2020 has been a year of unveiling and reckoning with the dark history America offers. During this time many marginalized groups have used their voice to throw flames to the narratives that define their lives. These narratives are often based on the confines of structural racism that’s embedded in America’s dark history. Black women are no doubt a part of these disproportionate groups, albeit so regularly unprotected and unheard. The issue of maternal mortality among Black women is one that is slowly being covered more in mainstream media, in some ways a result of the pandemic. However, while this issue is being researched more, solutions have not successfully been implemented. Black women are still dying at higher rates than their white counterparts. Black women (BW) are disproportionately affected by the structure of today’s health care system. This system is built upon flawed policies that produce implicit bias which requires a complete dismantling of the entire system. Hospitals and birthing centers all need to reevaluate and begin the process of implementing policies that protect and prevent mortality among Black Women.
The burden of this problem has unfortunately been placed in the hands of Black women. They have been put in a position where they have no choice, but to fight for dramatic changes that will benefit their lives. However, this burden should not fall on them. This country needs to rework the healthcare system so that every patient receives equal and quality healthcare. To accomplish this the work will need to start in the education/re-education of medical providers. Medical providers need to be educated to always confront their biases and practice medicine while recognizing the danger if they let their biases manifest. Although, racist people will be racist regardless of the medical training they received and will always be a danger to Black patients despite the training they received to suppress their racism. This is why new studies are showing the demand for Black health care providers and obstetricians. Journalist Yuki Noguchi from the NPR article, “To Be Young, A Doctor And Black: Overcoming Racial Barriers In Medical Training”, looks at this demand through the framework of Black physicians. Noguchi recognizes that Black people are a small minority in medical training programs and are often alienated.
This alienation can be recognized as a through-line to how Black birthing patients are alienated when they voice medical concerns. (Noguchi)
The physicians that Noguchi interviewed reflected upon how racist their resident training was and at that time was hard to identify. This invisible racism trickles down in the way Black people are cared for, the racism is there, but not visible to ones not listening to Black people. (Noguchi) Black medical physicians are necessary to see changes within this problem. Having a shared background as your physician results in better health outcomes. Black students interested in medicine need to pursue it strongly despite the stigmas surrounding the lack of Black medical professionals. Noguchi’s interviews show that there also needs to be safer environments for Black medical students to learn that is free of racism. The silver lining of all of this is that research does show that Black patients do have better health outcomes when they have Black doctors, so the work to get more is imperative.
The aforementioned statement broadens the conversation to how predominantly Black serving hospitals treat their patients regardless of the ethnic background of the physicians. Research shows that Black and white women that utilized Black serving hospitals have higher rates of maternal morbidity than low Black serving hospitals. These findings are troubling and signal an even bigger problem of how racist low-quality treatment can become the norm at places that mostly serve Black people. Moreover, the study also discovered that Black women could avoid life-threatening scenarios during delivery at hospitals if they delivered at the same hospital as white women. (Howell) This ties back to the earlier mentioned claim of the eradication of the entire healthcare system that’s rooted in systemic racism. There is no reason that predominantly Black serving hospitals are treating Black patients so poorly that it reflects in the care of non-Black patients. Policy changes such as education and racial bias training can’t completely fix these deeply rooted issues, but it is a good start.
While it’s saddening that medical education and hospital policies are not functioning in
the favor of Black women, there is still hope that macro-level changes can help remedy this issue. In the SELF article, “8 ways we can actually reduce Black Maternal Mortality”, Nina Bahadur makes the bold statement that getting home from the hospital is not enough. What this statement captures is not only the necessity to address why BW are dying at higher rates, but it leads to the bigger unveiling of the complete treatment of BW. To further explain, the article lists eight macro-level changes that should be implemented, one change details the need to expand Medicare coverage up to one-year postpartum. Bahadur is recognizing that maternal mortality affects Black women after they give birth and their medical care should be covered until then. Bahadur notes that the expansion of fourth-trimester care will provide follow-up appointments and prevent postpartum deaths that result from high blood pressure, stroke, and infection. (Bahadur) A Lot of what Bahadur is proposing is not exclusively challenging, it just takes the collective effort to start making these changes happen.
Moreover, there is not enough data being collected on this issue. After extensive research to develop a literature review on this topic, I discovered that a lot of the data collected became redundant. The data needs to capture more than the number of deaths that occur in a timeframe, it needs to encapsulate the data of different birthing processes for BW. This type of data will be beneficial in discovering the various ways we got BW being 2 to 3 times more likely to die from pregnancy complications. (CDC) Subsequently, additional data will help researchers better understand the relationship between having a doula and midwife for BW. To explain, Bahadur collected data reporting that having a doula will improve birth outcomes for BW. She talks about the study saying, “77 percent of the pregnant participants were black; The study found that the mothers with doulas were two times less likely to have a birth complication, four times less likely to have a baby with low birth weight, and also more likely to start breastfeeding.” These are amazing outcomes and prove that having doulas/midwives is a beneficial health decision. However, more data on doulas/midwives need to be produced so that the utilization of
doulas/midwives will become more normalized and access to them will be easier. (Bahadur) The lack of access to quality care is another cause of maternal mortality in BW. BW often wants doulas and midwives, but they are not widely accessible in all locations.
