The health disparities that black women face during childbirth and in the postpartum period have certainly become more commonly discussed in recent years. In fact, most people will recognize these buzzwords and agree that something must be done to address the inequities we see.
According to the CDC, black women die more than twice as often as their white counterparts during childbirth and in the postpartum period, up to one year after delivery (1). This number increases to 3 or 4 times the rate of death in other studies (2). It goes without saying that the higher rate of mortality that we see among black women is inexcusable.
The primary question in discourse about this topic – online and in real life – is: What can we do about these grim statistics? What can healthcare professionals do? What can black women do? What can their friends, families and partners do?
The reason why we see worse outcomes for Black women is, frankly, multifactorial. Part of it can be attributed to the higher rates of cardiovascular disease and other medical conditions in black women (which warrants a separate conversation about chronic stress, access to care, and a host of other issues).
However even when you control for pre-existing conditions in pregnant patients, Black women still have far worse outcomes. This, we can only attribute to systemic and interpersonal racism, or the racist ideals and realities that black women experience on a societal and day-to-day level. Even as a physician, I have felt uncomfortable accessing care in many instances during my pregnancy due to poor treatment, unfair assumptions, and straight-up dismissal of my concerns. As a pregnant Black woman, my experience was far worse than any I’d received as a Black woman seeking care for other medical problems. Other Black female physicians have shared similar stories, highlighting that no amount of education or status is truly protective.
With all that said, it is blatantly obvious that Black maternal mortality is a devastating issue that leads to the unnecessary loss of life. But how do we fix it? And more importantly, whose responsibility is it to do the work?
With the way that this system exists today, addressing this problem must involve all of those who have a stake in. This includes action on the part of healthcare providers, policymakers, researchers, patients, and their loved ones. The problem itself is complex and, as such, so will be the solution. Although it is unjust to place even a small part of this burden on black women, in the current climate, this may be the most actionable way to make meaningful change.
While providers, policy makers, and researchers are taking steps to improve the statistics, we as Black women can also spread awareness. If we speak up and ask the uncomfortable questions, we can apply necessary pressure on the system to see the changes we want to see.
We should not be afraid of making others uncomfortable because Black women deserve better.
Citations:
- Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019 | CDC. Published September 26, 2022. Accessed July 6, 2023. https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
- Chinn JJ, Eisenberg E, Artis Dickerson S, King RB, Chakhtoura N, Lim IAL, et al. . Maternal mortality in the United States: research gaps, opportunities, and priorities. Am J Obstetr Gynecol. (2020) 223:486–92.e6. 10.1016/j.ajog.2020.07.021 – DOI – PMC – PubMed
- Cited black physician story: https://www.statnews.com/2021/05/09/my-work-as-a-black-ob-gyn-tempered-my-joy-as-i-prepared-to-give-birth/
