Seven Ways Racism Harms Pregnant Black Women

The journey to motherhood and the experience of pregnancy should be one defined by joyous anticipation and dedicated care. But for far too many Black women in the U.S., the experience is often irreversibly marred by the structural and systemic racism in the industry that is to first do no harm. While this should come as no surprise given that the modern field of gynecology developed through experimentation on enslaved Black women who were kept awake even during surgical procedures, it doesn’t mean that people cannot be informed about race-driven causes and biases that kill mothers and babies; and it certainly does not mean that a dedicated group of people cannot create change. In fact, it’s critical that they do. 

The commitment to first do no harm, even if unintentionally, is ignored over and over when pregnant Black women seek proper medical care. Racial discrimination leads to stunning disparities in not only healthcare access but quality healthcare even when access is available. Black women across the economic landscape are equally represented in the extraordinary lack of diligent, thoughtful medical care they deserve, the New York Times reported.

With Mother’s Day coming up, NewsOne continues its reporting dedicated to examining and exposing the truth about maternal harm and mortality and the racism that drives it. In 2021, the Centers for Disease Control and Prevention (CDC) reported that of the 1,205 women who died during childbirth that year, Black women were the majority, despite white women’s presentation in the population being nearly three times higher.  Similarly–and tragically—stillbirths among Black women in the U.S. occurred at more than double the rate of their white and Latinx counterparts, the CDC reported. 

But there is a hope that exists even in the face of all these horrific realities. People–and not only Black women—can demand more and better in the healthcare industry, including the way doctors are trained. People can do that consistently until the practices change. Here, we’re sharing 7 ways racism undermines the health and lives of pregnant Black women—and what all of us speaking in a single, strong, and steadfast voice–can do to finally stop it. 

Lack of Access to Prenatal Care/Medicine

When a woman finds out she’s pregnant, she must be availed of prenatal treatment and care to help ensure the baby is born healthy without short or long-term issues. Unfortunately, many Black women face barriers to accessing those vital services. Factors such as socioeconomic status, lack of health insurance, geographical location, and implicit bias within healthcare systems contribute to prenatal care being inaccessible to Black women compared to other racial groups. According to a report via the National Institutes of Health (NIH), Black women are less likely to receive prenatal care and supplements, particularly during the first trimester. This inequality not only deprives Black women of the support and resources they need during pregnancy but also exacerbates existing health disparities and increases the risk of adverse outcomes for both mother and baby.

What Can Be Done: State and national representatives should be put on notice and in writing, that your vote hinges on how they treat pregnant Black women; stories of real-world harm, in cases where the victim of that harm agrees, should be posted with as many details (name of hospital, ie) as the law allows; complaints about care should be filed in real-time and followed up on. No one is at the hospital to make friends, just to get well and home safely. Be respectful, but don’t worry about being a nuisance. Keep notes. Report any failure on the part of professionals. 

Generally Limited Access to Reproductive Health Services 

In the matrix of lies that define America, one is about Planned Parenthood. Men and women who do not believe that women have the right to body sovereignty have ingrained in the collective social imagination, untruthfully, that critical health service organizations like Planned Parenthood exist to target women and make them get abortions. In fact, abortions at less than 8 percent are the rarest form of care provided by Planned Parenthood. Primarily, they provide high-quality reproductive healthcare to women—especially low-income women. In a post-Roe world, scores of Black women have now lost local access to quality healthcare, including pre and post-natal care. Planned Parenthood stated that 31 percent of Black women are enrolled in Medicaid and not accessing their services, and are more likely to get cervical cancer or die during childbirth. Therefore, the lack of reproductive health services will be disastrous. With states–where the majority of Black people live–following the federal lead and defunding Planned Parenthood, knowing it is a safe haven for Black and poor women, they are ensuring the deaths of Black mothers and Black children. 

What Can be Done: Vote in local and national elections. Elections aren’t only about Presidents and members of Congress–although the right representation in those offices matter. But your vote also impacts who your D.A. will be: a person who targets doctors and pregnant women or puts them lowest on the list of those to prosecute. Don’t let other people tell you what candidates stand for. Read for yourself and let your voice be heard before and on Election Day. Here’s a how-to sheet from the NAACP Legal Defense Fund. 

Environmental Racism 

Not only is prenatal care vital in fostering a healthy pregnancy, but so is the environment and surroundings that the mother lives in before and during pregnancy. According to a Howard University report last month, redlining, and infrastructural segregation put Black mothers at risk. Overall, 56 percent of Black people–in particular those who have been victimized by policies that both entrench and enforce intergenerational poverty– are forced into neighborhoods most likely to be exposed to toxicity because of their adjacency to waste sites and power plants. For pregnant Black women, subpar living situations and working conditions can harm the health of their unborn child. Racism often correlates with residential segregation and exposure to environmental hazards, such as air pollution and toxins, which can. 

