Racism: A Medical Practice

How America’s lack of maternal care is killing Black women

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The United States, a leading global economic and military superpower, has the most inferior maternal health care system when compared to every other developed country in the world. Black mothers, more prevalently than any other race, bear the heaviest burden from the country’s poor maternal health care system.

America’s maternal mortality rates soared from 19 to 24 deaths per 100,000 live births, from 2000-14. Other nations, such as the United Kingdom, have a continually decreasing maternal mortality rate of fewer than 8 deaths per 100,000 live births.

Maternal mortality disproportionately affects the lives of Black women. Black women are two to three times more likely to die from pregnancy or delivery complications than white women in the U.S. Black women experience maternal mortality at a rate of 44 deaths per 100,000 live births due to income inequality and medical racism, while white women have a maternal mortality of 13 deaths per 100,000 live births.

Illustration by Lizzy Choi

It is unacceptable that America does not value the lives of Black women, or women in general, as they are responsible for the continued growth and development of our nation.

Terrible, racial injustice in maternal health is not a new issue. It spans decades of women of color, especially Black women, not having the same access as white women to proper medical care in the U.S.’s inefficient and inaccessible health care system.

Anti-Black hiring discrimination is as prevalent today as it was in the late 1980s, according to Vox. About 70 percent of Black workers  are employed in blue-collar jobs that rarely offer health insurance coverage, according to the Henry J. Kaiser Family Foundation.

Because of this, Black women are systematically devalued by medical providers. They have less access to quality care including but not limited to insurance coverage, access to pre- and postnatal care and inadequate medical treatment in the years leading up to and following childbirth.

Black individuals have the highest poverty rates in America, with about 22 percent below the poverty level in 2016. With the rising costs of health care, quality maternal care is increasingly out of reach. Low-income Black women get funneled off into medical facilities that are less equipped to handle pregnancies, adding excess stress to the already jarring process of pregnancy and childbirth.

Black women already experience high rates of chronic stress due to prevalent racist encounters, which causes chronic low-grade inflammation, similar to having a low fever at all times. Their chronic stress is exacerbated by medical racism, the discrimination in medicine and health care systems based upon perceived race.

Historically, doctors and nurses believed there were biological differences between Black and white women. Dr. J. Marion Sims performed gynecological surgeries on unconsenting Black slaves in the mid-19th century without anesthesia because he didn’t believe Black people felt pain, according to National Institute of Health medical records.

Even today, doctors often do not take Black women’s pain seriously, perpetuating medical racism. A recent study by Dr. Carmen Green found that Black patients were prescribed fewer pain medications than whites and once they acquire a prescription, they have a more difficult time getting it filled.

Doctors take an oath to treat all patients equally, and yet the culture of medical racism among health care providers completely undermines that code. Ignoring a person’s pain due to the color of their skin is tremendously unprofessional.

The U.S. medical policies don’t provide any straightforward procedures for dealing with potentially fatal pregnancies, making treatable conditions worse, according to NPR. Medical providers’ immediate attention is on the health of the newborn, not on the life of the mother.

In 2009 the U.S. adopted a series of perinatal core measures, a set of measures aiming to  reduce pregnancy complications. Only one of these measures focuses on maternal health, causing both doctors and nurses to lack knowledge surrounding maternal mortality.

Postpartum nurses nationwide especially lack knowledge about postpartum maternal health care risks. According to a study published in the American Journal of Maternal/Child Nursing, the majority of nurses out of about 400 did not know the rates and timing of maternal mortality during the postpartum period of pregnancy in the United States.

Because many nurses are ill-informed about maternal mortality, they are unable to educate mothers about potentially life-threatening symptoms that may occur after pregnancy, such as painful swelling. The study showed 67 percent of registered nurses spent less than 10 minutes focusing on warning signs of potentially fatal symptoms.      

This is an alarming reality that must be addressed, as all health practitioners who specialize in female reproductive systems or perinatal practices should be versed in maternal health care.

The Centers for Disease Control Foundation estimates that 60 percent of these deaths are preventable. With a correctly trained staff, these symptoms can be treated without resulting in the death of a mother.

This brings into question an issue of medical training: ignorance about maternal care and medical racism costs thousands their lives, and affects children by either leaving them in single-parent homes, with distant relatives or entering them into the foster system. Maternity affects  not only half the population, it affects everyone.

These systemic issues could be prevented with adequate medical training. This isn’t the 19th century — medical professionals must take the health of Black mothers seriously, as their lack of concern echoes how deeply ingrained racism is in the U.S. health care system.