Three Generations of Black Mothers: Unchanging Struggles and the Call for Culturally Competent Care

By Jazz Ray

Black mothers have been navigating a healthcare system that often overlooks their voices and needs for generations. As I reflect on my own birth and postpartum experiences, I see similarities in the challenges faced by my mother and grandmother. These stories, spanning- decades- reveal not just personal struggles but systemic barriers that persist. Through their voices and mine, I hope to shed light on what needs to change. 

Grandmother’s Story: The Quiet Strength of Survival

In the 1970’s, my grandmother gave birth to her first child in the freshly desegregated South. “It was said to be desegregated, but the black women had a doctor that dealt with them, and another doctor looked over the white women.” My grandmother, like most black southern women, came from a long line of midwives- she was delivered by my great-great-great-grandmother in 1953. But due to Black midwives being pushed out of practice in the 1950s as part of the historical erasure of women of color in reproductive health, she turned to the hospital for her own pregnancy care. 

She described the hospital as cold- not just physically, but emotionally. “The nurses barely looked at me,” she told me. “I was in pain, but they said ‘You’ll be fine,’ and walked out.”  

She wasn’t offered pain relief, nor was she informed about what to expect during delivery. After giving birth to her second baby,  a 2-pound premature baby boy with hydrocephalus,  she returned home to a community that offered support, which included her church family, and the stern matriarchal figure (Big Mama) that was my great-grandmother, but the healthcare system never followed up, and my grandmother received no acknowledgment or support from her partner. “We didn’t think to ask for help. We just made do with what we had,” she said. My belated uncle met his demise just a few years later. 

My grandmother’s experience highlights the resiliency of Black women, but also the glaring neglect of comprehensive care.  

Mother’s Story: Progress on Paper, but Not in Practice

Fast forward to the 1990s, when my mother had her first child, me. By then hospitals were integrated and the long struggle for civil justice amongst the Black community was reported “over”, but my mother’s experience was still fraught with dismissal. “I was told that if I didn’t give birth by a certain time, that they were going to cut me open because my doctor wanted to be home in time” she recalled. “After that, I was determined to have you as soon as possible, they let me get into a squat and I had you that way.” 

In the postpartum period, my mother was sent home with a pamphlet and no real guidance. “They assumed I knew everything, but I was overwhelmed. I needed to get back to work as soon as possible. We didn’t talk about mental health, we didn’t have any check-ins to see how I was doing.” 

While some strides had been made in access, the lack of personalized empathetic care persisted.

My Story: Echoes of the Past 

Though decades had passed, and I had access to more resources and information than my mother, I found myself facing many of the same barriers. As I prepared for my own births, I believed things would be different. But despite my avid reading, and consumption of YouTube videos, my husband and I encountered the same dismissal and lack of support. During labor, I was pressured into interventions that didn’t align with my wishes. Despite educating myself, I felt and observed that my own self-study was the only informed care I received. Postpartum, unlike my grandmother’s time, where the church and family stepped in to fill the gaps left by the healthcare system, I found myself navigating both physical recovery and emotional upheaval without adequate support.

It became clear that while the language of inclusivity has evolved, the lived experiences of many Black mothers remain the same. We are still fighting to be heard, seen, and cared for. 

The Unchanging Thread: Systemic Disregard

Across these three generations, one thread is painfully clear: the healthcare system consistently devalues Black women’s voices. From my grandmother’s segregation-era neglect to my mother’s dismissal and my own struggles, we’ve faced systemic barriers rooted in racial bias. 

Research shows that Black women are three to four times more likely to die from pregnancy-related causes than white women. Yet these statistics fail to capture the everyday indignities we endure- being ignored, underestimated, and unsupported.

A Call for Change

This cycle must end. Healthcare providers must prioritize culturally competent care, actively listening to Black mothers and addressing their unique needs. Support should extend beyond the hospital, including mental health resources, lactation support, and follow-up care. 

Community-based models, like those involving doulas and midwives, offer a glimpse of what compassionate care can look like. By centering Black women’s voices and experiences, we can begin to dismantle the systemic racism that underpins our healthcare system. 

Conclusion

Three generations of my family have endured the same struggles. But our stories also reflect our resilience and hope for a better future. By sharing these experiences, I aim to honor my grandmother’s strength, my mother’s determination, and my own fight for change. 

It’s time for a healthcare system that listens, values, and supports Black mothers-not just for my generation, but for those yet to come. 

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