My mother often describes the births of my siblings and I with an unmatched sense of happiness. Her testimony of how she was able to bring new life into the world four different times quickly turns into a sentimental recount of what it felt like to hold each of her babies for the first time, all while in the presence of loved ones. When it comes to my birth specifically, she says it was an “easy birth” with minimal pain. As far as her experiences with my three siblings, it was not as smooth sailing and pain-free (as you can see, I am the good child). However, she never fails to mention that whatever physical and emotional pain she experienced was soon overshadowed by an overwhelming sense of joy. Those days go down as arguably the best days of her — and my father’s — life. As standard as this may sound, this isn’t every mother’s birth story. For some mothers, the tears cried on this day aren’t tears of joy, but of pain and loss. And this day, which is supposed to be the best day of their lives, ends up being their last.
Given that the United States is riddled with over-medicalized births and an inequitable health care system, it is not surprising that we have the highest rates of maternal mortality amongst developed nations. This is a problem that is endured by women of all backgrounds. However, in a society that is still characterized by institutionalized racism, it would be naive not to acknowledge that minority women — specifically Black women — bear the brunt of this burden. In fact, Black women are more than three to four times more likely to experience pregnancy-related mortality or morbidity in comparison to white women, as well as more than twice as likely to experience maternal mortality compared to non-Black women of color. To make matters worse, the onset of the COVID-19 pandemic has widened this gap. Continued racial discrimination, as well as a lack of space in Black hospitals to service both COVID-19 patients and laboring mothers, has worsened the state of Black maternal health.
While others used to try and explain away this disparity by blaming it on a lack of education and financial stability in Black communities, the discovery that a wealthy, college-educated Black woman is more likely to experience a pregnancy-related death than a poor white woman who did not graduate high school has since disproved this. There are many theories that explain racial differences in maternal mortality, one of the most prominent being Arline Geronimus’s Weathering Hypothesis. This theory states that biological consequences of the stress resulting from racism that Black women face can be linked to negative maternal health outcomes. Racism, which is inherently stress-inducing, can cause cells to divide and die at an abnormally rapid rate, resulting in the body’s premature aging. This can then cause an increased risk of chronic conditions such as diabetes and high blood pressure, both of which can lead to pregnancy complications and maternal mortality. Essentially, the body lacks the ability to promote a healthy pregnancy when the mother is faced with chronic stress, such as that from racism and other unquantifiable systems. While this theory can be applied to all stress regardless of cause, the ways in which anti-Black racism is embedded into the very structure of the U.S. makes stress a much more chronic issue for Black women than anyone else. This theory, paired with the history of unnecessarily high rates of cesarean sections done on Black women and lack of health care access in predominantly Black areas provides ample explanation for this maternal health disparity. With this plethora of information, it has become increasingly clear over time that Black women’s right to life is under attack.
This ongoing threat to Black motherhood presents an undeniable threat to the quality of life that is available to Black women and families. Black women — like everyone else — should never have to fear that their delivery bed will also be their deathbed. The ability to leave the delivery room alive and with the physical and emotional capacity to care for their newborn child should be a reality that women of all races can be guaranteed to experience. Currently, this is not the case.
Not only is the disparity in maternal mortality severe in its magnitude, but it is also two-tiered in its nature. The Black maternal health crisis is undeniably a result of the racism experienced both in the health care system and in everyday life. The physiological stress that is produced, as well as the lack of medical support in urgent medical situations experienced by Black people, has detrimental impacts to all aspects of health. However, given the lack of agency and autonomy during childbirth among women of all races, disparities in maternal mortality and mortality are also perpetuated by gender-based discrimination. Ultimately, the ways in which medical racism and gender-based discrimination work intersectionally to harm Black mothers at a disparate rate shows the double jeopardy that Black women experience due to the consequences of both. Because of this, the eradication of this disparity will require initiatives that cater to the specific needs of Black women.
This is why Black Maternal Health Week exists. Created by the Black Mamas Matter Alliance, it is a week in April (every April 11-17 to be exact) devoted to advocating for solutions to the Black maternal health crisis. The initiative also provides a platform for Black mothers’ and families’ stories to be heard in a space where they will be valued. Additionally, Black Maternal Health Week takes place during National Minority Health Month in April and contributes to the larger conversation of making health experiences and outcomes equitable for people of color. For the past three years, the Black Mamas Matter Alliance has hosted the Black Maternal Health Conference, in which participants are able to build their capacity in shaping Black maternal health policy, programs and advocacy, while also learning how to address maternal health disparities in different career sectors and building community among Black women. Through these events and the other resources they offer, Black Maternal Health week has created room for the issue of Black maternal health and mortality, as well as possible solutions for the Black women and families who will benefit from it the most.
Another victory of the Black Mamas Matter Alliance is its success of getting maternal health inequities prioritized by those with the political power to enact progress. The Congressional Black Maternal Health Caucus, established by U.S. Rep. Alma Adams, N.C.-12, and U.S. Rep. Lauren Underwood, D-Ill., in April 2019, is a manifestation of the political and societal change that Black Maternal Health Week has been advocating for. Just like the Black Mamas Matter Alliance, the Congressional Black Maternal Health Caucus aims to diminish the disparities in maternal mortality rates between Black women and white women. In June 2019, the caucus approved multiple priority initiatives including funding for research on maternal health disparity, the promotion of breastfeeding in hospitals (another maternal health disparity), funding for more midwife education in order to diversify the field, funding for community-based organizations that are dedicated to improving Black maternal health, the provision of support for incarcerated mothers (given that Black women make up a majority of the female prison population) and more. A list of more of the passed priorities can be found here and here.
The presence of these maternal health disparities is a clear indication that there is much more to be done in order to create an equitable society for Black mothers. The changes that have since been made are evidence of how far we’ve come in terms of starting to address these issues, as well as what is possible for the future. The fate of Black maternal health conditions looks hopeful. Yet, that optimism must be continually backed by increased accessibility of information, calls to action, policy initiatives and the collective sense of social responsibility that is key to any societal progression.
Hopefully, in time, less of Black women’s birth stories will end in mortality and severe morbidity, and more will end the way my mother’s did — still holding her children 21 years later.
MiC Columnist Kayla Thomas can be reached at firstname.lastname@example.org.