Questions to Consider
- Ware introduces her topic through a story. How does this introduction utilize pathos to connect with the audience?
- Ware recognizes the complexity of her topic by offering solutions that address various parts of the system. How does offering multiple solutions strengthen her argument? How are these solutions related to each other? How does Ware organize presenting her solutions in a logical manner?
- As evidence for her argument, Ware uses a variety of different types of sources from academic journals, news stories, and podcasts. What are some of the affordances of using different types of sources? How does Ware use evidence from these sources to support her in establishing the problem and proposing a solution?
Examining the Systemic Mistreatment of Black Mothers and Infants
Like many Black mothers, Taylor Tenneson felt ignored throughout her pregnancy. After suffering severe pain and excessive bleeding, she went to the hospital. Tenneson was surprised at how the doctors treated her. They would not “listen to the pain that [she] was going through” (Lucy). Eventually, she lost her baby to preventable complications and almost lost her life. This story may seem like an isolated event due to the actions of negligent doctors and dismissed concerns, but it is a story that shows the pattern of mistreatment of Black mothers and infants in the American healthcare system. This problem in the community of Black women across the nation isn’t limited to mothers. It creates anxieties for all Black women going into healthcare spaces because we have seen and heard the way we are treated, myself included. I know that our concerns are often dismissed and it makes me more reluctant to share information. This story is an example of the maternal health crisis the United States has faced for over two decades. This public health crisis is present across America, but it is exacerbated within the Black community, specifically Black mothers and infants. Maternal mortality rates for black mothers are three times that of white women and they are continuing to increase (Black Women’s Maternal Mortality). From prenatal care to delivery, Black mothers are constantly mistreated throughout their pregnancies. This problem requires a multifaceted approach, including action from patients, healthcare professionals, and bystanders. Healthcare professionals must recognize the history of systemic racism that plays into the high maternal mortality rates for Black women and infants in order to mitigate the complications and deaths of these women. The effects of the maternal health crisis can be alleviated through healthcare and medical education reform and an increase in advocacy organizations for black women.
The issue of Black maternal health is one derived from a lengthy history of systemic racism in America. The healthcare industry as a whole is rooted in slavery, but gynecology and obstetrics were specifically created through the exploitation and commodification of Black bodies. The two main issues that led to this pattern of mistreatment in healthcare are the involuntary sacrifices Black women slaves made that advanced reproductive science and sustained slavery and their fundamental function as midwives (Thompson 5). From the early days of slavery in the Americas, those with medical training were taught to serve the interests of slave owners instead of slaves. The main priority of the White doctors employed by slave owners was to assess the “reproductive soundness” of the slaves and determine their value (Owens). It was evident that these doctors catered to their employers as their job was to ensure Black women slaves were able to reproduce. Along with assessing their worth, White doctors used Black bodies to advance reproductive medicine. They had a strange fascination with Black women’s bodies which led to the myth that Black women had “medical superbodies” and could not feel pain (Thompson 6). This was meant to dehumanize the Black bodies White people were clearly dependent on. This notion led to the wide use of Black women being used as teaching material for medical schools and others. They were involuntarily used as cadavers, medical subjects, and surgery patients. The widely known Cesarean section surgery, colloquially known as a C-section, was developed by repeated experimentation on enslaved Black women. While this exploitation provided an advance in reproductive medicine, it has been detrimental to the lives of Black women to this day.
Secondarily, Black women as midwives play a large role in the current state of Black maternal health in America. Midwives took care of women “during pregnancy, labor, and the postpartum period, as well as care of the newborn” (Thompson 7). As a result of slavery, many Black women were midwives, employed by Black and White mothers. They helped with most births with the exception of complicated cases for White doctors. Their relationship with doctors remained beneficial until the evolution of modern medicine. As a way to increase business and decrease competition, White doctors spread false information about midwives being “dirty, illiterate, ignorant, and irresponsible,” compared to hospital physicians who were depicted as “clean . . . [and] educated.” (Thompson 7). They also levied false accusations of malpractice and incompetence against the Black midwives. Despite their deception, these campaigns succeeded in marginalizing Black midwives, effectively eliminating affordable and effective maternal healthcare for the Black communities. The marginalization of midwives, especially Black midwives, paired with the exploitation of Black women to advance medicine, along with other instances of systemic racism, have led to the current state of Black maternal health in the United States.
