The Maternal Mortality Crisis is Understandably Putting Black Millennials Off Children—We Need to Fix That

Demetria Johnson, a 39-year-old from Los Angeles, has seen firsthand how scary the birthing process can be for Black women, and troublesome stories amplify her anxiety over having kids. "My sister had a birth plan that was ignored and went out the window," says Johnson. "She is in the military and thought the doctors would protect her. She cried from having a forced C-section that, 10 years later, she still feels the effects of." Johnson's cousin also had a troublesome delivery, despite taking every precaution during her pregnancy. Her baby ended up spending three months in the NICU, which led her cousin to study to become a doula.

There is no doubt a Black maternal mortality crisis exists in the U.S., as Parents.com pointed out in an investigation on birth in America. And it's affecting Black millennials on a deeper level than others in their generation who research shows are also delaying having kids. The increasing cost of raising a child is an obvious deterrent for anyone, but that is only a smaller portion of a larger, complicated picture for Black millennials. Many have also cited societal pressures, as well as concerns about physical health, as reasons why they are avoiding or delaying having children.

Latham Thomas, a doula and founder of Mama Glow, a pregnancy wellness center and doula training program based in New York City, says she often hears these concerns. "What's interesting is that you don't have to have had your own experience that was adverse, you could just know about someone else's to build mistrust," she says. "You feel like you're stuck in your tracks. I hear a lot that people are fearful enough to not even pursue the idea of a family."

She recalls speaking to a Black woman in her 30s who broke down to her midwife out of fear she may die in childbirth. And that fear is not unwarranted: Black women are two to three times more likely to die from pregnancy-related causes than white women. The National Academy of Medicine (NAM) also released a report showing "racial and ethnic minorities receive lower-quality health care than white people—even when insurance status, income, age, and severity of conditions are comparable."

Societal issues are not lost on Johnson either, who planned to have children by 30—and then aimed for 35. However, she says life steered her in a different direction, especially with race relations in America today. "I am very leery of bringing a baby into this world," she says. "There's a global pandemic, rising unemployment, hate crimes happening every day. Who can afford the financial and mental stress of bringing forth a life right now?"

While statistics show many millennials in general are struggling financially, Black millennials often have an added layer of strain. Aside from Black women being paid 21 percent less than white women on average, Black millennials are often part of a different family dynamic. "There's a pattern with Black millennials having to take care of family, which sometimes affects their ability to move or leave the nest," says Eugenie George, a Philadelphia-based financial wellness strategist. "You feel guilty about it. My white friends' parents, on the other hand, are paying for their weddings. It's a big difference." George herself is part of the sandwich generation and is taking care of her parents, who are nearing retirement. She's had to help them navigate the next stage of life, despite them not having any savings.

Complicated financial situations have indeed meant that many Black millennials, especially women, have had to take on additional roles like raising siblings while their parents worked overtime or long shifts—often in low-paying jobs. One study revealed that in low-income environments, 58 percent of Black children will at some point be subject to parentification (when a child is obligated to take care of a parent or sibling) compared to 42 percent of white American children.

George, who says she has her own anxiety about having children, wrote the book Our Money Stories, which explores the historic laws that have held back minorities and has had ripple effects in today's society. "Black women are evicted at higher rates than any other group, and we have a tougher time financing homes," says George. "And when we do, it's at higher interest rates. This has made me rethink everything." For minorities, it's impossible to escape the added burden of race-based stress, including implicit bias.

These facts, plus the myth of the "Welfare Queen," a derogatory term for someone who is accused of cheating the welfare system, make Black women feel they must be successful at all costs. That's why psychologists like Cleopatra Kamperveen, Ph.D., the executive director of The Fertility & Pregnancy Institute, aim to counsel many Black millennials on how to prepare "epigenetically, psychologically, and professionally" for having children. She finds that many do feel pressured to achieve various milestones, such as starting a solid career, being promoted, and buying a home. Programs like Dr. Kamperveen's help millennials get out of their own way and embrace parenthood, and sometimes that means processing racial trauma.

Whether someone is on the fence about children or resolute in their decision, working on yourself should be a part of the conversation. That can mean sorting through your finances with a coach or seeing a therapist to get to the root of the anxiety.

But from her experience as a doula, Thomas knows there are ways to take back power in the birthing process and encourages all her clients to do so. She believes clients need to learn what consent looks like. That consent, which should be informed, can't be confused with compliance. Patients should be aware of what is being done to them and why at all times. "If I give my arm to draw blood, that is cooperation, not consent," she explains.

Power also means exploring your options for giving birth. "A lot of moms start off saying, 'I'm just going to be in the hospital,'" says Thomas. "Once they start doing research, they sometimes decide to have a home birth, and they seek out a midwife or doula." She also often helps clients—especially those opting for hospital births—put together a script in case they need to ask medical professionals tough questions, such as "Is this procedure necessary?" or "What are the risks and benefits?"

Ultimately, educating yourself on your options for a birth plan and learning your health care rights can help you feel empowered during pregnancy. Thomas says to remember that at the end of the day, "Joy is your birth right."