Warning: Explicit mentions of Slavery, Racial Injustice, Rape, and Other forms of Sexual Violence are present
While there are already shocking disparities in women’s healthcare, Black women experience these effects at heightened rates due to their race and preconceived stereotypes that continue to affect their livelihood systemically. From maternal mortality to pain management and even access to life-saving treatments that all humans should be entitled to, the statistics paint a clear image. Black women are three to four times more likely to die from pregnancy-related complications compared to white women. This reality has remained unchanged despite undeniable advancements in medical technology over the past decade. Although technology and capitalism continue to progress, Black women’s fate in healthcare has not changed as these factors rely on each other to stay in existence.
Historically, where does the disparity
stem from?
An old myth that originated during slavery claims that Black people feel less pain in comparison to “regular” bodies. This myth has not disappeared from medicine; in fact, it continues to persist in the way doctors dismiss pain and deny care. It’s a lie that remains persistent in healthcare, costing the loss of innocent lives. It is essential to ask how we got here.
There are four major historical eras that have led to our current reality: Slavery, Jim Crow Laws/Black Codes, Civil Rights, and today (post-Civil Rights), according to the National Library of Medicine.
Throughout the years 1619 through 1865, the emergence of stereotypes against Black women began in the West. Nude auctions were held publicly to examine the reproductive ability of enslaved women. During these auctions, men also evaluated Black women’s bodies because of their own sexual desire to rape them. From this emerged the Jezebel stereotype, a hyper-sexualized portrayal of Black women that not only dehumanized them, but also laid the foundation for cycles of generational poverty, reinforcing harmful narratives that continue to shape their lived realities. This not only dehumanized them but also made them more vulnerable to victim-blaming in cases of sexual assault and rape. As they were already seen as overly sexual, it was easier for society to shift the blame rather than acknowledge the violence inflicted upon them.
Black women’s bodies were put on display, stripped of dignity, and treated as objects. The very sexual traits that were once used to dehumanize them, are now exploited as people idolize and strive for them today. This highlights the hypocrisy in how Black women’s bodies have been commodified over time and continuously exploited for society’s changing exploitative needs.
Within the realm of healthcare, countless non-consensual gynecological and reproductive surgeries were performed repeatedly on enslaved Black women without anesthesia. This included cesarean sections and ovariotomies.
Throughout the Black Codes/Jim Crow period (1865-1965), there came an influx of rape, lynching, and genitalia/reproductive mutilation. Harmful stereotypes and distorted media portrayals made their way into hospitals and clinics, justifying medical experiments performed without consent while access to proper healthcare remained out of reach. An example of this is the Tuskegee Syphilis Study (1932–1972), where hundreds of Black men were intentionally left untreated for syphilis, even after an effective cure (penicillin) was discovered. Although this primarily affected Black men, Black women were then at risk of contracting syphilis. This led to severe health complications in fertility, which, for some, led to death. Under Jim Crow, this injustice only deepened. Black communities were denied treatment and forced to navigate a system that saw them only as subjects.
During the Civil Rights era (1955–1975), Black women faced relentless violence not just in the streets, but also in hospitals and clinics where their bodies were still sites of control and exploitation. Lynchings and state-sanctioned brutality were evident in the medical system, where nonconsensual experiments persisted, and forced sterilizations continuously robbed countless Black women of their reproductive autonomy. As the fight for civil rights grew, the healthcare system remained the most vulnerable environment for Black women, as they were denied agency over their bodies by medical professionals.
At this point, the Black community was tired of waiting for a system that was built upon their exploitation to finally help. This led to community efforts such as the Black Panther Party’s free healthcare clinics, where essential medical care was provided to those previously denied. However, even within this environment, Black women still faced misogyny, as the intersection of racism and sexism still determined their experience in all parts of society.
In the post-Civil Rights era (1975- now), Black women have been extremely exploited and hyper-sexualized in the media. Other times, Black women are often compared to men as their strength was exaggerated to reinforce the stereotypes rooted in slavery. By painting them as hypermasculine and unbreakable, this justifies the forced labor that they were expected to maintain.
Among many other factors, the persistence of harmful stereotypes has perpetuated generational poverty, igniting striking disparities in healthcare. This inequity has disproportionately impacted Black women, leading to the overuse of hysterectomies, forced sterilizations, and restricted access to abortions.
