There is a plethora of healthcare disparities in the United States; however, one of the largest is the Black maternal mortality rate. Black women experience maternal mortality as a result of complications due to pregnancy or childbirth at a rate 3-4 times higher than non-Hispanic white women.1 This is largely due to a racist history of the origin of American obstetrics based on the inhumane treatment of Black women. During the early development of gynecology in the United States, the “Father of Gynecology” (ironic, I know) Dr. James Marion Sims experimented on at least seven enslaved Black woman and girls without anesthesia.2 This false idea that Black women do not need anesthesia mirrors the contemporary misconception that there are racial differences in pain tolerance. Some medical “professionals” believe that these women are lying about their pain and refuse to listen to their concerns, which is unfortunately not an uncommon experience amongst Black women. According to the NIH, this has caused many healthcare workers to administer unequal and inadequate amounts of pain medication based solely on race.3 Furthermore, “race correction” algorithms such as VBAC (Vaginal Birth After Cesarean) deems it less likely to be successful for Black and Hispanic women to deliver vaginally, falsely suggesting that a statistically higher-risk cesarean section is necessary.4 Black women are 15-64% more likely to have a surgical delivery, increasing the risk of complications such as hemorrhage, blood clots, and infection.5 In general, Black female patients are more likely to face medical discrimination and experience provider mistrust due to often not being treated equally nor taken seriously.6
A famous example of pregnant Black women being mistreated and invalidated in obstetric care is Olympic gold medalist Serena William’s experience following a risky c-section. Williams had a strong feeling that something was wrong due to feeling short of breath after the surgical delivery of her daughter. Since she has a history of pulmonary embolism (blood clots in the lungs), Williams alerted the nurse to ask for a CT scan and blood thinner, to which the nurse replied that her pain medication must be making her confused. Only after insisting did Williams get an inconclusive ultrasound followed by a CT scan, which revealed several blood clots in her lungs.7 Williams has since advocated for combatting the disproportionally high Black maternal mortality rate, and her experience demonstrates that racial discrimination and invalidation in healthcare transcends socioeconomic status.
Many Americans underestimate the severity of the maternal mortality crisis; some even deny that there is a difference based on race despite evidence. Without the government allocating more funding to combat this issue, there is only so much individuals can do. Raising awareness, supporting Black women through advocacy, and encouraging diversity in the healthcare field are a few ways in which everyone can make a difference. If you feel like you cannot do it alone, I highly recommend starting or joining a club! On my campus at Thomas Jefferson University, I co-founded a community service-based club dedicated to fighting healthcare inequality in different marginalized communities in the Philadelphia area. For Black History Month, the club is hosting a fundraiser for NAABB (National Association to Advance Black Birth). NAABB is a nonprofit organization focused on reducing Black maternal and infant mortality through advocacy, providing resources, and funding scholarships/fellowships for Black women to become midwives and doulas. All funds raised will be donated to NAABB. You should check them out! They have a donation button on their website if you are interested.
References
Falako et al. “Utilizing Community-Centered Approaches to Address Black Maternal Mortality.” Health Educ Behav, vol. 50, no. 4, 8 June 2024, pp. 500-504. DOI: doi.org/10.1177/10901981231177078.
“Medical Exploitation of Black Women.” Eq. Just. Init, 29 August 2019, URL: eji.org/news/history-racial-injustice-medical-exploitation-of-black-women/.
Hoffman et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs About Biological Differences Between Blacks and Whites.” Nat. Int. of Health, vol. 113, no. 16, 4 April 2016, pp. 4296-4301. DOI: doi.org/10.1073/pnas.1516047113.
Vyas et al. “Hidden in Plain Sight – Reconsidering the Use of Race Correction in Clinical Algorithms.” New Eng. J. of Med, vol. 383, no. 9, 17 June 2020, pp. 874-882. DOI: doi.org/10.1056/NEJMms2004740.
Jones, Layla. “Philadelphia Created American Obstetrics.” The Phila. Inq, 12 July 2022, URL: https://www.inquirer.com/news/inq2/more-perfect-union-maternal-morbidity-philadelphia-medicine-history-racism-20220712.html.
Washington & Randall. “’We’re Not Taken Seriously’: Describing the Experiences of Perceived Discrimination in Medical Settings for Black Women.” Nat. Int. of Health, vol. 10, no. 2, 3 March 2022, pp. 883-891. DOI: doi.org/10.1007/s40615-022-01276-9.
Howell, Elizabeth. “’For Serena Williams, Childbirth Was A Harrowing Ordeal. She’s Not Alone’ – Maya Salam.” Mount Sinai, 11 January 2018, URL: www.mountsinai.org/about/newsroom/2018/for-serena-williams-childbirth-was-a-harrowing-ordeal-shes-not-alone-maya-salam.