According to the American Journal of Epidemiology in 2013, the risk of spontaneous preterm birth for non-Hispanic black women is approximately 1.5 times greater than the risk observed among non-Hispanic white women. Furthermore, research has shown that African American women experience various types of pregnancy loss more frequently than white women. This includes miscarriages, preterm births and infant deaths. On November 11, 2014, none of these statistics applied to me. I remember waking up and with a deep breath, had his name on my lips. I whispered his name “Phoenix”. Yes, that was his name. This was the life that I happily now carried with me at all times. Today was the day that I would lay eyes on him, not in a dream, like I had done for the past two months. Rather on a 72-inch tv monitored perfectly placed adjacent my holstered legs. For the first time, I was going to see my first child growing within me. With all the joy and love for the miracle of life I held in my heart, I quickly got dressed and headed to my first prenatal care appointment.
Clinical Roll Call: Here I am
It brought me immense joy to walk into the waiting room and witness other expecting mothers. I had finally been inducted in the “Motherhood Club”. Without a shadow of a doubt, I knew I already had that infamous “Glow”. Lord knows, I was just waiting for someone to notice it and compliment me on what I had already known. Pregnancy looked great on me. I took my place and proceeded on thumbing through the parenthood and pregnancy magazines. I was secretly praying that Phoenix, although the size of a jellybean, was exactly how I dreamed he would be.
“Hermence Matsotsa!” – An African American woman I assumed was the OB’s assistant or nurse shouted from the door searching for me. I immediately jumped knocking down the stack of magazines I had placed on my lap.
“Here I am! That’s me!” – I quickly picked up the magazines from the floor and followed her through the door. I would soon see my first born, my seed.
“How are you feeling?” she asked, without directly looking at me, but instead flipping through the pages of her chart. Knowing the question was routine, I answered, “Great! A little nervous. This is my first child.”
“Okay. How many pregnancies have you had?” She proceeded to ask, still fixed on the chart in front of her.
A little bewildered by the question, I answered; “It’s my first pregnancy. My first child.”
“Okay, well here’s a cup. Please go into the restroom and pee in the cup. Write your name and date on it and leave it on the counter. We need to confirm if you are really pregnant or not. After that sit in the waiting room to your left until someone comes to get you.”
After that statement, she walked away leaving me holding an unlabeled cup in my hand, along with fear and bewilderment in my heart. What did she mean if I am really pregnant or not? I took five different pregnancy tests, showing results of either two lines, a plus sign or better yet a digital message that clearly read pregnant! I thought it was rude of her. I took a deep breath walked into the bathroom. I proceeded to fill the cup and write my full name and date on the label. I whispered a prayer of gratitude and carefully placed my urine sample on the counter.
Isolation: The Heartbeat of an Empty Womb
I went into a smaller waiting room as instructed. I sat alone watching the clock that ticked to the pace of a millisecond across the room. A lifetime passed by before I was startled and brought back from a daydream of doubt and fear by an obviously annoyed women’s voice. A young White Caucasian woman attempted to pronounce my name with frustration and fatigue. I stood up and offered her the correct pronunciation of my name. Seemingly annoyed and without a care, she shrugged her shoulders and said, “Follow me!”. Her back was turned from me, as she lead the way into the examination room. The woman gestured to the bathroom. I was instructed to change into a gown and keep my underwear on.
Once again, I did as I was told and carefully laid down on the examination bed. Looking directly at the screen in front of her, the 20 something year old Caucasian sonographer asked me to verify my name and birthdate. Once she was sure it was the right 38-year-old African American women on her table half naked, she started squirting a cold clear gel on my lower stomach with one hand. The other hand was placed on the keyboard of the ultrasound scanning machine. Immediately, I was bothered. The position of the examination bed did not allow me to see Phoenix on the big screen tv monitor. Every time I tried to lift my head up, the sonographer (who had failed to introduce herself to me) instructed me not move and keep my head on the bed. This experience was not how I imagined my first prenatal visit. Something was not right about this process. There was nothing in the paperwork which I was asked to read, complete and sign, stated that the nurses and sonographers were to be short with the clients or show no interest in your exciting news. Or have seen so many “expecting mothers” that they should no longer care about positively engaging with them.
I was upset. I finally asked the question I feared the most: “Is everything alright? Can you see my baby?”
“You mean the fetus?” she responded. “How far along did you say you should be right now?”
“I never did say. I believe it is eight weeks. Why? What’s wrong?”
