Tessa
Tessa developed high blood pressure when she was 8 and a half months pregnant. She had a forceps birth at 39 weeks and her daughter had to be resuscitated at birth before being transferred to the neonatal unit where she was later diagnosed with meningitis. Tessa’s blood pressure gradually settled after birth and she stopped taking medication after two months. Clip read by an actor.
Tessa is a 42-year-old woman who lives with her partner and their 3-year-old daughter. She identifies as mixed Black and White British and works with an organisation that supports Black women during and after pregnancy.
More about me...
When she was 8½ months pregnant, Tessa developed blurred vision and went to see her midwife, where she was found to have very high blood pressure and was advised to go straight to hospital. Although she understood the seriousness of the situation, she felt the way it was communicated heightened her anxiety and made her blood pressure worse. Tessa was started on medication and discharged home. She was given a home blood pressure monitor, however, she found that her readings were often high at home but normal when repeated in hospital, which made her doubt whether the monitor was accurate.
Tessa wondered whether her high blood pressure was linked to the three and a half stone she gained during her pregnancy. She felt sick for much of the time and found that eating starchy, filling foods was the only thing that relieved her nausea. At the same time, Tessa feels that healthcare professionals' expectations of an "ideal" body weight are based largely on White populations and place unrealistic pressure on Black women.
Tessa’s doctors recommended induction of labour at 39 weeks because of her blood pressure, but Tessa was reluctant. She felt this would interfere with her body's ability to labour well and questioned whether the recommendation was influenced by general assumptions about her risk as a Black woman. Tessa was aware, through her professional work on maternity inequalities, that Black women are more likely to experience poor maternity outcomes and felt she needed to actively "co-pilot" her care by asking questions and being involved in decisions, rather than simply accepting advice. She sensed that some healthcare professionals were surprised by how engaged she was in decision-making. She also prepared her partner to advocate for her in labour and communicate her birth plan.
Tessa ultimately went into labour on her own without needing to be induced. After a long labour, she had a forceps-assisted birth and an episiotomy (a cut to the birth canal). Her daughter had to be resuscitated at birth, which Tessa found frightening, before being transferred to the neonatal unit, where she was later diagnosed with meningitis. Tessa was discharged after four days, but her daughter remained in hospital for a further two-and-a-half weeks. Tessa appreciated having time to rest and recover from what she described as a traumatic birth.
Tessa initially combined breastfeeding with formula feeding to ensure her daughter received colostrum, which she felt was particularly important. When her daughter was around two months old, she switched fully to formula feeding because she felt it would allow her to get more sleep and be better for her mental health.
Three weeks after giving birth, Tessa attended a postnatal check with her midwife, who noted that her blood pressure was settling and felt she would soon be able to stop taking her medication. However, her GP recommended that she continue treatment for three months, explaining that this was what he had found worked best over his 40 years in practice. Tessa was not convinced this was necessary and felt the NHS can be too quick to rely on medication. In the end, she reached a compromise with her GP and continued taking the medication for a further month before stopping.
Tessa was surprised by the impact that becoming a mother had on every aspect of her life. She described the physical recovery, the emotional adjustment, changes in her relationships, caring for a new baby and the shift in her sense of identity as her "matrescence". She was well supported by her partner and also saw a counsellor who was both a birth worker and a Black woman, which Tessa found helpful, because she felt her counsellor understood her experiences and perspective. Tessa found the return to work, when her daughter was nine months old, took a toll on her mental health as it was difficult trying to juggle motherhood and lack of sleep with work. She also developed back problems (slipped discs), which she believes were made worse by spending a long time in stirrups during labour.
Tessa felt that weight advice was based on White body norms and placed unrealistic expectations on women of colour (read by an actor).
Tessa felt that weight advice was based on White body norms and placed unrealistic expectations on women of colour (read by an actor).
Even if I worked really hard and starved myself, the most I could probably get down to is a 14 at my age and bearing... bearing on other things, but this build comes from my grandmother in Jamaica, she had this sort of build. She was big busted, big backed, yeah? And then the other people in my family are, you know, on the Caribbean side are like... my dad wasn’t, but some of the others, they’re, like, six-foot three Black men, big, tall Black men. So when... when I’m looking at where my build’s come from and where my health’s come from, they... they go grey later. Do you know what I mean? They have good skin. They tend to have freckles. I’ve... I’ve come from that side. I don’t... I don’t even look like the side of my mum’s family, even though they probably have more weight management issues than my Caribbean side did, but my build comes from my Caribbean side. So, I’ve always been at the top of, like, 24, 25 BMI, even when I was at my fittest. So, it’s like, it’s... it’s... it’s a slog for... for what... for looking at that as a measurement and then looking at, OK, what does healthy actually look like for me? You know?