How Maternal Health Disparities Plague Black Women

by Andrea Smith | Andrea Smith is a mother of two living in Delaware County, Pennsylvania. She finds joy in knitting and wine.

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Black women have higher rates of pregnancy-related deaths than White women, despite medical advancements. In the U.S. alone, maternal mortality, morbidity, and pre-term birth continue to rise.

Even across education levels, racial inequality can be seen as a contributing factor to maternal health disparities. Out of the women who have some college education or higher, Black women are five times likelier to die from pregnancy-related issues than compared to White women.

As such, it is important to speak about these maternal health disparities for the masses to hear. And one such person showcased this in her own maternal health story.

Serena Williams experienced an issue that commonly plagues Black women’s maternal health. Though she suffered dangerous complications while giving birth to her daughter, Serena almost died due to a pulmonary embolism. And because of her coughing, her C-section wound burst. The doctors had found a hematoma (a swollen blood clot) in her abdomen and immediately treated it, leading Serena Williams to another win, this time for her life.

While Serena was fortunate enough to have doctors treat her so quickly and successfully, other Black women are not so fortunate. For many Black women, complications during maternal health are a sad reality that can be prevented.

The Causes of Risky Pregnancy

People of color are at an increased risk for poor maternal and infant health outcomes. Black women, ages 30 to 34, run the risk of pregnancy-related death.  This occurs in roughly 49 out of 100,000 births.

Common conditions that lead to pregnancy-related death are myopathy, pulmonary embolism, high blood pressure, obesity, hypertension, and diabetes. These chronic illnesses are not detected early enough. If they are detected early, the treatment options are limited.

Why is this happening?

A lack of economic status, education, access to healthcare, and public outcry are the culprits. These social constructs have helped propagate the disparity in caring for maternal health in Black women. And because of these constructs, Black women’s babies are more likely to be born pre-term, as a stillborn, or suffering from an unhealthy low birth weight. 

It is fair to say that not all Black women suffer from such socioeconomic disparities. However, for those who do, the unfortunate maternal health disparities are strongly linked to the following:

  • lower education,
  • lack of affordable health insurance,
  • lack of efficient and medically advanced health facilities,
  • low socioeconomic status,
  • a lack of exposure in mass media,
  • and not enough income.

And while the above list is near impossible to believe in 2022, the fact remains that the disparities in health care are real, though complex.

Examples of Socioeconomic Disparities:

Social and economic barriers cause Black teens to have insufficient knowledge in reproductive health. In turn, Black teens suffer from more unplanned pregnancies due to a lack of contraceptive care. And if they do receive contraceptive care, it is likely an ineffective method.

These same barriers also cause limited access to prenatal care, abortion access, and overall maternal health. In recent years, specific states have aimed their laws at restricting maternal health and reproductive rights.

For example, Kansas passed bills designed to make it difficult for teens to receive sex education. This kind of law begs the question “Why?” when according to one article, Black girls are more than two times likelier to get pregnant in their adolescence than their White counterparts.

And then there is poverty. Poverty, in the Southern states, affects Black communities at disproportionate rates, which directly contributes to higher rates of teen birth. Which of course is a problem when there is zero or limited sex education. With a lack of sex education and financial access for care, it is no wonder why the CDC found that Black women were least likely to receive prenatal care, which equates to 10% of women giving birth without receiving this kind of care.

And then of course, there are states like Texas, Kentucky, Alabama and several others, that have passed the Heart Beat Bill. This bill made it illegal for women to have abortions prior to the six-week mark. So, if you are a Black teen with limited financial means, severely lacking in reproductive eduction, and can’t gain access to prenatal care or an abortion, then it only makes mathematical sense that teen pregnancy rates will begin to climb once again, causing a national health crises for the Black community.

Former President Obama attempted to tackle the problem in 2010 by funding two new programs geared towards preventing teen pregnancy – the Personal Responsibility Education Program (PREP) and the Teen Pregnancy Prevention program (TPP). In the years preceding his intervention (1996 – 2009), the conservatives used abstinence-only methods. Since Obama’s programs were implemented, in the U.S. counties that received his new programs’ funding, teen pregnancy dropped by 3 percent compared to the years where his conservative predecessors made attempts.

What does this mean?

Black women are more likely to experience pregnancy and post-pregnancy related maternal health issues compared to White women. Young Black teens’ rate of teen pregnancy are also expected to rise in the coming years, following the laws aimed to limit and restrict access to prenatal care and abortions.

As such, Black women are often left to face extremely difficult choices in the care of themselves and their families. These choices directly affect their ability to care for their families, leaving them to choose between necessities. This means that many will be required to choose between things like paying rent or prenatal care, between buying food or seeking child care for them to work, between buying diapers and affording basic necessities of baby care.

How does this affect Black teen moms?

Black teens in the U.S. are more likely to experience physical weathering – a condition related to the constant fear and stress of racism imparted on Black youth, that causes premature aging and poor health. This physical weathering plays a role in making pregnancy riskier for young Black teens.

Physical weathering causes the brain to experience stress. This then raises the hormonal levels of cortisol and adrenaline. In turn, raised levels of these hormones can cause a variety of bodily functions to go severely wrong. In the case of cortisol, your body fat percentage will begin to rise. With that, your heart will work harder to pump blood through your body, and if your body fat is too high, this will cause high blood pressure. All of which, are related to pregnancy-related health conditions such as pre-eclampsia, obesity, high blood pressure, and a host of other conditions.

This kind of stress on the body and mind, when occurring in short bursts for short periods of time, are what we all know as the fight or flight syndrome. And it is completely normal to experience this. When short periods of stress turn into chronic stress, it becomes unhealthy for pregnant women. So, racial disparities lead to chronic stress, and chronic stress leads to poor maternal health in Black women.

The Takeaway

There are several sociocultural constructs that play a part in Black women’s maternal health. And while this continues to be a pressing matter, it is important to note that current racial justice movements are working hard to close the health disparity gap.

There is certainly more work that can be done by those who are willing to participate in breaking this harsh reality. Will you help spread the maternal health disparity message? How would you break the cycle? If you do nothing else other than read this article, I hope you at least found a better understanding of this issue.

Andrea Smith, Author

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