Black women are three times more likely to die from a pregnancy-related cause than white women, as reported by the Center for Disease Control. Preeclampsia and eclampsia, which are both terms for high blood pressure at different times during pregnancy, is a leading cause of death for black mothers, yet if diagnosed early, is easily manageable. According to the Population Reference Bureau, “Black women are five times more likely to die from pregnancy-related cardiomyopathy and blood pressure disorders than white women.” Why is a treatable condition causing disproportionate deaths of black mothers? Evidently, a gap exists in communication between patients in the doctors, in which a lack of an adequate diagnosis and/or treatment leads to increased rates of black maternal mortality. The following are potential factors that can contribute to higher rates of black maternal mortality.
Historically, there is a lot of preexisting mistrust in black communities surrounding medical professionals. This may date back to when medical professionals such as J. Marion Sims, who is revered as the “father of modern gynecology,” performed repeated and painful experimental surgeries on enslaved black women without administering anesthesia, and without their consent. Not only does this raise ethical questions regarding informed consent, but such examples of doctors disregarding the pain experienced by black patients further exacerbate the mistrust some members of the black community have towards medical providers. Another example of this is Serena Williams’ childbirth experience. Serena’s doctors were aware that she had a high-risk tendency for blood clots, yet when Serena experienced symptoms of an impending blood clot during childbirth, her doctors were reluctant to believe her. When she explained to them that she needed heparin, a drug that prevents blood clots, she was told, “Well, we don’t really know if that’s what you need to be on right now.” After advocating for herself repeatedly, a CT scan showed she had multiple blood clots, and she was correct about her symptoms. This illustrates a current example of doctors disregarding the pain and symptoms reported to them by a black patient, leading to distrust of the medical community.
This is worsened by the false beliefs about biological differences in the bodies of black people that are even today, held by some members of society. In a 2016 study conducted by Dr. Kelly F Hoffman, it was found that approximately half of the medical student participants had false views about biological differences between black and white patients. This included the belief that black patients have a higher pain tolerance due to having thicker skin and less sensitive nerve endings. Implications of such biases include healthcare providers not taking their patients' reported symptoms seriously. This may lead to a failure to accurately diagnose certain conditions and prescribe the correct medication to treat patients. Beliefs about black patients' tolerance for pain can also lead to medical professionals being “rougher” and more careless when treating their patients. Long term negative effects include staggering increases in black maternal mortality rates.
Another factor that can contribute to high rates of black maternal mortality is weathering. Weathering is a term coined by Dr. Arline Geronimus, a public health researcher and professor at the University of Michigan, to describe how racism, discrimination, and other lived experiences can negatively impact the health of disadvantaged people and/or populations of color. The weathering hypothesis suggests that the accumulation of stress experienced by black mothers in their lifetime can contribute negatively to maternal health and exacerbate the higher rates of poor birth outcomes for African and African American mothers.
The effects of the weathering hypothesis combined with the devaluing of pain as well as mistrust towards the medical community, are all factors that need to be considered when discussing the high rates of black maternal mortality. This is a prominent issue today, and improving the understanding of these topics within the medical community can lead to better health outcomes for black mothers worldwide.
Edited by: Danika Dai
Graphic Designed by: Alejandra Gonzalez-Acosta
References
“Black Women Over Three Times More Likely to Die in Pregnancy, Postpartum Than White Women, New Research Finds,” Population Reference Bureau, https://www.prb.org/resources/black-women-over-three-times-more-likely-to-die-in-pregnancy-postpartum-than-white-women-new-research-finds/.
“Black Women Over Three Times More Likely to Die in Pregnancy, Postpartum Than White Women, New Research Finds,” Population Reference Bureau, https://www.prb.org/resources/black-women-over-three-times-more-likely-to-die-in-pregnancy-postpartum-than-white-women-new-research-finds/.
“Black Women Over Three Times More Likely to Die in Pregnancy, Postpartum Than White Women, New Research Finds,” Population Reference Bureau, https://www.prb.org/resources/black-women-over-three-times-more-likely-to-die-in-pregnancy-postpartum-than-white-women-new-research-finds/.
“A surgeon experimented on slave women without anesthesia. Now his statues are under attack,” The Washington Post, https://www.washingtonpost.com/news/retropolis/wp/2017/08/29/a-surgeon-experimented-on-slave-women-without-anesthesia-now-his-statues-are-under-attack/.
“Serena Williams on her near-death experience after giving birth: No one was really listening,” Today, https://www.today.com/health/womens-health/serena-williamss-essay-black-pregnancy-rcna23328.
“Black Maternal Mortality: ‘It is Racism, not Race,’” Johns Hopkins Bloomberg School of Public Health, https://ccp.jhu.edu/2021/05/17/maternal-mortality-black-mamas-race-momnibus/.
“Eliminating Racial Disparities in Maternal and Infant Mortality,” Center for American Progress Action Fund, https://www.americanprogress.org/article/eliminating-racial-disparities-maternal-infant-mortality/.