In 2017, the United States had more maternal deaths than Bahrain, Bosnia and Herzegovina, Iran, Japan, Kazakhstan, Kuwait, Portugal, Qatar, Korea, Saudi Arabia, Turkey and Uruguay. This is an all time high for any other developed country. In this blog, I will examine the racial disparities of black women in the health care system. Specifically, the unequal maternal mortality rate. I will focus on the history of racial bias within the American healthcare system and how that complicates childbirth for black women. I argue that black women are more likely to die during and after childbirth complications due to racial bias/stereotypes in comparison to their white counterparts.
BIOETHICS
Medical history has consisted of human experimentation on black individuals. The Tuskegee syphilis study was one of them. It lasted from 1932 to 1972. In this study, there were 600 black participants. 399 of the participants were infected with syphilis. However medical researchers never told participants about the illness. Penicillin was discovered in 1928 and yet they were never treated with the cure. Instead participants were given free medical exams, free food, and burial insurance. Participants were treated inhumanely and it wasn’t until years later that the study was labeled as unethical. During the pre-civil war period, both Southern and Northern medical schools experimented on black slaves. In the south, experiments were made possible through the permission of the slave owner.
J. Marion Sims was a famous gynecologist in the south. He was known for inventing a speculum for vaginal examinations. He used black enslaved women to experiment this device on. The procedure consisted of the bladder and uterus being torn, for which he used no form of anesthetic. Unfortunately, the dangerous myth that blacks feel less pain than whites is still alive today. Sims would perform experiments on both black women and children. Later in the early 1970s there was medical research surrounding black fetuses and genetic manipulation. It wasn’t until 1974 that a bioethics commission was created. (Gutmann and Moreno 2019). The bioethics commission was then responsible for labeling procedures as ethical or unethical.
RACIAL/ETHNIC DISPARITIES
Racial minorities in the United States experience greater chances of hospitalization for preventable causes than their white counterparts. In the United States, racial minorities are less likely to have access to quality care. Quality care includes resources that provide knowledge for nutrition and forming healthy habits. Barriers in health care include insurance, overall wellness, discrimination, trust and faith in the medical community. Limited access to health care can lead to being undiagnosed, not trusting health care providers and feeling ignored. All of which create a disconnect between the patient and the provider (Collins and Rocco 2014). The evidence of racial inequalities in medical treatment is supported by research from all over the world. Racism can be expressed through behaviors and practices such as medical treatment. Researchers are still figuring out ways to accurately measure healthcare provider racism. In the study, racism among healthcare providers included belief, practices and emotions. Self-completed surveys were also used to measure the assessment of the patient, stereotype, personal bias, perception of adequate treatment, racial preference, warmth towards race/ethic group and other attitudes including white privilege. The study concluded that there was indeed evidence of health provider racism, however there need to be more research on ways to address it (Yin et al 20).
Through the history of bioethics in medicine it is evident that black women have not been respected in life or in death. With the story of Henrietta Lacks, her body was treated as not even her own when researchers took her cells without her consent or her family’s. Kira Johnson’s death should not have happened. She came into the hospital with no prior complications, on a planned c section. When her husband voiced concerns over the blood in her catheter, it should have been the priority. The priority in any delivery and recovery room should be the wellbeing of both the baby and mother.
The painful history of racism embedded in the American healthcare system is still alive today. Racial and personal bias impacts the livelihood and longevity of black mothers. Despite the awareness of rising maternal mortality rates, there is little to no new hospital policies to manage the recovery of new mothers. There needs to be more research exploring maternal outcomes and the effects of insurance coverage (Molina and Pace 2017). There is not enough research surrounding this topic, that in itself is a disparity since academic research is the most accurate information. There is a correlation between past medical history and current events. The notion that black bodies are seen as material bodies has been translated since the pre-civil period to now. The notion that black bodies experience less pain is deadly. This belief can lead to providers not taking the pain of black patients seriously. That pain can soon turn into a situation the provider cannot reverse. Black women do experience less quality of care in the American healthcare system. The persistence of racial inequality in America takes many forms. For black mothers, this inequality can cost them their lives. In conclusion, black women are more likely to die from pregnancy-related causes due to racial bias/stereotypes in comparison to their white counterparts. This racial bias is embedded in institutional and systemic racism from which the American health system began.
VISIT this website to learn more about Black maternal health
https://everymothercounts.org/anti-racist-reading/?gclid=Cj0KCQjwvIT5BRCqARIsAAwwD-RqAFTsWQrcqFBHzWRW1lK7iBmJUllG6RdWM5M1HIERtKo6mEJ_Z0kaAhp-EALw_wcB
READ
Collins, Joshua C., and Tonette S. Rocco. “Disparities in Healthcare for Racial, Ethnic, and Sexual Minorities.” New Directions for Adult and Continuing Education, vol. 2014, no. 142, 2014, pp. 5–14.
Gutmann, Amy; Moreno, Jonathan D. Everybody Wants To Go To Heaven But Nobody Wants To Die: Bioethics and the Transformation of Healthcare in America. Liveright NY, 2019.
Hirai, Ashley H, et al. “Contributors to Excess Infant Mortality in the U.S. South.”
American Journal of Preventive Medicine, vol. 46, no. 3, 2014, pp. 219–227.
Kevles, Daniel J. “The History of Eugenics.” Issues in Science and Technology, vol. 32, no. 3, 2016, p. 45.
Metcalfe, Amy, et al. “Racial Disparities in Comorbidity and Severe Maternal Morbidity/Mortality in the United States: an Analysis of Temporal Trends.” Acta Obstetricia Et Gynecologica Scandinavica, vol. 97, no. 1, 2018, pp. 89–96.
Molina, Rose, and Lydia Pace. “A Renewed Focus on Maternal Health in the United States.” The New England Journal of Medicine, vol. 377, no. 18, 2017, pp. 1705–1707.
Paradies, Yin, et al. “A Systematic Review of the Extent and Measurement of Healthcare Provider Racism.” Journal of General Internal Medicine, vol. 29, no. 2, 2014, pp. 364–387.
Vera, Hernán ; Feagin, Joe. The Sociology of Racial and Ethnic Relations. Springer US, 2007.
LISTEN
to the personal story of Charles Johnson who lost his wife in 2016
Howard, Jacqueline. “When Women Die in Childbirth, These Are the Fathers Left
Behind.” CNN, Cable News Network, 22 Feb. 2020, www.cnn.com/2020/02/21/health/maternal-mortality-fathers-grief/index.html.
MY THOUGHTS
Above I provided a research based argument however these are my thoughts. In this country, where we are considered "developed". There should be no maternal mortality rate. This shouldn't be happening period. Regardless if the mother had a preexisting condition, her providers should be working diligently for the best possible outcome. Unfortunately, black mothers and fathers are not listened to when voicing concerns. In order to be a good physician you need to listen to your patients. Who knows more about your patients body than the person living in it? With any profession, if you ever feel explicit or personal bias towards someone or a group of people.....GET ANOTHER JOB. Every baby deserves to go home with their mother and vice versa. There needs to be new policies in place to protect woman of color from inequality. I don't think people understand how important it is for there to be diversity within a profession. I love seeing minorities going into medicine. I believe diverse minds can and will impact the medical practice. One day I hope to be one of those.
