Birthing While Black: When Giving Life Causes Death
The standard length of stay after having a cesarean section is three days. But I was sent home less than 48 hours after being cut open and my insides laid aside to bring my firstborn into the world. She was healthy but insisted on being born face up. I was given an emergency cesarean after more than 20 hours of labor (18 of which were unmedicated).
When the doctor said that I could go home, my husband and I were confused. We thought I would need to stay another day. Worn out and just coming through the experience of our lives, we were told the maternity ward was reaching capacity and since my daughter and I were doing fine, we could go home. In no position to argue, we took our bundle of joy home.
A few weeks later, I went to a follow-up appointment. When the nurse took my blood pressure, I noticed it was higher than it had been through my pregnancy. My systolic (top number) had never been over 120, but now it was 138.
I mentioned this to the nurse, and she took my blood pressure a couple of more times and then asked me if I was in pain. I said that I felt fine. My OB/GYN came out and asked what was going on and the nurse explained. He said that the number was indeed high for me, but it was nothing to be concerned about. We went on with the appointment.
I thought nothing of those experiences until I heard Shalon Irving‘s story. She was a black woman and an epidemiologist working for the Centers for Disease Control. Three weeks after her cesarean birth, she died of complications related to her delivery, postpartum condition, and high blood pressure. Shalon’s Twitter bio stated, “I see inequity wherever it exists, call it by name, and work to eliminate it.” Her mentor at the CDC said, “Shalon wanted to expose how people’s limited health options were leading to poor health outcomes.” In the end, she was taken by the very thing she advocated and fought against.
Black Women Under the Knife
When I heard Shalon’s story and the story of several other black women who had died under similar circumstances, I started to reflect on my own birth and postpartum care. I realized I could have been one of these women.
The CDC reports that black mothers die at three to four times the rate of white mothers. This is one of the widest racial disparities in healthcare. White women experience about 13 deaths per 100,000 births while black women experience 44 deaths. Other races experience around 14-15 deaths. According to a 2016 study, a college-educated black woman is more likely to die in childbirth than a white woman without a high school diploma.
Why are black women dying at higher rates? The factors are a myriad but I address a couple below.
First, the disparities that black women experience in everyday life regarding nutrition, access to health care, and financial resources play a significant role. Black women also experience the cumulative stress effects of systemic racism that manifests in their health. This phenomenon is referred to as biological weathering, where many blacks are biologically older than whites of the same chronological age. This can have a devastating effect on childbirth.
Second, black women experience disparate treatment in healthcare settings. They receive care from physicians who associate being black with being poor, uneducated, and more likely to engage in risky and unhealthy behaviors. Doctors and nurses often don’t take black women’s pain seriously and concerns are dismissed as complaints. Researchers have found a substantial number of white medical staff hold false and racist beliefs about biological differences between blacks and whites. These beliefs (including the belief that blacks feel less pain than whites) severely affect treatment recommendation accuracy.
Black Women Under the Thumb
The reason why black women are dying in childbirth can be summed up in two words: institutionalized racism.
In 2017, Planned Parenthood came under fire for sharing statistics related to black maternal mortality rates. Many conservative Christians in my circles concluded Planned Parenthood was saying that black women should abort their babies since they were more likely to die during childbirth anyway. In all of the flap about black women’s abortion rates that ensued, one crucial aspect was missed.
The reality that black women are dying as they attempt to bring life into this world is just as much of a ‘life issue’ as black women choosing to end a life in the womb. Racism is often a precipitating factor in both scenarios.
Black maternal mortality is more than a healthcare issue; it’s a justice issue.