Vitals Reporting on the pro-life movement

Black mothers matter

Life | High maternal mortality rates among African American women spark questions
by Leah Hickman
Posted 10/19/20, 04:03 pm

Twenty-six year old Sha-Asia Washington, a pregnant black woman, died this July while undergoing a cesarean section at a New York City hospital. Friends and family blamed Washington’s death on the negligence of the medical providers, who family members said pressured her into and improperly administered an epidural. The tragedy sparked local protests, and activists pointed to the situation as an example of racism in the healthcare system, a factor some say contributes to disproportionately high rates of maternal deaths among black women.

The most recent data available from the Centers for Disease Control and Prevention shows the mortality rate for pregnant African American women is about three times higher than for white women. While racism in patient-provider relationships could contribute to the disparity, laypeople and medical professionals say the problem reflects other societal trends, as well, including abortion.

“I’ve been seeing posts on social media saying never to let a white doctor deliver a black woman’s baby,” user EmilyIrene, who said she is biracial, posted in a forum on WhatToExpect.com in September. “… I’m just curious to know why people say that?”

Users gave mixed responses, some echoing concerns of racial inequality. “Doctors view black women as … ‘tougher’ [and] can handle pain more [and] totally disregard them when they say something doesn’t feel right,” wrote user DesiiiK1.

User NWTU2010, who identified herself as a black woman, told a different story: “My best OB experience was with a white male, I personally don’t think just [because] you have a black doctor it guarantees a good experience. But I do agree that black women are often unheard or their concerns are ignored.”

Dr. Donna Harrison, executive director of the American Association of Pro-Life Obstetricians (AAPLOG) and Gynecologists, said she did not doubt racism contributed to poorer maternal outcomes in some cases.

“I’m sure there are individual doctors who are racist. I’m sure that that exists,” she said. “I think you need to drill down a little bit deeper rather than accuse the entire medical profession of being racist.”

Mortality among U.S. mothers of all demographics has risen since the early 2000s, likely due to the increasing average age of mothers and the growing number of chronic health conditions that comes with a rise in the average body mass index of U.S. women. Harrison pointed to a data point that could partially explain the disproportionately high death rates of pregnant African American women: Their abortion rate is more than three times that of white women.

“If you have an abortion, you increase your rate of preterm birth,” Harrison said. “Preterm birth can be more complicated. You also increase your rate of placental spectral disorders … where the placenta grows into the muscle wall of the uterus. Women with [these disorders] have a higher rate of dying from hemorrhage in childbirth.”

Even though African American families make up only about 13 percent of the U.S. population, black mothers account for 38 percent of all documented U.S. abortions. Abortion businesses like Planned Parenthood contribute to the high ratio by targeting minority communities. Pro-life groups such as Life Issues Institute have found almost 80 percent of abortion facilities are within 2 miles of predominantly black or Latino neighborhoods. The views of Planned Parenthood founder Margaret Sanger, who believed in race-based eugenics, affect the abortion industry today. “We do not want word to go out that we want to exterminate the Negro population,” Sanger wrote to fellow eugenicist Clarence Gamble in 1939.

Existing data do not allow for establishing a true statistical correlation between abortion and maternal mortality among African Americans. “The total number of legal abortions performed in the U.S. is not known,” an AAPLOG committee reported in August 2019. “Estimated numbers of abortions are voluntarily reported to the CDC by state health departments.”

Some states, such as California, don’t report abortion numbers at all. Harrison called the lack of data unacceptable: “Black women deserve to know the real causes … a real, scientific answer as to why the black maternal mortality rate is higher.”


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Leah Hickman

Leah is a reporter for WORLD Magazine and WORLD Digital. She is a World Journalism Institute and Hillsdale College graduate. Leah resides in Cleveland, Ohio. Follow her on Twitter @leahmhickman.

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  • Ann Marshall
    Posted: Mon, 10/19/2020 05:09 pm

    Thank you very much for this informative article, heartbreaking though it is. I think in the US generally we're too quick to intervene in childbirth and too lax about post-partum care. 

