An OB/GYN On The Maternal Health Disparities Black Women Face

Systemic racism not only limits Black communities' access to employment, housing1, and education, but it also limits access to equal and appropriate health care. These inequities in the health care system2 are abundantly clear when it comes to Black maternal health.

After years of working as an OB/GYN, treating thousands of patients, and being a patient herself, Heather Irobunda, M.D., became aware of the discomfort many women—particularly women of color—face at doctor visits. She created an online platform to provide reliable and transparent information about women's health, and she believes it's her responsibility to remind the world that Black maternal lives matter, and Black babies matter, too.

The U.S. has the worst maternal mortality rate among developed countries, and the rate has been rising since about 1990. According to the Centers for Disease Control (CDC), the current maternal mortality rate is 17.4 deaths per 100,000 moms3. That means about 700 women die from a pregnancy-related death per year. To put it into some context, we rank right behind Russia in terms of maternal deaths worldwide.

These deaths are largely preventable. One of the biggest ways to prevent these deaths is to listen to the issues that Black women present during pregnancy.

Many times, families and friends of women who have passed away say the mom had been voicing concerns about her health in the time leading up to her death. And oftentimes, there are accounts of the mom saying she felt unheard by her health care providers. We need to make a bigger effort to listen to these patients. 

Black women are more likely to develop a variety of health complications5 while pregnant. These complications include gestational diabetes, gestational hypertension, preeclampsia, and preterm labor. The reasons Black women are more likely to develop these complications are due to many societal factors, rooted in systemic racism and implicit bias.

Stereotypes about Black women's pain tolerance6 have been known to affect the care that Black women have received in health care settings. Black women are believed to have a higher pain tolerance than other women. It is thought that when Black women make health care providers aware of their pain, these health care providers may not take it as seriously. This has affected the way health care providers respond to Black women.

Women are being blamed for these deaths and health complications. The argument is that if women engage in more unhealthy habits, they may end up with health problems that contribute to their deaths or health complications. Women are also being blamed for starting families later in life, which could cause them to have worse health outcomes.

It is damaging to make these claims because they do not take into account societal or environmental factors, which contribute to these increased health issues or behaviors.

For example, increasing studies show in both urban and rural regions in the U.S., there are areas where it's difficult to find fresh produce and healthier food options. These places are called food deserts and are believed to contribute to obesity. Women living in food deserts often have to buy less nutritious foods—due to lack of access and available options—contributing to worse health and health outcomes.

Systemic racism, unfortunately, plays a huge role in the death of Black mothers and Black babies. It shows itself in medical education. Students are taught there is a genetic, instead of a societal, reason Black mothers and babies are more likely to have complications in pregnancy and childbirth.

It also shows itself in the communities that more Black women and babies live in. These communities tend to have a higher rate of unemployment, which directly affects access to health insurance and health care. As mentioned earlier, many of these areas also have less access to fresh and healthy foods.

Reproductive justice takes reproductive rights one step further. Reproductive rights ensure that women are able to have contraception and get proper health care when it comes to pregnancy and abortion care. Reproductive justice ensures that we use all of the tools available within our society to ensure that everyone gets equal access to reproductive rights, no matter the race or economic status.

This is a huge topic that some scholars have dedicated their whole careers to studying. There are a lot of things that we know about health disparities and a lot that we still need to learn. It is wonderful that we are now starting to have a serious discussion about this because, through these discussions, we will find a path forward. All Americans have the right to be healthy, and taking these steps to work on improving health equity gets us closer to that goal.