Changing the Language of Geriatric Pregnancy

By: Robyn Brown

Happy Black Breastfeeding Week!

I cannot believe that after working in the behavior health field for 12 years, I get paid to help coach families into birthing their legacy, create gentle parenting plans, breastfeeding support, provide personalized in-home childcare and allow parents to live their best carefree life all while fighting for reproductive justice, birth equity and improving the way practitioners speak to and treat Black women.

I’m a strong believer of “the village” and know how important it is for families to feel supported; especially when bringing home a new baby. I’ve noticed that many of the families that I’ve served over the last couple of years have been significantly older than myself. I absolutely love it! I get to catch a few nuggets of wisdom, get marital advice and learn budgeting tips all while at work. It’s a win-win right?!

However; one thing that doesn’t sit well with me is how these families; especially the birthing individual, is treated by the medical staff at their OBGYN’s office or the hospitals they plan to give birth at. It was hard to determine if they were being treated poorly because they were disvalued as a Black birthing person or an “elderly” birthing person or the combination of the two.

A trip down memory lane

Excited to meet with my client to go over her birth plan and teach her all the crunchy ways to physically prepare for birth, I bounced to her front door and gently knock before entering. As I take off my shoes and announce my presence I hear weeping. Concerned, I abruptly throw down my belongings and rush to the common area.

“GERIATIC! That’s what they labeled me on all my paperwork. I have never been called old so many times in all of my 30s,” Mama M yelled as I rushed to her side.

Talk about first impressions.

To have waited ten years to get married. Suffered five miscarriages, one stillborn and seven rounds of in vitro fertilization (IVF) to conceive this pregnancy; only to be insulted after the first time meeting the doctor that is supposed to coach her for the next 35 weeks and deliver her baby. Oh the stress!

A geriatric pregnancy is categorized as a woman who becomes pregnant after the age of 35 also known as “advanced maternal age.” According to the CDC more women are having babies later in life than ever before. The number of women waiting until ages 35 through 39-years-old increases yearly.

Why are they waiting?

• More people are going to college or trade school directly out of high school causing increased debt and a delay in marriages. With the increase number of scholarships, grants and pre-college programs geared towards first generation students, especially of color; Black women are putting their education and career before marriage and children.
• Childhood trauma (sexual, physical, verbal, psychological abuse, secondary trauma from witnessing domestic violence, lifelong birth injuries, and death of a close relative etcetera) causes extreme anxiety about raising children; therefore, some couples are in agreement before marriage that they’ll never bear children.
• Mental Health Awareness has many millennials seeking therapy to break free from generational dysfunctions before dating, getting married and having children. Negative psychological health outcomes amongst Blacks typically stem from low socioeconomic status.
• Mass incarceration surrounding the drug epidemic and dismantling the Black Panther Party has played a huge part in breaking up families of color thus creating poverty stricken family dynamics that carry into adulthood. Children of single parents are more likely to have emotional and behavioral difficulties (depression, ADHD, anxiety, aggression, attempted suicide, to name a few), are less likely to finish high school, become victims of violence and have a higher mortality rate.

These are just a few variables. Looking at this list, it’s really a snowball effect of systemic and structural racism in the education system, healthcare system, commercial zoning and job market in poor neighborhoods. Racial disparity didn’t just start in maternal and infant mortality rate or breastfeeding; this is a historic epidemic.

By the time a Black women gets from under all the things society tried to bury her with; she’s exhausted! Couple that baggage with a practitioner she hired to be a part of her birth team who has unchecked implicit bias. Woosah!

Effects of being called old for 40 weeks…

In case you haven’t already heard, read or figured it out by now, being called old at every prenatal visit gets old. No pun intended. It can make a women feel insecure about if her body is properly preparing for childbirth. This insecurity coupled with scare tactics from her practitioners can push this mother into thinking she can’t birth her child naturally. As a result it’s easy for her to get talked into being induced solely based on her age which can eventually turn into a cesarean section and an increase in the newborn hospitalization stay and consequently costs, even when there are no physical precaution for her not to go into a spontaneous vaginal birth.