The United States is in a state of crisis regarding maternal health. For the last two decades, the maternal mortality rate has been increasing. This rate is surprisingly high compared to other highly developed and wealthy nations in the world. As the world’s maternal mortality rate has gone down 44%, the rate in the United States has gone up 16.7%, nearing countries like Afghanistan and Sudan. This signals a huge problem within the maternal healthcare industry. A large part of the problem is the Black maternal health crisis. Compared to their White counterparts, Black women are three times more likely to die throughout their pregnancy. Historical demographers estimate that, in 1850, the infant mortality rate for enslaved infants was 1.6 times higher than that of White infants. The most recent infant mortality rate for non-Hispanic Black infants is 2.3 times higher than mortality among non-Hispanic White babies (Owens). Centuries later, the infant mortality has not improved, but worsened. Even those with access to more resources have suffered mistreatment at the hands of healthcare professionals. For example, prolific and influential tennis player, Serena Williams faced mistreatment by healthcare professionals during the delivery of her child. Despite voicing her concerns to her doctor, Williams was ignored when she complained of blood clots, asking for a CT to confirm. Eventually her doctors performed an ultrasound, delaying treatment and putting Williams’s life further in danger (Thompson 14). If Serena Williams, an Olympic tennis player, does not receive adequate maternal healthcare despite her status and wealth, imagine the treatment of people who lack her socioeconomic status. This example proves that the mistreatment of Black mothers in healthcare surpasses socioeconomic status; it is all-encompassing. This means Black mothers and infants are dying unnecessarily, if their counterparts are surviving similar conditions. In fact, the CDC reports that 4 out 5 pregnancy-related deaths are preventable (The Black Maternal Mortality Crisis). If these deaths are preventable, what is causing them?
While most deaths related to pregnancy are proven to be preventable, they still occur at alarming rates. The deaths are due to a multitude of causes, but most prevalently caused by the effects of systemic racism in the healthcare system. Black women were exploited and dehumanized by the healthcare system in order to further medicine and sustain slavery. As Thompson states in his analysis, “the side effects of normalizing these beliefs [were] the harmful and medically incorrect perceptions about Black women, such as their ability to withstand pain and their inability to accurately assert agency over their bodies.” (Thompson 6). Black mothers are consistently mistreated and ignored in a place they should be cared for, creating a mistrust of the healthcare system as a whole. The medical mistrust present due to actions of healthcare professionals coupled with the history of mistreatment of Black people in healthcare develops a reluctance to seek help from healthcare professionals. As a result, their health problems build up until they must be treated, which leads to bigger health problems creating worse outcomes.
This problem requires a multifaceted approach to a solution, including action from patients, healthcare professionals, and bystanders. The effects of the maternal health crisis can be alleviated through healthcare and medical education reform. Since the entire issue is rooted in systemic racism, the healthcare system must be rehabilitated. The healthcare system as a whole must recognize how they were built within a system of racism, intent on depriving Black patients of the care they deserve. Once they acknowledge the fact that they were built to serve White patients, the system can begin to reform its ways. After this acknowledgment, hospitals must work to combat the structural racism ingrained into their institutions. The reform of the healthcare system must be coupled with that of medical schools. To combat the racial and ethnic profiling often found in clinical contexts resulting in improper treatment and medical errors, cultural competency is key (Bolnick). Cultural competency should be taught in medical schools and reiterated in hospitals. Providing culturally competent representatives within hospitals can ensure patients are understood and taken care of. Hospitals must also provide training for their healthcare professionals to eliminate withstanding bias, implicit or explicit, and to listen to their patients. For instance, any biases regarding Black patients’ ability to withstand pain must be addressed. Many doctors believe that Black women patients exaggerate or misinterpret their pain. This has been tied to “inequities in how pain medication is dispensed in hospital emergency rooms”, leading to countless deaths of Black mothers (Bolnick). Reforming medical education is key to rehabilitating the healthcare system, which leads to less mistreatment of Black mothers in healthcare.
Medical education and healthcare system reform will not solve the mistreatment of Black mothers alone. However, the addition of the promotion of advocacy groups and the use of doulas will significantly mitigate the mistreatment and decrease the Black maternal and infant mortality rate. A large part of this issue is the dismissal of Black mothers’ concerns and pain throughout their pregnancy. According to Karen Sheddield-Sbdullah, a nurse-midwife and professor of nursing:
One of the biggest pieces of it is that we can do a better job of listening to Black women and what they are saying in terms of their own lived experience as they navigate the health care system and really how they’re interfacing with the health care system in ways that are not optimal and truthfully biased (Scott).
