Pressure of a Black Mother

Pregnancy complications happen more frequently than most people think. It has been

found that women of color, specifically African American women, have a disparagingly larger

amount of complications and death(mother and child) during birth and pregnancy.

Although it is said that underlying health problems in African American women cause such a

disparity in mortality rates and complications, I believe that racism is a huge part of the issue

minority women face while pregnant because of the mortality rates of mothers and infants,

differences of health care in comparing countries, first hand accounts of discrimination, and

scholarly reports.

The history of disparities between white mothers and black women hasn’t changed much

from the slavery times. The deep origins of these patterns of maternal and infant health

inequality lie in the commodification of the childbearing of enslaved Black women and the

investment of physicians in serving the interests of slave owners. In the growth of the field, even

such medical specializations, such as obstetrics and gynecology, owe a debt to enslaved women

who were experimental subjects. According to Deirdre Owens, a researcher studying the issues

that can occur when minorities and patients with mental illness give birth,“Infant mortality in

plantation settings remained high, however. In the South, an estimated 50% of enslaved infants

were stillborn or died within the first year of life” (Owens). Through time the discrepancies

between the lifespan of both the mothers and children of color during the slave era can be seen as

the roots of the problem in some arguments. Black women were seen as specimens/objects and

not actual people with rights. Women of color no matter the era have faced issues pertaining to

the medical field.

 The hardships African American women face emotionally and physically during

pregnancy and labor are significant and not always recognized. Women of color face almost

double the amount of pressure than someone of Caucasian descent. A researcher by the name of

Emily Petersen talked about the statistics of birth complications in general, “Non-Hispanic black

and non-Hispanic American Indian/American Native women experienced higher

Pregnancy-Related Mortality Rate (PRMR, 40.8 and 29.7, respectively) than all other

racial/ethnic populations. Petersen goes into detail about how the main problem is that even

though there are approximately 700 deaths of women as a result of birth/pregnancy

complications, non-hispanic African Americans and Native Americans were the highest. This

was 3.2 and 2.3 times higher than the PRMR for white women”(Petersen). It is often argued that

the preexisting health conditions, like heart problems, diabetes and obesity, of these women are

the leading factor of issues, but that leads back to racism too. There is a history of racism in the

health care system when it pertains to minorities especially with a focus on African Americans.

The amount of women who face issues is disparagingly high and disappointing. In the

past government officials made a plan to decrease the difference in mortality and have overall

rates to go down, yet they’ve only increased over time. Petersen discusses the exact racial

comparisons that can be made because of stated statistics, “During 2007–2016, a total of 6,765

pregnancy-related deaths occurred in the United States (PRMR = 16.7 per 100,000 births).

PRMRs were highest among black (40.8) and AI/AN (29.7) women”. Based on numbers alone

the distinctive difference is in the care of African American women. The amount of people is

staggering but the amount of issues pregnant women of color can face because of discrimination

faced during the process is even worse.

 Discrimination is an experience that does not occur equally through race, gender, or

socio-economic status, which may lead to differences between the amount of stress and

depression a mother will face. While not all research has found a correlation between

racial/ethnic discrimination when pertaining to health care and the health system, (Broman,

1996), literature reviews indicate that such discrimination is related to poorer physical and

mental health. Jamila Taylor who talked about the overwhelming mental conditions that a

mother can have brought out the point that, “Perinatal mood disorders—including postpartum

depression—can affect any woman, yet women of color often face life circumstances that

increase their likelihood of experiencing perinatal mood disorders”(Taylor). Women of color are

more likely to face alarming psychological conditions that can have more severe consequences in

the long run. One problem that can surface is the amount of undocumented cases since people

don’t always recognize the signs, and the severity each individual case can have.

The added pressure of mental/psychological issues to the malpractice doctors often give

to African American women can often be a deciding factor of the life of both the mother and

child later on. The process, weathering, is when stressors and the cumulative experience of

racism and sexism, especially during sensitive developmental periods, trigger a chain of

biological processes. “When women of color do access mental health care, the services and

supports they find are often woefully inadequate. Women of color who have experienced

postpartum depression report seeing health professionals yet remain undiagnosed, even after

multiple visits” (Taylor). Even though there is access to “acceptable” health care pertaining to

the issue discussed above, they aren’t very adequate and usually are “half-mast”, below the top

of what’s required. Mental health services must be culturally aware and culturally appropriate

for women of color. In order to help them more readily understand the symptoms associated with
mood disorders, large-scale educational campaigns representing the living experiences of women

of color are also required.

