How This Racist System Is Stealing the Lives of Black Mothers and Children... and What Can Be Done

April 30, 2018 | Revolution Newspaper |


From a reader:

On April 11, the New York Times Magazine published “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis,” by Linda Villarosa. The article is an essential read. It focuses attention on the shocking disparities between the mortality rates of Black and white women and infants in the U.S. The article’s subtitle is: “The answer to the disparity in death rates has everything to do with the lived experience of being a black woman in America.”

Black Lives and the Cumulative Effects of Racism

Villarosa writes, “Black infants in America are now more than twice as likely to die as white infants—11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies.” This amounts to more than 4,000 Black infants dying every year!

This racial disparity is wider than in 1850, 15 years before the end of slavery, when most Black women were considered property (although the overall rate has fallen significantly). This shows the lie of the U.S. as a “post-racial” society. The cold truth is that racism and national oppression are deeply integrated into the system and in many ways are getting WORSE.

The disparity between Black and white maternal mortality is even wider than that for infants. According to the most recent report from the Centers for Disease Control (CDC) Pregnancy Mortality Surveillance System, Black women died at a rate 3.4 times that of white women from pregnancy-related causes between 2011 and 2013. According to a recent article by National Public Radio and ProPublica, in some places this disparity is even wider and continues to grow. In New York City, the article reports, Black mothers are 12 times more likely to die than white mothers. This disparity is increasing, up from seven times during the period from 2001 to 2005. (“Nothing Protects Black Women from Dying in Pregnancy and Childbirth,” by Nina Martin, ProPublica, and Renee Montagne, NPR News, December 7, 2017)

The maternal mortality rate for all U.S. women has increased almost two and a half times since 1987, while the rate is declining in other industrialized countries. Black women in the U.S. bear a double burden: national oppression and racism compounded by the vicious oppression of women generally.

Until recently, high maternal mortality was widely believed to affect, almost exclusively, poor or less-educated women. But recent studies have shown that disparities in maternal death persist for Black women across lines of education background and economic status. A study conducted by four researchers at the CDC found that infants born to college-educated Black parents were twice as likely to die as infants born to similarly educated white parents.

The reasons for the Black-white divide in both infant and maternal mortality likely involve many factors. “But,” Villarosa writes, “recently there has been growing acceptance of what has largely been, for the medical establishment, a shocking idea: For Black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions—including hypertension and pre-eclampsia [a pregnancy-related disorder characterized by high blood pressure and other symptoms that increase the risk to the mother and fetus]—that lead directly to higher rates of infant and maternal death. And that societal racism is further expressed in a pervasive, longstanding racial bias in health care—including the dismissal of legitimate concerns and symptoms—that can help explain poor birth outcomes even in the case of Black women with the most advantages.”

It is not primarily a lack of education or even unequal resources that are responsible for the deaths of more than 4,000 Black infants every year. Instead, according to the studies and experts cited in the article, it is the cumulative result of the stress and trauma of living in a racist society. Having to fear arrest because you show up early for a work-related appointment at Starbucks... worrying about whether your son or daughter will come home alive... being denied housing and employment... being treated as less than human in everyday interactions... and in a thousand other abuses.

Villarosa writes that, at Essence magazine, where she was health editor from the late 1980s to the mid-’90s, they covered the issue of infant mortality by promoting an “each-one-teach-one” mentality: “encourage teenagers in your orbit to just say no to sex and educate all the ‘sisters’ in your life (read: your less-educated and less-privileged friends and family) about the importance of prenatal care and healthful habits during pregnancy.” Her current article is a refutation of this approach. “Each-one-teach-one” and “educating” those who are abused by a heartless system and not taking into account (and taking on) the economic and social causes behind these disparities amounts to blaming the victim and can only makes things worse.

Racism Inside the Health System

In addition to the cumulative effects of racism, the disparities in fetal/maternal mortality are the result of racism within the health system. In her article, Villarosa reports on a study underway by the Averting Maternal Death and Disability Program at Columbia University’s School of Public Health. Interviews conducted by the researchers revealed a range of grievances—from having to wait one to two months before an initial prenatal appointment to being ignored, scolded, and demeaned, even feeling bullied or pushed into having C-sections [caesarean section].

One Black woman wrote to the New York Times about her experience: “I am a mother of two sons,” she writes. “Both times it was a struggle to get doctors to even pay attention to my symptoms. When I first noticed that my blood pressure was elevated, I was told, ‘You people usually have higher blood pressure,’ but for the presence of my father who called an OB-GYN friend in California, I would be dead. The second ... I still was not listened to until my family threatened litigation. I am an African-American woman with degrees from Princeton and Yale.... You would have thought I was a mute from Mars. It was the most frustrating experience of my life.”

This racism inside the health system in the U.S. goes way beyond mother-infant mortality. Black people are discriminated against from the moment they enter the healthcare system. These disparities cut across lines of wealth and education. For example:

  • A 2014 study showed that Black people do not receive as much medication and preventive care for diabetes as other patients and are three times more likely to lose a leg to amputation because of the disease. (Dartmouth Atlas Project cited in Reuters Health, October 14, 2014)
  • Black people are two to three times as likely as whites to die of preventable heart disease and stroke.

To illuminate the reason behind these differences, Villarosa cites a 2016 study by researchers at the University of Virginia which examined why Black patients receive inadequate treatment for pain not only compared with white patients but also relative to World Health Organization guidelines. The study found that white medical students and residents often thought, falsely, that Black people have less-sensitive nerve endings than whites, that Black people’s blood coagulates more quickly, and that black skin is thicker than white. These are lies that date back to slavery when they were used to justify the torture of Black people.

These inequalities play out in years or decades stolen from the lives of our brothers and sisters. In Oakland, California, a city with a diverse, multinational composition, life expectancy varies by as much as 24 years between neighborhoods. The census tract with the highest life expectancy, 91 years, is in the Oakland Hills, affluent and primarily white. The tract with the lowest life expectancy, 67 years, is in West Oakland, which is poor and mainly Black. The life expectancy in West Oakland is similar to the life expectancy of countries such as Turkmenistan, Kazakhstan and North Korea. (“Neighborhood-Level Determinants of Life Expectancy in Oakland, CA,” Center on Human Needs, Virginia Commonwealth University, Richmond, Virginia, 2012)

This Is Unacceptable!

There is no reason that thousands of Black infants and mothers in the U.S. have to die unnecessarily every year. It is UNACCEPTABLE. Why does it continue? Because the oppression that Black people face in this country is literally toxic. Add to this the deeply ingrained racism in medicine. Ending these disparities cannot be achieved by working through the white supremacist, capitalist system where racism is built-in and reinforced in a thousand ways by the economic and social relations. These lost lives cry out for revolution.




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