An alarming analogy once made to me during a discussion of medical racism, which actively juxtaposed the ongoing oppression of two black populations in America, is as follows: doctors are to black women as police officers are to black men. This analogy highlights the abuse of power by those that were given the civic duty to help the American people, actively pointing out the inherent power that our police officers and healthcare professionals hold, and their subsequent failure of using such power justly. Understanding the root of such deeply systemic racism in healthcare and beyond is important in finding a solution to such problems and protecting our black mothers. Due to deeply-rooted issues of racism, sexism, and much more in the United States, black Americans have been marginalized and have had implicit barriers placed, preventing them from accumulating a sustainable income. Furthermore, from being redlined into impoverished neighborhoods and being overpoliced in those very communities to being denied properly-funded education, healthcare services, housing, and food, black Americans are systemically oppressed in the United States and denied basic necessities. This also directly affects black women by preventing proper contraceptive care and counseling and only increases the number of unintended pregnancies (Dehlendorf, Park, Emeremni, Comer, Vincett, & Borrero 526).  Understanding this discrimination of black Americans in the context of medical racism is essential in addressing the issue of doctors using unconscious bias and ignoring the medical needs of black women, especially pertaining to black maternal health. 

Black women are 3 to 4 times more likely to die during childbirth due to complications such as pre-eclampsia and hypertension as compared to white women, according to the findings in 2011-2013 of the CDC Pregnancy Mortality Surveillance System. These statistics disproportionally place black women at a higher chance of pregnancy mortality, thus causing one to step back and understand how doctors’ unconscious biases directly and damningly affect the maternal health of black women. Neel Shah, an obstetrician-gynecologist at Beth Israel Deaconess Medical Center in Boston and director of the Delivery Decisions Initiative at Ariadne Labs says in Amy Roed’s article “America Is Failing Our Black Mothers” that, “the common thread is that when black women expressed concern about their symptoms, clinicians were more delayed and seemed to believe them less… it’s forced me to think more deeply about my own approach. There is a very fine line between clinical intuition and unconscious bias.” Black women’s medical needs are not only outwardly ignored and denied by healthcare workers but so many have also died due to psychological and physiological complications of pregnancy, post-partum. As mentioned, black women are at a disproportionally higher rate of developing pre-eclampsia and resulting hypertension, as well as developing post-partum depression and substance abuse problems in comparison to white mothers. As the gap between black and white pregnancy mortality rates only increases in the United States it only becomes more evident that this is deeper than a medical issue, it is a humanitarian issue. 

So what can doctors do to prevent such disparities? We can increase access to healthcare in black neighborhoods, which looks like the acquisition of affordable birth control, abortion, informative sexual education, prenatal and medical care, and expand the coverage for Medicaid. This would greatly increase the chances for black mothers to have a successful pregnancy and help lessen the gap between pregnancy mortality deaths of black and white women. In addition, doctors must incorporate more patient-centered care (of course, this should be the standard anyway) in order to really assess and listen to the needs of struggling black mothers. Black women deserve fair and quality healthcare service, however, “22 percent report discrimination when going to the doctor or clinic” according to a 2017 report by the Robert Wood Johnson Foundation entitled “Discrimination in America: Experiences and Views of American Women.” Addressing such issues in healthcare is important in preventing further instances of discrimination against our black mothers.

References:

“Black Women's Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities.” Black Women's Maternal Health, National Partnership for Women & Families, Apr. 2018, www.nationalpartnership.org/our-work/health/reports/black-womens-maternal-health.html.

Creanga, Andreea A et al. “Pregnancy-Related Mortality in the United States, 2011-2013.” Obstetrics and Gynecology vol. 130,2 (2017): 366-373. doi:10.1097/AOG.0000000000002114

Dehlendorf, C., Harris, L. H., & Weitz, T. A. (2013). Disparities in abortion rates: A public health approach (p. 1776). American Journal of Public Health, 103(10), 1772–1779 (describing that “studies have found that restricted access to abortion services can limit women’s ability to abort a pregnancy when they wish to do so, and that these effects may be particularly pronounced for Black women and women with lower educational attainment”); Henshaw, S. K., Joyce, T. J., Dennis, A., Finer, L. B., & Blanchard, K. (2009). Restrictions on Medicaid funding for abortions: A literature review. Guttmacher Institute. Retrieved 27 March 2018, from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.295.8439&rep=rep1&type=pdf 

Roeder, Amy. “America Is Failing Its Black Mothers.” Harvard Public Health Magazine, 10 June 2020, www.hsph.harvard.edu/magazine/magazine_article/america-is-failing-its-black-mothers/.