Addressing Pregnancy Pain

I still remember gripping the cold hospital bed rails during my first labor, determined to have a natural birth. The pain was intense but manageable. Three years later, I entered the delivery room for my second pregnancy with the same confidence. However, this labor was dramatically different. Determined to uphold the “Strong Black Woman” image, I endured over 6 hours of relentless, painful contractions before finally asking my doctor for whatever medication could bring relief.

In 2022, the U.S. maternal mortality ratio (MMR) was 22.3 deaths per 100,000 live births. For Black women, it was a staggering 49.5 deaths per 100,000 live births—significantly higher than the rates for white, Hispanic, and Asian women.

As a mother of two, I’ve experienced different pregnancy-related discomforts, from nausea to joint pain. Those experiences taught me that suffering doesn’t make me a “strong woman.” Instead, true strength lies in prioritizing my own well-being and my unborn child.

With the rising high-risk pregnancies and persistent disparities in maternal healthcare for Black women, understanding pain management in pregnancy has become crucial. With the correct information, we can drastically reduce maternal mortality in our community and be empowered to advocate for better care we deserve.

Maternal Health Disparities in the Black Community

Black maternal health is surrounded by alarming statistics. Black women are three times more likely to die from pregnancy-related causes than white women. Most concerning is the CDC’s report that about 80 percent of these tragic deaths are preventable.

Why are hundreds of our women dying daily during pregnancy? The leading causes are excessive bleeding, seizures, placental blockages within the birth canal, mental health issues, and cardiovascular conditions. Barriers like poor access to healthcare, poverty, domestic abuse, and implicit bias worsen outcomes.

Recent research by the University of Glasgow revealed that epidurals in labor reduce severe maternal morbidity (SMM) by 35%. Yet, U.S research shows that Black women are about 10 percent less likely to receive an epidural. This disparity is tied to racism (structural, interpersonal, and institutional) and social equity in education, criminal justice, and employment, which affects mostly Black women.

Furthermore, in a recent KFF survey, 21% of Black women reported unfair treatment by healthcare providers due to their racial or ethnic background. Meanwhile, 22% of pregnant or newly delivered Black women were refused pain medication in the past 10 years.

At the core of this bias is the idea that Blacks don’t feel pain, which stems from harmful myths dating back to Dr. Marion Sims, who performed surgeries on enslaved Black women without anesthesia. This misguided notion didn’t stop with Dr. Sims, as medical professionals tend to dismiss concerns, especially involving pain management, Black women have during pregnancy.

Pregnancy Pains: What Are They?

During pregnancy, your body undergoes many changes to support your growing baby. In the early stages, symptoms such as headaches, nausea, breast tenderness, weakness, and frequent urination are common.

As you progress into the second and third trimesters, you may experience leg cramps, back pain, round ligament pain, heartburn, swelling and varicose veins, bleeding gums, constipation, hip discomfort, hemorrhoids, and unpredictable uterine contractions, resulting from hormonal changes, weight gain, an increase in blood volume, and the developing fetus.

While these aches and discomforts can be challenging, most are a normal part of pregnancy and not usually a cause for alarm. However, call your doctor if you have any of these symptoms:

Severe nausea and vomiting accompanied by dehydration, rapid heartbeat, or dry skin
Severe headache, blurred vision, or sudden weight gain
Vaginal spotting or bleeding
Fever (over 100°F) with chills, bloody urine, or backache

Safe Medication Use During Pregnancy

Not all medicines are safe during pregnancy, and what works in the first trimester may be risky later. While prenatal vitamins are essential, always check with your provider before taking other vitamins, supplements, or herbal remedies.

A few medications to avoid include:

Aspirin (unless prescribed)
Ibuprofen
Certain herbs, minerals, and regular vitamins
Isotretinoin (for acne)
Thalidomide
Aromatherapy essential oils

Always consult your doctor before starting any medication or therapy to protect both you and your baby.

Solutions to Pain during Pregnancy

While pregnant, your body undergoes changes, some of which are painful and uncomfortable. These strategies can help:

Support pillows – Quality pregnancy pillows can help to improve sleep by supporting the growing abdomen to ease back/hip pressure
Thermal therapy – Warm baths (with moderate water temperatures) can help to relax muscles and boost circulation, while cold compresses can help to reduce swelling/headaches
Maternity support belts – Most helpful in the third trimester, these supportive garments help to distribute the weight of the growing abdomen to lessen back and hip strain
Prenatal massage – When performed by a certified prenatal practitioner, massage therapy can ease muscle tension, improve blood flow, and provide relaxation
Gentle yoga – Pregnancy-specific gentle yoga poses help to address common pregnancy discomforts by building strength, flexibility, and stress relief
Swimming – Water exercises provide natural buoyancy that reduces joint pressure, supports muscle tone, and aids heart health
Walking – Walking regularly can improve circulation, manage weight, and lower complication risks
Mind-body practices – Proper deep breathing exercises and meditation help to ease anxiety and tension, while being valuable for labor preparation

Given the disparities in maternal healthcare for Black women, there’s need for self-advocacy during pregnancy. Ask specific questions on pain management options at your medical appointments. Also, document your symptoms and concerns, and seek second opinions if you feel your concerns aren’t well addressed. It’s important to go for important appointments with a support person who can help advocate for your needs and ensure your questions are answered thoroughly.

Should I Get an Epidural?

Around 70 to 75 % of women in labor choose epidurals, so, it’s up to you to decide whether you want one or not. Reports suggest that Black women are 10% less likely to receive it mostly due to historical distrust and misinformation. This effective numbing medicine is given through a catheter in the lower back, numbing the body from the belly button to the thighs. Relief begins within 15 minutes, allowing women to stay alert, rest, and manage longer labors or surgical procedures.

Benefits include:

Pain relief
You’ll get more rest
It keeps you alert
May help with postpartum depression
It can be administered at any point during labor
Helps with longer surgical procedures

Epidurals are generally safe for both mother and baby. Still, side effects can include low blood pressure, headaches, itchy skin, bladder issues, or—rarely—spinal infections, nerve damage, or blood clots.

As a pregnant Black woman, you don’t have to endure unnecessary suffering. Rather, know your options, understand your rights as a patient, advocate for appropriate care, and use safe pain-relief strategies for your well-being and that of your unborn baby.

Remember that no two pregnancies are the same; what works for one pregnancy or person may not work for another. Elevate Black Health recommends working with your healthcare provider to find safe but effective strategies for managing pain and ensuring the best possible outcomes for you and your baby.

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