We're Talking About Police Brutality. Now Let's Talk About Black Maternal Morbidity.
The past week has been filled with consistent conversation about the horrors of police brutality. We've seen countless videos of police instigating violence during protests, and we need to continue these conversations and demand accountability.
But to truly work towards a world of racial equity, we need to talk about how dangerous it is to be Black and pregnant in America.
We don't typically discuss maternal morbidity in America today. As a rule, we tend to not discuss things that make us uncomfortable, especially if it tarnishes the narrative facade of American excellence we've fortified to facilitate our own comfort.
But in the past week, we've shown that when you lift up the American carpet, you'll see dry-rotted, roach and termite-infested hardwood flooring ready to cave in below us.
So let's talk about the pregnant people in America dying in droves.
When comparing 2017 numbers with similarly developed countries, America has the highest rate of maternal morbidity.
The most alarming part?
We're the only country in the survey with deaths on the rise. In countries with the same technology and access to care, the number of maternal deaths per 100,000 live births is falling.
But why? We have the technology, we have the expertise, so Now Let’s Talk About Black Maternal Morbidity.
The Centers for Disease Control (CDC) says that 60% of maternal deaths before, during, or within a year after childbirth — the accepted definition of maternal morbidity — are preventable.
In 2019, it was safer to ride a plane than be pregnant in American. 589 people died due to airplane accidents. 700 people die annually due to pregnancy or delivery complications.
There are droves of recorded accounts online of people saying their doctors didn't believe them when they were in pain or when they showed symptoms indicating a more significant issue.
For example, a patient reports to their doctor that they have bloody discharge after they gave birth. The doctor writes it off as just a usual postpartum symptom. Even if the patient pushes back, the doctor tells them to stay home.
Then they arrive to the hospital and bleed to death. They were hemorrhaging and the doctor wrote it off as usual postpartum discharge.
The kicker? A CDC survey showed that in 2014, US infant deaths reached a historic low.
We clearly aren't lacking the ability to care for our patients.
It's just that we care more about babies than the people giving birth to them.
Don't believe the statistics? Let's take a look at the pre and post-birth medical care for mothers versus babies.
4 to 28 weeks One visit per month (every four weeks)
28 to 36 weeks Two visits per month (every two to three weeks)
36 weeks to delivery One visit per week
Here's a typical schedule for infant appointments:
See the difference?
After delivery, doctors don't insist on postpartum visits for mothers.
When 33% of maternal deaths occur one week to one year after birth, wouldn't you think we should have check-ups for the mothers, too?
Once the baby is born, they become the priority. Women* are secondary.
And we certainly care more about babies than we do about Black women*. We make that loud and clear when we have a public health crisis of preventable deaths and we choose not to talk about it.
In NYC, Black pregnant people are 12 times more likely to die than their white counterparts. As if the national statistic of 3 times more likely wasn't alarming enough.
And it's not just a wealth issue. Theoretically remove the factors of systemic wealth inequality in Black communities. A poor white woman has a better chance of pregnancy outcomes than a wealthy Black one.
A white person's birth outcomes improve with wealth. Black people's outcomes don't.
Look at Serena Williams.
A woman, whose profession is knowing, caring, and using her body for skills that require peak physical condition, informed her nurse that she was experiencing a blood clot and needed a blood thinner. She's had them before, and she knows what they feel like. That nurse dismissed her, saying Williams was on pain medication and it made her confused. They completely disregarded her specific description of symptoms.
Thankfully, she put her foot down and demanded an ultrasound and lung CT. If she didn't push back, she would likely be dead.
Imagine a mother who doesn't know as much about her body. Imagine a mother without as much pull as an international tennis star.
How much less seriously is a doctor going to take her?
Consider the story of Shalon Irving — an epidemiologist at the CDC with a B.A. in sociology, two master's degrees, and a dual-subject Ph.D. She had a solid support system and ironclad insurance plan.
None of this prevented her preventable death. She died three weeks after giving birth to a bright, beautiful daughter due to high blood pressure complications.
Black women are 243% more likely to die from pregnancy and childbirth complications than white women.
And you can't blame it on the narrative that they have poorer health. Even when compared to a woman with the same diagnosis, they are still two to three times more likely to die.
One of the many factors include the stress of facing microaggressions and racism in their daily lives. A person experiencing continuous, chronic, systematic stress will have lower chances for positive birth outcomes than someone without that stress.
Inequality in healthcare system literacy, economics, support systems, insurance, and access to adequate care certainly pit the odds against Black pregnant people. But even with those factors removed, they still have an alarming disparity in maternal morbidity.
So where does this leave us?
Healthcare professionals: Black women* know their bodies better than you. Listen to them. During check-ups, give them a list of warning-sign symptoms they should look out for. Tell them what is normal and not normal so they have the resources to understand when they need to advocate for further medical attention.
Black women*: This is not your fault. This is a product of a system that pits itself against you. It's hollow as me as a white woman to tell you how to handle this. All I can tell you is what I would tell every other woman*; don't stop pushing back. Don't be quiet. When they decline to give you the test you ask for, tell them to record it on your chart that they refused to offer you the care you requested. When faced with owning up to their accountability, they might change their mind and order the test. You can't control doctors dismissing you, and if they have made up their mind, either consciously or unconsciously, not to listen, it's not your fault. But you can push over and over and over and make as much noise as humanly possible.
Everyone: Support Black women*. When structural racism contributes to chronic stress, their chances for positive birth outcomes decrease. Practice anti-racistism to help contribute to a society where they can give birth more safely. If you have a pregnant person in your community, ask if there is any way you can act as a helpful part of their support system. Ask if they need a ride to the doctor's, if they need childcare while they go to appointments, if you could make their family dinner once a week so they could take time to care for themselves. Don't assume how you can help. Ask and listen when they tell you.
Educational Resources for Further Research: