Her husband stayed with her day and night as Afrika Gupton-Jones rested in the hospital after developing high blood pressure at 28 weeks pregnant. Still, her nurses often assumed he was her brother and she was a single mother, and when doctors and nurses administered medications or drew blood, she kept the bare minimum. She said she only gave an explanation.
“They didn’t seem to trust me with my own physical decisions,” she said.
In the United States, people with more money generally have better health care. More expensive insurance plans usually cover more doctors. But Gupton-Jones and her husband felt they were treated insensitively despite being upper middle class and privately insured. Her marketing career hasn’t made a difference in how doctors and nurses see them, she said.
Earning more and being well educated doesn’t protect black mothers during childbirth the same way it protects white mothers. The richest black mothers and their babies were more likely to die in childbirth than the richest white mothers and their babies, according to a new study of her 10-year births in California released this year. was found to be twice as high as
Missing from mortality statistics are many stories of abuse and negative experiences. In interviews with black women asked to share their birth stories from The New York Times, they said pain dismissedthe concern is ignored, the plan was ignored in labor. They recalled walking a fine line between speaking up for themselves and being nervous about pushing too hard.
Many studies suggest that racism and how it affects the health of black women throughout their lives is a major factor. researchers say.it happens across the healthcare environmentstudies show that even if medical staff are generally empathetic, only one such interaction Great effect. It continues throughout childbirth when discrimination, whether unconscious or unconscious, affects the hospital care of black mothers.
Tyan Parker Dominguez, who studies race and birth outcomes at the University of Southern California School of Social Work, said, “The long-term problem of disparities in maternal outcomes cannot be reduced to class.” It doesn’t work along the social side, because even if you control it, it’s still a factor.”
Gupton-Jones’ son Sydney, now 8, was born at 30 weeks and spent six weeks in the neonatal intensive care unit. Medical professionals at a suburban Ohio hospital were white, she said, but it was full of families of color. I felt that I was
She was comfortable defending herself with her career, but didn’t want to cause conflict with those who were looking after Sidney, so she and her husband said nothing at the hospital. “You had to have blind trust in the night shift that they were taking good care of your child,” she said.
“Racism doesn’t work for economic reasons”
Research shows that higher income levels and higher education generally lead to better fertility outcomes, including lower fertility rates. caesarean section, premature birth and infant mortality — unless the mother is black.
One reason, according to Professor Parker Dominguez, is that many black women with more resources have probably recently been promoted to classes. It has been found to have a greater impact on reproductive health than attained socioeconomic status.
“They’ve likely lived at a disadvantage, and just because they hit $100,000 in income at 30 doesn’t make it go away,” she said.
In her work, and that of others, there is also evidence of: experience racism It has long-term effects on health.It may increase the incidence of underlying conditions such as high blood pressure and Diabetesaffect birth resultThese effects are passed down through generations.
Professor Parker Dominguez said, “It’s probably been a generation or two that African Americans have had the opportunity to move into the middle class en masse.
Research has shown that black women who plan to have a birth without an epidural are more likely to be pressured into using an epidural. low caesarean section rate For white women with advanced degrees, but not for highly educated black or Hispanic women.When a black woman has a caesarean section, they twice as likely A white woman undergoes general anesthesia and becomes unconscious for the birth of a child.
A new study conducted in Pennsylvania found that black mothers were significantly more likely to be tested for drugs than white mothers, even though white mothers were more likely to test positive. I was.
Black women are more likely Reported to Child Welfare Division After delivery. In qualitative research, they explained Health care workers who assume they are single, have multiple children, or have low incomes, regardless of whether that is true.
“When black mothers or births enter the health care system, regardless of their socioeconomic status, they are beginning to challenge racial stereotypes,” says the University of Minnesota, which studies racism in health care. epidemiologist Jaime Slaughter-Asee said. .
