As we prepare to usher in Black Maternal Health Week, I’d like to pay tribute to the first post I ever wrote for Those Nerdy Girls, titled, “We Need to Move the Needle on Black Reproductive Health. Like, Yesterday.”
In early 2023, I was intensely homesick while studying in Oxford. In my search for recourse and comfort, I unearthed two lasting treasures: A love for reflective writing, and a mentorship relationship with Dr. Jenn Dowd, Those Nerdy Girls’ Founding Editor-in-Chief. As a young Black woman who was navigating her own reproductive health woes while an ocean away from home (only recently were these woes of mine given a name: polycystic ovary syndrome, or PCOS), the continued dismissal of Black women’s pain weighed heavily on my spirit. And, still reeling in the wake of Roe v Wade’s overturning the year prior, I was unsettled by the increasing possibility that the same home I so sorely missed would no longer be a safe place for me to (re)plant my roots and build a family post-graduation.
I felt compelled to write about Black Maternal Health more than I had ever felt driven to write anything before, knowing that writing about people and issues close to my heart would bring me a desperately needed sense of connectedness and purpose while so far away from home. Jenn and the Editorial Review Team took a chance on my sentimental, impassioned take on science writing, and two years later, TNG has become a crucial part of how I see, analyze, and derive hope from the world.
To me, Those Nerdy Girls is so much more than an educational resource; it is a tapestry of accountability, woven together by thousands of calls to action to build a more understandable and just landscape of health and science information. My post on Black Reproductive Health is just one such call to action that I hope you’ll consider as we move through Black Maternal Health Week and all the weeks to follow.
If there’s anything that I’d ask you to do in response to this piece, I’d ask for you to remember. Remember the names of the Black women and other birthing people we’ve lost to societal failures during pregnancy, childbirth, and postpartum. Remember to pour validation and care into the Black birthing people of today and of future generations. Remember to shine the spotlight on organizations and movements that have been fighting for Black lives long before racial disparities in reproductive health entered “mainstream” consciousness. Remember that, in April 2020, Amber Rose Isaac’s final Tweet condemned a system that we’d already known was unjust by design. Remember that, five years later, we still have a tremendous amount of work to do.
We Need to Move the Needle on Black Reproductive Health. Like, Yesterday.
“Can’t wait to write a tell all about my experience during my last two trimesters dealing with incompetent doctors at Montefiore [Hospital].”
On April 17, 2020, Amber Rose Isaac logged into her Twitter account and aired her grievances for the last time. Just four days later, she died of childbirth complications from a severely delayed diagnosis while receiving an emergency c-section. Her baby, Elias, survived the traumatic procedure. But why did Amber, only 26, have to die for Elias to live? Why was her light extinguished in the process of bringing a new light into the world?
Across the Black American community, stories like Amber’s are not as unusual as they should be. The Centers for Disease Control and Prevention (2022) reports [archived link] that Black women are three times more likely to die of pregnancy-related complications than their White counterparts, a statistic that has not budged for several years. Some of the most cited causes of this harrowing divide include the increased likelihood that Black women are uninsured or underinsured [archived link], as well as the reality that non-Hispanic Black women are significantly more likely to suffer from overweight and obesity than white women, increasing their susceptibility to a long and morbid laundry list of maternal health complications. Living in neighborhoods and towns that have historically faced residential racial segregation, disinvestment in their healthcare infrastructure, and food insecurity (which helps to explain stark racial differences in overweight, obesity, and resulting chronic illnesses) reduces the chances of Black mothers having positive – or survivable – birthing experiences. With this said, Black identity itself is perhaps the greatest risk factor of all.
Blackness, irrespective of education level and socioeconomic status, brings with it increased risks of medical racism [archived link] missed and delayed diagnoses, and discrimination-induced stress, from prenatal to postpartum care. Modern medicine still needs to adjust its sensitivity toward the ways societal ills imprint themselves on Black women’s bodies, and more effort must be made to work with Black women’s communities to develop culturally sustaining care plans that minimize physical and emotional trauma. Does an expecting Black mother have access to a food system that will offer adequate, long-term nourishment to her and her baby? What about access to reliable transportation to and from prenatal appointments? At the appointments themselves, does this mother receive educational materials and instructions that use dignified and easily understandable language? During the birthing process, will she be surrounded by people who are in tune with her unique articulations of discomfort? Will her primary care team administer the proper screenings for postpartum depression in the months following childbirth, and is her community then equipped to provide necessary support in the instance of a mental health crisis?
And what about birthing Black people who are not women? Are clinicians and communities trained to ensure that their birthing experiences are as medically sound, discrimination-free, life-affirming, and gender conscious as everyone else’s?
These questions have yet to be fully answered in mainstream research and practice for one reason: America has a lingering habit of dismissing Black women’s pain – of perceiving and treating Black women’s bodies as fundamentally different from white women’s bodies. For more generations than are countable, Black women have been socially conditioned to be independent and strong, to be stalwarts in their work of building and sustaining so many facets of American society while estranging themselves from their own hurt. The idea that Black women are wired for resilience is why women like Amber Rose Isaac [archived link] are dismissed as “pestering” when they share their anxieties about not feeling normal.
Why women like Shamony Gibson [archived link] are asked whether they are abusing drugs when they begin complaining of chest pains (she soon died of a pregnancy-induced pulmonary embolism).
And why women like Kira Dixon Johnson [archived link] are left waiting hours for proper post-caesarean aftercare because it is assumed that they will be “alright” until their doctors can get to them (Kira bled out while still on the operating table, waiting for her doctor to follow up with her).
Thus, Black women’s loved ones, clinical care teams, and allies should invest in healthcare systems that are dedicated to exploring, highlighting, and healing the various contours of Black women’s pain. At the individual level, this means challenging the Strong Black Woman trope [archived link] in households and workplaces, taking care to validate Black women’s concerns, and removing undue stressors that take physical tolls. Beyond community spaces, medical professionals must do their due diligence – yes, beyond existing training curricula – to grasp how past and current realities of food, housing, and economic inequity shape how birthing Black people access and present themselves in clinical spaces. Policymakers at local and federal levels can further allocate funding and attention to efforts that are dedicated to changing these realities. To know which efforts merit such advocacy, policymakers would be prudent to look toward the storytellers, culture bearers, cultural brokers, and seasoned mobilizers within the communities they serve. Among this group, I’d bet good money that you will find legions of Black women. And I can assure you that these Black women know best what it looks like to protect, preserve, and honor the lives of other Black women.
History has proven time and again that when a Black woman uses her voice – when she signals that something is amiss – we should listen. With respect to America’s Black maternal mortality epidemic, listening might just save a few lives.
