Did you know that, in the United States: Black embryos and fetuses are up to twice as likely to be lost to miscarriage as white embryos? Black fetuses are more than twice as likely to be lost to stillbirth as white fetuses? Black women are three times more likely to die from a pregnancy-related condition than white women? These disparities are evident statistically, even when we control for a variety of factors.
Why is this? The short answer is that the culture of our medical system punishes Black women, embryos, and fetuses for existing in a way that it does not punish white women, embryos, and fetuses.
Take, for example, maternal mortality. Black women and white women have statistically similar rates of conditions such as preeclampsia, eclampsia, placental abruption, and postpartum hemorrhage, but Black women are two to three times more likely to die from these conditions. This is controlling for differences in age, education, insurance coverage, and more. In fact, even Black women with great privilege in other areas continue to be at a significantly higher risk of maternal death than white women in less privileged groups. One report found that the risk of maternal death for a college-educated Black mother is 60% higher than that of a white or Hispanic woman with less than a high school education.
Researchers point to factors such as being ”less likely to receive adequate care” as possible reasons why so many Black women die.
Why would Black women not receive adequate care? One answer is implicit racist bias against them. Fourteen studies have found that providers’ implicit bias against Black people affects “patient–provider interactions, treatment decisions, treatment adherence, and patient health outcomes.” A meta-analysis of these studies also found that “implicit attitudes were more often significantly related to patient–provider interactions and health outcomes than treatment processes.” That means that researchers could make a stronger statistical tie between a provider’s attitude toward Black people and the eventual health of a patient, than between treatment and the eventual health of a patient.
What does this implicit bias mean for real women’s experiences? Say a Black woman and a white woman (college roommates, same major, working in similar jobs, same health habits) both go to the emergency room because they are pregnant and experiencing spotting. The white woman is more likely than the Black woman to walk out of the hospital believed, treated, and still pregnant.
Even if we had exclusively anti-racist medical providers, there would still be hurdles to making sure that Black mothers and children have the best opportunities to live. The enduring effects of racism presenting as chronic diseases join myriad other threats to the right to life, including lack of transportation to doctor’s visits, lack of nearby doctors or specialists, unlivable housing conditions, and lower standards of care in hospitals that primarily serve Black women.
We need to correct this disparity. And in our present reality, this means acknowledging that Black women and children face extra obstacles to living. If that statement challenges you, or if you’re feeling motivated but don’t know what to do next, here are some suggestions:
- Sit with the stories of, and take time to mourn, Black women who have lost their lives or their children’s lives because they weren’t heard or believed. Here are a few stories from Ebony, TIME, The New York Times, and ProPublica as a starting point.
- Participate in the month-long anti-racism challenge from the Institute for Perinatal Quality Improvement (don’t worry about the dates, you can start anytime!).
- Buy a book for a Black doula or midwife in training.
- Research the history of the Mothers of Gynecology.
As we strive for a more just world, we need to be conscious of the ways that certain populations face greater injustices. Honoring the dignity of each human life, and especially each Black life, is ongoing work for us as individuals and as a society.