Racism in health: the roots of the US Black maternal mortality crisis

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

Demography: The Pregnancy-Related Mortality Impact of a Total Abortion-Ban in the United States: A Research Note on Increased Deaths Due to Remaining Pregnant

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

PNAS: Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites

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

JAMA Network: Black Representation in the Primary Care Physician Workforce and Its Association With Population Life Expectancy and Mortality Rates in the US

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