Addressing obstetric violence requires enduring solutions rooted in cultural transformation.
In 2002, Alyne da Silva Pimentel Teixeira, a 28-year-old Afro-descendant woman in Rio de Janeiro, sought medical help for severe abdominal pain during pregnancy. Despite her critical condition, she was left unattended for hours and mistreated, ultimately leading to her tragic death.
Some might believe these stories are relics of the past, yet similar cases continue to occur across the globe. What do they share in common? The intersection of gender and race. In 2016, Kira Johnson, a 39-year-old African American woman, died after a routine C-section in Los Angeles. Despite her husband’s repeated pleas for medical attention due to signs of internal bleeding, hospital staff delayed intervention.
The following year, Dr. Shalon Irving, a Black epidemiologist at the CDC, faced a similar fate. Shortly after giving birth, she died from complications. Despite her medical expertise and her concerns about postpartum symptoms, her doctors dismissed her fears.
As recently as this past October, three maternal deaths linked to obstetric violence gained national attention in the U.S. Bevorlin Garcia Barrios died in New York following complications that required an emergency C-section. In Georgia, Amber Nicole Thurman and Candi Miller also lost their lives after complications from abortion procedures. Thurman reportedly waited over 20 hours in a hospital for a dilation and curettage procedure but tragically passed away before receiving the necessary care. According to her family, Miller avoided seeking medical help because she feared legal consequences under restrictive abortion laws, according to her family.
Alyne, Kira, Bevorlin, Amber and Candi lived in Brazil, Los Angeles, New York, and Georgia, respectively. Despite their geographic differences and varying ages, personal backgrounds, and professional paths, these five women shared one identity—they were all Black women. Their stories underscore a broader, systemic issue: maternal mortality has a racial component that needs to be further studied.
These tragedies highlight a disturbing pattern where Black women’s pain and concerns are frequently overlooked, underscoring systemic biases in healthcare that transcend borders and cultures. Addressing obstetric violence and racial discrimination is essential to ensuring every woman, regardless of race or background, receives dignified and responsive care.
Pregnancy in itself presents a risk to the life of women. As Dr. Warren M. Hern has said, “a woman’s life and health are at risk from the moment that a pregnancy exists in her body, whether she wants to be pregnant or not.” Nevertheless, the risk of death from pregnancy-related causes is connected to various social determinants of health. For instance, Black women in the U.S. are three times more likely to die from pregnancy-related causes than White women. These disparities arise from intersecting factors rooted in structural racism, including delays in timely care, lower quality healthcare, and biases in treatment. The COVID-19 pandemic deepened this disparity. Other studies reveal that Black women die at rates four times higher than white people in some U.S. states and at rates more than twice the national average.
As Khiara Bridges has illustrated, obstetric racism cannot be seen as a snapshot distant from the past. Rather than that, this phenomenon is a product of a history marked by racial injustice and myriad forms of violence. The tragic stories of Alyne da Silva Pimentel Teixeira, Kira Johnson, and Dr. Shalon Irving reveal not only individual pain but also a global pattern rooted in deeply ingrained biases against Black women. Enslaved Black women were historically subjected to unethical medical experimentation, as exemplified by Dr. J. Marion Sims, whose practices reinforced harmful stereotypes like the “superhumanization bias” that continues to diminish the voices of Black women in healthcare today. These biases persist globally, with Black women facing disproportionately high rates of maternal mortality due to delayed care and dismissed concerns.
Some of the reasons behind this can be traced to systemic disparities with deep historical and racist roots. At the group and social condition level, inequities across broader social and economic factors, like income, education, housing, safety, and access to health services, affect decisions related to family planning, and reproductive and sexual health. Also, healthcare systems have a long history of racist practices targeting the reproductive rights of women of color, eugenics, medical experimentation, forced sterilization, denial of services, and other gross violations of human rights. At the interpersonal level, implicit bias can negatively impact individual health and exacerbate health disparities across groups. In this regard, many Black women have reported discrimination by healthcare providers, being subjected to stereotypes, and facing conditions that white women do not encounter.
Although violence in the context of pregnancy and childbirth has become more recognized, there are no single or definitive solutions to address it. Some Latin American countries, for example, have incorporated definitions of obstetric violence into their gender-based violence framework laws. Others have enacted specific laws to tackle this type of violence, even going so far as to criminalize the behavior. Some have proposed regulatory frameworks promoting respectful, humanized childbirth practices, while others have technical regulations for medical personnel that prohibit discriminatory treatment and any form of violence toward women during pregnancy, childbirth, and postpartum, as well as toward newborns. However, in other countries, the discussion continues on how to regulate and prevent obstetric violence, and many of these ideas and regulations have yet to be enacted, remaining merely as proposals and legislative initiatives.
While these regulations are undoubtedly necessary, they often serve as a minimal baseline, as a comprehensive and multidimensional approach must be designed to encounter the complex problem of obstetric violence. It’s also important to question whether these new measures can genuinely reduce the racial biases embedded in obstetric violence. Should we frame obstetric violence from a health rights paradigm, an equality framework, or as a prohibition against violence and mistreatment? For instance, to what extent is criminal law the most effective tool for protecting women and pregnant individuals? Who might be disproportionately affected by the introduction of criminal law?
These questions are especially significant because addressing obstetric violence requires enduring solutions rooted in cultural transformation. Criminal law alone rarely fosters the deep, lasting change needed to reshape entrenched norms and practices in social life. Instead, many times, the use of criminal law becomes a tool of oppression against those it was intended to protect.
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