A new article from ProPublica and NPR examines how pervasive racism makes Black women more likely to die from pregnancy and childbirth-related illnesses than their White counterparts.
“Nothing Protects Black Women From Dying in Pregnancy and Childbirth” opens with the story of Shalon Irving, a Black single mother in Atlanta who died three weeks after giving birth to her daughter.
At 36, Shalon had been part of their elite ranks—an epidemiologist at the Centers for Disease Control and Prevention, the preeminent public health institution in the U.S.
Much of Shalon’s research had focused on how childhood experiences affect health over a lifetime. Her discovery in mid-2016 that she was pregnant with her first child had been unexpected and thrilling.
Then the unthinkable had happened. Three weeks after giving birth, Shalon had collapsed and died.
Underneath the numb despair was a profound sense of failure—and an acute understanding of what Shalon’s death represented. The researcher working to eradicate disparities in health access and outcomes had become a symbol of one of the most troublesome health disparities facing Black women in the U.S. today, disproportionately high rates of maternal mortality. The main federal agency seeking to understand why so many American women—especially Black women—die and nearly die from complications of pregnancy and childbirth had lost one of its own. Even Shalon’s many advantages—her B.A. in sociology, her two master’s degrees and dual-subject Ph.D., her gold-plated insurance and rock-solid support system—had not been enough to ensure her survival. If a village this powerful hadn’t been able to protect her, was any Black woman safe?
Writers Nina Martin and Renee Montagne go on to break down the statistics. “According to the CDC, Black mothers in the U.S. die at three to four times the rate of White mothers, one of the widest of all racial disparities in women’s health,” they write. “Put another way, a Black woman is 22 percent more likely to die from heart disease than a White woman, 71 percent more likely to perish from cervical cancer, but 300 percent more likely to die from pregnancy- or childbirth-related causes.”
And those trends are not disrupted by education or economics. A 2016 analysis of New York City maternal mortality cases showed that college-educated Black mothers were more likely to experience severe complications than White women without a high school diploma, begging the question: why?
The fact that someone with Shalon’s social and economic advantages is at higher risk highlights how profound the inequities really are, said Raegan McDonald-Mosley, the chief medical officer for Planned Parenthood Federation of America, who met her in graduate school at Johns Hopkins University and was one of her closest friends. “It tells you that you can’t educate your way out of this problem. You can’t health-care-access your way out of this problem. There’s something inherently wrong with the system that’s not valuing the lives of Black women equally to White women.”
The authors go on to cite evidence that racism is the underlying driver of the fatal disparity.
Many social scientists and medical researchers agree, the problem isn’t race but racism.
The systemic problems start with the type of social inequities that Shalon studied—differential access to healthy food and clean drinking water, safe neighborhoods and good schools, decent jobs and reliable transportation. Black women are more likely to be uninsured outside of pregnancy, when Medicaid kicks in, and thus more likely to start prenatal care later and to lose coverage in the postpartum period. They are more likely to have chronic conditions such as obesity, diabetes and hypertension that make having a baby more dangerous. The hospitals where they give birth are often the products of historical segregation, lower in quality than those where White mothers deliver, with significantly higher rates of life-threatening complications.
Those problems are amplified by unconscious biases that are embedded throughout the medical system, affecting quality of care in stark and subtle ways. In the more than 200 stories of African-American mothers that ProPublica and NPR have collected over the past year, the feeling of being devalued and disrespected by medical providers was a constant theme.
The article also examines how the stress of being a Black woman in America has perhaps the biggest negative impact on maternal health:
But it’s the discrimination that Black women experience in the rest of their lives—the double-whammy of race and gender—that may ultimately be the most significant factor in poor maternal outcomes. An expanding field of research shows that the stress of being a Black woman in American society can take a significant physical toll during pregnancy and childbirth.
Read the full story here.