The morning that I reached 30 weeks of pregnancy, I woke up feeling ecstatic. I couldn’t believe I had made it so far in my pregnancy and that I may even surpass the time that I had carried my first child, Lily, who had been born nine weeks early. During that pregnancy, my doctor discovered that I have a short cervix, which can cause preterm labor and even pregnancy loss.
This time around, I was determined to avoid another preterm birth. Yes, my condition would make it challenging, but my doctor told me it would be possible if I took preventative measures in my first trimester like receiving progesterone or getting a cerclage, where your cervix is literally sewn shut to keep the baby from coming out too early.
The only problem was, for my second pregnancy, I had a new healthcare team because my family had recently moved from New York to Nashville. Unfortunately, I found my new doctors and nurses incredibly difficult to work with. No matter how much I explained my medical history and need for preventative care, I felt they ignored me and stared past my head as I spoke, as if the wall behind me was more interesting than anything I had to say. Gaslighting is incredibly common in women’s health, and I was experiencing it firsthand.
When the health of my pregnancy became more dire and threatened the life of my baby, it was only then that my healthcare team believed me, and began to take the necessary precautions, like progesterone and a cerclage (as my previous doctor had recommended), to prevent a preterm birth. But by that point—it was too late. Any measure taken was but a small bandage on a gaping wound.
I switched doctors in pregnancy several times until I found one I thought I could trust. She oversaw the OB department at the hospital I was going to deliver at, and all of her reviews online were positive. I was going to see her that morning for my 30-week appointment, and I was feeling happy and confident.
For the first time in my pregnancy, everything had been looking and feeling good. And I felt that finally, I was with a doctor who really cared about me.
My husband, Daniel, and I talked excitedly that morning about what it would be like to hold our baby after birth. Oh, what it would feel like to have that first eye-lock moment that I had heard and dreamed about, to nuzzle her on my breast and be able to breastfeed, an opportunity I didn’t have with my firstborn.
I practically skipped into my doctor’s office, with a smile so radiant that other patients in the waiting room looked at me quizzically. My OB was a small-framed woman with short, curly hair that always appeared to be wet. I imagined her as this super dedicated doctor, who rushed out of her house post-shower every morning because her patients were more important than drying her hair.
“How are you feeling?” she asked, looking at me, her brown eyes peering over her frameless glasses.
“I’m so, so happy to have made it this far,” I said. My voice broke, but I didn’t care. I was full of emotion. I told her I was confident that I was going to carry to term this time.
“Well, that’s wonderful,” she said with a small smile.
We both paused, looking at each other, as if we both didn’t know how to spend the rest of our time together.
“Should I check your cervix?” she asked.
I had been told by the doctor who delivered my first child that cervical checks were rarely performed past 24 weeks. Cervical exams, I remember her explaining, can come with risk, such as an infection or accidentally breaking your water.
I tried to suss out the pros and cons quickly in my head. Wait, this is my OB asking, I thought. I trust her. Why would she ask if it wasn’t safe?
“Sure,” I said.
The cervical exam was long and painful. She dug her finger around inside me, like she was rummaging through a closet packed with clothes. I started to silently cry and I wondered when she was going to be done. When I thought it might be over, she dug even deeper.
I was sobbing by the time she was done.
“Are you OK?” she asked, studying my face, as if she hadn’t heard me whimpering throughout the entire exam.
“I just didn’t think it was going to hurt like that. Was this exam really that necessary?” I asked, choking back a river of tears.
“Well, we are here, so we might as well not waste time,” she said. “And anyway, everything looks great, and your cerclage is still in place.”
Everything looks great, I said to myself, a small smile spreading across my face. I was relieved to finally hear those words, yet I couldn’t ignore the bruised feeling in my pelvis and my worry that the exam hadn’t really been necessary.
For the rest of the afternoon, I felt a significant shift in my body. The kicks from the baby were very low and sharp, and I could sense changes that were wildly different from the moments before the exam.
I couldn’t quite place what it was, though I didn’t need to—a woman’s intuition about her body is always right.
Before I fell asleep that evening, I turned over to Daniel.
“Something feels so wrong,” I said. I rubbed my belly and whispered to my baby that everything was going to be OK, and slowly drifted off to sleep.
A few hours later, I sprung right up in bed, alert to the slow and steady trickle of fluid down my thigh.
“Daniel,” I whispered in exasperation. “Wake up. Wake up, please—my water. My water just broke.”
When we got to the hospital, my contractions had already kicked in, coming at me quickly in angry waves. We were admitted and stunned by the sloth-like pace of the OB emergency room and a nurse who provided a painfully slow explanation of how she was going to be using different swabs on me. Daniel, myself and my doula stared at her as she fumbled to open the packaging, dropping the IV bag on the floor—twice—like she was playing a game of hacky sack.
The nurse practitioner came in to evaluate how much I was dilated by performing the same long, painful cervical exam that I had the day before with my OB. She said it was too hard for her to determine so she brought in another nurse to “double verify,” who also performed the same exam–only this time it was excruciating.
“You’re 9 cm dilated, and the baby is breech,” the nurse announced matter-of-factly. “The doctor will be in shortly to talk to you about having a C-section tonight.”
The next thing I knew, I was being wheeled to the operating room, where they would give me a spinal tap, completely numbing my body from my stomach to my toes.
My body had no choice but to go limp, and so I decided to mentally release what was out of my control, and let the doctors do their job.
