By Crystal Good, writing for the “When All Are Counted” project.

I was 20 years old when I gave birth to my first child. I had an episiotomy, an epidural, and a creepy white male OBGYN. I gave birth in the hospital under fluorescent lights and the gaze of friends and family. Had I known that I could have asked them to leave, I would have. I would have preferred to share the experience alone with my partner. Thankfully, my 9lb 10 oz baby boy was healthy.

I never imagined there was another way to give birth until I had my second child at 23. Still a young mother, this time, I had a­­ doula, a Black doula, Pia Long, who was from the local midwifery practice and from the tradition of Black midwifery in West Virginia. At the time, Pia was the only Black doula in West Virginia. Through her insight and guidance, I had a much better birthing experience. So many more decisions were up to me that I didn’t know with my first birth, like asking the friends and family visiting me to leave! 

Since then, like so many of my West Virginia friends, Pia and her family have moved away. When you’re the only Black anything in West Virginia, you carry a weight: “If I leave, who will take up this work?”

As the Publisher of West Virginia’s only Black newspaper, Black By God (BBG), I know this burden, recognizing that I am one of three Black reporters in 35 years that the West Virginia Press Association can identify.

Without my publication, I worry that there wouldn’t be articles and resources accessible to the Black community about mental health. I’m proud of the work BBG has started to inform West Virginia’s Black communities.

For the next few years, I’m working on a grant project called “When All Are Counted.” We’re studying how health data collection affects three specific populations: the Black, LGBTQ+, and disability populations in West Virginia. I’m a communications team member; it’s my job to share my experiences as a Black woman in a state that doesn’t tell our story. Instead, it’s left to people like me and Dr. Lauri Andress. 

Dr. Andress is a researcher and associate dean for equity, inclusion, and community engagement at Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania. She’s studied racial disparities in infant mortality in West Virginia, where she discovered Black infants die at almost twice the rate of white infants. It’s a statistic nursed by racism and other adverse circumstances that impact West Virginia and the nation.

Imagine what it’s like to live feeling constantly threatened, insignificant, excluded, stressed or made to feel you’re on the bottom. Chronic stress can come from racism and discrimination, which can increase certain hormones, such as cortisol, which creates the flight or fight response.” Andress told the WV News in 2020.

She said normally the body’s response to stress starts and ends, giving the body a rest. But for Black people in West Virginia, especially pregnant persons, stress is a constant.

In 2018, Andress told 100 Days in Appalachia that she struggled to find state-specific data on the issue, even though every state must submit raw data on infant mortality rates to the Centers for Disease Control and Prevention. I spoke with Dr. Andress in 2022 for my article, For Black expecting mothers in West Virginia Black doulas and midwives offer expertise and protection.

According to Andress, West Virginia did not submit this data because the state has such a small population of African-Americans. Collecting “statistically insignificant” data wasn’t worth their time and resources.

Nationally, we know health inequities exist for Black Americans. For example, Black women are three times more likely to die from a pregnancy-related cause than White women. While the March of Dimes gave West Virginia an “F” in its 2021 Report Card, it credits the state’s Maternal Mortality Review Committee to “help improve equitable maternal and infant health.” In 2013, the state combined the Unintentional Pharmaceutical Drug Overdose Fatality Review, the Child Death Review, Domestic Violence Fatality Review, and the Infant and Maternal Mortality Review Teams into one team. According to their website, the data this group has collected from 2017 is still under review and has not been released.

Does this “committee” have data? Why doesn’t it report it? Why doesn’t the WV Legislature’s Select Committee on Minority Issues put this “team” on an agenda and ask them themselves?

As one of three Black reporters, I carry the weight of these questions. And I look for the trusting souls like my former doula to show me a better way– like Dr. Wesley.

Dr. Jerica Wesley’s work through the Black Coalition for Safe Motherhood teaches the ACTT method in West Virginia. The ACTT Method was developed with, by, and for Black women and birthing people. It instructs you to ask questions until you understand the answers because you have the right to learn all there is to know about your pregnancy. And when you do, you can make educated decisions based on what you prefer for yourself and your family. You can “claim your space.” You have the right to say, “No decision about me without me.” 

But what happens when you don’t know all there is to know about your pregnancy because your state— the powers that be— won’t share the data? What if they see you and your baby as statistically insignificant? How can you speak up when you don’t know what to ask?

We’re all entitled to dignified care, to know all there is to know about our health to make educated decisions.

Early next week, I’ll continue to carry on the work of my job as one of West Virginia’s few Black reporters. I’ll be listening to the Joint Committee on Health meet during legislative interims on Monday to discuss maternal and infant mortality in West Virginia. Will the Black maternal mortality rate warrant time on their agenda, or will we have to speak up and claim our space?

We’ll keep going until the health of our moms and children is considered statistically significant.

Crystal Good (she/her/hers) is a writer-poet, performer, and publisher whose work seeks to trouble the Appalachian narrative toward inclusion and a more truthful representation. She is the founder and publisher of Black By God THE WEST VIRGINIAN, a print and multimedia publication centering Black voices to address the information gap. Crystal tweets @cgoodwoman.


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