  • Janet B
    Posted: Mon, 10/19/2020 05:19 pm

    I understand that the Guttmacher Institute (guttmacher.org), closely affiliated with Planned Parenthood, keeps track of the number of abortions each year.  Where they get the info, or how accurate it is, I do not know.  But it has, ironically, shown some trends that weigh against abortion.  Have you tried to get info from them?

  • Cyborg3's picture
    Cyborg3
    Posted: Mon, 10/19/2020 05:34 pm

    "Dr. Donna Harrison, executive director of the American Association of Pro-Life Obstetricians (AAPLOG) and Gynecologists, said she did not doubt racism contributed to poorer maternal outcomes in some cases." 
     

    Ironically, she makes this PC statement but provides no evidence for it. If she said racism is not an issue then there would be a cry for her to resign so I don't really blame her for making it in this PC environment that exists. If you looked at white, Asian, Hispanic, or other women living in similar neighborhoods and economic levels, I would bet that the death rate would be similar which would show that it has nothing to do with racism. 
     

    It is a tragedy any time somebody dies due to a mistake made by a doctor or health care worker, but it doesn't necessarily point to racism. 
     

     “Black women deserve to know the real causes … a real, scientificanswer as to why the black maternal mortality rate is higher.”

    I am all for looking at the evidence objectively and trying to discern the reasons for the high maternal mortality rate in black women. There should be statistics kept, required by law, to better determine the causes of the high mortality rate. This should include statistics on abortion for this may be related. 
     

    A great article written by Leah. 

  • not silent
    Posted: Mon, 10/19/2020 06:18 pm

    Cyborg, I understand your desire for evidence; but I guess I'm wondering how one could objectively "measure" racism in the medical community.  I have worked in healthcare; and, although I would never claim that racism is the ONLY reason for disparate outcomes, I do think it may contribute in SOME cases.  I don't think it necessarily means that the provider views the patient as "less human" because of race; it may take the form of viewing people of certain races as "tougher" or "not needing pain meds" and minimizing their pain or failing to treat it properly (as described in the article). 

    Because it's often essential to make decisions rapidly and efficiently in medical situations, there is a danger of falling back on stereotypes and failing to see when an individual case does not fit the perceived "norm."  I personally witnessed an aggregious case where hospital staff assumed a patient was drug seeking and slanted their documentation to support that view.  They wound up missing a potentially serious medical problem even though the patient had classic symptoms and signs of the actual problem.  There have been studies showing that confirmation bias can be a real problem in medical settings that require quick decision-making, and it's a problem whether it's caused by racism or some other form of bias (in my example, it was a bias against someone with a history or mental illness, which is a HUGE problem in medicine in the US today).

  • Cyborg3's picture
    Cyborg3
    Posted: Tue, 10/20/2020 05:25 am

    Not Silent, you can look for reasons besides racism, such as complications due to abortion, poor nutrition as KG explained, stress levels due to environmental factors etc.  If you could show that other reasons besides racism was the cause, then you could rule out racism.  
     

    You could make a list of racist reasons for the high mortality rate and attempt to identify markers for them.  Then you could look for the markers to identify the racism.  I say this glibly but you are exactly right that the markers may be very difficult to identify and very subjective at that. If I was conducting the study, I think I would try both methods: looking for non racist reasons, and looking for racist reasons. If racism really exists, you would expect that both methods would show that. 

  • not silent
    Posted: Tue, 10/20/2020 09:41 am

    Thanks, Cyborg.  I would agree with your suggestions for how to study the subject.  The only thing I would disagree with is that I don't think finding other reasons for a disparity in care automatically shows there was no racism at the same time.  It MIGHT show that, but it might not.  Human beings are very complex and our motives can be mixed. (A person may have thoughts that could qualify as racist but still treat all patients equally.  Or a person may "say" all the right things but still treat patients unequally.)   It's tempting to reduce situations so that there are only two choices or to find one villain to blame for all problems and focus on that one thing at the exclusion of all else, but human beings and our society are complex. It's much easier to blame someone else or something else and avoid looking at ourselves.

