There is an alarming health crisis happening in the U.S.–– Black women are dying at a disproportionate rate during pregnancy and childbirth.
According to the CDC, Black women are three times more likely to die from a pregnancy-related cause than White women. Though childbirth complications are not exclusive to Black women, these shocking statistics underscore systemic challenges and distinct issues that other racial groups may not encounter. These challenges go beyond lack of access, education levels or economic status.
In fact, a recent study from the National Bureau of Economic Research discovered that the maternal mortality rate for Black mothers who are financially stable is similar to that of White mothers with lower incomes. This finding indicates that this complex issue runs much deeper than economics.
Tragically, Olympian and track star Torie Bowie passed away due to childbirth complications. Celebrated tennis legend Serena Williams, who can no doubt afford the best health care in world, nearly lost her life while giving birth. This issue doesn’t solely impact poor Black women; it is affecting Black women across all socioeconomic backgrounds.
When we witness Black women dying at a disproportionate rate, we have to critically look at unconscious biases and systemic racism. Unconscious biases are social stereotypes that are formed about how people can look, think, or behave. Sadly, a study published as recently as 2016 by the Proceedings of the National Academies of Science showed that 40 percent of first- and second-year medical students endorsed the false belief that “Black people’s skin is thicker than White people’s,” and that trainees who believed that black people are not as sensitive to pain as white people were less likely to treat Black people’s pain appropriately.
During my recent TEDxRutgers Talk titled, “Do No Harm,” I explored several contributing factors that lead to these damaging outcomes. These factors include the prevalence of unconscious biases that still exist within the health care system and outdated race-based medical practices, such as the controversial V-BAC calculator. This tool was devised by the government to help doctors feel comfortable with assuming the risk of recommending that a patient undergo a
C-section after having a vaginal birth. C-sections carry a higher risk of mortality, and during the 90s and early 2000s, once a patient underwent the surgery, they would continue to have the procedure for subsequent births.
To help determine which patients were candidates for a C-section, doctors would take into consideration factors such as health, age, height, weight, and if the patient was Black or Hispanic. Consequently, Black women were being disproportionately pushed to deliver by
C-sections solely based on their race –– which is a social determinant and has nothing to with whether a patient will have a successful natural birth.
Although this race-based tool is no longer recommended, it is still used today.
Even as a physician and woman who is privileged to work in health care, I experienced a similar ordeal as Serena Williams –– my pain was ignored, and I had a near-death experience during childbirth.
Six years ago, I was pregnant with my second child and was scheduled to deliver the baby via cesarean birth. As I have an underlying health condition, I delivered my first child the same way so I knew what to anticipate. The day of the surgery, my husband and I were ready. We were a little nervous about now having two children, but excited to welcome our new addition.
I arrived at the hospital and was wheeled in the operating room, spoke with the anesthesiologist, and was given an epidural and oxygen. Numb from the waist down, I didn’t feel any pain. My doctor talked me through the entire process. In rotations, as a family medicine doctor, I had assisted obstetricians with numerous C-sections, so I was well acquainted with the surgery. After approximately 30 minutes, they pulled our baby girl out. My husband cut her cord, the doctors weighed her, and they took her away to conduct additional tests while my incisions from the C-section were being closed.
About thirty minutes after post-op surgery, something didn’t feel right. Something was wrong.
I could barely speak or focus, was exhausted, and in pain. I felt drastically different from what I experienced after my first child’s delivery. My excitement turned to dread. My husband tried to communicate with me but I was having a hard time verbalizing what I was experiencing. I shared with the nurse that I didn’t feel well. She maintained that no one ever feels right after giving birth, which I understood. Yet again, this time was different.
I continued to tell her that something was off and asked her to call my doctor. She insisted that my vital signs were fine and if I grew worse they would reassess. At that point, I asked my husband to find my phone and call my doctor. I recall him saying to the doctor, “There’s something wrong with Bayo.”
I’m usually known as being an upbeat person, “the happy doctor.” Upon my doctor’s arrival, he too recognized that I wasn’t myself. I was taken back to the operating room and underwent anesthesia with reassurances that I would be OK. When I came out of surgery, I learned that I was bleeding internally. I was transfused multiple units of blood and remained in the hospital for two weeks. My family feared for my life.
My husband calling my doctor and having him listen to me, hear me, saved my life. My doctor didn’t dismiss my pain or concerns.
At the end of this month, my daughter will turn seven years old. Since her birth, health care has evolved to be more robust and innovative. What hasn’t changed though is the approach to the delivery of care of Black women as our mortality rates during or shortly after childbirth has increased.
What can be done
To make progress in addressing the high maternal mortality rates among Black mothers, some would argue that we need to expand access and Medicaid. Again, the issue goes beyond mere economics. When we think it only affects poor black women, we are diluting the true scope of the problem.
We have to invest in listening and responding to people’s pain.
Not being heard can happen to anyone, but when one group is systematically impacted and are dying at higher rates during or after childbirth, we have to start asking why and truly listen.
I shared my personal story during my TEDx Talk and on this platform in hopes of helping health care providers and others who might have their own biases to start to listen to and advocate for women of color. Being open as well as hearing and responding to patients is critical to their care.
When you feel that you are not being heard by your health care provider, be persistent. Continue to advocate for yourself, or enlist a family member who can do so on your behalf. Additionally, this issue could potentially impact someone you know, so please share this information or your own story. The more we talk about it as a community, the closer we can end this health crisis.
Bayo Curry-Winchell is a family physician and can be reached at Dr. BCW and on TikTok, Instagram, LinkedIn, and Twitter @DR_BCW. Dr. Bayo Curry-Winchell holds the esteemed position of medical director of community engagement and health equity, where she spearheads diversity, equity, inclusion, and belonging initiatives. Additionally, she serves as the medical director of urgent care clinics at Saint Mary’s Regional Medical Center, Reno, NV, and is the visionary founder of Beyond Clinical Walls.