I absolutely hate the question “what is your biggest fear?” Normally, my answer is that I have already lived through my biggest fear. Someone very near and dear to my heart passed away and it broke me. However, the truth is I have another fear that I hardly speak about. You see, I identify as a Black woman. I am in my mid-30s and I have yet to have my first child. I fear that I will pass away from pregnancy complications. Every time I try to visualize what would potentially be an exciting time in my life I am also filled with anxiety.
Even though the United States is a well-developed nation, we still have the highest maternal mortality rate in the developed world.[1] Childbirth is even more dangerous for Black women. As recent as 2021, the maternal mortality rate for Black women was 2.6 times as much as the rate for White women.[2]
That’s me. I am a Black Woman. I know what you are thinking. You see the letters behind my name and feel like my education and current social status protect me. The truth is in spite of all that, black women with the highest levels of educational attainment have worse birth outcomes than white women with the lowest levels of educational attainment.[3] I am an epidemiologist so I can’t help but think about Shalon Irving who was an epidemiologist at the CDC. She passed away after her symptoms of out-of-control blood pressure following the birth of her daughter were dismissed by medical professionals. I almost lost a really close friend after she hemorrhaged out following the birth of her son. I mention these stories because as much as I love numbers and data it is imperative that we remember the data represent real people, with real stories. It is also easy to use the number to place the blame on the victims instead of the inadequacies in the system.
The health consequences of racial discrimination are produced through structural, institutional, and individual processes. Implicit attitudes influence provider behavior and treatment choices that are presented.1 For example, research shows that residents and medical students still believe that the black body is biologically different. This idea results in the belief that black patients feel less pain, have less sensitive nerve endings, and have thicker skin.1 Additionally, it is often ignored that the father of gynecology, J. Marion Sims, performed experimental vaginal surgeries on unanesthetized enslaved women.[4]
Even though the data demonstrates the severity of the situation there is a part of me that is filled with hope for the future, my future, the future of Black women. There has been a rise in the availability of doulas, who often provide emotional support and advocate for their patients with medical professionals.[5] Doulas are often referred to as “the one who mother’s the mother.” As a future birthing Black woman I find so much hope in the concept of a doula. Having someone who’s main concern is the safety, care, and wishes of the mother is imperative in a system that regularly dismisses our concerns. Black women are stepping up to help each other (as it seems we always have to do because if we wait on others we get overlooked, but that’s another post for another time).
Layo George created the platform, a free resource, Wolomi. Wolomi is a supportive community that helps birthing people explore the healthcare system.[6] In DC, an area near where I am located, Mamatoto Village offers accessible prenatal support services to Black women and their families.[7] So yes, I may be filled with anxiety every time I read data on the current status of maternal mortality in the United States but also I am filled with hope because a shift in the trajectory of the health outcome of Black women is on the horizon.
Written By:
Zenobia Bryant, PhD
Founder & CEO of Black Health Black Wealth, LLC.
IG: @blackhealthblackwealth
[1] Saluja B., & Bryant, Z. (2021). How implicit bias contributes to racial disparities in maternal morbidity and mortality in the United States. Journal of Women’s Medicine, 30(2), 270-273 [2] Hoyert, DL. Maternal mortality rates in the United States, 2021. NCHS Health E-Stats. 2023. DOI: https://dx.doi.org/10.15620/cdc:124678 [3] Davis, D. (2019). Obstetric racism: The racial politics of pregnancy, labor, and birthing. Medical Anthropology, 38(7), 506 – 573. [4] Reproductive Injustice by Dana-Ain Davis [5] https://www.virginiamercury.com/2021/11/22/in-a-push-to-reduce-maternal-mortality-virginia-is-expanding-access-to-doulas/ [6] https://afrotech.com/layo-george-wolomi-maternal-health?item=2 [7] https://www.mamatotovillage.org/about-us/