Black Maternal Health Care and Twin Pregnancy: Advocating for a Better Birth Experience

The realities of maternal health in many parts of the world are stark. And sadly, even in contemporary times, so many groups of women face additional challenges with accessing quality prenatal and maternal care. Read this twin mama’s experience with black maternal health care and advocating for a better birth experience.

Inside a recent episode of the Twiniversity Podcast, courageous twin mama Tracey-Alexis Dixon shares her behind-the-scenes journey of advocating for better care for herself and her twin boys. 

Tracey’s story is an important and inspiring one, and it’s a reminder that we all need to take a stand in advocating for improved black maternal care and better maternal care overall.

Because all moms and their precious bundles of love deserve quality, compassionate care. 

Nat: Good morning, Tracey, thanks for joining us today.

Tracey: Good morning, Natalie, how are you?

Nat: I’m hanging in there. I think that’s my response. Whenever somebody asks, I’m like hanging in. That’s it, that’s as good as it gets. I don’t know if it’s just from, that’s just my life is, I’m just making it. And that’s all right, it’s all that we need. Ah, Mama Bear, tell us about your twinnies.

Tracey: They are going to be 18 months by the 25th of this month. Wow, they, time is flying. That’s something I didn’t realize with twins. It’s like it’s a constant going. And you don’t realize by the time you look up, they’re already a year and a half. They’re thriving, they’re doing really, really well, they’re learning, they’re growing, they’re talking a lot. Yeah, I love it. I really do. It’s a lot. I love it. 

Nat: Now, today we’re going to dive into having a more healthful twin pregnancy and it’s not necessarily what people may think, right? There’s people who are like, I ate only flaxseeds and two egg whites a day and I lived healthfully. 

There’s a lot of ways to be healthful and that involves whether it’s holistic care, whether it’s alternative medicines, whether it is literally exercising and doing things for you and your mind and your body. 

So tell us a little bit about your pregnancy and tell us about your life before you got pregnant…

Tracey: Oh, gosh. Okay. So my life before pregnancy, oh man, I was living. I was outside, as they would say. I was traveling a lot, I was very, very involved in the nonprofit community. Technically still am, but so always volunteering. 

Like I said, traveling, just doing, just really being involved, hanging out with my friends, doing brunches. I was outside, really having a good time and just enjoying life, honestly, you know, I was so involved in the community, I was the chair of different organizations.

Like I said, I had just came back from South Africa, doing nonprofit work over there. I was just involved pre-pregnancy. 

And then when I got pregnant, everything slowed down.

And I know people talk about, you know, like my past life and who I was before. While that’s kind of true, I still try to remain true to myself and still do those things. Maybe not traveling, but really finding time for myself.

And I said for 2026 especially, every month I’m going to make sure I have a self-care day or something. So changed a lot with the twins, but yeah, I’m enjoying it now. Things are a lot different, but yeah, such is life when you become a mom.

Nat: It’s a big change, it is a big change, but you’ll evolve and you’ll be outside again. It will happen. So you get like a little break from like super reality.

And so you have to ease back in to acclimate back into society. But now knowing the life that you had before you got pregnant, how did pregnancy change what you were doing and your travel and the work that you were doing and being with your friends? 

Like how did the impact of pregnancy alone, let alone the impact of a twin pregnancy? Like was it in levels? Did you find out that you were expecting twins in the beginning? And then tell us a little bit about that.

Tracey: Yeah. So when I first found out that I was, funny story, pregnant, let alone with twins, I found out with my best friend. I mean, it was literally, I ended up getting sick. So really quick, quick story.

I ended up getting sick, going to the hospital. I called my best friend to show up with me, and we’re literally in the emergency room. They call us to the back. And the nurse was going through, looking at my stomach and I’m laying on the bed like, okay, is everything good? Is everything okay?

And this older gentleman, he’s like, yeah, the doctor will tell you. 

And I’m like, okay, but like, is everything okay? Like, what do you see?

And he’s like, don’t worry, the doctor will tell you. So then I go back to the emergency room, waiting room, and they finally call me back, and I call my best friend to come with me, and we’re sitting on the table, feet are just swinging away, like, okay, let’s hold hands. Like, what’s going on?

I hadn’t had my first appointment yet, didn’t know it was twins. And we’re just sitting there like, okay, what’s going on? And she rolls in the monitor and sits directly in front of me, and she’s just looking like, yeah, Tracey, everything looks really good.

