“All of my status characteristics screamed ‘competent’, but nothing could shut down what my blackness screams when I walk into the room” was once quoted by Serena Williams (Cotton 1).
The United States is known for its ‘land of the free,’ but does that free include equality for all? Can someone receive different treatment in this country just by their ethnicity? The quote from Serena Williams written in TIME magazine helps shine a light on these questions as we dive deeper into this analysis: Is the United States health care system racist towards pregnant African American women?
An African American woman shared her birth experience in an article written in TIME magazine. Her story first began with her bleeding at work while being four months pregnant. She called her husband to pick her up from work to take her to the hospital to ensure that nothing seriously horrific was happening to her or her baby. After calling ahead and explaining the condition she was in, she still had to wait 30 minutes in the waiting room, where her condition was so serious to the point where she bled through the chair. After the husband confronted the nurse about moving to the back, the nurse eventually was able to get her a room. Once when she was in a room, she was able to meet up with her doctor, where they announced to her that the spotting was normal and could be due to her being fat. She was then sent home with no help or other input from her health care providers (Cottom 1).
Later that night, she felt extreme pain in her butt to the point where they had to call the nurse. The nurse stressed that since her back wasn’t hurting with her butt pain, it was probably due to constipation. The pain hurt so badly that she was only able to sleep about 15 minutes out of a 70-hour time span. She decided to go back to the doctor’s office, where the doctor’s reassured her it was probably due to something she ate that was bad. The doctors then hesitantly decided for an ultra-sound to be performed, where it was found that there were two tumors present in her uterus bigger than her unborn child. The doctors also found out that she has been in labor for the past three days and blamed her for not telling them. While she was in the labor room, she asked for pain medication, but the anesthesiologist replied that he wouldn’t give it to her unless she would quiet down. After the first couple of minutes of her child being born, the little infant passed away. The nurse replied, “Just so you know, there was nothing we could have done, because you did not tell us you were in labor” (Cottom 1).
According to Merriam-Webster, racism can be defined as “the belief that race is a fundamental determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race” (Merriam-Webster). So, let me ask, was this rooted to racism?
Let’s dive deeper into an analysis of this situation. When the four-month pregnant women first presented her situation to her medical care, she explained to them that she had a severe bleeding problem, which should have been a concern. The doctor explained to her that it was normal to spot while being pregnant and completely brushed off the situation. This first encounter was not handled correctly due to the fact that this woman was not just spotting if she was bleeding enough to go through a chair. This would be considered as a heavy bleeding and she should have been examined right off the bat to ensure she wasn’t having a miscarriage, or any other serious condition. When she was sent home and started to be in pain, the nurse’s only input was that that she was constipated and should try to go to the bathroom, since it was only her butt that was hurting. With the women experiencing severe pain not long after going to the doctor for bleeding, she should have been asked to come into the office for an examination. Instead, her pain was brushed off as if she didn’t know what she was talking about. When she finally went to the doctor’s again for her pain, two tumors were found, and it was expressed that she had been in labor for the past three days. The horrific part about this is that the doctors were extremely reluctant to perform the ultrasound in the first place. If it wasn’t for the ultrasound, they wouldn’t have found the tumors and wouldn’t have realized she was already in labor. The doctors seemed very careless and hesitant to help the women figure out what was wrong with her. It also seemed as if they knew nothing was wrong with her but decided to do an ultra-sound to prove to her that she is over thinking the situation.
If she was examined in the first place, her situation could have been caught sooner. When she went into the labor room to give birth to her baby, she was in so much pain, but the anesthesiologist also acted hesitant. Normally when doctors are hesitant to give women in labor pain medication, it is due to how far in labor they are, not because of them being loud. This comment from the anesthesiologist was extremely uncalled for and unprofessional. This woman has not only had the pain of labor, but she is also dealing with two huge tumors that have been causing her extreme pain in the first place. It seems as if the anesthesiologists thought she was exaggerating the pain she was feeling by making noises and screaming. Even though she was receiving terrible treatment from her care team, the most painful part about this women’s story was that the nurse put the blame of her baby’s death on her. To say they could do nothing to prevent the death of the baby because she didn’t tell the care team that she was in labor was monstrous. The women had presented her problems and concerns to the doctor’s several times and what did they do to help her? Nothing. So, let’s ask, was this racist?
