Racism in health: the roots of the US Black maternal mortality crisis
Aug 10, 2023
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Leading academics and experts discuss the racism in the US healthcare system that contributes to the Black maternal mortality crisis. They explore the historical links between slavery and gynaecology, the erasure of Black midwives, and the potential impact of overturning Roe v. Wade. The podcast also delves into the mistreatment and health disparities faced by people of color, the racial disparities in maternal care and mortality, and the need to challenge the medical system and address racial disparities in healthcare.
Racial disparities in maternal healthcare in the US are fueled by a lack of access to abortion clinics and obstetricians, particularly affecting black pregnant individuals.
The history of gynecology in the US is rooted in racism, with experimental surgeries conducted on enslaved black women without anesthesia, perpetuating the belief that black people do not feel pain and impacting treatment today.
Deep dives
Impact of Abortion Restrictions on Black Pregnant People
The abortion laws in the United States have a disproportionate impact on black pregnant people. With the overturning of Roe v. Wade, black women face even greater challenges in accessing reproductive care. The statistic that only 1% of abortions are performed for health reasons is often used to dismiss the need for abortion access, but this ignores the fact that black women in particular often face significant health risks during pregnancy. The lack of access to obstetricians in many areas of Georgia further exacerbates the problem, forcing pregnant people to travel long distances for care.
Historical Links Between Racism and Gynecology
The history of gynecology in the United States is intertwined with racism and the control of black women's bodies. Marion Sims, often referred to as the 'father of gynecology,' conducted experimental surgeries on enslaved black women without anesthesia. The belief that black people do not feel pain contributed to the justification of these horrific procedures. This belief persisted in medical circles and continues to impact the treatment of black patients today, with studies showing that black individuals are less likely to receive adequate pain medication.
Systemic Failure in Maternal Healthcare
The maternal healthcare system in the United States has failed black women. Discrimination and racism within the healthcare system contribute to poorer health outcomes for black pregnant people. Mistreatment during childbirth, such as shouting, privacy violations, and delayed responses to requests for help, is more prevalent for women of color. Black women also face higher rates of unnecessary C-sections and experience higher rates of complications. Socioeconomic factors, such as limited access to insurance and healthcare deserts, further contribute to disparities in maternal care.
Eradication of Black Midwives and Reproductive Healthcare Disparities
The erasure of black midwives in the United States is a testament to the systemic racism within reproductive healthcare. Black midwives were highly skilled and successful in providing care for women, but they were vilified and portrayed as uneducated, dirty, and dangerous by white doctors seeking to establish their own dominance in the field. The resulting eradication of black midwives contributed to the current disparities in maternal healthcare. The integration of midwifery-led care has been shown to reduce maternal mortality rates in other countries, highlighting the need for increased access to midwives in the United States.
A perfect storm of factors has led to huge racial disparities in maternal healthcare. In the USA, as abortion clinics continue to close, this inequity is projected to widen. In this podcast from Nature and ScientificAmerican, we hear from leading academics unpacking the racism at the heart of the system. From the historical links between slavery and gynaecology to the systematic erasure of America’s Black midwives. What is behind the Black maternal mortality crisis, and what needs to change?