The evidence is irrefutable: Racism is getting away with murder as the leading cause of maternal and infant deaths and premature births among Black women.
Such is the conclusion of two major reports released this year in 2018. The first is a collaboration between the University of California San Francisco and California Department of Public Health: “California’s Maternal and Infant Health Assessment,” presented in July to First 5 California, a state-wide commission aimed at improving the lives of women and children. The second, “Fighting at Birth: Eradicating the Black-White Infant Mortality Gap,” is based on research by Duke University’s Samuel DuBois Cook Center on Social Equity and Insight Center for Community Development.
It was once thought that the most significant factors in deaths among pregnant women or the cause of premature births were so-called “risky behaviors.” The most obvious adverse behaviors included smoking, alcohol abuse and drug use. Long-term studies showed that a reduction in risky behavior and increasing women’s access to education and employment opportunities shifted maternal and infant outcomes. It was proven that if women received more education and enjoyed economic security through employment, they were less likely to engage in behaviors that placed them and their unborn child at risk.
That is no longer the case. Both of these reports blow that thesis out of the water.
What the studies revealed was that assumption of positive health outcomes for mothers and infants through a reduction in risky behaviors and improved socio-economic status was certainly true—but only for white women. The Duke study made crystal clear that Black women with higher education and more economic success were at an even greater risk of early death for them and their infants during pregnancy and were more likely to deliver prematurely.
Serena Williams and the premature delivery of her first child illustrates the major findings of both reports. At the time of her pregnancy, Williams was an athlete in great physical condition; she had no evidence of “risky behaviors” and had access to the best medical services. What then caused her to give birth premature? Was it just a fluke, or did her premature delivery prove the case that these studies are making? Was racism—and the accumulated stress of being publicly denigrated, a recipient of unequal treatment—responsible?
It is rare for a scientific study to make such a provocative declaration that racism is the primary cause of maternal and infant deaths and premature births for Black women, and even rarer for researchers grounded in data to declare unconditionally, and with emphasis, that “there is no safe age for Black women to have children.”
That is such an all-encompassing pronouncement it leaves little room for misunderstanding.
Racism. Without any hesitation, both of these studies point clear and definitive fingers, supported by data, at racism as the primary cause of Black women maternal and infant deaths. Regardless of age and socioeconomic circumstances, Black women have the highest maternal and infant deaths and premature birth rates among any other group in America. “For Black women,” they report, “exposure to discrimination and racialized stress throughout the lifespan can negatively impact birth outcomes.”
While such a conclusion seems counterintuitive, it points to the everyday reality of professional Black women. While working in high profile professions or in leadership positions may improve their socio-economic status, a side-effect is that, more often than not, they find themselves working in hostile work environments that contribute high levels of stress to their lives. Additional stress may emanate from the fact that professional women often live in predominantly white communities, where they may not experience community support and acceptance. At work and at home, Black women are in direct contact with high levels of micro-aggression, targeting, exclusionary behavior and overt racism.
We witnessed this with Serena Williams. Although she is the reigning tennis queen, Williams has had her fair share of stress brought on by racism. She has been booed by predominately white audiences when she won tennis competitions. Her most recent encounter with unequal treatment were the challenges of her tennis attire being judged inappropriate, and the penalty she received for challenging comments made by a judge. (The public, and other white tennis professionals, agreed that Serena was in the right—and pointed out that white players, men and women, have made similar challenges and comments and none were penalized nor reprimanded in any way.)
Just like in health, a double standard for Williams was at play. Did the stress Williams encounter over the course of her tennis career play a significant role in the premature birth of her daughter? Is she the poster woman for how racism is getting away with murder?
One Black OB-GYN physician thought so. In a piece for Vice, Sanithia L. Williams, MD, asserts that, based on the information already presented, it’s highly likely that racism played a part in Williams’ difficult birthing experience—and that the world is lucky she did not die. Too many other Black women have.
The adverse, and sometimes deadly, outcome of coping with racism as a Black woman in America is not accidental. The concept of “murder” requires a level of premeditation—in this instance, rooted in the ongoing discrimination and structural forces of racism that deliberately sets forth barriers to the progress of Blacks. Even successful individual Black women such as Williams are subjected to unequal and unjust treatment and public disparagement as they make their way in the world.
The lives of Black people in America have been shaped by living under a system of oppression that harkens back to slavery. While the institution of slavery may have been dismantled, it was replaced with structural oppression that manifests itself in the form of socioeconomic and political inequality that lead to systemic disparate treatment in health care, personal and public disparagement (“angry Black woman,” “hoes and bitches”), cumulative acts of microaggression and daily exposure to stressful and hostile work environments and living environments.
The results of these studies are not new—but in truth, conditions that seem to adversely impact Blacks as a group do not receive the same medical priority attention. The adverse impact of living while Black under racism has been taking its toll on the health of Black Americans for generations. We have the highest incidence of hypertension and diabetes than any other group in America, except possibly Native Americans (also a highly oppressed group). And while all people of African descent live with the stress of racism, Black women face intersecting systems of oppression that include gender alongside race.
“Racism and sexism are inextricably intertwined, combining into one hybrid force that is founded in the devaluing of (Black) women and racist perceptions of gender roles,” one group of scholars said in reporting research supported by the National Institute of Health. “Throughout history, essentializing and contradictory images of African American women have pervaded U.S. culture.”
There is virtually no safe place for Black women. It is our hope as a group that the genius and technology we have contributed to the shaping of American culture, despite the barriers constructed by racism, become permanently inscribed in America’s history. We are very much a part of the cultural and political DNA of this country, and have made significant contributions to America’s reputation as a world leader. We have kept this country on a path of moral righteousness that lives out the principles of its Declaration of Independence and the Constitution of the United States.
We too sing: “America, we are its people.” We are contributors to this country’s genius. We are part of “we the people.” And we must stand strong against racism getting away with the murder of our Black mothers and infants.