Black women are more likely to die during or soon after childbirth due to systemic racism and sexism in the medical system, not genetics or lifestyle, according to the United Nations.
A U.N. agency, the United Nations Population Fund, released a report on these issues after analyzing the health care experience for Black women during pregnancy and childbirth in the United States, Caribbean and Latin America.
The agency found that Black women were more likely than white women to experience denial of medication, or physical and verbal abuse in these settings.
“The result is horrendous,” executive director Dr. Natalia Kanem, who is a physician and is Black, told The New York Times. It is “a human rights crisis that is largely ignored or overlooked by decision makers.”
Among the reasons are patterns of bias beginning in medical school, the report said.
According to the report, medical school curricula include claims about Black women’s health that are not accurate. Among those is that Black women have less sensitive nerve endings, requiring less anesthesia. Another error is that Black women’s blood clots faster than that of white women. This can lead to delays in treating dangerous hemorrhages.
Textbooks depict European women’s pelvic anatomy, which can cause unnecessary interventions, the Times reported.
“When a Black woman dies during childbirth, whether in São Paulo, Bogotá or New York, it’s often put down to her lifestyle or to individual failure: She didn’t get there in time to see the doctor or the nurse, she made poor life decisions, she was predisposed to certain medical conditions. And then the world moves on,” Kanem said.
This report “categorically refutes that,” she added.
The U.N. had not previously examined the maternal health of Black women across the Americas.
Most nations did not collect maternal health and death data by race. Although researchers looked at 35 countries, only nine had the data to be included. Those were Brazil, Colombia, Costa Rica, Cuba, Panama, Suriname, Trinidad and Tobago, the United States and Uruguay.
Of these countries, the United States had the lowest overall maternal death rate, but the widest racial disparities, the investigators found.
Black women in the United States were three times more likely to die during or soon after childbirth than white women. The problems persist across income and education levels. Black women with a college degree were 1.6 times more likely to die in childbirth compared to white women who dropped out of high school, the Times reported.
The overall death ratio of maternal deaths per 100,000 live births grew about 15% throughout Latin America, North America and the Caribbean between 2016 and 2020.
U.N. officials called for a re-examination of medical school curriculums, strengthening policies around denial of patient care and patient abuse, as well as ways to get around structural barriers, such as transportation and insurance, to ensure prenatal care.
The agency also called for better data collection.
The U.S. Centers for Disease Control and Prevention has more on maternal death in Black women.
SOURCES: United Nations Population Fund report, July 2023; The New York Times, July 12, 2023
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