I’m like, okay, well, why do I feel so sick? And, you know, and she’s like, no, everything is fine. They look great.

Excuse me. THEY?

Nat: Oh, gosh.

Tracey: And she said, she peeks from behind the monitor. It’s like, wait a minute, you haven’t seen your OB yet? I said, no, I don’t see my OB for like another week and a half.

She’s like, oh, so she goes back and looks at the monitor. And I think she’s counting just to make sure she sees correctly. And she’s like, yeah, you’re having twins.

Immediately, I look at my best friend. She looks at me and we say, twins, what? And I think the whole emergency.

Nat: Yes, I could imagine.

Tracey: I immediately was like, let me see what you’re seeing, because there’s no way, there’s what? And sure enough, yeah. So from that moment on and just-

Nat: How many weeks were you?

Tracey: I think it was early, maybe like six, seven weeks. I mean, it was early on. And I, yeah, we were just freaking out. I immediately told my mom, she was like, Oh my God. I surprised everyone in my family.

And yeah, from that moment, I knew the health tips started right away. 

And just sharing it with my friends and everyone was just so overwhelmed crying for me and excited and happy. It was just a wonderful experience. I actually had a very good pregnancy.

And just going through that experience, it was amazing. And as much as my past life, being outside and having fun and things like that, even during my pregnancy, I was still meeting up with my girlfriends.

They were like, mama bear is coming through, like watch out everyone, like making sure I was good. And even with my family, like we would do little outings and everyone was just so happy for us. So not so much changed. Barely. And I think that was so important to continue that healthy pregnancy, to just have that support was just huge.

So yeah, like it was my family, my friends, they were all excited for me. And like I said, during the pregnancy, it was really wonderful and no morning sickness, no anything. It was great. 

Nat: Wow. Honestly, it’s so nice to hear that. Because we do, I think that bad news travels faster than good news. 

So often when you hear about twin pregnancies…

there’s, I mean, we really try to focus a lot on the positives, but we try to balance it as much as we possibly can at Twiniversity to focus on, everybody’s got a different reality. 

And we don’t know what we’re going to get and we’re going to always stay positive and we hope for the best and whatever happens, we’re going to deal with it as it goes.

So now knowing that twin pregnancies can be a little bit more challenging. When you did go to the first OB appointment, did they give you any restrictions on what you could and couldn’t do? Did they give you any warnings about how a twin pregnancy would be different?

Tracey: Yeah, I definitely got all the warnings as far as, of course, even with a singleton pregnancy, there’s things you can live, things you have to be very cautious about. 

But with the twin pregnancy, I think they were very more restrictive of things that I could and couldn’t do.

And there was already, after my first appointment, twin B was smaller than twin A, and so they wanted me to rest. It was just a lot of restrictions, essentially. And when it came to just like eating and things like that, of course, you know, like the folate. 

And I think I got like the list of everything that I’m supposed to eat, everything that I’m supposed to do and things like that.

But I think, yes, because it’s a twin pregnancy, they’re very more cautious. I immediately started seeing my MFM early on. And yeah, everything seemed like you’re walking on needles because of the twin pregnancy, especially during those first three months.

They want to see you constantly all the time. They did tell me to walk. And even when it comes to exercise, just to be very cautious, do light work.

Yeah, I think there was the difference because you’re having that, you’re more of a higher risk.

Nat: Of course. Of course. So now, with the advice that they gave you, and knowing that you’re a little bit more on the active side, how did you blend those two?

Right? Because if they’re like, you got to be cautious, but you’re like, let me live and I got things to do. So how did you find the merge between what they want you to do and what your reality was? 

How did you handle that?

Tracey: I think finding that balance is important. I’m the type of person that does a lot of research anyway. So I found online YouTube videos of pregnancy workouts.

And so I started doing those. And even when I went to the gym, it was very light work. So a lot of stretching. And also my best friend held me accountable. My partner held me accountable too. Like just make sure you’re constantly moving.

And I think that contributed to the pregnancy, like the overall health of the pregnancy for sure. But yeah, watching those videos, I got one of those big medicine balls. So I had it at home.

So I was doing my stretches on that. And to be honest, before pregnancy, I wasn’t like a gym guru where I was constantly, every day I had to go to the gym. But I knew how important it was for me to stay active during pregnancy.

Not just for me, but just for the health of the babies too. So I absolutely made it a priority. So finding that balance was kind of tough, but just getting the okay from my doctor, being transparent, having that open communication. These are the exercises that I’m doing, really helped. So I think that’s fine.

