Q&A with Nina Bahadur, Co-author of the SELF series on Black maternity
Nina Bahadur is a reporter who contributed to Self’s Black Maternal Mortality series, and we’re so excited to share our interview with her. Nina is a writer and editor based in NYC, where she and her husband are proud dog parents of a former street mutt, Joey. She covers health, wellness, and culture, specializing in health disparities, reproductive rights, sexual assault, and sleep. She's written for Women's Health, SHAPE, SELF, Glamour, Cosmopolitan, Teen Vogue, the New York Times, and more.
Mirza: Maternal mortality is such an important, heavy, impactful topic. Thank you for lending your voice and platform to create this awareness. If you’re comfortable sharing, how did you feel in this process? Did going through the research and writing impact you personally, and how did you take care of yourself?
Nina: Thank you for spotlighting this issue! Maternal mortality reporting is pretty data-heavy, and behind those numbers are people who have died or nearly died. Speaking to grieving families and communities is always difficult, but I am so grateful when people are willing to share their stories with me. If I have an interview that will be very emotional, like speaking to a bereaved spouse, I make that my last call or appointment of the day. That means I can give them as much time or space as they need, and also means I can set work aside afterwards and really sit with that person or story in my own head. When I’m working on longer stories, I take a lot of walks.
It can be frustrating and saddening to write about this topic, but I also get to speak with researchers, policy makers, physicians, educators, and birth workers doing their absolute best to find and implement solutions. That can be so uplifting.
One of Nina’s article from SELF’s Black Maternal Mortality series
M: What was something that surprised you as you learned more about this area?
N: An estimated 60 percent of maternal deaths in the United States could have been prevented. That is an absolutely shocking number. And the more I report, the more I learn. Recently I was surprised to learn that, for many people, postpartum care consists of one singular medical visit sometime in the first three months after birth. Compare that to pregnancy care—a routine schedule includes visits monthly up to week 28, every two weeks up to week 36, then every week until delivery. So, we have a ton of work to do on improving and optimizing postpartum care.
M: How has learning this information and writing these pieces changed your relationship with your doctors?
N: On a recent reporting call I spoke to an ob/gyn and maternal medicine researcher who said the patient-provider relationship should always be a team collaboration, rather than a model I’ll call authority-ignoramus. He stressed that a patient is the expert on what’s normal in their own body. Asking questions or seeking a second opinion is not a challenge to authority; it’s advocating for yourself.
I have the unbelievable luxury of good health insurance, so I’m in a position to be selective about my doctors. Based on my reporting, I will no longer see doctors who I find patronizing or dismissive. I get it, doctors have bad days too, but since I do have a choice I will exercise it. I have a great GP who already works pretty holistically and collaboratively, who I have seen for almost a decade. But I have yet to find an ob/gyn I really like, which it might be time to do. I once read a story where a Black pregnant woman asked her ob/gyn, “what will you do to make sure I don’t die in childbirth?” That’s a question I see myself asking.
M: Did this experience influence how you would personally approach having children?
N: Definitely. I’m not quite ready for parenthood yet, but my reporting has solidified a few things for if and when we get there. First off, I would 100% hire a doula. I speak to doulas all the time for reporting and they are worth their weight in gold—offering support, advocacy, knowledge, comfort, it goes on. They are there solely for you, whereas physicians have to oversee multiple patients. The research is clear that doulas improve birth outcomes.
I am also fully recommitted to health literacy. If we don’t know what’s normal, how can we know when something is wrong—and push when we are not being heard? I’ll be reading everything I can get my hands on, particularly about any pregnancy or postpartum symptoms that are red flags for conditions like preeclampsia or stroke.
M: So much of Black maternal mortality stems from systemic issues, and we need to actively work towards that change. What legislation and policies are top of mind for you, and what would you want readers to be prepared to vote for in our next elections? And/or what organizations are you most excited about, and excited for us to also spend our time & money in tackling these obstacles?
N: This is a great question and I could talk about this forever, so thank you for asking it. I believe crucial legislation to support includes:
Medicare expansion to cover at least one year postpartum in every single state. In 2017, Medicare was the source of payment for 43 percent of births, but many plans only offer 60 days of coverage postpartum for the birthing parent.
Comprehensive sex ed and health education in schools.
Reproductive rights legislation, including birth control access and abortion access. Allow people to make the decisions that are right for them and their families without unnecessary barriers and bureaucracy, particularly when and how they get pregnant and when and how they add to their family.
Expansive paid parental leave policies.
Funding for any and all of the following: Community health programs, nutrition programs, safe and accessible public transport, safe and affordable housing, safe and affordable childcare. Anything addressing the systemic issues you mention. I find it helpful to think about this anecdotally. Let’s say you have two pregnant people, each expecting their first child. They both work full-time, but one gets no benefits while the other has excellent health insurance and paid leave. They both live in a neighborhood with poor public transport; one of them has a reliable car and the other doesn’t have a vehicle at all. What changes would give these two people equitable opportunities for a healthy pregnancy, birth, and postpartum experience?
Organizations to follow:
The Black Maternal Health Caucus, which has introduced the Black Maternal Health Momnibus Act of 2020—nine individual bills addressing all aspects of black maternal mortality.
M: In the short term, what would you recommend as key things to always ask your doctor?
N: For me, a key takeaway is that every decision should be an informed one. So, I think the best question to ask your doctor is “why?” They should be able to explain to you the rationale behind every decision, and talk you through any alternatives. Why do they recommend a certain medication, treatment, test, procedure? What are the risks? What are the side effects? Never be afraid to ask for clarification if something is confusing or upsetting. Also, mention any symptom, no matter how trivial it might seem.
If you are pregnant, it might be helpful to research the hospital you plan to deliver at (but obviously, due to COVID, hospital guidelines are constantly changing). Do they have data available about their birth outcomes, including cesarean birth rates, mortality rates, and morbidity rates? Can you tour the facility (maybe virtually) and familiarize yourself with it? This is a pretty good list of questions you can ask. If you have friends who gave birth at your hospital, see if they are willing/able to speak about their experiences to see what they recommend. Basically: Don’t scare yourself by assuming the worst will happen, but equip yourself with the knowledge you need to make informed decisions.
M: What do you hope readers take away as an action item? Something to take care of themselves and their friends personally, and something to take care of our society?
N: Takeaway for the individual: Ask questions. In an ideal world, every pregnancy- and birth-related decision should be an informed decision where you were told everything you need to know.
Takeaway for society: When relevant legislation is introduced, please call your representatives and ask them to support it.
M: What startups or businesses operating in this space are you most excited about?
N: I’m a huge supporter of all local doulas serving their communities, especially those who can operate on a sliding-scale fee basis to improve access. Birth work is a really difficult business to run, both financially and time-management wise. I tell everyone about the Sista Midwife Directory, which helps you find local Black doulas and midwives.
I’m also really interested in doula training businesses and programs, community health centers, and startups or automations that make it easy for you to contact your elected officials about relevant legislation or political actions. I’m keeping an eye on Mahmee, a startup backed by Serena Williams that aims to monitor parents and babies, and I’ve heard rumblings about some exciting data collection and storytelling platforms. While we must think large-scale and nationally about this topic, local and grassroots programs have been doing this work for years. There is a lot we can learn from them.
