Black Maternal Health: Our Healthcare System Fails Women of Color
My Mom’s Pregnancy
Have you ever talked to your mother about her experience with childbirth? My mom has continuously warned my siblings and I about the terrors of her own pregnancies. She suffered from something called hyperemesis gravidarum, which was not known well or understood at the time of her pregnancies.
What this condition entails is severe nausea and vomiting, leading to intense weight loss and dehydration and typically requiring hospitalization. While it wasn’t formally recognized at the time, my mother told me she felt dismissed and invalidated by her female doctor. She was told that her debilitating nausea, lasting for three consecutive months, was perfectly normal.
I can imagine that to be told that you have no valid reason to question your ensuing misery might produce a rare feeling of loneliness.
Luckily, she had the support and knowledge to switch to a more supportive doctor. Proper medication was still not available, but having her symptoms validated was an enormous source of reassurance.
Why is my mom’s pregnancy and dismissive doctor at all relevant? It fits perfectly into the puzzle of gender injustice that we more frequently discuss—the way we are silenced.
We are gaining access, confidence, and a language that allows us to protest sexual violence, unrealistic cultural depictions of women, injustices in the workplace and classroom and beyond. But what about our health? What about how we are treated in doctors offices and hospitals, in a nation that prides itself on top-notch healthcare?
Would you be surprised if I told you that my mom, being white, was actually less likely to endure this dismissive attitude from doctors?
SERENA WILLIAMS: FEMINIST HERO
I’ve admired Serena Williams as a shining role model for all women for as long as I can remember. You probably know who she is because of her outstanding tennis career—and how she has fiercely devoted herself to skyrocketing the role of women in sports.
And, since the birth of her daughter, she has publicly discussed the injustices she has faced as a mother and an athlete, in comparison to her male opponents whose tennis careers were not in any way impacted by their children.
What you might not know, though, is the harrowing health care experience she endured involving the birth of Alexis Olympia.
I won’t pore over the complicated medical details involved in the procedure, but I will acknowledge Williams’ testimony of the terrifying experience.
The day after Olympia was born via emergency C-section, Williams suddenly felt short of breath. Although she was nearly positive that because of her history of blood clots, she was having a pulmonary embolism, the nurse seemed to think that her pain medicine was confusing her and delayed the CT scan and heparin drip that would identify the blood clots in her lungs. Over the course of the next 6 days, her C-section wound popped open due to her coughing spells, and a large hematoma was discovered in her abdomen. Several surgeries later, she spent the first 6 weeks of motherhood bedridden.
Why is it that her doctors were surprised and unprepared for the complications that arose after her cesarean, both when they knew her health history and that blood clots are one of the most complicated side effects of C-sections?
This isn’t an isolated medical incident or an unavoidable health scare. As many doctors and journalists revealed soon after, her story is a cautionary tale. Her story provides a disturbing window into a world where proper healthcare is not distributed equally.
BLACK MATERNAL HEALTH
Did you know that black women are three to four times more likely to die from childbirth than white women?
And, it turns out that childbirth deaths might not even be primarily medical crises. Something else is at stake. Something that I feel is absolutely essential to a conversation about feminism.
Journalist Linda Villarosa spoke about this in the New York Times on April 11th, 2018, writing about “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis.” Her article, containing evidence from personal interviews as well as years of scientific research, makes a bold statement that shockingly inverts our faith in the American medical establishment.
No, there is not a genetic component explaining why black moms are significantly more at risk for maternal death (a scientific study in 1997 refuted this notion).
We can’t blame education or income, either. In fact, a black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education.
Rather, it is the atmosphere of “societal and systemic racism” that can manifest in life-threatening physical conditions such as hypertension and pre-eclampsia, leading to higher rates of infant and maternal death. In turn, this racism is manifested in “a pervasive, longstanding racial bias in health care — including the dismissal of legitimate concerns and symptoms.”
Regardless of your race, I’m sure you can recall a time where you have been silenced or shamed. A time where being a woman presented a stark disadvantage— ridding you of the ability to have a voice.
Have you ever considered that this suppression could be life-threatening? That mental suffering can be directly expressed in physical ways?
We have been silenced in bedrooms. In the classroom. In offices, in meeting rooms.
But what about in a hospital room? Where your life is at stake? Will it really take thousands of maternal and infant deaths a year to recognize the unmistakable danger of silencing?
The Story of SIMONE LANDRUM
22-year-old Simone Landrum offers her traumatic childbirth story in Linda Villarosa’s article. The mother of 2 sons was immediately distressed by her pregnancy, as she was afflicted by crippling headaches and noticed that her hands, feet, and face were swollen. Her doctor’s response was to take Tylenol.
Complaining more forcefully about her symptoms at a later pre-natal appointment elicited a dismissive order from her doctor to “lie down—and calm down.”He then told her that he was planning to go out of town and that he could perform a C-section the day before he left, 6 weeks before her due-date, if she wished. Her medical records from this appointment do not mention the headaches, swelling, or her elevated blood pressure.
Her symptoms undoubtedly point to the possibility of pre-eclampsia (“dangerously high blood pressure during pregnancy”). It took her own online research, months later, to understand the implications of this condition.
During childbirth, her elevated blood pressure led to the separation of the placenta from her uterine wall. She nearly bled to death, and her child was delivered a still-born. The hardest part, she says, “was going to pick up her sons empty-handed.”
EXPANDING YOUR FEMINIST AGENDA
I don’t read or hear enough about how our healthcare system fails women, particularly women of color.
The point is not to punish doctors, to criticize our medical establishment. And it is certainly not to victimize women. It is to refuse to accept the forms of injustice we encounter. Ask young women if they feel validated, supported, listened to by their doctors. And if they don’t, encourage them to do something. Demand attention, or leave.
Perhaps it’s easy for us to self-advocate and speak out against gendered violence that we’ve experienced and can relate to—whether in school, work, or in relationships. It’s time to expand our feminist agenda, though, and advocate for those who we can’t always relate to.
I believe that there is no stronger form of empathy than this—to acknowledge the problems of those women that we have not experienced, and to still stand in solidarity with them. To take their problems as our own.