She quickly removed the cold ultrasound wand from my belly. She told me she had to step out for a minute and would be right back. As she walked across the room and opened the door, I asked her again, this time with tears in my eyes, “What is wrong with my baby?” The only response I received was from the sound of the door closing behind her. Confused, scared, and now all alone I lifted my head up to I see Phoenix cradled in my uterus and myself on the large monitor in front of me. To my shock, the image of my uterus, my womb did not appear like many of the images I saw last night on YouTube miracle of life videos. Mine was empty. There was no dark matter, blob attached to the walls or happily floating around. Although, I could feel and hear his heartbeat as loud as my own , Phoenix was nowhere to be found. As I began to get off the bed to get a closer look, Kathy walked in and instructed me to get dressed and go back in the waiting room until my OB was ready to see me..
“Please look at me and tell me why?” I said affirmatively. “What is wrong with my baby?”
She eventually responded: “It’s not my place to say, but it doesn’t look like you have a viable pregnancy. It’s an ectopic pregnancy. So please wait in the waiting room until a doctor can provide you more information.”
After that straightforward but heartbreaking statement, she walked out of the room leaving me alone once again. My fingers trembled as I pulled my jeans over my “non-viable pregnancy” belly, while silent hot tears fell from my eyes, hitting the cold white bathroom tile like rain. Could this be true? Something must be wrong with their ultrasound scanning machine. This was not my fate. Oh, no I would not accept it. Not now, not ever.
The Truth Teller: Hard Pill to Swallow
Twenty painful minutes later, an Asian American woman of Indian descent entered the room. She was wearing a medical coat and held my chart, attempting to pronounce my name. At this point, I cut her short of her misery and stood up, letting her know I was the one she was looking for. She offered an awkward smile and asked how I was feeling. She motioned me to follow her into an examination room and sit down.
She asked me: “Could you please confirm your name and birthdate?”.
So, for the fourth time that morning, I did.
“How do you pronounce your name? It’s unusual.” she commented.
“It’s Hermence Matsotsa! “It’s French and African. It means female warrior! What is an ectopic pregnancy?” I retorted.
A little surprised, she lifted her head up from my patient chart and said:
“An ectopic pregnancy is when the fertilized egg implants in a woman’s fallopian tube or somewhere outside of the uterus. When this happens, the pregnancy can not continue normally. The fetus is not viable and it requires emergency treatment. I believe this is what you are experiencing. You have two options. You can either have it surgically removed or receive an injection of methotrexate.”
Her lips kept moving but my ears ceased to hear what she was saying. All I heard was surgically removed. This woman was telling me that Phoenix never fully existed. And furthermore, parts of what did exist needed to be scraped away or flushed out! Throughout this entire interaction, not once did I hear or see her stop and ask if I was okay. Was I still breathing? Was my heart still beating?
When I woke up from my shock, I interrupted her medical explanation of why I would remain childless. Why my motherhood dreams were not going to manifest themselves into my physical reality.
I asked: “Can I use your phone? I need to call someone who loves me. I don’t feel good.”
“Sure.” she said. “Just press 9 and then the number. I’ll step out and give you privacy and let you decide what works best for you.”
I was experiencing overwhelming disappointment and unbelievable pain in my whole being. I decided to receive an injection of methotrexate. Within those following seven excruciating and painful days my uterus, fallopian tubes and abdomen were medically cleaned of any remains or physical memory of Phoenix.
During that time and many months later, the entire experience tested my faith in God and my partner. As well as, the medical professionals who did not call to see if I was okay, needed additional medical assistance or counseling. In a matter of one week, I went from being an excited “mother to be” with dreams of one day meeting my unborn child to a statistic too commonly found among African American women. Although, there is an abundance of research showing that African American women experience all types of pregnancy loss more frequently than white women, not many explain the emotional toll and aftermath when seeking competent healthcare. A number of medical professionals see us as just another black woman void of feelings and motherhood dreams. Even worse, many choose not to acknowledge or inquire about the journey we have endured to emotionally feel and connect with the life in our womb. How long it took for us to feel comfortable enough to walk through the doors of their medical practice or facility.seeking prenatal and medical services, “Glow” and all.
In all their years of medical study and practice, too many medical / public health professionals have failed to acquire the art of compassion, interpersonal and cross-cultural communication and human interconnectedness.
The UBUNTU Way: I Am Who I Am Because We All Are
Thus, four years later: one preterm birth and two other miscarriages, I founded uBuntuSpeaks, LLC. I consciously made it my mission to train public healthcare providers and their workforce leadership. I created curriculum for the communication skills needed to effectively deliver services and communicate with patients from diverse cultural and geographical backgrounds. I have worked with national and international organizations and associations to empower a movement of interconnectedness in public and clinical healthcare industry. I believe no other woman should have to endure the emotions and unwarranted patient experiences I had realizing their dreams of motherhood. UBuntuSpeaks, LLC champions the cause for improving patient-centered communication and culturally competent health care, clinical customer service, and positive health outcomes.