Black Maternal Health
Maternal mortality spans from the time of conception to up to a year postpartum or post-birth.
*GRAPHIC PER THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND HEALTH PROMOTION
The connection between implicit bias and racism in the outcomes of Black birthing people is undeniable.
Racism is a social construct.
Racism has been engrained in the fabric of this nation. Inherently this affects the maternal mortality/morbidity, infant mortality and the generational curse that has been and continues to be black maternal health.
According to an article published in The Journal of Perinatal Education, African American women are made to feel marginalized and stereotyped because of racism and the institutionalized barriers placed in the care and education of black women, before during and after pregnancy.
The Realities of Maternal Health
Between 700 and 1200 black women die each year from pregnancy and/or childbirth complications in the United States.
Black women are 250% more likely to die during pregnancy, birth or postpartum than white women.
Black mothers who are normal weight are more likely to die as a result of pregnancy than white mothers who are obese.
Black women who received prenatal care in the first trimester are more likely to have complications than white women who haven't received prenatal care.
History
African American women were not considered full citizens of the United States until the mid-1960's. Even then there were still roadblocks to black women being able to even vote without discrimination and institutionalized barriers.
In our society there has been and continues to be a disregard of the contributions that Black women have made to modern medicine and our systems' understanding of human anatomy. The reality is that there were barbaric measures and methods taken by white male doctors on Black women in the name of science and experimentation.
History of Wet Nurses and its Effective on Black Breastfeeding
Breastfeeding Master's Babies
Tragic Plight of Enslaved Wet Nurses
"Weathering"
Dr. Arline Geronimus a researcher and professor at the University of Michigan Institute for Social Research released a study on “Weathering” which took a look at cumulative stress as a result of socioeconomic status and social status. Ultimately she found that these stressors were endured at a higher rate in black women than in white women. She found the telomeres of women of the same age yet different race aged by seven years for black women in comparison to white women. The conclusion being that systematic racism is literally killing black women, altering their DNA. The data shows that trauma literally alters the DNA specifically the telomeres.
Environmental Racism
The environment is not racist or prejudiced to one group of people over or above the other. That being said there are certain environmental conditions that certain groups of people are subjected to and other relieved from.
Factors that contribute to this:
- Socioeconomic status
- Race/Ethnicity
- Class
- Education
Mohai, Pellow and Timmons in the Environmental Justice article (that can be found in your resources) does an excellent analysis of how impactful the exposure to pollution is to certain populations of people who have been left vulnerable. The truth is that certain exposures are unequally distributed by race and class. One example would be the gentrification of certain major cities.
Hurricane Sandy
On October 22, 2012 Hurricane Sandy touched down on land causing nearly $70 billion in damage. In the days following the hurricane there was a significantly large boost in the number of babies born in one New Jersey hospital. According to a study published in the Department of OBGYN there is a relationship to spontaneous delivery and the atmospheric pressure fluctuation, like the shift that happens during a hurricane.
What's the relationship?
Climate change has led to increasingly destructive hurricanes. Lower income neighborhoods without the resources and access to health care and the ability to rebuild/relocate following a natural disaster are at a higher risk.
Hurricane Katrina
Hurricane Katrina touched down in August of 2005, causing over $125 billion in damage and killing over 1,800 people. I would urge you to look into further lack of response by the United States government.
Louisiana at 44.8 per 100,000, has one of the highest rates of Black maternal mortality and morbidity of all the United States.
After the destruction of Hurricane Katrina there was an immense privatization of hospitals. This was partly due to the lack of resources and the amount of money that was said to be gained. These "private" hospitals were largely Catholic.
What's the relationship?
The Public Rights/Private Conscience Project (PRPCP) now known as the Law Rights and Religion Project is an organization whose mission in part is to ensure that laws and policies acknowledge freedom of religion and those who are non-religious. This organization recently came out with a report that examined Catholic hospitals and their impacts on Black women. This study found that women of color disproportionately relied on Catholic hospitals for care in relation or comparison to white women. More specifically black and Hispanic women, currently 44 states have Catholic hospitals. This in part is a result of a lack of access to healthcare. Catholic hospitals and Catholic providers follow a set of directives known as the Ethical Religious Directives drawn from the Church’s moral and theological teachings. Catholic hospitals are partly funded privately from both the Catholic church as well as private donors. The amount of Catholic hospitals in Louisiana and more specifically around some of the main areas of damage following hurricane Katrina were disheartening. The amount of resource that these hospitals in particular have access to creates a space where they were able to dominate care following the Hurricane’s wake to pregnant or birthing mothers. This left a need that was being largely filled by those who do not have the patient’s best interest or autonomy at heart, this is exemplified in the structure of the way and the laws they use to practice by. This overtaking is directly because of our government's inaction.
It is just as important to tell the stories of happy endings as those that end in grief. As doulas we are charged with the responsibility of educating our clients in hopes of not only preparing them but also to actively work against the influences that need to change in order to create healthier moms and families.
Applied knowledge is power. You have the power to make a tremendous difference, even if it is only one.
I've intentionally chosen Black moms to highlight in this portion of our training because Black women are genuinely at risk. I will say that these issues are susceptible to everyone, irregardless of race. Re-telling these stories as they've been told are a tool of education, I will not and you should not pass judgement.
Be mindful that most if not all of these women are not here to tell their own stories so ultimately it is all based on interpretation.
Honor these mothers' with your understanding, honor them by learning from what failed them.
Approach these very sensitive experiences with grace and humility. If you cannot, recognize that and reevaluate your decision to pursue birth work.
**TRIGGER WARNING TO FOLLOW