When going through the recent uproar of social equality, the discrimmination for births is

apparent. Though many will focus on the prejudice towards black males, women of color face

the same issues and maternal care is one area of them. The painting done by Titus Kaphar,

represents the issue of injustice in modern society but also of the unfairness African American

women face during birth. The pictures depicts a sorrowful mother holding a child but the child is

cut out of the painting. This can symbolize the higher rate of infant mortality in the black

communities. While the maternal mortality rate is high, the pressing issue of the high rate of

infant mortality among African Americans and significant disparities between racial groups also

remain, despite overall decreases in infant mortality in the U.S. and much recent research and

public interest dedicated to the connection between race and infant mortality. “This social

problem is even more pressing when we look at the widening ratio of infant mortality rates
between racial groups. The African-American to Anglo infant mortality ratios were 1.6 in 1950,

1.9 in 1960, 2.0 in 1980, and about 2.2 by 1989” (Hummer). The amount of times

malpractice/negligence has happened can definitely be sometimes attributed to racism and the

old beliefs during slave times. One example of malpractice/negligence is the first hand account

of Tressie Cottom. Cotton was ignored and handled incorrectly on more than two occasions.

“When my butt hurt, the doctors and nurses did not read that as a competent

interpretation of contractions and so no one addressed my labor pains for over three days.

At every step of the process of having what I would learn later was a fairly typical

pregnancy for a black woman in the United States, I was rendered an incompetent subject

with exceptional needs that fell beyond the scope of reasonable healthcare.”

The amount of bias that occurred because of race resulted in a large amount of mental anguish

for Cottom. An opposing side would be that racism isn’t a main factor but the hyper focus on the

infants is.

There is a broadcast between David Green and Renee Montagne that talks about the

extreme focus hospitals have on the infants and not the mothers. It goes into discussion of the

different protocols that these hospitals have for infants but not the maternal ward. “We

discovered hospitals, even those with intensive care units for newborns, woefully unprepared for

a maternal emergency”(“Focus on Infants'') and “We found that in the U.S., some doctors

entering the growing specialty of maternal fetal medicine were able to complete that training

without ever spending time in a labor delivery unit. And we heard stories of hundreds of women

who have died” both express the concern in maternal care(“Focus on infants”). Though this

points to racism not being that large of a part in the discrimination, the distinctive differencce in

issues involving infants of color is still large.

 With the issue of hospitals not having enough protocols for maternal emergencies, it

could be attested that the lack of a large enough budget could be a factor of racism faced. The

CDC estimates that 60% or more of the deaths could be prevented by improving access to quality

healthcare. The responsibility of the government and the unfairness in health care goes hand in

hand. “Growing research indicates that quality of healthcare, from preconception through

postpartum care, may be a critical lever for improving outcomes for racial and ethnic minority

women. This article reviews racial and ethnic disparities in severe maternal morbidities and

mortality, underlying drivers of these disparities, and potential levers to reduce their occurrence”

(Howell). The discussion of an increase in better healthcare might help the situation.

The discrimination and racism is deeply embedded in some of the systems of today. One

way that we could work on and improve the problems is more discussion. The National Birth

Equity Collaborative (NBEC) and the Sista Midwife Productions and the Sista Midwife

Directory are both two organizations that are fighting for and working with black mothers. Both

are working towards lowering the frequency of negligence and mortality rates of African

American women during pregnancies. Oftentimes the smaller notions or less noticed effects of

racism aren’t recognized and talked about, which can cause large amounts of problems. If the

discrepancies between African American maternal care and Caucasian maternal care is talked

about more and brought to the attention of more important people it might help. To reduce racial

and ethnic inequalities in extreme maternal morbidity and mortality rates, a holistic approach to

quality enhancement across the care continuum (from preconception to postpartum and

inter-pregnancy care) is required.

While underlying health conditions in African American women can cause a gap in

mortality rates and complications, because of distinct discrepancies in mortality rates, disparities
in other countries, personal experiences, and academic studies, it can be believed that prejudice

is a huge part of the issues faced by minority women while pregnant. There are substantial racial

and ethnic disparities in maternal results in the United States, and inequalities need to be reduced

urgently. The role that systemic racism plays in creating these inequalities is recognized by a

growing body of research. A multipronged approach to minimizing their incidence recognizines

the nuanced existence of racial and ethnic differences in extreme maternal morbidity and

mortality rates. Racism is alarmingly still a part of day to day lives right now, but one thing that

needs to be fought for during these crucial times is equal health care in all situations.
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Focus On Infants During Childbirth Leaves U.S. Moms In Danger [Radio broadcast transcript].
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