“I just don’t want to die.”
The pregnant woman’s words broke the heart of Navy Reserve Chief Petty Officer Krystle Thomas.
As a doula in her civilian job, Thomas had asked her new client a standard question: What did she want from Thomas during this special time in her life?
And the woman ― like Thomas, a person of color ― simply wanted to survive labor and delivery.
“It makes me sad. Pregnancy and childbirth should be [the] most beautiful time in your life,” Thomas said. “But it can go to disaster for so many people of color, and you could die. It’s another form of racism.”
Racial disparity in childbirth
Black women and babies have long had higher maternal and infant mortality rates than women of other races in the United States. The Centers for Disease Control and Prevention record-keeping shows that pregnant or postpartum Black women die two-and-a-half times more than their white counterparts and at three-and-a-half times the rate of Hispanic women, according to 2019 findings.
And their babies don’t fare any better ― higher percentages of Black babies die before their first birthday than any other race in America.
Additionally, a 2021 study on maternal morbidity in the Military Health System showed that Black mothers connected to the military were more likely to have C-sections, visit an ICU and experience overall severe maternal morbidity than white mothers with the same military background.
“With women in general, doctors think we’re exaggerating, and for Black women it’s even worse,” Thomas said. “Black women and babies are dying, and I hope the military responds by opening up TRICARE to more doulas, midwives and birth centers to stop that.”
Expectant mothers who use doulas experience significantly better birth outcomes, according to a 2013 study published in the Journal of Perinatal Education. It’s a career Thomas became interested in as a teenager after watching a graphic video in a school class of a birth.
“It showed all of it, and all the kids were looking away,” Thomas said. “And I’m like, ‘Oh my goodness, this is so great!’”
Addressing infant mortality
Thomas joined the Navy at 17, serving on active duty for four years, then transitioning to reserve and active reserve. After several years with the Troops to Teachers program, Thomas is now a reservist quartermaster.
As a civilian, she’s a perinatal coach, a birth/postpartum doula and a client resource specialist for a nonprofit women’s health services center in Dallas, Texas. Thomas also volunteers with Delighted to Doula, another Dallas-area charity that provides free or low-cost postpartum support and education in underserved communities.
“My ultimate goal is to have my own birth center in Dallas in low-income areas, because I want women of color or low-income women to be able to have a wonderful birthing experience through a birthing center,” Thomas said. “I would also love to be a speaker in the military, helping fix these things for veterans and being a voice for birthing women in the military.”
That’s a goal former Army Maj. Christopher Cole, an OB-GYN, supports.
“As a member of the military community, it is important to pay attention to this discrepancy in maternal/infant morbidity rate,” he said. “The military community should understand that it is not insulated from potentially explicit and implicit racial biases within its health care system.”
Thomas is ready to tackle the challenge.
“The Navy taught me to be resilient and get through any challenge,” she said. “If I set my mind to it, I can do it.”
“Chief Thomas’s work is vital, because she is actively involved in this issue,” he said. “She appears to see it firsthand and brings an awareness to it.”