From the moment she takes home paperwork marked “geriatric pregnancy” prenatal and perinatal mood disorders may develop.

She starts to stress.

Her blood pressure increases.

The anxiety and depression sinks in.

Food aversion begin.

A voice in her heads tells her she’s too old to take are of a newborn.

She starts calculating how old she’ll be by time they graduate high school.

She remembers her mother is too elderly to adequately help her when she returns home from the hospital.

All her friends are already far removed from the newborn stage to understand her woes.

Excessive research causes sleep insomnia.

She’s now questioning if she made the right choice to wait.

Call to action.

All of the above factors can negatively impact the production of breastmilk, maternal bonding and even the physical healing postpartum. During this week, be intentional about motivating a breastfeeding, chest feeding, pumping, supplementing person. It’s already hard to be Black in America. Don’t shame her feeding choices or her age on top of that. Take this week to help out a family for a few hours so they can partake in self-care. Don’t ask them to cover up. Don’t stare. Don’t take up extra space. Don’t be weird. Be supportive.

You can also support Re+Birth Equity Alliance by hosting a implicit bias training for birth workers, medical providers including nurses and sonographers, reproductive justice organizations, and more in Texas and surrounding states. You can host a Re+Center Gathering which is a monthly meetup to unpack the trauma surrounding pregnancy, birth and postpartum or the loneliness surrounding parenting. You can fund or host one of the monthly Carnal Knowledge: Inclusive Sex Education that teaches about healthy relationships, consent and sex positive education to keep it at no cost to the community.

 

Sources:

Chen, E., & Paterson, L. Q. (2006, October). Neighborhood, family, and subjective socioeconomic status: How do they relate to adolescent health? Health Psychology, 25, 704-714.

Colhoun, H. M., Hemingway, H., & Poulter, N. R. (1998, December). Socio-economic status and blood pressure: An overview analysis. Journal of Human Hypertension, 12, 91–110.

DeCarlo Santiago, C., Wadsworth, M. E., & Stump, J. (2011, November). Socioeconomic status, neighborhood disadvantage, and poverty-related stress: Prospective effects on psychological syndromes among diverse low-income families. Journal of Economic Psychology, 32, 218-230.

Erratum, J. (1998, November) Office of Population Research, Princeton University, NJ, USA. Fam Plann Perspect 30(3):127.

Grimes DA, Gross GK. (1981, November). Pregnancy outcomes in black women aged 35 and older. , Obstet Gynecol 12 (5), 614-20.

Lamberti, P. (2019, March) More so than preceding generations, millennials are waiting to start a family -- or skipping marriage and kids altogether. Financially and otherwise, there are definite pros and cons. Web blog post. Retrieved from https://www.moneyunder30.com/millenials-waiting-to-start-a-family

Lampinen,R,Vehviläinen-Julkunen, K and Kankkunen,P. (2009, Aug) A Review of Pregnancy in Women Over 35 Years of Age. Open Nurse J. (3) 33-38.

March of Dimes. (2019, March). Depression During Pregnancy. Retrieved from https://www.marchofdimes.org

Newacheck, P. W., Hung, Y. Y., Park, M. J., Brindis, C. D., & Irwin, C. E. (2003, October). Disparities in adolescent health and health care: Does socioeconomic status matter? Health Services Research, 38, 1235-1252.

Reichman NE1, Pagnini DL. (1997, November). Maternal age and birth outcomes: data from New Jersey. Fam Plann Perspect. 29(6):268-72, 295.

Robyn Brown is the founder and owner of Robyn Cares Birth and Wellness Services where she serves as a full spectrum doula, nanny, newborn care specialist, life coach, sleep consultant, creates homemade toiletries for grieving care packages and host donation drives for parents in need. Robyn serves as a member of Re+Birth Equity Alliance board managing the social media content and co-trainer for Implicit Bias curriculum. Robyn holds a BA in journalism with an emphasis in print and marketing, a BS in Chemistry and a MS in Mass Communication; non-corporate sector and marketing from the University of Wisconsin-Whitewater. She lives in Texas with her husband and two sons.

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