The conversation of access to care is one that is not absent from COVID-19 and today’s current medical crisis. The recent policy changes have not been in favor of BW and go against the aforementioned study of having a doula present during prenatal care. To further explain, co-authors Michale Lemke and Kyrah Brown discuss that the biggest maternal health care changes the pandemic presented are in the physical distance policies. These changes have created social isolation among women that can lead to psychological troubles. (Lemke and Brown) For BW social isolation during birth can be detrimental, when life-threatening discussions are being made on their behalf, and a support system that’s on their side is not present. Understandably, social distance policies are necessary however there need to be better alternative options. One option would be to have doctors recommending that their patients have a virtual support system with them at all times during appointments and labor. This will ensure that if the women become unresponsive their support system will be there to make decisions on their behalf. Unfortunately, the social distance changes are also affecting the number of times BW can physically see their doctor check for any complications. To remedy this policy change, doctors need to be ultra receptive to any concerns their patients raise through virtual appointments and bring them into the office as soon as the patient feels something is wrong. BW medical concerns weren’t being heard before the pandemic and they sadly weren’t being heard through the pandemic either. Alternative options still need to be proposed in hopes that conversations of helpful policy implantation will rise.
Apart from policy changes and medical care reworking, it’s important that this issue is being heard from BW themselves. They can vocalize exactly what they want for their medical care. The problem is they are not always heard unless they are speaking as a collective.
Fortunately, there is an organization called “Black Mamas Matter Alliance ” which is founded by Black women and caters to Black mothers. Their vision is to create an environment where BW has the resources and rights to thrive before, during, and after pregnancy. They are composed of Black women doctors and aim to achieve policy changes, advance care for Black Mothers, and be able to shift culture. It’s powerful and in some ways disheartening to know that Black women are leaning on each other to fix a problem that they shouldn’t have the burden of fixing. They have a website where they accept donations to help further their reach and impact. This conversation must always go back to Black women because, in the end, the changes that happen will affect them directly and the work to accomplish these changes will, unfortunately, be the result of their efforts.
Professor and activist Keeanga-Yamahtta Taylor, says, “If Black women were free, it would mean that everyone else would have to be free since our freedom would necessitate the destruction of all the systems of oppression.” This powerful quote acknowledges how oppressed Black women are and the lack of recognition of the countless ways they are oppressed. It’s time for the work to end maternal mortality and the systems that oppressed Black women to not be placed solely in their hands, but in everyone. To see countless Black women fall victim to maternal mortality is so disheartening and infuriating when medical researchers are reporting that they are often preventable. Black women in many ways are the backbone of this country so it’s time that this country pays its dues to them by simply fighting for equal maternal health care.
Bahadur, Nina. “8 Ways We Can Actually Reduce Black Maternal Mortality.” SELF, SELF, 31 Oct. 2019, www.self.com/story/how-to-reduce-black-maternal-mortality. Accessed 24 Oct. 2020.
“Black Mamas Matter Alliance – Advancing Black Maternal Health.” Black Mamas Matter Alliance, 10 Mar. 2020, blackmamasmatter.org/. Accessed 24 Oct. 2020.
Howell, Elizabeth A., and Jennifer Zeitlin. “Improving Hospital Quality to Reduce Disparities in Severe Maternal Morbidity and Mortality.” Seminars in Perinatology, vol. 41, no. 5, Aug. 2017, pp. 266–272, www.ncbi.nlm.nih.gov/pmc/articles/PMC5592149/, 10.1053/j.semperi.2017.04.002. Accessed 24 Oct. 2020.
Lawson, Kimberly. “Black Mothers Share the Devastating Impact of Racism in Maternal Health Care.” Vice.Com, 12 Jan. 2018, www.vice.com/en/article/43bp43/black-maternal-health-care-racism-stories. Accessed 24 Oct. 2020.
Lemke, Michael Kenneth, and Kyrah K. Brown. “Syndemic Perspectives to Guide Black Maternal Health Research and Prevention During the COVID-19 Pandemic.” Maternal and Child Health Journal, vol. 24, no. 9, 21 July 2020, pp. 1093–1098, www.ncbi.nlm.nih.gov/pmc/articles/PMC7372977/, 10.1007/s10995-020-02983-7. Accessed 24 Oct. 2020.
Noguchi, Yunki. “To Be Young, A Doctor And Black: Overcoming Racial Barriers In Medical Training.” NPR.Org, July 2020,
ck-overcoming-racial-barriers-in-medical-training. Accessed 24 Oct. 2020. Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths. 2020,
www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.htm l. Accessed 21 Oct. 2020.
Taylor, Keeanga-Yamahtta. “Until Black Women Are Free, None of Us Will Be Free.” The New Yorker, The New Yorker, 20 July 2020, www.newyorker.com/news/our-columnists/until-black-women-are-free-none-of-us-will-b e-free. Accessed 21 Oct. 2020.