Last January tennis star Serena Williams appeared on the cover of Vogue magazine. Mario Testino photographed the 37-year-old in a fitted sleeveless crimson dress, simple drop earrings, and with her newborn daughter Alexis Olympia Williams tucked into the crook of her left arm. In the accompanying interview, Williams talked about her emergency C-section, and how her health spiraled after she received inadequate medical care during and after birthing her daughter. In the days following its publication, Williams’ Vogue story managed to tug the public’s attention toward a health care epidemic that’s largely gone unnoticed in the U.S.: the life-threatening birth complications many women of color experience far too often.
How the US ranks internationally in maternal mortality rates
The U.S. is one of only 13 countries in the world where the maternal mortality rate is worse now than it was 25 years ago, according to the New York Times. The U.S. also ranks 32 out of the 35 wealthiest nations in infant mortality. Black infants are now more than twice as likely to die as white infants, a disparity that is wider now than it was in 1850, before the end of slavery.
“I didn’t expect that sharing our family’s story of Olympia’s birth and all of the complications after giving birth would start such an outpouring of discussion from women— especially black women— who have faced similar complications and women whose problems go unaddressed,” Williams later stated online, highlighting the importance of talking about intersectional reproductive health care, especially in pregnancy and especially for black mothers.
The frustrating disparity
And while Williams’ celebrity gives her a platform to call out the racism present in pregnancy care in the U.S., black mothers across all socioeconomic backgrounds are impacted by the problem. The disparity in health outcomes exists even when a person’s education level, income and prenatal care are taken into account. A 2016 study showed that in New York City, black, college-educated mothers who gave birth in local hospitals were more likely to suffer severe complications of pregnancy or childbirth than white women without a high school diploma including blood transfusion, disseminated intravascular coagulation, hysterectomy, ventilation, and adult respiratory distress syndrome. These indicators reflect the end-organ failure often associated with many lead causes of pregnancy related mortality, such as hemorrhage, hypertension, and embolism. As Rewire reported in April, “black women who live in affluent neighborhoods, receive prenatal care in the first trimester, are normal weight, and have advanced degrees are still more likely to die or have their baby die than white women in poor neighborhoods, with no prenatal care, who are obese, and don’t have a high school diploma.”
Recognizing when you are being undertreated
Black women regularly report that medical staff underestimate and undertreat their pain. Further, medical staff are not usually trained on how to recognize and address racial bias in how patients are treated. If you are a woman of color and receiving prenatal care, make sure to advocate for yourself if something feels wrong. Some tips to help do this include:
- Ensure you are happy with your clinician. If you don’t feel comfortable with the person, do some research on the available clinicians and request a change.
- Ask questions when you don’t understand something.
- Speak up when something feels ‘off’ with your body.
- Consider working with a doula; she would be your advocate, especially during and post-labor.
Organizations leading the way for change
Fortunately, women across the U.S. are stepping up to fix what our country is failing to provide. Women of color are organizing to help other mothers in their communities. Organizations like the Center for Reproductive Rights to more local groups like Black Mothers United, a program that provides education, resources, and support to expectant African American women, are building networks of support to ensure the wellbeing of black mothers. The Center for Reproductive Rights produced Black Mamas Matter: A Toolkit for Advancing the Human Right to Safe and Respectful Maternal Health Care, first published in 2016. The toolkit laid the tracks for the now independent entity the Black Mamas Matter Alliance, a group led by black women with expertise in a range of disciplines working to shift the movement for black maternal health, rights, and justice, continuing the momentum that stories like Williams’ roused for black mothers in America.