What Can Be Done: Strengthening existing anti-discrimination laws and regulations, such as the Fair Housing Act can help combat redlining. Also, investing in underserved communities and public housing programs can help to cultivate a healthier environment for expecting Black women. 

High Ratio of C-Sections

In 2022, March of Dimes reported that Black women, at 36.6 percent, had the highest rate of C-sections in the United States.  C-sections, which can be life-saving, are too often the default for Black women, whether health necessitated or not. And there are significant risks that come with the surgical procedure, according to the Mayo Clinic. These include, but are not limited to, infection in the lining of the uterus (endometritis), in the urinary tract, or at the site of the incision; significant blood loss; poor reactions to anesthesia are possible; and life-threatening blood clots. More mothers who have C-sections have increased risk during future pregnancies: an increased number of C-sections means an increased risk of the placenta attaching to the wall of the uterus.

What Can Be Done: Legally, fighting against a coerced C-section can be difficult. Lower Courts, as the scholarly journal, Sage reports, typically side with medical teams. But it is illegal to force someone to have a surgery and in most cases, the decision to perform a C-section is at the discretion of the physician, the National Institutes of Health has long reported. And it sounds reasonable, until you consider that there are very, very conditions that actually require a C-section as a response. To help ensure a childbirth that is optimum, interview doctors and know you can change providers at different points if you need to. Develop a birth plan and ensure it’s on record with the hospital and your doctor supports it. Make sure your health providers say upfront what conditions would cause them to recommend a C-section and how often C-sections, especially first ones, occur at the hospital. 

High Ratio of Gestational Diabetes

Gestational diabetes, a type of diabetes that develops during pregnancy, disproportionately affects Black women compared to other racial and ethnic groups. The CDC indicates that Black women are at 63 percent higher risk of developing gestational diabetes due to underlying genetic factors and a higher prevalence of risk factors such as obesity and insulin resistance. Additionally, socio-economic factors such as limited access to healthy foods, lower rates of physical activity, and higher levels of stress can further increase the risk among Black women. Black families forced to live in marginalized neighborhoods with more fast-food restaurants than healthy food alternatives are just one example of how systemic racism exacerbates such conditions. According to NIH, black neighborhoods average 2.4 fast food restaurants every square mile, while white neighborhoods only average 1.5 per square mile. 

What Can Be Done: Several steps can be taken to help prevent gestational diabetes. The Mayo Clinic suggests increasing exercise both before and during pregnancy while eating food that’s high in fiber and low in fat. Also, check with a physician for polycystic ovary syndrome (PCOS), as those who have it are more likely to develop gestational diabetes. 

Criminalization via Abortion Laws

The Supreme Court’s overturning of Roe v. Wade has caused swift and severe law changes when it comes to abortions across the United States. Some states have now made legislation that has altered the period when women can legally get an abortion and for Black women, that poses a particular problem. KFF reports that 60 percent of Black women from ages 18 to 49 live in states that have made drastic anti-abortion laws and restrictions, more so than any other ethnic group. Among those women, 11 percent are uninsured. Since many of these laws don’t take rape, incest, or physical complications into consideration when it comes to rationalizing abortions, this increases the likelihood of criminalizing Black women who seek to get an abortion throughout the country. 

What Can Be Done: Programs like Planned Parenthood are being severely undermined and underfunded due to the new abortion laws. Planned Parenthood provides far more than just abortions, but crucial health care and education about pregnancy prevention, prenatal care, and more. Investing in Planned Parenthood and other such organizations available to Black women could help combat the criminalization of them at this time. 

High Ratio of Postpartum Depression

Following childbirth, women are still susceptible to physical complications and lingering ailments that can disrupt the beauty of the period immediately following childbirth. One of the most crippling ailments is postpartum depression. It can cause extraordinary fatigue, depression and even suicidal ideations. And while Black women suffer postpartum depression at a significantly higher rate than other women, they are also less likely to be treated for it. Medical professionals rarely enough engage Black women’s pain—emotional, mental and physical —with the kind of intentional and compassionate listening and care provision that leads to healing. More, because even anecdotal data has informed pregnant Black women of what is true in the medical industry–that they are  far more likely to be deemed unfit, there is a high level of very reasonable mistrust in providers who say they are there to help, NPR reported. 

What Can Be Done: Increased education on mental health is crucial to helping to combat postpartum depression. Asking vital questions during healthcare visits can help, according to AHA Institute for Diversity and Health Equity. Ensure the OB/GYN mood and emotional well-being assessment to help screen for postpartum. Also, forming support groups among fellow Black expecting moms can help as well, as exemplified by the Centering Pregnancy Model. 

SEE ALSO:

Black Maternal Health: Top-Performing Hospitals Supporting Pregnant Women Of Color

Maternal Death Rates Have More Than Doubled For Black Women, New Study Finds

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