Painful but afraid to speak up
Lia Gardley, 32, wanted to give birth to her son Jaxson without an epidural. A construction manager, she figured that if she could get past her 7 cm dilation, the point at which her pain peaked, she could make it to the end. However, she repeatedly asked her nurse to check how much she had dilated, but was denied.
“She kept saying, ‘No, if you’re that worried, you should get an epidural,'” Gardley said.
Exhausted and unsure of how much effort she had left, she agreed to an epidural. Shortly after, her nurse checked her dilation and she was already over seven centimeters.
“When I think about it, it still bothers me because I had that kind of intention and determination. Good for you,” Gardley said.
Others described it as being influenced by stereotypes. One woman said her pediatrician thought she thought her baby was on Medicaid. Another explained that a nurse referred to her domestic partner (now her husband) as “baby daddy.” She was one third of her age inappropriately seeking her opioids when she returned to the hospital multiple times after giving birth because she was experiencing severe headaches and dangerously high blood pressure. was accused of
“The nurse said, ‘What do you want? This is my third time here. Mrs. Diloudid, what do you want?'” said the doctor, a mother from Maryland. “I just said, ‘No, it’s time to go,’ and I didn’t go back because obviously the nurse thought I was looking for drugs. I wasn’t feeling well.”
The doctor didn’t want to use the name because of her connections to health care professionals, but she and her husband decided not to have another child, largely because of their postpartum experiences. said.
“Historically, I think black pain has been ignored and underestimated,” she said. And much of it is unconscious, and your own assumptions cloud your judgment.
Many black mothers described themselves as walking a tightrope. You want providers to recognize your knowledge and expertise as healthcare professionals themselves, but you don’t want to be labeled as difficult.
Sade Meeks worked in the neonatal intensive care unit while pregnant with her daughter Leilani in November 2020, two months before her due date. Meeks underwent a difficult emergency caesarean section. She recalled her consciousness flickering on and off while being driven to her operating room. She was surprised and worried when the hospital told her she was ready for her discharge in just three days.
“I could hardly stand,” she said. “I was in a lot of pain, but I didn’t want to make a fuss. , saying, ‘You’re a woman, you’re strong, other women have had worse experiences.’ “
During her time in the NICU, Meeks knew that the hospital would likely provide child welfare services to black families. This is a nationwide trend. She feared that pushing back too hard would result in such a result, and she reluctantly returned home.
But the next day, Ms. Meeks, still in great pain, went to another hospital’s emergency room and was diagnosed with a serious infection. She was hospitalized, where she spent several weeks recuperating while her daughter traveled across town in her NICU at another hospital. She tried to send her breast milk to Leilani, but found the logistics impossible.
“It was traumatic. I felt like I had failed not only myself, but my child,” Meeks said. “I wish I had been more assertive about my concerns, but they kept brushing it off.”
“You can’t change what you don’t have a name for”
Dr. Donna Adams Pickett, an obstetrician practicing in Georgia, treats all black patient pregnancies as high-risk because of well-documented adverse outcomes.
“There are often excuses for our complaints and concerns, but they are consistently kept to a minimum,” she said. “I often have to play more of an advocate role than a doctor.”
Even her presence as a black doctor may help protect her patients: study says black Newborns delivered by black doctors have much better results.
But she also realized the bias extended to her as an obstetrician for black women. described a case in which a white doctor involved in a delivery dismissed her expertise. I had to convince him by showing him the blood between his legs.
“It bothered me to have to go through all these steps and waste precious time to prove to him that my patient needed emergency surgery.” she said.
The women in these stories survived and so did their babies, so for most women their negative experiences were not categorized as bad outcomes. He said tracking is needed to combat racism in hospital care. in her organization Birth of cultural rigorwhich she developed Survey to measure racism at birth.
Ask patients questions about abuse and concerns, such as whether the mother communicated openly and felt empathetic with her healthcare provider, and how her partner and others were treated in the hospital. Issues that otherwise go unnoticed come to the fore, such as black husbands being guarded in hospital corridors.
“Looking at results alone minimizes what hurts black birthers,” she said. “
