By Marilyn Silverman
Your doctor has wonderful news for you—you’re pregnant. Both you and your partner happily count the days until you will welcome a tiny baby girl or a tiny baby boy into your domestic abode. But that happy day might be darkened with sadness and tragedy if you are a minority woman due to the very real possibility that you might die before reaching the delivery room. The cries of that newborn baby might never reverberate within the sterile walls of your hospital room.
According to Planned Parenthood of New York City, “Structural barriers to quality health care kills black pregnant women at alarming rates…it cuts across age, education and income levels.” If you are a high school graduate flipping burgers in a fast-food restaurant and going home to a city housing project or a PhD in an ivory tower going home to your Park Avenue penthouse, you both have an equal chance of dying. Prof. Marian MacDorman, Population Research Center, says, “even college-educated black women have substantially higher infant mortality than college-educated whites.”
A contributing factor is in a word—stress—precipitated by racism and discrimination. According to Planned Parenthood, “the experience of being black in the United States can cause high stress levels that lead to…high blood pressure and heart disease…can cause life- threatening complications [during pregnancy].” How much abuse can the body endure from this unending assault? The detrimental impact of racism on the expectant mom are not the types of medical diagnoses you want to see written on your medical chart as you are wheeled into the delivery room. “Overt racism…from health care professionals can lead to pregnant black women receiving…often worse care…which can lead to…complications. Patients have reported not being believed, being ignored and having health care professionals dismiss their symptoms.” You go to your doctor not because you want to, but because you have too. He can’t visually see your pain, but the pain is there, and it is real.
Peter Schafer, director, Center for Health Policy Program, NY Academy of Medicine, graciously provided me with the transcripts of the 2018 NY Maternal Mortality Summit.
Speaker Dr. Howard Zucker, NYC Health Commissioner: “55 black women die from complications for [every] 100,000 black babies born.” These 55 women should be cradling their babies instead of lying in a coffin. Zucker continued, “All NY women should have access to quality care…before, during and after pregnancy regardless of race.”
Speaker Elizabeth Howell, MD, Mt. Sinai Icahn School of Medicine: “African American women mortality rates are actually higher than in some countries…in sub-Sahara Africa.”
Planned Parenthood alludes to the fact that black women fortunately, are able to access treatment that will in fact ensure healthy pregnancies via Medicaid. Encouraging news? Wait, there’s a catch. It’s shocking that there are states in America where elected officials adamantly refuse to expand this federal program. These women thereupon fall into a “’coverage gap’ and don’t have health care coverage that contributes to a healthy pregnancy.” They are not walking around with that official government-issued card safely tucked in their wallets. And hunting for a doctor who won’t unceremoniously slam the door in your face is time- consuming and fraught with anxiety, thus interfering with the joy of this special time in your life.
Speaker Dr. George Askew, Deputy Commissioner for Health, NYC Dept. of Health: “We have to remember that for every number there’s a person…there’s a family…the numbers are bad in themselves; the individual outcome for families is worse.” These figures are amassed from years and years of comprehensive hospital death records and are just black and white numbers; we don’t see the faces of black women behind the numbers—women who used to be vibrant breathing women who are now mourned by their loved ones. “The day-to-day impact of structured racism is chronic stress…which markedly increases the risk of maternal mortality.” We don’t often recognize the correlation between stress levels attacking the body and how it precipitates the onset of serious medical disorders.
Speaker Dr. Joia Crear-Perry, president, National Birth Equity, paints an analogy between a lupus patient and racism: “Because you have lupus your body is constantly fighting…trying to survive…being black in American is like having lupus.” Another troubling issue is the existence of black servicing hospitals. ”Instead of questioning why these…hospitals are so bad your question is why do we have something named black serving hospitals in 2018 and white serving hospitals….I have patients…because she’s not screaming…she is not in pain, we don’t acknowledge our pain in the same way; that doesn’t mean we don’t hurt…physicians believe that black patients can tolerate pain differently ; as if there is this image of genetic blackness….some of the most segregated places in the world are hospitals and patient waiting rooms…next time you’re sitting in your doctor’s waiting room look around and see how many people look like you.”
Speaker Chanel Porcia-Albert, founder, Ancient Song Doula Services, “We have…racism…it’s not a coincidence that some of the most poorly resourced hospitals are in communities of color. That is because of structural racism…there is inadequate bias training in the population of health care workers. Black pregnant women face substandard medical treatment and unnecessary surgery.”
We are known throughout the developed and undeveloped nations in the global community as a nation that allocates an exorbitant amount of expenditures to embark on medical research initiatives, our medical schools and hospitals are the envy of the world- yet minority pregnant women are dying.
As per Planned Parenthood, “We need to expand Medicaid… is instrumental in preventing black women from falling into the ‘coverage gap’ and to make sure they can receive necessary services to promote a healthy pregnancy…Medicaid [covers] vital prenatal care and health screening [to detect] possible preexisting conditions that could complicate pregnancy such as high blood pressure and diabetes. Instead of helping expand Medicaid which can help close the devastating racial gap in maternal health outcomes the Trump Pence administration is…working to impose restrictions on enrollment.”
Porchio-Albert, founder, Ancient Song Doula Services, “We have …racism…It’s not a coincidence that some of the most poorly resourced hospitals are in communities of color…that’s because of structural racism. There is inadequate bias training in the populations of health care workers. Black pregnant women face substandard medical treatment and unnecessary surgery.” This unrelenting internalization of stress precipitated by racism contributes to medical conditions that in turn contribute to life threatening complications—racism is the root of it all.
Patients are checking into hospitals to make appointments for a plethora of conditions from a slight cold to serious conditions that necessitate surgery; the outcome obviously cannot always be successful, but the outcomes are too often not successful if you are black.
Questions, Questions and more Questions
Why is there a disproportionate number of black pregnant women dying in childbirth? Why are medical practitioners manifesting unconscious racism? Why are black women facing roadblocks to accessing Medicaid? Why are black women treated at underperforming hospitals?
It is imperative that this shocking truism whereby chronic stress precipitated by a lifetime of racism attacking the bodies of pregnant women of color, resulting in life threatening complications that attack their bodies, rich or poor, educated or uneducated—is finally out in the open. Hopefully, these statistics will change so that pregnant black women will no longer be robbed of the opportunity of enjoying what should be the happiest moment in their lives.