Maya Wiley, J. D.

Dying To Be Mothers: Why We Need to Look At Race to Save Black Lives

Maya Wiley, J.D.

President & CEO, The Leadership Conference on Civil & Human Rights

Dr. James Marion Sims, a 19th century surgeon and slave owner, was considered the father of gynecology and even served as the president of the American Medical Association (Holland, 2017). His notoriety earned by dehumanizing experimentation on enslaved Black women, without anesthesia, under the racist assumption that Black people did not feel pain. Nearly 200 years later, the dehumanization and disregard for Black women's pain and well-being that were prevalent in Sims' era continue in subtle and not-so-subtle ways in today's health care practices.

In Brooklyn, NY, a 30-year-old Black woman, Christine Fields, died after giving birth by cesarean section (Goldstein, 2024). Christine Fields bled to death in the hours following the surgery. The surgical team appears to have failed to alert other medical staff to complications after the surgery. Doulas, birth support professionals, often point to ignoring Black women’s reports of pain, or failing to take seriously the complications and conditions that point to dangers to health and life that can be addressed, like preeclampsia. An investigation at the same hospital found that an anesthesiologist botched epidurals that led to the death of at least two Black mothers.

April 11-17 was Black Maternal Health Week to raise awareness of this national and preventable shame. What preceded it was North Carolina Rep. Greg Murphy’s introduction of a bill to prohibit medical schools teaching the history of racism in obstetrics and gynecology, like that of Dr. James Sims (Ellis, 2024). The bill, disingenuously entitled “Embracing anti-Discrimination, Unbiased Curricula and Advancing Truth in Education” or EDUCATE, is about slapping a gag on the mouths of educators who dare to tell the truth about our history to help inform our health care. This “war on woke” is a war that tries to prevent this nation from solving preventable deaths.

Black women are dying needlessly because we want to be mothers. As the Center for Disease Control and Prevention (CDC) states, most, more than 80 percent, of pregnancy related deaths are preventable, and as Black women, we are three times more likely to die from pregnancy related causes than White women (2024). In some places the rates are significantly higher. The rates are not only high, they have been rising, more than doubling since 2000. In San Francisco, for example, Black women are five out of 10 reported maternal deaths (SF Black Infant Health Program, n.d.). That is half of all deaths. In New York City, Black maternal deaths are nine times that of White women. This is not just a race-neutral poverty problem. Black women die at higher rates despite income levels. The wealthiest Black woman in California, for example, is at a higher risk of maternal mortality than the least wealthy White woman (Winny & Bervell, 2023).

Let us be clear. No pregnant woman should fear death because she wants to have a baby. But there is no question that prevention is not happening for Black women, or we would not see these despicably high rates at all. When the CDC points to “implicit bias” and “structural racism” along with “social determinants of health,” it is calling our attention to the fact that we must look at the conditions of Black disparities to address them. In other words, color blindness can be a death sentence. The curricula under attack by proposed legislation seeking to silence medical education to train physicians to understand what they may not understand can literally deny Black women life-saving fair and appropriate health care.

We know how to save Black women’s lives (Winny & Bervell, 2023). Expanding Medicaid for higher rates of insurance is critical to accessing prenatal and postpartum care. Paid leave after childbirth is also critical. Half of maternal deaths happen in the first year after childbirth. Allowing time to heal and get healthy matters for Black women. And having access to a provider that shares the patient’s racial identity and can provide culturally competent care also matters (Lacy & Fung, 2023). If we ignore that doctors need to be more diverse and better trained to understand the serious health needs of Black women, rather than ignoring their pain, their complaints, and their health care, we will continue to be a rich nation with shocking rates of maternal deaths of Black women.

And let not forget having the right to full access to all the medical interventions available to save our lives. Abortion is medical intervention that, in too many states, is being banned or curtailed even when in a medical emergency (Snipe, 2024). Federal law requires access to emergency health care, and the Supreme Court is considering right now whether that requires emergency abortions or not. Black pregnant women are more likely to need an emergency abortion.

Black women have real power to protect our right to be mothers without risking our lives and demanding that we have control over our bodies and our health care. That power - the power to require that this country and its lawmakers and medical professionals learn from the past and pay attention to us as Black women - is a vote away. When we demand that anyone who wants to serve us, agree to see us, and vote accordingly, we can be authors of our own healthy future.

References

Centers for Disease Control and Prevention. (2024, April 8). Working Together to Reduce Black Maternal Mortality. Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/features/maternal-mortality/index.html

Ellis, N. T. (2024, May 1). A Lawmaker Proposed a Bill That Would Ban DEI in Medical Schools. Doctors Say It Could Roll Back Progress Toward Improving Black Maternal Health. CNN.

https://www.cnn.com/2024/04/17/us/dei-medical-schools-black-maternal-health-reaj/index.html

Goldstein, J. (2024, January 14). Investigators Find Hospital Error Caused Mother’s Death in Brooklyn. The New York Times. https://www.nytimes.com/2024/01/14/nyregion/christine-fields-death-brooklyn-hospital.html

Holland, B. (2017, August 29). The “Father of Modern Gynecology” Performed Shocking Experiments on Enslaved Women. History.com. https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves

Lacy, L., & Fung, L. (2023, May 17). Addressing the Black Maternal Health Crisis Requires Better Support for Black Health Care Workers. Urban Institute. https://www.urban.org/urban-wire/addressing-black-maternal-health-crisis-requires-better-support-black-health-care

SF Black Infant Health Program. (n.d.). Maternal and Infant Mortality - Black Infant Health Program (San Francisco). SF Black Infant Health Program. https://www.sfbihp.org/health-topics/maternal-and-infant-mortality/

Snipe, M. (2024, April 24). What Comes Next In The Battle For Emergency Abortion Care Access. Yahoo! News. https://www.yahoo.com/news/comes-next-battle-emergency-abortion-130000759.html

Winny, A., & Bervell, R. (2023, May 12). Solving the Black Maternal Health Crisis. Johns Hopkins Bloomberg School of Public Health. https://publichealth.jhu.edu/2023/solving-the-black-maternal-health-crisis