Racism in Healthcare: A Black woman’s childbirth story

Jay-Z’s Empire State of Mind blared in the background of the delivery room from my iPhone as the nurses in the labor room encouraged me to push harder. It was one of the most important days of my life, and the day I almost lost my life.

On December 21, 2020, I woke up around 12:15 a.m. with a painful ache in my abdomen. This ache rapidly spread across every part of my body but managed to remain concentrated around my belly. At the time, I was nine months pregnant and nine days away from my due date. Months before that day, I had taken multiple trips to the OBGYN office and was informed that my baby was developing steadily. Towards the later months of my pregnancy, the process of carrying a baby became increasingly difficult. In the 28th week of my pregnancy, I got diagnosed with gestational diabetes, a condition that affects how cells use glucose sugar in pregnancy and causes high blood sugar. To avoid further complications, doctors encouraged me to measure my blood sugar with an AquaLance Lancets device four times a day. As the weeks continued to progress, I measured my blood sugar often and followed a healthy diet plan, but most of the questions that I directed towards my healthcare provider were either met with passive aggression or barely vaguely answered. 

As a Black woman and an immigrant of African descent, I was operating under the belief that the U.S healthcare system was second to none. I tried to ignore the dismissiveness that I was subjected to and tried to remain as healthy as possible throughout my pregnancy in the months that followed.

After four hours of tossing and turning in bed, I told my husband that the pain was beyond excruciating, and at about 4:30 a.m., we climbed into our Toyota RAV4 SUV and headed for the hospital, about 30  minutes away from our apartment in Allendale, Michigan. When we arrived, I was transferred to a wheelchair and wheeled down the halls towards a hallway whose entrance read “Admissions.” Three hours later, I was in the labor room, getting prepped for labor. The nurses injected me with an epidural to help me endure the stinging pain of childbirth, and seven grueling hours later, I gave birth to my son at 2:39 p.m., and he weighed 8 pounds and 3 ounces. I took a breath of relief as I was wheeled to another room upstairs to recover, but the worst was yet to come. Four hours later, at about 6:17 p.m., I finally held my son in my arms for an extended time, and I was immediately overcome with inexplicable love as he fell asleep in my arms. Before long, my husband came to stand beside us and immediately froze.

My bed was drenched in blood that I didn’t feel leaving my body, and my husband immediately called for a nurse who came into the room and calmly said she would call the doctor to come in and take a look at me. I never saw her again after that day. Later that night, another doctor came into the room to check on me, and she immediately went white in the face, calling for the other senior doctor on call to attend to me. By this time, my entire bed was soaked, and before I knew what was happening, nine people were in my room, three doctors and six nurses, all clamoring around my bed and asking me my symptoms. At first, I was unalarmed because of the lax way that the first nurse had approached the bleeding and because I felt no significant pain. 

The doctors informed me that I was losing blood at a dangerous and rapid pace,  and needed to go in for a dilation and curettage surgery, a surgical procedure in which the cervix is dilated so that the uterine lining can be scraped with a spoon-shaped instrument to remove abnormal tissues. The doctors gave me a general anesthetic through an intravenous line (IV) into a vein in my arm that caused me to sleep throughout the surgery. I woke up from the surgery feeling disoriented, groggy, light-headed, and lethargic. My tongue felt like rubber, and I felt excruciating pain as I struggled to gulp. The room had the smell of rubber gloves and hand sanitizer.  I tried to speak but could barely make out a word as one of the nurses flatly informed me that my baby was in the nursery and my husband was in the waiting room. Before the surgery, I had two blood transfusions, and after the surgery,  I had four transfusions, making it a total of six transfusions. I could barely move my body as I was wheeled back to the recovery room. 

As it turns out, I am not the only Black woman who nearly lost her life due to a lack of care from healthcare professionals in the United States. And racism, unfortunately, lies at the core of this malpractice. Millions of women have suffered my fate or, even worse, died.

 In the United States, Black women are two to six times more likely to die from pregnancy complications than white women, depending on what part of the country they live in. This rests on many factors, including the racial divide in healthcare. When data obtained from 1979 to 1992 was analyzed by medical experts, the overall pregnancy-related mortality ratio was 25.1 deaths per 100,000 for Black women, 10.3 for Hispanic women, and 6.0 for non-Hispanic white women. According to the American Medical Association, these rates have not improved, and the leading causes of maternal death are hemorrhage, pregnancy-induced hypertension, and embolism. Black women have almost three times the risk of death from hemorrhage than white women.

Although the data exists to measure the maternal mortality rate in Black women, it wasn’t until recently that there has been national attention given to this issue. According to Dr. Neel Shah, an Assistant Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School, medical professionals did not systematically measure the mortality rates in childbirth until relevantly recently.

“It was only in 2018 that we discovered that the maternal mortality rate of Black women in our country has been going up for 25 years, and the only way to try to understand that is through the lens of racism. A Black person, on average, is more likely to die from childbirth than a white person, and that disparity is even larger when you are in places like New York City where there is a lot of segregation not only geographically but in terms of opportunities to thrive,” said Shah.

He also said that racism in healthcare also affected the outcome of many Black women’s births.

“When it comes to Black birthing experiences, in particular, there are structural causes of racism, and there are also interpersonal stories of racism that we see play out in the media sometimes when people don’t get heard and feel dismissed,” said Shah. “There are systemic traces of racism that are built into this practice, and the way doctors are trained and some of that has roots that go back to slavery.”

Kimberly Sallers, the owner of Irth App, a nonprofit organization where Black women can find prenatal, birthing, postpartum, and pediatric reviews of care from other Black and brown women, said that education and status do not protect Black women from racism in healthcare.

“We can look at what happened to Serena Williams as an example. She had some complications during her childbirth and had her white millionaire husband was by her side, but still, she was dismissed,” said Sallers. Sallers also said that despite the stories of Black women who have died during childbirth or experienced traumatic birthing experiences and experience traumas, there remains hope.

“Although the narrative around Black birth is often painted as doom and gloom, we can’t just let this be a fear-based event,” Sallers said. “Using fear has been used as a tool to control Black people from time, but we should not allow Black births to be a solely negative event because there is hope for the future of Black births.”