Nat: So what were they? When you were looking at the YouTube workouts, what were some of the exercises? Was it a lot of squats? Was it using any weights? Mostly stretching? How did you find that those workouts differed than a non-pregnancy workout? 

How Tracey kept up her health during her twin pregnancy

Tracey: Yeah. So there were the squats, of course, but I think it’s a lot of the pelvic floor exercises that helped. So with the stretches, so the base signal stretching, touching your toes, butterfly stretches, leaning over, laying on your back, but not too long. That’s also important.

So doing stretches like those, again, using that medicine ball to like lay on your back, because throughout the pregnancy, what will happen is as your stomach grows, and as you know, as in a twin pregnancy, your stomach gets huge, your back support, like you need that. Strengthening my back was really important. I started a lot of those back stretches early on.

So that helped out a lot. And then the walking, like I said, just walking every day, just for about at least 30 minutes. Started doing that. Yes, that was my everyday. Let me get out and get some exercise.

Nat: Yeah. Did you find that your body responded differently on days that you couldn’t get out? Like if it was raining outside or you just had other things, did you find that once you started this routine, that your body craved it?

Tracey: Yes and no. I would say yes because the days that I didn’t go out, I did feel some type of slumber, like, all right. I need to move, I need to stretch, I need to do something. And no, because of like I mentioned the YouTube videos. So it is something that you can do at home. So I definitely took advantage of that when I could. 

Honestly, I worked all the way up until two days before birth. 

And even later in the pregnancy where I was super tired, I made sure at least 15 minutes, 30 minutes, just turn on a video and just stretch.

Nat: How did you find the motivation to do that? So many people that are expecting, right? They’re so fatigued. And then you have your reality on top of it. Like, what was your self-talk to be like, okay, girl, like, you got to get this. Like, how did that work, Trace?

Tracey: Honestly, because this was my first pregnancy and knowing that it’s a twin pregnancy too, I just wanted to do everything right. Like, I just wanted to be healthy. I wanted to make sure that they were healthy, they were thriving, they were growing.

And I think that was my drive. That’s what kept me so focused on making sure that I stay healthy throughout this entire pregnancy. So my day-to-day, yes, I was fatigued.

I mean, there were times, thank god I work from home, in between meetings, I’m taking naps. 

So yeah, I definitely had those moments. But it’s just knowing that I’m growing two babies and I want them, I just want my pregnancy to just go well, especially because of the black maternal health and the situation there.

That alone is pretty scary with singletons, let alone with twins. So knowing that too, I think that was my drive. I just want to make sure that I stay healthy, not just for myself, but for them too.

Advocating for the best care even if it means changing doctors…

Nat: I definitely want to talk about that. Okay, we’re going to take a quick break, and when we come back, I want to talk about the challenges of being a woman of color and being pregnant. 

Because I do not think that people understand that your reality and the reality of a white woman are two totally separate realities.

We gotta dig into this. So as I am a New Yorker, and I live in the melting pot, and I try to be very mindful as a white woman to always be thoughtful about regardless of how I’m going to treat somebody, how they could have been treated by somebody else before they got to me. 

So whenever I see a client, whether it is for lactation, whether it’s for twin pregnancy education, no matter what it is, twin parent coaching, I always realize that people bring baggage from other professionals into the next professional.

And I have definitely found that all my families of color, and it’s not just African-American women, it is Indian, it is Asian, it is literally anybody who is outside of the baseline of Caucasian does come into my room with a little bit more baggage.

Now, I always say, I hope that our city does better, and I hope that we can do better.

But the only way that we can do better is by really being on top of it and knowing that this is the way that the world is treating people.

So we could go into the history of this and as a childbirth educator, I could dive deep into that right there. But we’re going to leave that aside and we’re going to talk about you and the way that you have, as a Black woman, you know that this is a thing.

You know that maternal medicine within the African American community and women of color are definite. It’s definitely different based on where you are in this universe. But even no matter where you are, you still have people in major metropolitan cities that are still going to have a bias, and you even have people of color being biased against people of color.

So knowing that was there, how did that play a role into your pregnancy and even that emergency room visit? I just want to like apologize on behalf of every moron in the universe that literally thinks that your vagina is somehow different than another vagina really is very alarming to me. Yeah. But namaste, the only one I can control is myself. Yeah.

So how did you deal with that?

