They Don’t Feel The Way We Do: Racial Bias in Maternal Health

by Executive Editor Timantha Norman

An absent OBGYN, an unknown, apathetic stand-in, an epidural, a medically unwarranted Cesarean section procedure, and unnecessary physical complications during the recovery process made what should have been the most joyous event of my life one of the most traumatic. Even my first experience with breastfeeding with my newborn son was quite upsetting. A middle-aged white nurse decided to teach me how to breastfeed by callously pushing into my back while she had her other hand under my son’s head somewhat roughly bringing his head towards my bare breast. 

Sadly, my experience is a common one for black mothers who often feel minimized, mistreated, and unheard at the hands of a cold, unfeeling, white, medical industrial complex. According to a recent Harvard University T. H. Chan School of Public Health study, black mothers “are monitored less, their concerns are often dismissed, and they tend to be sent home without adequate information about potentially concerning symptoms…. The risks jump at each stage of the labor, delivery, and postpartum process” for us. 

I spoke with maternal support practitioner and founder of mother support group WEBaby Rose Hurd about the troubling personal and professional experiences that led her to working on behalf of empowering black mothers, the historical trauma associated with biased medical practices, and the importance of spreading the benefits of breastfeeding to black mothers in the North Tulsa area.

Norman: In your own personal and professional experience, why do feel as though maternal health disparities are so rampant when it comes to black mothers?

Hurd: We do see a higher rate of maternal deaths in the black community. But not only that, there is just a huge difference with the way black women are treated, period. What happens a lot of times is that we do get ignored. A lot of doctors are not listening. Mothers who have just given birth are sent home without any real postpartum care. There’s not someone there to provide that higher level of care after the fact. There is a lot that have not been recorded in the statistics. A lot of our black mothers are dying after they give birth to their babies because their doctors aren’t listening to them when they have this issue or that issue. When I had my child at 16, the doctor came in the room, told me the baby was breached, and told me that I was going to have a C-section. No one discussed anything with me. No one asked me anything. No one went over any alternatives with me. Nothing. Then another doctor came in and said that I didn’t need a C-section and said that I could have this baby. Basically, all of the decisions were made without me. When it comes to pain medication after the birth, black women’s pain is just not taken as seriously as that of other women. A lot of women are not given the medicinal relief that they need. I had my own experience where I was misdiagnosed and had to go back three times to the hospital after being continuously turned away and ended up going to intensive care and going into code blue. They were not listening to me. We have moms going home with infections from C-sections. That happens even today. Doctors don’t tell mothers that you can go longer during the birth as long as there aren’t any serious health issues going on. C-section rates are extremely high now as well. That’s another reason a lot of moms are having so many postpartum issues. Being in that room alone and not having anyone there with me to inform me and support me was very hard and led me to the work I do today. 

Norman: What role do you think trauma plays in a woman’s probability of breastfeeding their child?

Hurd: Mothers having to endure this additional trauma pre and post-birth also has an effect on their ability to properly breastfeed their babies. As soon as a woman gets an epidural, it automatically puts you in a higher risk category and a lot of mothers are not educated on that by their healthcare professionals before they have the procedure. The March of Dimes Foundation has been telling mothers to keep their babies in for 40 weeks, but we keep seeing statistics about the large number of women of color having premature babies and a steady increase of doctors offering to do inductions 36, 37 weeks. One of the women I worked with was told that these inductions are offered because ‘most women want their bodies back by now.’ The inductions usually end up becoming C-sections unfortunately. Some doctors are actually routinely offering women the option of having a C-section birth or a vaginal birth. There’s also this status symbol that comes with having a C-section over a natural birth. Almost as if only poorer women have natural births.

Norman: Do you think history has continued to play a role in the maternal health disparities of black mothers?

Hurd: Most definitely. Even when you think about the so-called “father of modern gynecology” J. Marion Sims performing unethical experiments of black slave women because of not seeing them as truly human, you can see where the racist thinking comes from. Alot of stereotypes have also been passed down through misinformation in the medical schools and it’s just now being addressed. However, even with these changes, it will take years for the new unbiased protocols to trickle down to all the medical schools and hospitals in the country. There were actual passages in textbooks at some nursing schools that insinuated that black people have a higher pain threshold than whites.

Norman: What advice would you give to black mothers when it comes to having their voices heard pre and post birth?

Hurd: We don’t know our rights as birthing people. The American College of Obstetricians and Gynecologists has said a mom can choose how she wants to have her baby. The doctors are allowed to come in and negotiate with the mother, of course . However, whatever decision the mother makes is the final outcome of that situation. There are no legal ramifications that can be brought against a mother for making her own well-informed choice around how she wants to give birth. When you know your basic rights, then you know you truly have a valuable voice with these doctors. Even with a stalled labor, there are definitely ways to negotiate and advocate for yourself. If it’s not an emergency, you can definitely do that. That’s what I teach the mothers and families I work with as well. Women really need to do their research beforehand on the type of hospital, birth center, or home setting they want to give birth in, what kind of experience do the medical practitioners in those healthcare settings have, and so on. Every little intervention affects the mother and the child. We want both of them to come out of the experience healthy.

Norman: Why do you feel as though the breastfeeding rates are not where they should be when it comes to black mothers in North Tulsa specifically?

Hurd: Most of the breastfeeding support groups are located in the southern part of Tulsa, which creates accessibility issues for poor, black mothers who live in North Tulsa. There just isn’t a lot of support in the community. You don’t grow up seeing other black mothers breastfeeding. The sexualization of breasts and breastfeeding is a major issue as well. Lack of education on the importance of breastfeeding has caused low rates of engagement too. We have to normalize breastfeeding in our community. The more people who see it, the better in the long run. While there is a WIC office located in North Tulsa, there are no breastfeeding support groups or postpartum services there currently. Also, some of the programming for mothers are at inconvenient times for those who work. working mothers. Breastfeeding is important for the collective health of the community. Having babies take in human breast milk for brain development helps improves those negative health outcomes related to maternal health. There will ultimately be better health outcomes for both the mother and the child.

Illustration: Patrick Norman