The Deaths of Black Mothers and Babies in America
Mothers are the sources of human life, our greatest examples of compassion, so why, with America’s medical knowledge, financial abundance, and ability to protect the sanctity of motherhood, do medical systems choose instead to violate it. Specifically, why are black mothers facing unproportional childbearing/birthing risks? Induced by Barbie, it is timely to remember women who have engendered prior feminist movements, but also to rectify the disenfranchisement of black women in many of those factions. Sojourner Truth, an activist during slavery, affirmed her rights in her speech “Ain’t I a Woman?” where she asserts, “Where did your Christ come from? From God and a woman!” In contemporary America, pregnant black women and black babies are experiencing unnecessary medical trauma, pre and post natal; it is an urgent feminist question of why and how so that our solutions can be effective.
Firstly, the CDC cites maternal mortality (MM) as “the death of a woman while pregnant or within 42 days of termination of pregnancy […] not from accidental or incidental causes.” And in America, the discrepancy between white and black MM is perverse, as illustrated in the charts below from Vox (left), CDC (right), CDC (bottom). As a developed nation socially and economically, the medical industry should be ashamed for its indifference towards some of the country’s most vulnerable populations, especially considering that the CDC found from 2017–2019 that “More than 80% of pregnancy-related deaths were preventable.”
Similarly, there are remarkably high numbers of black infant mortality (IM). The New York Times even detailed in 2018 that “In 1960, the United States was ranked 12th among developed countries in infant mortality. […] the United States has fallen behind and now ranks 32nd out of the 35 wealthiest nations.” This disparity has long existed; fifteen years before the Civil War ended, the black to white infant mortality was “340 per 1,000” to “217 per 1,000.” However, this disparity has not only existed in the past, but has actually grown, the gap larger now than in 1850.
There are three extraneous factors (general racial genetics, poverty, education) to address — none of which are more impactful on pregnant black women and babies than the simple basis of race itself, except in cases where the two intercept such as a black woman in a neighborhood without close medical care, or a black woman who is also poor.
Firstly, there is little indication of racial genetics affecting pregnancy. For instance, while there are disparities between male and female health issues, such as heart attack symptoms, frequency of aortic aneurysms, and others, black and white women are not biologically adverse. While “black women have more bone and muscle mass, but less fat, as a percentage of body weight, than white women [… and] have more upper-body fat” these are minor differences and should not affect a pregnancy to any large degree. Further disproving the racial genetic theory, “A 1997 study […] found that babies born to new immigrants from impoverished West African nations weighed more than their black American-born counterparts […] they were more likely to be born full term, which lowers the risk of death.” For comparison with the 1997 study, “the [American] grandchildren of white European women actually weighed more than their mothers had at birth.” So while proponents of racial inferiority would agree that genetic makeup is the main cause of infant or maternal mortality, race is scientifically moot.
Next, poverty is often the maternal/infant mortality argument riddled with sophistry. In 2019 black people made up 23.8% of the poverty demographic while only being around twelve percent of the general population. And while “Almost 95% of all maternal deaths occurred in low and lower middle-income countries in 2020,” isolated poverty still does not provide as clear of an indicator of medical negligence as race. This is threefold. One: in American society, wealth is highly correlated with race (Assata Shakur argued in her autobiography, “Black people are oppressed because of class as well as race because we are poor and because we are black” and most likely poor because of being black). This meaning, less money does usually mean worse medical care, but if the prime reason for that poverty is arbitrary race restrictions in the first place, then it still falls more within the racism category. Two: poorness itself is not the factor considered in this argument, but the tendency for poorness to be synonymous with drugs or lack of pregnancy knowledge leading to the woman herself not seeking help. However, a study “found that black women were less likely to drink and smoke during pregnancy, and that even when they had access to prenatal care, their babies were often born small.” Therefore, common attributes of poverty alone are also not enough to account for the IM gap.
And finally, education is not simply insubstantial when explaining the white/black IM, but is actually represented in an inverse relationship. For instance, “A black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education.” And even when the white and black mothers are similarly educated, black infants are still “twice as likely to die.”
But if racial genetics, poverty, and education — tangential effects of racism — can not account fully for this discrepancy, this means that perhaps simple, plain acts of racism could be enough to inadvertently kill a mother and her child. Specifically, stress as a result of direct or tangential racism is a leading guess for high black MM and IM rates. For instance, the two most common medical complications leading to black MM are heart disease, postpartum cardiomyopathy, and blood pressure disorders, preeclampsia and eclampsia; the two significant factors of black IM being low birth weight and preterm birth. And as it turns out, stress can be a direct cause of both the leading disorders and complications of MM and IM; high blood pressure, from stress, sometimes induces preterm labor or giving birth to a baby with a low birthrate. Further, “Stress can also exacerbate issues with the placenta, such as preeclampsia, eclampsia, and fetal growth restriction.”
This race-related stress can be caused by any of the following: “limited or no access to health insurance and quality healthcare, less access to well-paying jobs, living in an unsafe environment, less access to healthy foods, attending a low-performing school.” Tangential effects of racism, as well as blunt and daily forms of racism in communities and in medical clinics are noted as agents of stress. Black women are more at risk for all of those agents, but even if they are not, like athlete Serena Williams, there is a common sentiment that they are still more likely to be ignored and dismissed by medical professionals. Williams recounts here how she was denied attention during her pregnancy. If that is how a wealthy, topical public figure is treated, then it is a gross assumption we must make of how the disadvantaged, ordinary black woman is treated in similar circumstances.
These environmental pressures are known epigenetic, “changes, especially heritable changes, in the characteristics of a cell or organism that result from altered gene expression or other effects not involving changes to the DNA sequence itself.” The term, often associated with more concrete expressions like diet, also relates to violence and abuse. Stress, incremental and accrued over the years, especially chronic forms, has been found to change brain structure, personality, and even physical health. For black women that fear for their children’s prospects and opportunities, as well as their own, that stress could evince actual, medical consequences. This article gives an especially comprehensive view of how to understand epigenetics in pregnancy and even solutions on how to redress (minorly) the racial impact of being black and pregnant. The article also accounts for why studies found that “black women in their mid-20s had higher rates of infant death than teenage girls did.” Arguing this is “ presumably because they were older and stress had more time to affect their bodies. For white mothers, the opposite proved true.”
Reminiscent of prior racial degradation of motherhood: enslaved children being sold separate from their mothers; the forced breeding or sterilization of black women; inadequate medical care of segregated society; black women killing their children, saving their souls, while destroying their own; or the unnatural solace of black fathers over losing their kids, preferring the peaceful death rather than the rageful life for them. The disproportionate death of black mothers and children is an atrocity history will judge similarly to those presented in the former list. It is unnecessary, undeserved, and more, cruel.
