Last week, the world got to learn a little bit more about pro-tennis player Serena Williams’s experience giving birth to baby girl Alexis Olympia, through her interview with Vogue magazine. That little bit is now shining a big spotlight on the American health-care system and the hurdles and dangers women face bringing life into the world.
Williams delivered Alexis Olympia by emergency C-section after the baby’s heart rate declined. All was well until the next day, when Williams felt short of breath. She immediately brought this to the attention of her care providers and requested a CT scan because of her history of pulmonary embolism—that is, blood clots in her lungs—but they thought her pain medication was making her confused. Nonetheless, she was able to insist on a CT scan and get an accurate diagnosis and appropriate treatment.
Williams is an international superstar, a sports phenom, and is on track to set a new record for Grand Slam victories. But for all her celebrity and status she is, still, a black woman in America. And as such her birthing experience can’t be separated from the birthing experiences of so many black women in America, who are far likelier than white women to suffer serious complications or die as a result of childbirth. When discussing Williams’s maternal-health emergency, it’s vital to address the role played by racism and racial discrimination—a requirement to sustainably address the United States’ growing maternal-health problem.
Black women are nearly four times more likely to die from pregnancy and childbirth than white women, and are also more likely to experience a severe maternal morbidity such as a heart attack, hemorrhage, sepsis, or blood clots like Williams did, regardless of their level of education or income. In fact, data from the New York City Department of Health show that black college-educated women were more likely than white women who hadn’t completed high school to experience adverse maternal-health outcomes.
Knowledge and money aren’t enough to save black women, because racism trumps all.
Denying that fact, or failing to mention it when the opportunity presents itself, hinders meaningful progress on maternal health in the United States, where maternal mortality is rising, instead of declining as it is in the rest of the developed world. We won’t go far in solving the American maternal-health problem without first acknowledging and then addressing how racism—both inside and outside the health-care setting—harms black moms.
Racial discrimination within the health-care setting is a modern problem built on the legacy of slavery, reproductive oppression, and control of medicine and black bodies. It’s important to remember that the white medical establishment worked hard to eliminate black midwives through smear-messaging campaigns claiming they were “dirty” and by passing laws restricting their practice. Today racial discrimination in clinical care presents in a variety of ways. Research has shown that implicit racial bias may cause doctors to spend less time with black patients and that black people receive less-effective care. Doctors are also more likely to underestimate the pain of their black patients. And anecdotes of disrespect and mistreatment abound.