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Opinion: What Explains Black Women’s Higher Rate of Horrible Birth Stories? Nothing But Racism

Dr. Veronica Gillispie-Bell, medical director for the Louisiana Perinatal Quality Collaborative and the head of women’s services at Ochsner Medical Center in Kenner, La., provided virtual testimony last week to the U.S. House Oversight and Reform Committee about the high rates of maternal morbidity among Black patients. She told the committee that a Black person with a college degree is twice as likely to experience a severe physical or mental complication from childbirth than a white woman without a high school degree. Screenshot.

Tatyana Ali, who starred as Ashley Banks on “The Fresh Prince of Bel-Air” from 1990 to 1996, entered Harvard the next year where she double majored in government and African-American studies. In 2016, Ali and her husband, an English professor at Stanford, welcomed their first child, but only after mother and baby were roughly treated by a hospital’s obstetrics team, she testified last Thursday to the U.S. House Oversight and Reform Committee.

“One doctor climbed up onto the side of the bed and pushed his forearm into my belly and squeezed downward — like my baby was toothpaste,” she said. “Then when my husband and I yelled no to the forceps, they used suction: a plunger. I screamed, ‘Stop!’ because they were aggressively popping it off of his head again and again, four times.” Soon after that, Ali said, she lost consciousness.

Ali’s story — the least horrible one told during the committee’s “Birthing While Black” hearing — illustrates what statistics have long shown: that in the U.S., neither a Black woman’s money, education or status serves as protection from mistreatment in labor and delivery. Financially secure Black women with Ivy League degrees have to worry just like those with less money and education if doctors or nurses will do (or not do) something that costs them their lives or their babies’ lives.

As obstetrician Veronica Gillispie-Bell, the head of women’s services at Ochsner Medical Center in Kenner, La., testified Thursday, “A Black woman with a college degree is twice as likely to experience a severe maternal morbidity when compared to a white woman with less than a high school diploma.” In New Orleans, that finding holds true even for Black women with graduate degrees.

However, here’s what Rep. Bob Gibbs (R-Ohio), said when it was his time to speak Thursday: “In these urban centers, the leadership is lacking in a lot of cases. … These people in our inner cities, the Black community, has been trapped in poverty. Housing, mental health issues, drugs, suicides, we’ve all heard about that. And one of the reasons they’re trapped in poverty is because our education system has totally failed our Black community, and they don’t have a choice to get out or get to a better opportunity. We have in the Black community a lot of families [where] the father’s not there. So there’s a lot of other issues that go into this, too, I believe.” Gibbs who touted “opportunity zones” as a solution said “poverty is a root cause of this issue.”

That’s not true. But even if it were, Gibbs seems oblivious to racism’s role as a root cause of poverty.

Black women in this country suffer more during childbirth because of racism. In an interview three days before Thursday’s hearing, Dr. Gillispie-Bell, who also serves as medical director for the Louisiana Perinatal Quality Collaborative, said there’s no way to honestly engage with the numbers and say otherwise. But, she said,  in 2018, as the collaborative started working with birthing centers to reduce the number of horrible birth stories in Louisiana, “some teams felt offended and walked out” when racism was named as the reason Black women have a higher number of horrible stories.

In her testimony Thursday, she said J. Marion Sims, the so-called father of gynecology, chose not to use anesthesia when he used enslaved women to perfect his surgical techniques. “What got perpetuated and what got published in the textbooks,” she said, “is that Black individuals don’t feel pain in the same way.” Gillispie-Bell, who’s Black, said, a recent survey conducted with white medical students and residents revealed their belief that “we don’t feel pain in the same way.”

Using strategies that include urgently treating hypertension and assessing a patient’s risk of hemorrhaging, the perinatal collaborative has helped decrease the number of severe maternal morbidity events, Gillispie-Bell said earlier in the week. But the work continues. “Implicit bias and structural racism are not going to be solved in three years,” she said.

But we can’t stop addressing racism. Ali said having a Black midwife for her second delivery made a world of difference.

Dr. Joia Crear Perry, a former New Orleans obstetrician who leads the National Birth Equity Collaborative, testified that Black babies are far more likely to survive neonatal intensive care under the watchful eye of Black providers.

Focus on what that says about white providers. If we assume they’re no less competent than Black providers, what — other than racism — explains more Black babies dying on their watch? 


The writer is the editor of the Louisiana Illuminator.


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Opinion: What Explains Black Women’s Higher Rate of Horrible Birth Stories? Nothing But Racism