“Like millions of women of color, especially black women, the healthcare machine could not imagine me as competent and so it neglected and ignored me until I was incompetent” (Cottom 1). People in the healthcare had prejudice thoughts about the pregnant women and assumed she was not knowledgeable, skillful, or fit for understanding what was happening. These prenotions put her and her child on the line, which in the end, was inhumane. Her medical team felt superior over her capabilities, leaving her defenseless and helpless in a time when she needed them most. If she was a white woman, would her care team have acted on her situation quicker? It’s horrible to say that this can also be an example of an intersectional identity to where this woman not only had to deal with the fact of just getting care as an African American, but she was also getting the quality care of being a woman in general. There is a greater chance that if this woman was white, she would have received better care. With the health care team believing that white women are competent, they would have examined her sooner and could have potentially changed the outcome of this situation.
Just like this women’s story, these situations are not rare in the United States. It has been found that African American women have a higher maternal and infant mortality rate due the inequality in health care. Statistics show that African American women have a mortality rate of 41 per 100,000 births, where American Indian women have 30, and white women have 13 (Taylor 1). Not only does African women have 28 more deaths than white women, but they are also 11 deaths higher than another race. This shows that African American women have more complications and are receiving a lack of care compared to white American women and other races. It is extremely shocking and heartbreaking to find that the amount and quality of care a woman gets when she is pregnant is dependent on her race.
Not only are these women getting the lack of support they need in the medical field, but they are also losing care support from other programs. Many programs like Medicaid, nutrition assistance, and TANF are being defunded and have had major budget cuts (Taylor et al., 1). If African American women are being treated unfairly in the medical field and have other programs defunded, what will they do? Where would they go? Their support in the United States is so limited and it’s immortally wrong to put them in this situation, especially when it’s based off of the color of their skin.
So, let’s ask again, is this racist? It is evident that the amount and quality a pregnant woman receives in health care is dependent on their ethnicity. There are predetermined feelings, beliefs, and judgements on whether an African American woman is competent. These prenotions have increased the mortality rate for African Americans, which clearly shows there is inequality in the system. The way her care team treated her also portrayed de Beauvoir’s theory of the ‘One’ verse the ‘Other’ (Beauvoir 1). The care team thought less of the African American women and provided her mediocre care quality during her birth experience. The care team demonstrated power over her and made her feel incompetent, when she was.
It is extremely upsetting to say that lives are being put on the line due to other people’s thoughts and actions. With African American women receiving poor quality in the health care system and having other programs defunded, they are not being properly taken care of. It is crucial for a light to be shined on this systematic injustice, because there are 28 women for every 100,000 births who die that don’t have the ability to fight for their lives.
Figure 1. A visual representation of the amount of maternal mortality rates per 100,000 births of different races in the United States (Petersen et al. 762-65).
Figure 2. A visual representation of the infant mortality rate per 100,000 births of different races (Petersen et al. 762-65).
Work Cited
Cottom, Tressie. “I was pregnant and in Crisis. All the Doctors and Nurses Saw Was an Incompetent Black Women”. TIME. 2019. https://time.com/5494404/tressie-mcmillan-cottom-thick-pregnancy-competent/
Definition of RACISM. https://www.merriam-webster.com/dictionary/racism. Accessed on April 4th, 2021.
Petersen et al., “Racial/Ethnic Disparities in Pregnancy- Related Deaths- United States. 2007-2016. “Morbidity and Mortality Weekly Report 68, no.35: 762-65. Retrieved from https://tcf.org/content/report/racism-inequality-health-care-african-americans/?session=1
Taylor, Jamila. “Racism, Inequality, and Health Care for African Americans”. The Century Foundation. 2019. https://tcf.org/content/report/racism-inequality-health-care-african-americans/?session=1
Taylor, Jamila. Novoa, Cristina. Hamm, Katie. Phadke, Shilpa. “Eliminating Racial Disparities in Marternal and Infant Mortality”. Center for American Progress. 2019. https://www.americanprogress.org/issues/women/reports/2019/05/02/469186/eliminating-racial-disparities-maternal-infant-mortality/