Because I am sure that within your network of women and your network of even influencers and your algorithm, it’s telling you that you’re going to probably be up against some barriers that other people may not be. How did you go into the pregnancy knowing this?

Tracey: Yeah. That’s huge and it’s a loaded topic, to be honest. I was already involved in the Black maternal health space. I’m involved in it and at work. The research, the statistics is always at my face. Talking to colleagues, but also hosting events and things like that, just sharing awareness.

So I knew going into this pregnancy, when I first thought it was just a single pregnancy, that was going to be something that’s going to be on the forefront. 

But then learning that it was a twin pregnancy, just to be honest, it raised my anxiety a lot. 

Like I mentioned earlier, I’m very big on doing research. That’s what I did. For one, your book was my holy girl during pregnancy. I mean, all the highlights and everything, the whole planning of it. Even in your book [What to Do When You’re Having Two], you mentioned about doulas, and I knew I absolutely wanted a doula.

I know I can advocate for myself, but in the moment, I wanted someone there to also advocate for me as well.

And granted, my partner, I’m sure he could too, but I knew I needed a doula. 

So, and my thing was, I wanted my OB, she’s Caribbean American. I have a Caribbean background as well. So I wanted to stay with her. But what I didn’t know is that, during pregnancy, you go through a rotation, because you don’t know when you give birth, who you’re going to have, who’s going to deliver your baby.

So this was my first real experience of dealing with everything. So it wasn’t until I had spoken to a number of doulas, and they told me about the hospital that I was aligned to through my OB. 

And they mentioned that they are very intervention-focused. They are very stringent about just going by the book.

But then also I heard personal experiences of women of color who did not have good experiences at all, including my neighbor. And so I knew that if I was aligned to that hospital, I wanted to have a doula, someone that looked like me, someone could advocate for me. 

Now I had an appointment, and I believe I was about 26 or 27 weeks. It was the doctor that I was seeing, she was a white lady, and I went into my appointment and I had my notebook of questions. 

I knew what type of experience I wanted to have. And granted, they told me early on that I was going to have a C-section.

But in any case, I wanted to make sure that I felt safe, I felt heard should anything happen to me. I want to make sure that the doctors know that myself and my babies, we want to come out of this alive, basically.

And I asked her, what is that experience going to look like? 

And she sat down in front of me just so cold and was like, oh, it’s going to be chaotic. You’re going to have about 12 people in the room.

Each child is going to have their own team. It’s going to be loud. It’s going to be chaotic.

Like, just nonchalant like that. And I sat there and I was just like, okay, that’s not what I want. 

And after that appointment, mind you, I had earlier appointments where they were supposed to follow up on certain things, and they misplaced my files. Some of my appointments, they didn’t even know who they were talking to, really. 

Just finding out that it was a twin pregnancy, didn’t know what stage I was in. I had to tell them, you know, like what was going on. Especially meeting with my MFM, sometimes they wouldn’t even receive the information from my MFM. 

Or the growth, you know, like what was going on. And that to me, just experiencing that was shocking. You know, to me, granted, yes, there’s statistics, but it’s actually happening to me. That was my reality. And so immediately I started calling around.

I said, you know what, I don’t want this experience. I don’t want this for myself. 

And in speaking with a number of different doulas, they mentioned other hospitals that felt more safe and more caring.

I love this nurse. I love working with this doctor. So I started doing my research. And at 27 and a half weeks, super late, I found another OB and I changed.

Nat: Good for you.

Tracey: Yeah, I changed. I ended up at a different hospital and I had the most amazing experience.

Nat: That’s the way to do it. I’m so proud of you, Tracey, for real. That’s so scary.

Just dealing with that on a regular basis to go for your appointments. It’s neglect is really what it is. And so many women just accept it. But you really went the mile. And I want people to know, a lot of times doulas are covered by insurance. So it’s interesting.

It’s now starting in 2026, really to be a lot more commonplace to have them be covered. But they are covered by Medicaid. So that is a really, really positive thing because usually when something starts getting covered by Medicaid, it gets picked up by everybody else.

It’s kind of like the norm. But having a doula and an advocate, and not only to advocate for you specifically, but to come with a historical knowledge of what hospitals are better for you.

And the thing is, there is a right hospital for every person.

And that is something that we don’t know until it’s too late that it wasn’t our hospital. So having an advocate for you that is so well-versed in the art of birth is incredible. So seeking the support of a doula while people always think, oh, you know, I’m not going to need somebody to tell me how to breathe. Like it is so much more than that.

