Client interview: Anese Barnett's story
by Anese Barnett
1. Why did you decide to hire a doula?
Like many Black women, I have read lots of articles discussing the high mortality rates for us in childbirth. I also had an intense fear of childbirth as long as I could remember. I knew I would need the support of an expert who would educate me and also advocate for my choices.
I knew that my mother was going to be present at birth and be supportive. But I also didn’t want to put pressure on my mom to help me manage my ideal birth. I wanted us to have a bonding and special experience without stressful expectations. I knew that by having a doula, I could reduce my expectations of my mother.
Lastly, one of my close girlfriend’s gave birth the year prior and talked about the power of having a doula each time I saw her. I especially loved that her doula helped her husband to feel confident as a support person during birth. I knew I wanted that experience for my husband.
2. How was your pregnancy?
My pregnancy was challenging. Around 10 weeks, I had a subchorionic bleed. A subchorionic bleed is the accumulation of blood around the uterine lining which can cause light to heavy bleeding. It sounds a lot worse than it actually is but for me, it was actually pretty scary. I had a huge bleed in the middle of the night that had clumps in it. I immediately thought I was miscarrying. Thank God I did not. My OB did identify me as high risk for several weeks and labeled it as a “threatened miscarriage”. As soon as I overcame this and became excited for my 20 week checkout, everything took a turn for the worse. The sonographer noticed my cervix was short. A common problem with a solution; you get a stitch called a cerclage to hold together the cervix. However, the resident maternal fetal medicine doctor (high risk doctor) would not recommend me for a cerclage.
This is when I began to feel I was a statistic. I was that Black woman that was not heard and seen by the doctor. At this time, I was still being seen at INOVA Alexandria. Despite constant pain and pressure, the doctor still refused to give me a cerclage and only recommended weekly check-ins. Per the advice given to me by a close OBGYN friend, I requested that my doctor see me more frequently and told her, “If something happens to my baby, it’s a statistic for you but it’s my life and will stay with me forever.” She immediately agreed to see me in 4 days instead of 7. Guess what, at day 4 for my cervix had deteriorated so much, it was unlikely I would have sustained my pregnancy much longer. After receiving the cerclage my pregnancy lasted another 8 weeks and I was admitted into the antepartum unit at GWU hospital because my water broke at 31 weeks.
3. How was your experience dealing with preterm labor? How was your hospital stay?
My water broke at 31 weeks about 40 minutes after leaving my weekly check up. Luckily I was still across the street grocery shopping. It first felt like air passed through my body and I feared I was about to experience another bleed. I checked myself out in the grocery store restroom and was relieved to see no blood. As soon I was ready to get in the car to head home, I felt a huge gush and saw that my pants were soaked. I was so nervous and afraid. I wasn’t really prepared for this. No one really told me it was possible for me to still go into labor or for my water to break even though I had the cerclage. Gratefully, I had switched to GW hospital in DC just a few weeks before my water broke. They treated me well and explained what was happening often and clearly. The doctor that admitted me spoke to me so calmly and respectfully that it truly relieved some of my anxiety.
The night I was admitted into the hospital, two doctors came to check how far I was dilated. I was 5cm dilated when I was admitted but did not progress for any further for 2 weeks. I was 5cm and still had the cerclage stitched in my cervix so they needed to do an emergency removal to prevent any or any further damage to my cervix. After two weeks in the antepartum unit, doctors finally scheduled me for an induction. But my son came a few days before that! I was sort of afraid of an induction so this was a blessing to me.
My only criticism about my stay at GW is regarding my mental health. I’ll never understand how the social worker doesn’t check on women in the antepartum unit. Many women can be there from 2 weeks to 2 months and are at high risk for depression.