The National Library of Medicine states that, according to some sources, an estimated 58% of enslaved women between the ages of 15 and 30 were sexually assaulted by slave owners and white men. Considering that the laws at the time classified them as “property,” they had no legal protection. Instead, they were deliberately subjected to harm.
In addition, the acts of violence against African American men overtly affected African American women as well. The social stigma against Black men fueled widespread racial violence, with large groups of white men openly lynching them to assert dominance and eradicate the bonds of love, family, and community between Black men and women. This dehumanization has reinstated the false narrative of Black women as perpetual single mothers. It ignores systematic implications such as mass incarceration, systemic violence, and disproportionately high maternal mortality rates.
Continued problems today
Society is quick to blame Black women for medical problems, but it rarely acknowledges how many die in childbirth due to medical neglect; this further normalizes the reality behind these statistics.
In light of birth and mortality, cesarean procedures are most commonly pushed onto Black women as the surgeon capitalizes the most off of this form of birth. The cost of a natural birth is significantly higher because it requires time and care, unlike the quicker, more profitable surgical extraction of a baby. Depriving Black women a birthing doula or even a natural birthing process is another tactic that dehumanizes and maintains power imbalances.
Additionally, pregnancy and childbirth were not seen as the creation of life and connection but as a capital gain. Enslaved women were forced to bear children for the sole purpose of increasing the labor force and generating profit instead of the human right that is motherhood.
Enslaved Black women had their babies ripped from their arms and sold at infancy, and this heinous separation created long-lasting generational trauma. Contributing to emotional detachment, this leads to postpartum hardship.
Here at the University of Virginia, medical students once practiced on the bodies of enslaved people, using them as cadavers without consent. When they were finished, the bodies were discarded in unmarked graves, where they were left without acknowledgment of their existence. They were denied even the humility of rest.
Stories like these, infested with hate and inhumane practices, reinforce the need for an active dismantlement of the current system that treats Black patients in the United States. There was no active reform or discarding of the same institutions and systems that initiated these practices; instead, there was a continuation in time. How can these systems claim to have changed when they still uphold the same disregard for Black lives?
The growth in medical neglect and systemic barriers to essential care helped alleviate these systems.The foundation of these institutions was built on exploitation, and without meaningful structural change, the echoes of that past still make the present reality of our world.
While taking the Data Science in Public Health course by Dr. Rajesh Balkrishnan, he often discusses these class disparities. During our interview, he shared insights from his research and experience as a healthcare professional and educator, highlighting the undeniable inequities Black women continue to face in the medical system.
“It is very clear that white women have different outcomes compared to Black women, with noticeable variations in care. In the United States, these differences are even more pronounced. There are stereotypes about African men and women that influence healthcare, affecting the way they are treated. Racial and ethnic minorities are often perceived as second-tier citizens, a perception that stems from the history of this country.”
Interview with Dr. Rajesh Balkrishnan
Death and mourning for Black mothers have become too normalized. A recurring statistic that we, as students, learn about in Professor Balkrishnan’s course highlights the ongoing reality of these deaths: “There are different outcomes for Black women; Black women and infants face higher mortality rates. Black women have almost ⅔ of the difference in mortality and complications. This statistic is somewhat misleading. These differences are even more pronounced in reality. These women are socially and economically disadvantaged.” Healthcare is a basic human right. This is a capitalist country, so I am not surprised.”
The question was then posed to Dr. Balkrishnan regarding a solution to these disparities and how they might be remedied in the future. He responded: “Given the current circumstances and the intense pressure on the medical system, doctors are forced to treat patients like numbers. I do not know if we can remedy the situation—maybe something like the Affordable Care Act. I think we need to offer more choices and respect people’s needs. Different people have different needs. The outcomes of this greed are coming back to haunt us in more ways than one.”
As someone in the health field and an educator, he emphasizes that medical providers must work with people from all communities as a first step.
There needs to be an entire reform of healthcare to diminish these disparities. The same healthcare system that relied on the explosion and abuse of Black women’s bodies cannot be the same system that is expected to protect them in our modern era. As stated before, time passing does not mean a step towards reform. Instead, the forms of injustice have adapted to technological and social changes, but the inequality has gone nowhere.
“I don’t know if we are doing enough in modern education and healthcare to eliminate these disparities. A lot of it is the isolation of people who belong to a racial or ethnic minority within neighborhoods. These patients need to be talked about and approached.”
Dr. Rajesh Balkrishnan