The day I told my wife I was ready to start trying to conceive, I was ecstatic. For a long time, we had been on different pages regarding timelines. Initially, my biggest concern about motherhood was the possibility that it would be all-consuming. I wanted to ensure I knew the woman I was—both inside and outside the identity of “mother”—before taking the leap. Having found that clarity, I was ready for the next chapter.
Sakinah met my enthusiasm with love, but also with a sobering caution. As the daughter of a committed RN, MSN and the eldest child of a woman who nearly died during childbirth, her perspective is shaped by the lived reality of Black maternal risk. When she suggested immediate blood panels and genetic testing, my excitement significantly decreased. Discussing the risks too often endured by Black women heightens my anxiety, but ultimately, I had to reckon with the fact that her approach was warranted.
In the United States, the statistics surrounding Black maternal health are not just alarming; they are warnings. Black women are three to four times more likely to die from pregnancy-related complications than our counterparts. We see this in the tragic story of Kira Johnson, who died from internal bleeding after a scheduled C-section despite her husband’s repeated pleas for help. We see it in the cases of Brittany Watts and Selena Maria Chandler-Scott, and the horrifying reality of women being arrested for seeking healthcare after miscarriages.
This is the medicalization of our existence. From Cherise Doyley, the Florida doula forced to attend court while in active labor, the system often treats Black bodies with a mix of negligence and over-policing. As a Black woman, I am scared. However, as my mother-in-law’s story reminds us, fear, when repurposed, can be a catalyst for advocacy.
When I finally met with my primary care physician—a Black woman I have trusted for five years—my bloodwork revealed low iron, low vitamin D, and a pre-diabetic status. I was distraught. However, my doctor’s approach was a masterclass in supportive care. Instead of fixating on weight loss, she pivoted toward long-term diet improvements and movement I enjoy.
But physical preparation is only half the battle. Mia Brantley, PhD, an Assistant Professor of Sociology, notes that preparation for us is often invisible. “It’s preparing yourself mentally for what it means in our current society for Black women to be pregnant,” Dr. Brantley-Wright explains. “We know that stress is a huge factor… It’s the literal preparation of making sure my physical body is prepared, but it’s also preparing my mind and emotional preparation. Even just what it means to prepare yourself to raise a Black child.”
Brantley expressively added that it’s also societal and intergenerational. We are navigating a system in which research shows we are less likely to be heard. Preparing for motherhood means being your own loudest advocate. Beyond pregnancy, it’s also about building a community, familial or otherwise, to support your evolving needs.
To move from fear to agency, I’ve leaned into the wisdom of those who occupy this space daily. Rachell Dumas, RN, MSN, and founder of HEARD, a patient advocacy app, and Founder of the maternal health non-profit A Light After Nine, views preconception as a critical window for preventable intervention. “I always encourage moms-to-be to catch up on doctor’s appointments,” Dumas says. “If you have chronic illnesses, see specialists before you start. Get tested for vitamin D—deficiencies are linked to miscarriages. Talk to your family about hereditary illnesses.”
But Dumas also stresses the prophylactic power of mental health care. She advocates for counseling prior to conception, noting that no matter how “cookie-cutter” a journey may seem, it will test your body, mind, and spirit. My journey toward motherhood now involves a modified diet focused on reducing gluten and overly processed foods while trying to remain active in the midst of the nine-to-five grind. It also involves building a village consisting of a doula, a therapist, and a post-baby support system.
Preparation, as Dr. Brantley suggests, is a broad life course. It is about acknowledging the mortality rates and the stereotypes while simultaneously holding space for the joy of a new life. By the time I hold our child, I want to know that I didn’t just prepare a nursery, I prepared an outcome of health, advocacy, and mental resilience. In a system that often fails to see us, the most radical thing a Black mother-to-be can do is be equipped with knowledge and a village — and a praying grandmother for good measure.