4. Did preterm labor impact the way you wanted to give birth?
Definitely. I envisioned a labor without pain medication in which I would be able to move around and utilize different pain relieving positions. This was one of the reasons I hired a doula, for pain management. I also was adamant about having a vaginal birth and was terrified of a c-section like many women. Thanks to my doula, Jacquelin, who recommended I switch to GW hospital because they were more likely to support my birthing plan.
With the support of a midwife and a great team of doctors, they were able to help me safely deliver my 3 pound munchkin vaginally. However, my labor was nothing like imagined. Due to the size of my baby and being high risk, I had to stay attached to the monitoring machines the whole time so I was unable to use the pain management techniques my doula taught us. I had to rely on breathing through every contraction. It was back labor so it was BAD! However, my husband was so calm and confident as he helped me through each contraction. I really believe that our doula’s education and tips helped him feel confident.
The nurses also had a hard time seeing my contractions on the monitor so they did not confirm that I was in labor until I was extremely close to giving birth. Since we didn’t know what was going to happen, we didn’t ask our doula to come yet! Don’t be like us...just ask her to come. Thank God Jacquelin arrived right before I started pushing and she was still an awesome help during delivery. I was afraid she might not make it before I started pushing and asked my husband, “OMG, I don’t remember how to do this. What did the doula say?” He pulled out the notes he took during our last session with our doula and was able to explain how to prepare to push and how to breathe. This was invaluable. This kept me so calm as I prepared to give birth...to a tiny little baby.
5. Can you tell us how you would describe your birth?
It took me 2 hours to push. Honestly because I was in so much pain by the time I was taken to a birthing room, I did beg for an epidural. I started pressing that button with urgency and definitely used too much. Unfortunately that did slow down the process and I couldn’t really feel any pressure from contractions. Once I started to feel more pressure, things sped up a little bit and I felt more confident. One of my favorite parts of birth was using the birthing bar and mirror to help me. In some ways I regret getting the epidural. When I got it, I had no clue I was already 10cm. I remember all of sudden the sensation of the contractions changing and feeling pressure on my vagina like my body was ready to push. I was just in so much pain for the labor progressing so quickly with no ability to use pain management skills. However, the epidural was useful. I was exhausted. I don’t even know how I would’ve pushed without it.
Once the baby was almost out, everything stopped and someone left the room to get the doctor who returned with the NICU team. I was told that there would be people from the NICU coming but I didn’t expect so many and it was quite overwhelming. I just remember this sudden shift in the energy of the room. Things were peaceful as I had Sade’ playing in the background with my support group cheering me on. Then suddenly, I felt worry and urgency. He was taken so quickly and inspected. Which is great but very shocking.
6. How was your experience having a baby in the NICU?
The NICU experience was tough on us emotionally, physically, and financially. Being separated from your infant is tough on the spirit. You have to put your trust in nurses and doctors for the survival of your baby. Of course they are experts at their jobs but they're not the parents. Like any new parent, it’s hard to give up control and trust other people to care for your child. One thing that always stuck out to me was how breastfeeding impacted my experience. I would wake up throughout the night pumping and I’d cry a lot thinking, “all the other moms are up too but they get to hold their baby.” That was really emotionally tough. I would wake up every day and rush to the hospital and stay there many times for more than 12 hours. I wasn’t eating enough, my body wasn’t healing because I was going back and forth from PG county to the city. And GW doesn’t have a free or affordable garage so we were paying for street parking for 5 weeks. It was really challenging and I didn’t feel like I had the support I needed.
The other thing is the trauma. It’s traumatic to be separated from your infant at birth. It’s traumatic to walk into a room full of incubators and find your infant in one too. It was traumatic to see him on a ventilator fighting for his life. In the NICU, you experience that trauma over and over again...daily. That’s what is called complex trauma. A repeated trauma that happens at a vulnerable time in life. I would consider motherhood a very vulnerable time in life. Especially NICU motherhood.
