Historical Aspects of Racism and its Relationship to Mortality Among Black Women in America

This paper explores the Black Maternal Mortality Crisis as it stands in the United States. In this paper I will also briefly explain both the definition of Black woman regarding this piece of work as well the history of childbirth in the United States for Black women. The purpose of this paper is to identify the crisis that Black women face in this country as well as the factors that have led to this maternal crisis. This crisis leaps over socioeconomic, class, educational barriers that one might think would be tell-tale factors to systemic healthcare access. This even reaches beyond mothers and pregnant women who are active drug users. In this melting pot that is named the United States of America we are sold on this “American Dream”, this dream which embodies the idea that we are afforded the same opportunities regardless of what we look like or where our parents came from. Such a marvelous idealist way of thinking. Now what happens when we as a people have different birthing experiences? How does that impact our parenting, the way we raise our children and our level of trust in this country. Furthermore, I’ll delve into what we as a community can do, what caregivers can do, and what changes I’ve found through research need to be made to combat this issue.

Black Maternal Mortality Crisis in the Developed United States

Black women are in crisis in the United States with a maternal mortality rate at the highest of any developed nation. Black women in the United States as it relates to maternal mortality rate is comparable to that of poor nations like Iran and Sri Lanka. Between 700 and 1,200 black women die each year from pregnancy and/or childbirth complications in the United States. Black women are 250% more likely to die from childbirth than white women. Black mothers who are normal weight are more likely to die during childbirth than white mother who are obese. Black women who received prenatal care in the first trimester are more likely to have complications during childbirth than white women who haven’t receive prenatal care (. Maternal mortality spans from the time of conception to up to a year postpartum or post-birth. This fact is essential in being able to understand the timeline and being able to recognize that a mother’s care needs. In this work I was able to study and interview both women who have had traumatic birthing experiences but also on the opposite side, care givers and the system of superiority that engulfs hospitals. Delving into racism and the huge effect that racism has on the Black woman, the generational stress she carries and what those affects have had on the physical structure of our DNA. Throughout this reading black women and African American women will be used interchangeable but have the same meaning for the purposes of this analysis. Racism has been engrained on the DNA of black women in this country and that inherently affects her maternal mortality, infant mortality and this orbital generational curse of maternal health.

History

African American women were not considered full citizens with the abilities of citizenship until the mid 1960’s, approximately 50 years ago. Even then there were still roadblocks to black women being able to vote without discrimination and institutionalized barriers. African American women in birth. There is a notion in our American culture and in birth culture that African American women have not made contributions to childbirth. In reality the contributions that black women have made include but not limited to Midwifery as when white women birthed their babies, they called their black slaves, for generations (Mason). This was instead of going to hospitals or having private Midwives. In hospitals at the time there were white male doctors that practiced barbaric methods such as restraints during contractions (Gaskin, 2003). For generations and generations Black women birthed their own babies with the help of their mothers. And in that time before it was normalized to go to the hospital and birth was a medical event that required medical interventions, we had a lesser percentage of women dying and babies dying in the birthing process then now with all of these technological and medicinal advancements.

Racism

Racism is a social construct. Race is not genetic by design. According to an article published in The Journal or Perinatal Education, African American women quite frankly are made to feel marginalized and stereotyped because of racism and the institutionalized barriers placed in the care and education of black women, before during and after pregnancy (Abbyad, 2011). Studies have shown that doctors have an implicit bias when it came to women of color. Other studies have shown that racial bias with some believing that African American women have a higher tolerance for pain and so under-treat the women in their care (Ashton et. Al. 2003).

Dr. Arline Geronimus a researcher and professor at the University of Michigan Institute for Social Research released a study on “Weathering” which simply put took a look at cumulative stress as a result of socioeconomic status and social status she found that these stressors were endured at a higher rate in black women than in white women. She found the telomeres of women of the same age yet different race aged by seven years for black women in comparison to white women. The conclusion being that systematic racism is literally killing black women (Geronimus, 2006). The data shows that trauma literally alters the DNA specifically the telomeres

The Public Rights/Private Conscience Project (PRPCP) is an organization whose mission is to, “bring legal academic expertise to … religious liberty rights conflict with [fundamental] rights to equality and liberty”. This organization recently came out with a report that examined Catholic hospitals and their impacts on Black women. This study found that women of color disproportionately. relied on Catholic hospitals for care in relation or comparison to white women. More specifically black and Hispanic women, currently 44 states have Catholic hospitals. This in part is a result of a lack of access to healthcare. Catholic hospitals and Catholic providers follow a set of directives known as the Ethical Religious Directives drawn from the Church’s moral and theological teachings (United States Conference of Catholic Bishops, 2018). Laurie Bertram Roberts Co-founder of the Mississippi Reproductive Fund illustrates her experience as a 17-year-old mother in her second pregnancy and how close she came to death a result of a Catholic hospital’s unwillingness to save her life. After multiple attempts of seeking medical help as her pregnancy miscarried and eventually hemorrhaged and lost consciousness. Her experience is so much like so many experiences of mothers, how these women are untreated sent home and left to suffer and more often die as a result of this lack of care. The standard of care needs to be apparent and taught to all. There needs to be a standard of the level of care and attention a person receives when they go to a hospital and entrust their care, the care of their unborn child to these medical professionals.

Economy, Education and Class.

The assumption that is made when discussing this issue is that it’s a class issue, or a socioeconomic issue or a lack of education issue. In reality that’s just not true. In reality a black college educated, “upper-class” woman is more likely to die from childbirth in American than a white woman who doesn’t have a high school degree and is considered the lower class that relies on public assistance. I have the amazing privilege of serving as a Doula. As a doula my role is educational, physical and spiritual support that begins at the time of conception well after baby is born. My role as a doula has allotted me the opportunity to speak to and service very young and economically challenged women. I’ve also been given the opportunity to speak to and know other doulas and connect with them. The overarching theme with the doulas who serve women who aren’t able to necessarily afford care is this notion that their economic status should rightly affect the level and quality of care that they receive. It’s shocking to hear from women who genuinely believe that they deserve less care because of their lack of money. Pregnancy is an amazing and tumultuous journey to the beginning of motherhood. This journey sets the tone for the entirety of one’s experience as a mother. This is especially true for the women and young girls who were not prepared to become mothers but have chosen to carry their pregnancies to fruition. A traumatic beginning i.e. a negative provider, negative birth experience can set the tone for a women’s sense of confidence in herself as a mother. Later in the up-stream interventionist section I’ll delve further into doula work and the work being done to combat and equalize the settings for all women to have a good experience.

Up-Stream Efforts.

Our country is built on the entrenched ideals of Blacks being lesser than. It’s in the original framework that founded this nation. It’s built into our institutions and how we put our policies together. Our healthcare system thrives on the inequities that are within these racial disparities. 

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