The US has the worst maternal mortality rate among developed countries, and it’s only getting worse every year.
I am a white woman with great health insurance, who, in June of 2019, delivered a baby in an excellent hospital. I was the definition of privileged.
It’s hard to pinpoint exactly where things went wrong but, due to my OB’s call schedule, I was set to deliver with a physician from another practice. She didn’t know me or my history and I’m fairly certain she merely skimmed my chart. She was cold, and her bedside manner left much to be desired. I didn’t feel comfortable (read: safe) with her from the start.
Hours into my labor, she performed an intervention procedure that she failed to explain and never asked for my permission to do. When I complained of pain, I was dismissed. When I started hemorrhaging, she and the staff were too busy trying to fix the problem she created to effectively communicate what was happening to me. I looked at my husband for help, and they brushed him off, too. All I could think was, I am going to die.
Now, nine months later (and a lot of PTSD therapy), all I can think is, I’m a white woman. What would have happened if I weren’t?
The feeling in the pit of my stomach knows the answer to that question.
The maternal mortality rate in the US is a disgrace, but the rate for women of color, especially black women, is downright horrific. In America, black women are three to four times more likely to die during pregnancy/delivery than white women. Researchers have come up with various contributors to this statistic, but it mostly boils down to access to quality health care and implicit bias.
Because of the inequality embedded in our culture, the odds are immediately stacked against black women who hope to have a baby. The National Partnership for Women and Babies explains that black women are, on average, paid less than white women (who are already paid less than white men), which makes taking time off from work for prenatal appointments and maternity leave more difficult because of the income lost. Not to mention, access to quality health insurance is dependant on employers (for the most part) and black women are at a disadvantage there because of biases in hiring procedures.
Even if a black woman does have access to quality healthcare, she is likely to face implicit (or explicit) bias by someone on her care team. The American College of Obstetricians and Gynecologists have come out and said that bias within healthcare is a major contributing factor to the maternal mortality rate among black women. Women who are subjected to this are often dismissed by professionals, are undertreated for pain or other conditions, and/or flat out ignored.
According to the World Health Organization, communication plays a significant role in the outcome of pregnancy/delivery because, as it stands, doctors have control over the process. And if they are not effectively communicating with a patient they could “expose [an] apparently healthy pregnant [woman] to unnecessary medical interventions that interfere with the physiological process of childbirth.” Implicit bias leads to poor communication which leads to unnecessary medical interventions, which leads to complications, which can lead to death.
It’s no wonder the maternal mortality rate among black women is so high.
I’m lucky because I, and my baby, came out of the experience alive. But, that’s a pretty low bar for a doctor who is specialized in delivering babies to meet. The communication throughout my labor and delivery was poor (at best) and left a mark on me that I will never be able to forget.
My story is unique for white women, but it’s a common narrative for black women. Nothing about that is okay.