Black women in America are four times times more likely to die from pregnancy or childbirth than white women. In New York City, this number rises to twelve.
Not only are Black mothers more likely to experience increased rates of preterm delivery, infertility, and maternal mortality, but Black infants are twice as likely to die than their white counterparts. These are not isolated incidents, nor are they just a health(care) issue. These disparities are influenced by and exist within a system of injustice, racism, and inequity; one that has taken various forms over the last 400-plus years. In a 2002 article in the American Journal of Public Health, Dr. David R. Williams states that “the health of minority women is to an important extent a product of their location in larger historical, geographic, sociocultural, economic, and political context.”
Moreover, these disparities appear to only apply to US-born Black women. Take, for example, the existence of the “healthy immigrant effect,” in which Black immigrant women have better birth outcomes as well as higher physical and mental health ratings than US-born Black women. These phenomena, in conjunction with numerous research studies, point to a confounding variable that transcends socioeconomic status or education level and is culturally specific to the United States of America: racism.
The stress that results from experiencing racism and discrimination is both institutional and subjective. When a person experiences discrimination (which all Black women in the U.S. most likely will), the experience triggers an automatic response in the body that releases stress hormones–namely, cortisol and adrenaline. These hormones, while beneficial in the short term, are detrimental in the long term. This is known as “weathering,” or “stress induced wear and tear on the body”. When examining this over the course of someone’s life, the allostatic load– the “accumulation of stress over a lifetime,” has been found to create a poorer physiological adaptation, contributing and leading to various health problems and vulnerabilities.
As a Black woman, and future OB/GYN, I am horrified by these statistics and facts. When/if I choose to become pregnant, I will do so knowing that all of the odds are against me, regardless of my education or income level. The struggles and losses of many Black women before me only reinforces this: Serena Williams. Shalon Irving. Simone Landrum. Very recently, Nicole Thea.
We must acknowledge these women, and all of the unnamed women before and after them. We must “understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes.” We must work to decrease these disparities and the racist systems and experiences that reinforce and uphold them.
Note: The stories and statistics above are only representative of cis women. More research must be done on this issue overall, but especially research that includes the experiences of trans, non-binary, and other menstruating and/or reproducing people with marginalized genders.