his Black identity would just be somebody trying to like approximate that. Whereas like here I am. And I'm here to sort of be that example for him, you know? And so I think about that oftentimes, like he was almost robbed of that experience. He was almost robbed of like, being able to experience me in his life.

Gabrielle Horton: Yes, what happened to Myeshia is one story, in one state, California. But today there are currently over half a million Black Californians of reproductive age who this could happen to if they decide to have children. Myeshia's story is unfortunately the story of so many Black birthing parents. Not all of them are still with us to share their story.

As we're learning with COVID-19, underlying health issues and inequitable access to health care exacerbate negative outcomes for us. The Centers for Disease control and Prevention estimates Black mothers are three to four times more likely to experience fatal, or near fatal, childbirth outcomes compared to white mothers. And 60% of those deaths are preventable. 

With the Black birthing experience as is, it's not unreasonable for people to be concerned or afraid going into it. What we as Black folks know is systematic racism and racial bias, conscious or unconscious, can unfortunately be the death of us, even when we're bringing life into the world.

We deserve better.

[This article was originally published by NATAL.]