7. How has being a therapist helped you heal and what advice can you give?
As a therapist I’m aware of harmful and intrusive thoughts. When I started developing symptoms of PPD, once my son came home, I called my support network immediately. My dad came to MD that same day and brought me back to the NYC for an entire month to stay with my parents. This really helped me overcome any postpartum symptoms through their support for my wellbeing and transition to motherhood.
When I was ready, I sought help from a perinatal mental health therapist. During my postpartum period, I learned that there were professionals that were trained specifically on helping women through pregnancy and the first year after birth. I started seeing one of these therapist about year after birth. It was helpful to talk about my NICU experience but I did feel that my therapist didn’t really understand my experience and didn’t really know how to explore that traumatic experience. However, she helped me greatly with separation anxiety. In part, my attachment and anxiety developed as a response from my trauma. Through her support, I truly started to release that separation anxiety. I then utilized my social media platform to share my story and help other women I know share their stories to help break the stigma of maternal mental health in Black women. This experience was so freeing and healing.
As a therapist, of course I would say get help from a perinatal mental health therapist if you notice that you’re feeling depressed. I repeatedly seek help from a perinatal mental health therapist, not just any therapist. You will know they have training because they will either have PMH-C as a credential, indicate that they have training from Postpartum Support International (PSI), or another training from a reputable organization like Seleni institute.
My big thing as well is prevention. I think that families should research certified and qualified therapists in their area and reach others during pregnancy. Ask for a consultation and let the therapist know you’re pregnant and looking for someone you like in case you need support when you’re postpartum. When you’re depressed it’s very unlikely you’re going to research and call a therapist. This way, the support is already identified and you have basic rapport. I think that doulas can also support this process in their role. Part of preparing for birth should also be preparing for what emotional needs you may have.
Lastly, I’m still healing. I’ve gotten over that big hump, but I still have some ways to go. Advocacy is truly a healing agent. I’ve been sharing my story to raise awareness about NICU trauma, antepartum depression, and postpartum depression. I’ve been supporting women in doing the same. Now I’m at the start of a new initiative when I hope to be able to bless at least one Black mom per month at GW’s NICU with a basket of must have items for herself and baby. I’ve also been studying for the GRE. My prayer is that I will be able to pursue my PHD in clinical psychology so that I can research NICU trauma, antepartum depression and how to implement improved assessment and treatment. I want to lay down the groundwork for myself, in case I have another NICU experience. I also want to create something that didn’t exist for me so that other mothers have protective factors against trauma.
8. What would you like other Black women to know about birthing?
We know that racism and White supremacy has deeply impacted our society. So much so that it bleeds into the birthing world. A place and time where women should be protected and honored even more so than normal. Sadly, we know that as Black women, we are at significantly higher risk for child birth and infant mortality. Women like myself and other advocates will do our best to dismantle this. But in the meantime, you need to provide protective factors around you.
● A doula is a powerful tool in protecting Black birth and Black women. She educates you, prepares you, and advocates for you.
● Research more than one hospital and ensure that their policies and standards align with your vision for birth.
● If you’re choosing to breastfeed research and set up lactation support in advance. The support in the hospital is really good. It’s just not enough. Breastfeeding is beautiful and of course, the best source of nutrition. It just doesn’t always go as smoothly as you expect and that can impact your mental health, you value yourself, and judge yourself as mother. Lactation support can help you manage expectations and give you the education and skills you need to thrive.
● Reach out to a therapist in advance as stated above.
I also want Black women to know that depression and anxiety can happen during pregnancy and it’s so important to seek help during that time. It will improve your outcomes for postpartum depression and your overall birth experience. I know I needed it desperately during pregnancy but I was on bedrest and didn’t even think, “Hey maybe there's a special who provides online counseling.” There are! And if you’re on bedrest, most will definitely provide online counseling or come to your.
Lastly, your transformation into motherhood is a revolution for you, your child, and generations to come. So be empowered as you walk or get wheeled into that birthing room. You got this. You’re powerful. You can change the world through your mothering.