It is like having your local birthing professional give you insider information on how you could have, you specifically could have a more successful delivery based on what you are looking for in that experience.

Tracey: Yeah. It was unbelievable.

Nat: But we had moms that have changed to 36 weeks. So I’m telling you, you feel that it’s late, but it’s only too late if you don’t start now.

How you can find a doula to support you (and insurance may even cover the costs)

Yeah. There is no wrong time. If you ever, ever, ever doubt your hospital or your medical team, immediately start seeking different opinions, whether you go to a local mom group, whether you go to a mommy and me class, a music class, go find people, or the best thing, doulamatch.net.

And I should be reaching out and be like, listen, I am shouting your name from the rooftop because you could sort by your zip code.

And then they have real-time reviews, and it’s where all my doula friends are listed, where they like to list themselves. So it’s very reputable.

Yes, of course, everybody should always check their references and their resources.

But in general, it’s a good place to start. Because it is so scary. And I mean, I don’t want to get political, but it’s very hard not to when it comes to birth, because it does start at the top and it trickles its way down.

And there are no regulations and policies in place for the way that women are treated regardless of who they are. So whether you are a Black woman, whether you are an older woman, whether you are a younger woman, whether you are a single person, like everybody, there are team members of hospitals that are always going to have bias. And I do understand, and I just unfortunately feel like bias is tolerated way too much nowadays, and I’m not understanding why.

I feel like my, unfortunately, both my parents have passed. And there is a piece of me that is happy that they passed, because if they saw what was happening, they would be devastated. Especially my mom, who was such like a feminist before her times, but would never say that, would never have labeled herself a feminist or an ally ever.

That would, those weren’t even words in your vernacular in the 40s. So it’s, it’s unbelievable that we’re still in this day and age.

We have been thrown back 50 years.

I could roll my eyes about what’s happening to women, but literally what’s happening to any women of color is, is really upsetting and I don’t know what we could do other than this to be like, listen, it happens.

Yeah. And regardless of that, sometimes I think that I have heard health care professionals say, “Oh, she has a chip on her shoulder.” Yeah, because she’s been ignored by nine other professionals.

Yeah. So how do we get these chips off her shoulder?

Tracey: Yep. Exactly. Exactly. It’s like you have to be an advocate for yourself regardless. I mean, I’m not sure if you saw what happened with Serena Williams when she was pregnant. It’s like it happened to any of us, right?

But being an advocate, educating yourself, and if you are able to afford a doula, I have private insurance, so my insurance didn’t cover, but if you are able to afford a doula, absolutely.

Nat: I would skip the wipes warmer. How about that? How about we skip the wipes warmer? No, but look, if we have to see money to spend the doula, like if we have to find where we’re going to get this money, there you go, we’re going to do that, right? Maybe skip the gym membership, do more of the YouTube videos. But there’s always a way to get what you need, and I don’t think that people really think they need it.

Tracey: They need it.

Nat: But it really depends on the person, right? So it really depends. There’s a lot of different variables, but if you ever once felt that your voice wasn’t heard at your doctor’s visit, then you need an advocate.

You need an ally. That’s going to be there to be your mouthpiece to make this be a better experience.

Tracey: Absolutely.

Nat: It’s important that it’s included because that is part of having a healthful twin pregnancy.

Tracey: Yeah, it is. You want to have that overall good experience, and you’re supposed to be close with your health care providers. You’re seeing an MFM at least once a month, plus your OB. They’re a part of your life now for, what, nine months, eight months?

Nat: But I will say also for the people that are listening, MFMs are not standard of care. It really depends on a lot of different variables, because I don’t want somebody who doesn’t have an MFM to be like, I should be seeing an MFM. And I’m like, no, you shouldn’t. If your doctor doesn’t feel okay, you need to, you’re okay. So don’t get too nervous.

But yes, it is very, very, very common for us to see maternal fetal medicine specialists because of the high risks that come with our pregnancy. So it’s just an extra pair of eyes. 

To continue listening to Tracey’s story and her birth experience, listen to the full episode here!

Want to learn more about prenatal care and birth experiences as an expecting twin parent? Check out these articles too:

• Choosing Your Medical Team for Twin Pregnancy
• What is an MFM doctor? Will I need one for my pregnancy?
• Happy Twin Pregnancy Stories
• How a Doula Helped Me and My Twins

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