By: Basilia Oferbia
Image retrieved from Harvard Public Health
Black pregnant women have one of the highest mortality rates in America. This research explores the underlying factor causing this alarming issue: racial bias in the medical field. We detailed the origins, the statistics, and most importantly, the solution to this pressing concern.
According to the World Health Organization, the United States has the highest maternal mortality rate of any developed nation. Maternal mortality refers to the deaths caused by pregnancy and childbirth. Most maternal deaths can be prevented if skilled and professional doctors, nurses, and/or midwives tend to these individuals. According to UNICEF, “hypertensive disorders of pregnancy, especially eclampsia, as well as sepsis, embolism and complications of unsafe abortion also claim a substantial number of lives.” In 2016, cardiomyopathy, thrombotic pulmonary embolism, and hypertensive disorders in pregnancy contributed significantly to the deaths of Black women. Evidently, many of these women’s deaths could have been prevented had they received the proper care from their doctors. We are left to wonder if this harm is intentional and if these women are neglected by their supposed caretakers.
Women of color are more likely to give birth in Catholic-affiliated hospitals that follow the protocols of the Ethical and Religious Directives for Catholic Health Care Services, according to Elizabeth Boylan, the Associate Director at the Center for Gender and Sexuality Law in Columbia University. These protocols prevent doctors from providing multiple necessities such as contraceptives, sterilization, abortion, fertility services, and more. In these facilities, women of color would be exposed to the risk of death by pregnancy complications more often than white women who give birth in Catholic-affiliated hospitals less frequently. The issue is seen nationwide and systemic racism is embedded into societies.
Many doctors ignore or disregard the wishes of a patient who is a woman of color. New York State Assemblywoman Rodneyse Bichotte shared a painful experience during which the hospital refused to treat her when she went into preterm labor at 22 weeks, resulting in the death of her son. The hospital told her to “terminate [her] pregnancy of leave” and we are left baffled at the lack of professionalism and disregard for protocols the hospital had for an emergency pregnancy complication.
History of Gynecology
What is gynecology? According to the National Cancer Institute, Obstetrics and Gynecology is a branch of medicine specializing in the care of women during pregnancy and childbirth, analyzing the diagnosis and treatment of diseases related to the female reproductive organs. Specializing in women’s health and in the health of the female reproductive system, obstetricians and gynecologists deal with a variety of women's health issues. Visiting the gynecologist in a woman's early teens whether it be for annual screening, general health issues, or whenever one has any concerns, is vital.
One must wonder how this field came to be. Correlated with the institution of slavery, the field of gynecology was brought forth through a racist, sexist, dark, and devastating history. Acknowledged as the founder of gynecology, James Marion Sims was a surgeon born in South Carolina in 1813. He established tools and surgical techniques relevant to women's reproductive health –– some of which are still used today. Sims was able to initiate the field of gynecology through experimenting on female slaves without any consent or anesthesia, and with minor coursework and training. Between 1845 and 1849, Sims conducted research through the pain and suffering of at least a dozen enslaved Black women who had no say in what could happen to them. Racial notions and biases still linger in the medical field and it is important to be informed on the history of the field of gynecology.
1) To practice in the medical field, 6 months of anti-bias training should be required. In the survey conducted by Basilia Oferbia, 13 out of 20 women of color stated there was at least one occurrence during which a doctor or nurse ignored their concerns or made them feel uncomfortable. When a life is in your hands, the utmost training must be required. A structured anti-discriminatory training program will lead to inclusivity and it will spread the message that race does not correlate to the severity of someone's pain. If racial bias continues in the medical field, legal action will be taken against any offenders. I also believe that if there was an app or website created that allowed people to research midwives, they could choose individuals they are comfortable with based on their records.
2) Black women who worked with a midwife reported that they were more likely to receive care based on trust and listening. Additionally, a four-year study from Black Women Birthing Justice (BWBJ) in California found that these patients felt supported and empowered. Therefore, if we create an app that will connect women of color with midwives, they will have more support through their pregnancy and their concerns will be heard. Having a team of nurses and doctors accompanied by midwives will provide the patient with a safe space to express their needs.
3) The number of designated doctors/nurses to each pregnant patient must be high enough so that hospitals put an end to patients with extreme needs being tossed around from doctor to doctor. Tests should be held for doctors and nurses to test their knowledge on how they would handle certain situations since some hand patients off to others when they do not feel like dealing with a patient that requires “more work." This will hopefully minimize the number of times women of color are ignored by doctors.
4) Every 4 weeks for a year, postpartum patients should have an appointment to check that everything is okay or to catch signals before something harmful develops since a large percentage of patients, or even their children, die within a year of the birth. Furthermore, postnatal care needs to be extended on insurance for a year after childbirth.
The racial bias in the medical field has contributed to the high mortality rates of Black pregnant women. This growing issue must be addressed immediately and I know our solution has the potential to help.
Written by writer Basilia Oferbia