Obstetric Racism

By: Estée Keith

“The most disrespected person in America is the black woman. The most unprotected person in America is the black woman. The most neglected person in America is the black woman.” – Malcolm X. 

Many stereotypes come to mind when we examine society’s relationship with Black Women. Sassy, big, loud, rowdy…angry. These misrepresentations of the constant struggle Black Women face when trying to make themselves seen and heard are dehumanizing. The true damages of this struggle extend far further than what is obvious. The harmful duality of the representation of Black Women construes them as “superhuman,” whilst also making them hesitant to take up space in any setting for fear of being reprimanded.

In her New York Times article Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis, Linda Villarosa tells the story of Simone Landrum, a young black mother, and her traumatic experience in the American healthcare system as she gave birth to her third then fourth child. Landrum’s story highlights the disparities experienced by black women in healthcare, not only during pregnancy but, more widely when receiving any form of health council or treatment.

What really struck me was the huge difference in infant and mother mortality between black and white mothers and babies. As a black woman, it was very disturbing to learn that my child is more than twice as likely to die than a white woman’s (CDC, 2019). What’s more, I am three to four times as likely to die of pregnancy-related complications than that white woman, regardless of our respective educational levels (Petersen et al). The difficulty I had coming to terms with how terrible the experiences of black mothers are and how likely they are to affect my life completely altered my understanding of motherhood and childbirth. It was hard to learn that as a healthy and college-educated black woman I would still be at risk of, medical racism, discrimination from nurses and doctors and of having an underweight baby. Worse still, there is practically nothing I can do about it. 

What is even more frustrating is that I am learning about this information at 21 years old. Childbirth and motherhood seem so far away for me and many of my peers, they aren’t part of my everyday conversation. But that doesn’t account for the grossly underreported discrepancies in the treatment of black mothers and babies. This alarming pattern, that ought to be part of the wider conversation around women’s rights and healthcare, seems to be new information for anyone I ask. Including my friends who are black mothers. 

To try and bring this experience closer to home I spoke with two friends of mine. Both are black, both are college-educated, both are (or are to be) mothers. The similarities between their experiences speak for themselves. Both were asked multiple times to confirm their health insurance status, asked if the father of their child was involved, if there was a stable home situation, and if they had a plan for their future. It could be that these are standard questions for all young mothers, but nevertheless, the fact that the specific context made them seem racially charged highlights much about how safe black mothers-to-be feel in American health clinics. 

Each of my friends shared a story with me that painted a very clear picture of the treatment of black mothers in American hospitals. One mother sought care from a private clinic, where she was consistently reminded of the cost of private healthcare, asked if she had insurance to cover it and seemingly dismissed as a low-priority patient. Later on into her pregnancy, when her partner started to join her at appointments, the level of treatment and care completely transformed. Upon recognizing the father to be a well know local celebrity, the doctors and nurses seemed to re-assess the importance of her wellbeing. The topic of conversation at appointments shifted from concerns about insurance coverage to discussion of the father’s career ambitions. My friend felt uncomfortable given the complete 180 in the degree of care she was receiving. She had gone from a low-priority to a high-priority patient instantly and through no action of her own. The volatility in care and priority standards showcase just how easily overlooked black mothers are in healthcare. 

My other friend did not go through a private clinic and saw multiple doctors through her pregnancy. She recalls being seen by a revolving door of different doctors one of whom assumed outright that the father of her child was not present in her life. She tells a jarring story about a medical student “practising” stitches on her post-delivery. “I was so excited I wasn’t focused on it” but the doctor “was standing next to him telling what to do and at one point he yelled ‘no not that part.’” 

Neither of my friends had truly considered how their race could adversely impact their pregnancy and delivery experience. Though they hadn’t thought about it until I prompted them, the evidence was clear. The fact that they were predisposed to accept this treatment, and that it didn’t raise huge red flags until they were prompted to consider it worries me. Not only is the general public grossly ignorant to this culture, but the victims of it are so used to that treatment that they often don’t process it as abnormal. 

Though I only spoke to black women, the facts speak for themselves. We need to inform and empower black mothers, persecute mistreatment and negligence, fight for accountability, and protect them. 

Reference List:

CDC 2019.  Infant Mortality Statistics from the 2017 Period Linked Birth/Infant Death Data Set.  National Vital Statistics Reports. Table 2.https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_10-508.pdf

Petersen, EE et al. 2019. Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016. MMWR Morb Mortal Wkly 68, 762–765. DOI: http://dx.doi.org/10.15585/mmwr.mm6835a3external icon.

Villarosa, L. 2018, April 11. Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis. Retrieved from https://www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html