     

  • Cyborg3's picture
    Cyborg3
    Posted: Wed, 10/21/2020 02:57 am

    The goal of the study is to reconcile the disparity in mortality rates between black pregnant women and other pregnant women at large. For example, if I took a large statistical sample of pregnant white women who had similar weight (BMI), and found their mortality rates were exactly equivalent to the black women, then you would be hard pressed to show the cause was due to racism.  

    In real life, it is never that easy. More likely there may be 5 main issues (e.g. obesity, abortion, nutrition, etc) and 5 other minor issues.  If you statistically evaluated all this and found that the mortality rate disparity disappeared, then you would be confident that racism was not a factor.  

    More likely you would still find a small disparity and you would have to find another reason explaining it. If you couldn’t find other non-racist reasons, then it could well show racism is the cause - though it is only a small percentage for this case. If you found a huge gap between black women and non-black women even after many non-racist causes were assessed, then you would have a strong indication that racism was the cause. 

  • KG
    Posted: Mon, 10/19/2020 07:18 pm

    As a midwife, I do not feel the area of nutrition is properly addressed. Nutrition is the number one indicator of the outcome of a pregnancy. - Anne Frye

    Vitamin D is vital to mom and baby health. It is typically lower in any person with darker skin. Medicaid pays for cheap synthetic vitamins which can cause more damage than good in a woman especially a woman with an MTHFR mutation which is over 70% of the population.

    Poverty plays a huge role in nutrition and health. With lack of nutrition, it will take its toll on placenta health, pre-eclampsia, high blood pressure, gestational diabetes. There is lack of education on proper nutrition and when prepackaged food is cheaper than nutrient dense real food we have a problem. Almost every women that had to transfer to a doctor from my care is due to lifestyle and nutrition.

     Then add in the stress of fatherless homes which is higher in black communities and that adds another dynamic. This in addition to abortions listed in article adds another layer to the problem.

     There is likely some racist doctors that  do not treat blacks with the care they need and deserve. However I have heard many horror stores of births and doctors with white women as well. Unethical care providers generally are power hungry and don't care the skin color. But if we minimize this problem by saying it is all racism, we will never find a solution to a very multifaceted problem.

     It is going to take people caring enough to go into a community in conjunction with working with those in the community to make real meaningful lifestyle changes. It is also going to mean people have to take responsibility for their own part as well.

  • Sun shine
    Posted: Tue, 10/20/2020 07:30 am

    As an ICU pediatric and neonatal nurse of 14 years, I have so many questions when I read these stories.  Why has no one talked about the overwhelming obesity among African American women?  Why has medicine refused to combat the "big, black, and beautiful" movement that continues to foster poor health among black women?  Why is your MD not listening an issue among black women?  (It's an issue in almost every patient room!). Why are we surprised by pressure from providers?  We have an entire medical community pressuring the population into vaccines, yearly exams, colonoscopies, elective surgeries, birth control, etc. Why is this woman not considered intelligent enough to make her own decisions, sign her own consent form and be responsible for the risk?  (Risks and consent must be obtained before an epidural.).  Was there negligence or a fluke error?  Can we please recognize that even the best medical provider is human and will make errors?  Why is this being published on social media and not being addressed within the hospital system to make changes?  The most legitimate lawsuits I've experienced were done quietly and respectfully as the degrees, experience, and character of staff were respected by the family suing.  

  • RC
    Posted: Tue, 10/20/2020 12:04 pm

    The answer to your last question, is in the first paragraph of the article, "The tragedy sparked local protests, and activists pointed to the situation as an example of racism in the healthcare system,".  Obviously, the family was not protesting or making a claim for racism.  The "activists" are desperately searching for any and all situations where they can create cases for racism, even from thin air.  

    Based on all the factors raise in the article and many from other commenters, as well as your other questions, the problem has a multitude of layers, Health Education, Poverty, Crime, Abortion, Morality, etc. and if racism is an issue, it comes in dead last.

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