Before they proceeded with the C-section, the doctor let me know that she needed to check on my cerclage first.
“Who checked this patient?” she asked suddenly, her head poked up above my legs. “They said she was 9 cm dilated. This patient is less than a centimeter dilated and her cerclage is still intact. She shouldn’t be having a c-section right now. We still have time to keep the baby in.”
They wheeled me out of the operating room, and the doctor came in to tell me that the nurse had trouble during my exam, and admitted that she made a mistake.
“She should have told someone that she was having issues,” she said, as if she was critically evaluating a student. “But nevermind that, you’re with a great team, and we’ll be making sure you get the right medicine so that this baby of yours stays in your tummy for as long as possible.”
Any ounce of anger that I had in that moment dissipated—because what mattered to me most was my baby, and I was so deeply relieved that the worst had been prevented. Moments later, I started to notice the people around me become more faint. Their voices started to blend in with each other. My eyes felt thick and heavy, and I thought that maybe, for just a minute, I could close them.
When I woke up, I was sprawled out on the operating table like an animal. People in scrubs were rushing around me. I could hear someone say that the baby’s heart rate was going down. And shortly after, I heard someone say that my heart rate was going down, too.
“Move, move, move, people,” I heard my doctor say.
I looked up from the operating table, my bottom half still paralyzed from the spinal tap.
“What’s happening? Doctor, can you tell me what’s happening?” I demanded in my half-fog from the drugs.
“Oh, ah, yes. So, it can be a lot for babies when we do things and they’re not quite ready for it, and right now we just really need to get her out.”
I looked next to me, and I was relieved to see Daniel, dressed in scrubs from head to toe. As they began the surgery, we grasped each other’s hands tightly and met the softness in our eyes, and wept together. Overwhelmed with emotion from the last three chaotic hours, there was a desperation to be near each other and feel the comfort of our love and commitment. As if to say, this is wild, but I’ve got you and you’ve got me and we’re not going to let each other fall.
That morning at 6:59 AM, Violet Bea Wright was born at 3 pounds and 11 ounces. She would spend the next 28 days in the NICU clinic at the hospital. I couldn’t believe this was happening again, that another baby of mine would spend her first weeks fighting for her life in the NICU, instead of being home, safe, and in my arms.
The rage and heartbreak that I have felt from this experience has been beyond anything I’ve ever felt.
The concerns that were long ignored, and the mistakes that were consequently made because of it.
The thick incision line from my C-section that throbbed and ached—a reminder of the scalpel blade that cut across my belly while I laid there awake, confused and traumatized.
The sound of my bone-chilling howl echoing in the halls of the recovery rooms—the type of visceral crying that comes not from pain but from crushing grief.
The trauma of seeing Violet’s tiny body wrapped up in wires, and being unable to hold her, breastfeed her, love on her for weeks.
Sadly, I’m not alone in this. Each year, hundreds of thousands of babies in the U.S. are born preterm—and those numbers are on the rise. In 2021, the preterm birth rate reached 10.5%, a significant 4% increase from the previous year and the highest recorded rate since 2007, according to a recent March of Dimes report. Women of color are impacted the most—infants of Black and Brown mothers are 62% more likely to be born preterm than babies of white women. As a woman of color, this stat hits particularly hard.
Why are NICU admission rates on the rise? There’s a whole host of reasons. For me (and thousands of other women), medical malpractice is at the core of it.
I’ll never get over how many gross mistakes were made, and I’ll always wonder if I could have carried Violet to term if my OB hadn’t broken my water that day.
Another issue is a lack of prenatal care, which research shows is associated with increased preterm birth rates. Early screenings and preventative treatment, like vaginal progesterone, some studies show, can reduce preterm birth by more than 40%.
And women, yet again, are not believed. A recent study by the Centers for Disease Control and Prevention found that 1 in 5 women were scolded, threatened or otherwise mistreated during doctor visits while pregnant, and nearly 50% were afraid to discuss their pregnancy concerns with their provider. According to the agency’s findings, Black, Hispanic and multiracial women reported to receive the highest rates of mistreatment.
Then, there’s the issue of the medical industrial complex and health insurance companies. According to the authors of one study, some hospitals are overusing their NICU units because they have too many beds than they know what to do with—and need to justify their existence. Plus, they get a higher payout from insurance companies when babies are sent to the NICU.
At the end of the day, I’m one of the lucky ones. My daughter and I survived despite living in a country that has the highest maternal mortality rate among other high-income countries globally, with Black women dying at nearly three times the rate of white women. (How sad is it that simply not dying during childbirth in this country is something to celebrate?)
We need to talk about these issues more. We need to speak critically about the existing systems that can fail women before, during and after pregnancy.
We have to dig deeper into the racial and ethnic inequities that exist within both maternal mortality rates by listening to the stories of Black and Brown women who are giving birth, and centering their experiences to create stronger care models. We cannot expect women to just carry on and ignore the lasting impact this can have on the health of their baby and their ability to care for their family and themselves. It is unconscionable. It is an attack on women, on families and on the prosperity of our nation.
I am not sure if I’ll ever want to be pregnant again—not because I don’t want to have another child, but because I don’t want to claw my way through the systems that are set up to only see us fail. But until then, I’ll hold my daughters close and feel grateful that we all survived.
A version of this story was originally published on Nov. 8, 2023. It has been updated.