Domonique Smith is no stranger to risk.
In her last shift as a firefighter before claiming maternity leave, Smith, then two months pregnant with her daughter and armed with pregnancy strength, fought four fires in a single day.
But when it was time to give birth to her daughter, Smith wasn’t taking any chances.
Smith, a Gary native, opted to seek prenatal care and support at a birthing center that would allow her 11-year-old son to be present during childbirth, which was not available at any local hospitals.
After scouting dozens of birth centers – facilities run by midwives or practitioners who specialize in natural births rather than hospital doctors – Smith chose an Illinois birthing center offering a key component.
“I chose a medical university out of Illinois for my maternal care because the care team is Black,” Smith said. “So whether that was OB-GYN or midwife, I had access to a Black female maternal care team, which isn’t as accessible here in Gary.”
While fighting fires when pregnant is astounding and rare, the barriers to accessible maternal care in Gary are all too common.
Black Maternal Health Week, observed nationally from April 11-17, was created to bring awareness to the disparities Black women face in maternal health. Founded and led by the Black Mamas Matter Alliance, BMHW is a time of awareness, activism, and community building to empower Black mothers to advocate for Black maternal health, rights, and justice.
Indiana has the third-highest maternal mortality rate in America, and most of those deaths are Black mothers. A recent report found that Black women accounted for 13% of live births but 21% of maternal deaths in Indiana in 2021. Data from the Centers for Disease Control and Prevention revealed the grim reality that Black women are three times more likely to die from pregnancy-related causes than white women. These numbers in Lake County, home to Gary’s majority Black community, are even more revealing.
“When you look at the numbers and you drill down on the numbers of maternal mortality, you have higher numbers of maternal mortality in African American women in the Lake County area,” Gary Health Commissioner Janet Seabrook said. “When you drill down to areas specifically like Gary, those numbers are astronomical.”
While there is no city-specific data for Gary because the state collects data by county, the numbers still paint a clear disparity.
“When you look at the number of African Americans versus Caucasian numbers for Lake County, it breaks down that African Americans are fewer in number, but have a higher maternal mortality rate,” Seabrook said.
Comparatively, the state with the highest maternal mortality rate, Mississippi, is nearly 40% Black, while Indiana is only 10% Black, according to the U.S. Census.
“That’s astounding to be third in the United States with the highest maternal mortality,” Seabrook said. “And typically those numbers are for African Americans, but you don’t have as many African Americans in this state as Mississippi and Alabama. So that speaks volumes on the work that needs to be done in our state.”
The city of Gary has recognized Black Maternal Health Week with events and workshops, including an event at Indiana University Northwest featuring a birthing justice film screening and panel. Meanwhile, the health department continues to offer prenatal and maternal care resources. These include pregnancy testing, screenings for sexually transmitted diseases, and promotions of additional resources through Methodist Hospital, Community HealthNet, and the Northwest Indiana Health Department Cooperative.
State Rep. Carolyn Jackson, D-Hammond, vice chair of the Indiana Black Legislative Caucus, and state Rep. Vanessa Summers, D-Indianapolis, also published an op-ed, detailing the “crisis” of Black maternal health in the state.
“While we’ve made strides in improving maternal health outcomes, the fact remains that there is much more work to do,” they wrote in the op-ed. “If we are able to deploy those resources and enact policies to make healthcare truly equitable, Black maternal mortality can be greatly improved, but that’s only if we can muster the necessary support behind the notion that Black mothers’ lives are worth protecting.”
The severe disparities in Gary, according to Seabrook, stems from intersectional issues and overlapping problems.
“It’s multifaceted,” she said. “Addressing something like transportation, tearing down buildings, and having affordable housing could impact maternal health.”
Seabrook added that addressing environmental factors such as leaks from old cars, abandoned tires, and soil pollution where children play could help improve the city’s maternal health status.
Another common barrier for mothers in Gary is distance and cost. For Smith, this would’ve meant an hourlong drive to Illinois, and delivery at the birth center would cost nearly $8,000.
In the end, Smith decided to have a home birth so that her son could be present for the delivery and be part of her support team. Using the techniques she learned as a breathing coach, Smith gave birth to a healthy, nearly 10-pound baby girl without pain medication. She was supported by her son, husband, and a trained doula who offered expert guidance during delivery.
“Giving birth at home was a beautiful experience for my entire family,” Smith said.
Her husband, Wesley, calls her a superhero.
“I am a lot of things,” says Smith, who in addition to her firefighter career is also a wellness coach and personal trainer, “but the most important thing I am is a mom.”
*An earlier version of this story said Smith did not want to give birth in Gary. Capital B Gary updated the story to clarify that Smith did not want to give birth in any hospital because her son couldn’t be present due to Covid protocols.