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In the United States “Black women are three times more likely than White women to die from a pregnancy-related cause” with “most of the maternal deaths being preventable” according to the Center for Disease Control and Prevention. And unlike widespread belief, these staggering statistics span all education and economic levels. The “wealthiest Black woman in California is at higher risk for maternal mortality than the least wealthy White woman.” What is behind this maternal health crisis?
Causes for Pregnancy-Related Health Disparities
There are a few factors that contribute to these health disparities between Black and White women. Here are a few:
Underlying Chronic Conditions
According to Johns Hopkins School of Public Health, “Black birthing people are more likely to experience life-threatening conditions like preeclampsia, postpartum hemorrhage, and blood clots.” A predisposition to sickle cell disease and other family history or genetics may play a role, but other factors must be considered as well.
Structural Racism
Black people are more likely to suffer with chronic health conditions such as high blood pressure, diabetes, obesity, or chronic kidney disease because of the systems that prevent Black people from accessing quality care. As a result of structural racism, Black people are less likely to be admitted to the hospital for a chronic condition even when reporting severe pain or problems.
Implicit Bias in the Medical Field
Due to structural racism in The United States, there was a period throughout history where the idea that Black patients have a higher pain-tolerance than White patients was reinforced for medical students. Purporting that Black people have “thicker skin and less-sensitive nerve endings” is unfortunately not a thing of the past. In a study conducted as recently as 2016 in the Proceedings of the National Academies of Science “more than 40% of first and second-year medical students believed that “Black people’s nerve endings are less sensitive than white people’s, Black people’s skin is thicker than white people’s, and that Black people’s blood coagulates more quickly than white people’s.”
Leading Cause for Black Maternal Death
Currently the leading cause for Black maternal death is Preeclampsia or Eclampsia. These disorders are pregnancy-related high blood pressure disorders. According to the National Insititute of Child Health and Human Development, “In preeclampsia, the mother’s high blood pressure reduces the blood supply to the fetus, which may get less oxygen and fewer nutrients. Eclampsia is when pregnant women with preeclampsia develop seizures or coma.” Medical professionals are still trying to figure out the causes for these conditions and ways to better treat them. Unfortunately, women suffering from preeclampsia are at “increased risk for organ damage or failure, preterm birth, pregnancy loss, and stroke. Eclampsia means a woman is having seizures, which may lead to coma or death.”
Johns Hopkins reports, “advocates are pushing forward solutions from multiple angles, including reforming policy, health systems and medical education, and bolstering community-based organizations that advocate for better care and resources for Black moms.”
What Pregnant Black People Can Do
Although the system is quite imperfect, there are things that pregnant Black people can do to help themselves through the pregnancy process. Some recommendations include:
- Pregnant people can bring allies and friends to their appointments to help advocate for them. These folks can also serve as witnesses to any mistreatment or misinformation.
- Watch out for urgent maternal warning signs and seek medical attention immediately if you experience headache, swelling of the hands or face, difficulty breathing, heavy vaginal bleeding, or overwhelming fatigue.
- Gather your pregnancy and family history and make this information available for your medical provider.
- Find support groups or other informational resources to best prepare yourself before, during and after pregnancy.
What Healthcare Providers Can Do
Healthcare providers notoriously bring implicit bias into the examination room. Here are some things that medical providers can be doing to better advocate for and best treat all their patients:
- Address patients concerns with respect and inquiry.
- Help patients by educating them on common health concerns especially as it relates to pregnancy.
- Leave time and space for patients to ask critical health questions and to advocate for their needs and current conditions.
- Help patients manage chronic conditions or conditions that may arise during pregnancy like hypertension, diabetes, or depression.
- Recognize and work to eliminate unconscious bias in the office and examination rooms.
- Treat all patients with the exact same quality of care, respect, and patience.
What We Can Do
States, communities, and individuals can do many things to support the growth of the research field around Black maternal health, as well as advocate for Black women’s rights within the medical field by:
- Support the “enhancement of reviews and surveillance in the medical field to eliminate maternal mortality.”
- Address the social factors that contribute to the maternal health crisis including homelessness, lack of access to transportation, food insecurity, addiction, violence, and inequality. To learn more about some of these factors, check out this other blog post.
The Black maternal health crisis is just that, a crisis. There are ways that all of us can step up to create a safer world for Black women everywhere. Systemic barriers no longer need to serve as a platform for unnecessary disease, suffering and death. It starts with us unpacking our unconscious bias together and recognizing that we, as people, can foster a better world.
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