So many deaths could be prevented if doctors listened to their patients and considered their concerns and pain. Black mothers may not know how to voice their concerns and what the right questions are to ask. This can be solved with the help of advocacy groups for Black mothers. Groups like Cradle Cincinnati and Queens Village assist in advocating for Black mothers, whether finding doulas for them or educating them on the risks they face as pregnant Black women. These groups also promote medical staff of diverse backgrounds to increase the outcomes for Black women. Diverse medical staff and/or racial concordance between Black newborns and their physicians has halved mortality, compared to White newborns (Black Women’s Maternal Health). Therefore, increasing the number of Black doctors and nurses will positively affect birthing outcomes for Black women and infants. Another advocate option for Black mothers are doulas. Unlike midwives, doulas are not medically trained, but they have proven to produce better outcomes for mothers and infants. A study published in the journal Health Equity shows that “low-income and African American moms who used community doulas were more likely to have successful pregnancies and deliveries, especially when the doulas were Black, too” (Lucy). Doulas provide culturally competent care, guidance, and support for the mother. So, a doula is an advocate for the mother, while a midwife is a medical specialist. These advocacy groups should be promoted because they have proven to improve maternal and infant mortality rates and improve the quality of care for Black mothers in healthcare.
There is no simple solution to the mistreatment of Black mothers in healthcare. Systemic racism cannot easily be eradicated from the healthcare system and it is the root of this mistreatment. However, it can be lessened with medical education and healthcare reform and an increase in advocacy groups for Black women, including doulas. These solutions can lower maternal and infant mortality rates and increase the quality of care for Black women in America. Hopefully, they will spread awareness of the reality of the Black maternal health crisis. As more people learn about the situation, they will be less likely to perpetuate stereotypes and exacerbate the issue. As more Black women learn of the risks of pregnancy, they will learn to better advocate for themselves and take measures to ensure their safety.
Works Cited
“Black Women’s Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities.” Black Maternal Health, National Partnership for Women & Families, 2018, https://nationalpartnership.org/report/black-womens-maternal-health/. Accessed 26 Sep. 2023.
Bolnick, Deborah A. “Combating Racial Health Disparities through Medical Education: The Need for Anthropological and Genetic Perspectives in Medical Training.” Human Biology, vol. 87, no. 4, 2015, pp. 361–71. JSTOR,
https://doi.org/10.13110/humanbiology.87.4.0361. Accessed 23 Sept. 2023. Lucy May Lucy May and Lisa Smith. “Maternal mortality: Could doulas help keep more Black moms and babies alive?” WCPO 9 Cincinnati, July 02, 2020.
https://www.wcpo.com/news/our-community/maternal-mortality-could-doulas-help-keep more-black-moms-and-babies-alive . Accessed 1 Oct. 2023.
Owens, Deirdre Cooper, and Sharla M. Fett. “Black Maternal and Infant Health: Historical Legacies of Slavery.” American Journal of Public Health, vol. 109, no. 10, Oct. 2019, pp. 1342–45. EBSCOhost, https://doi.org/10.2105/AJPH.2019.305243. Accessed 30 September 2023.
Smith, Parys. “Combatting the Mistreatment of Black Women in Healthcare.” WUNC Youth Reporting Institute, North Carolina Public Radio, 2022, https://www.wunc.org/wunc-youth-reporting-institute/2022-09-08/combating-mistreatme nt-black-women-healthcare-doula-pregnancy-gynecology. Accessed 22 Sep. 2023.
“The Black Maternal Mortality Crisis and Why It Remains an Issue” Consider This From NPR, NPR, 2023, https://www.npr.org/transcripts/1186019422. Accessed 29 September 2023.
Thompson-Dudiak, Melia. “The Black Maternal Health Crisis: How to Right a Harrowing History through Judicial and Legislative Reform.” DePaul Journal for Social Justice, vol. 14, no. 1, Winter 2021, pp. 1–45. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=asx&AN=148874213&site=eds-live&s cope=site. Accessed 4 Oct. 2023.