A perfect storm of factors has led to huge racial disparities in maternal health care. In the United States, as abortion clinics continue to close, this inequity is projected to widen. In this podcast from Nature and Scientific American, we hear from leading academics unpacking the racism at the heart of the system. From the historical links between slavery and gynaecology to the systematic erasure of America’s Black midwives. What is behind the Black maternal mortality crisis, and what needs to change?
Read more of Nature’s coverage of racism in science
Sources in order of appearance
PEW Research Center: The Growing Diversity of Black America
Reuters: Georgia Allows Georgia ‘Heartbeat’ Abortion Ban to Take Effect
Advancing New Standards in Reproductive Health: One In Three People Learn They’re Pregnant Past Six Weeks’ Gestation
Georgia Recorder: New Poll Finds Nearly Two-Thirds of Georgia Voters Object to State’s New Abortion Restrictions
Atlanta: In Much of Rural Georgia, Maternal Health Care Is Disappearing
TIME: Armed Protestors And Far Right Groups Are Escalating Protests At Abortion Protests
Grady Newsource: In Georgia, The Most Dangerous State for Pregnant Women, Policy Change Could Save Lives
KFF: Reported Legal Abortions by Race of Women Who Obtained Abortion by the State of Occurance
CDC: Maternal Mortality Rates in The United States, 2020
Nature: ‘We Are Bearing Witness’ Health Researchers Navigate a Post-Roe World
Reproductive Health: The Giving Voice to Mothers Study: Inequity and Mistreatment During Pregnancy and Childbirth in the United States
Journal of Racial and Ethnic Health Disparities: Racial and Ethnic Disparities in Cesarean Delivery and Indications Among Nulliparous, Term, Singleton, Vertex Women
American Journal of Obstetrics and Gynecology: Site of Delivery Contribution to Black-white Severe Maternal Morbidity Disparity
Harvard School of Public Health: America is Failing its Black Mothers
Vascular Cures: Serena Williams and her Experience With Pulmonary Embolisms
History Channel: The ‘Father of Modern Gynecology’ Performed Shocking Experiments on Enslaved Women
World Health Organization: Obstetric Fistula
The History of Medicine: J. Marion Sims: Gynecologic Surgeon
The Atlantic: The Surgeon Who Experimented on Slaves
UVA Today: Study Links Disparities in Pain Management to Racial Bias
Journal of Racial and Ethnic Health Disparities: Acknowledging and Addressing Allostatic Load in Pregnancy Care
Cleveland Clinic: Heart Disease and Pregnancy
Penn Medicine News: Pregnancy-Related Heart Failure Strikes Black Women Twice as Often as Those of Other Races
Journal of Racial and Ethnic Health Disparities: Contraceptive Desert? Black-white Differences in Characteristics of Nearby Pharmacies
CDC: Current Contraceptive Status Among Women Aged 15–49: United States, 2017–2019
Perspectives in Sexual and Reproductive Health: Race, Ethnicity and Differences in Contraception Among Low-Income Women: Methods Received by Family PACT Clients, California, 2001–2007
WebMD: Black Women and Birth Control
The Journal of Perinatal Education: Where Have All the Midwives Gone?
AMA Journal of Ethics: How Should We Respond to Racist Legacies in Health Professions Education Originating in the Flexner Report?
Medpage Today: Racial Bias in Flexner Report Permeates Medical Education Today
US News: Stop Meddling With Midwives
ACLU: The Racist History of Abortion and Midwifery Bans
Columbia Mailman School of Public Health: End Racial Disparities in Maternal Health, Call a Midwife
The American Journal of Nursing: The Midwifery Problem
Kaiser Health News: Doctors, Hospitals Tussle Over Role of Nurse-Midwives
World Health Organization: Nursing and Midwifery
The Commonwealth Fund: Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries
Journal of the European Economic Association: Midwives and Maternal Mortality: Evidence from a Midwifery Policy Experiment in 19th-century Sweden
The Guardian: Black women in UK four times more likely to die in pregnancy and childbirth
Nursing Times: Only half of babies in England now delivered by midwives
Economics Observatory: Does access to abortion vary across the UK?
NPR: Supreme Court Overturns Roe v. Wade, Ending Right to Abortion Upheld for Decades
Reuters: Factbox: U.S. Abortion Restrictions Mount After Overturn of Roe v. Wade
The Washington Post: Majority of women ages 15 to 44 would face new post-Roe abortion limits
The Commonwealth Fund: Health and Health Care for Women of Reproductive Age
US News and World Report: The U.S. Maternal Mortality Rate Surged by Nearly 20% in 2020
Clinical Obstetrics and Gynecology: Reducing Disparities in Severe Maternal Morbidity and Mortality
The Guardian: Controversial Statue Taken Down but Debate Still Rages