The Unbelievable Reasons Behind the Astonishing Rate of Black Maternal Death


By Dawn Washington

As I'm watching a news story on the rise of maternal deaths in America, I'm shocked to learn that America leads the world in the number of maternal deaths. But that shock didn't compare to what happened in me when I heard the stats related to maternal deaths among African American women and the reason why.

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In response to the question of why deaths during delivery are 3-4 times higher among African American women, Harvard Medical Professor and Obstetrician, Neel Shah prefaces,"...this is going to be hard to hear.” And he goes on to say,
“We believe Black women less when they express concerns about the type of symptoms they are having, particularly when it comes to pain.”
Hard to hear is an understatement. Several days after hearing them, the truth of his words still stings.

While the news story goes on to contribute unnecessary C-sections to the shocking stats among American mothers, it drills down to other issues that lend themselves to the national and deadly problem: gender and race. Dr. Shah says that there is an element of gender discrimination in hospitals.
"[For] a woman, after birth, who comes into a hospital with concerning complications, there are no rules for how quickly obstetricians have to see her. In fact, it's a routine case that it will take hours."
Serena Williams and most recently, Beyoncé in her Vogue article have spoken out about their near death experiences during the delivery of their babies (both worth checking out to understand the scope of this problem). But beyond the fact that once again Black women are hit with real data that points to the problem associated with being Black and female, the question is begged, what is it about Black women that they are not believed on the hospital bed?

Representation in media studies offers at least one answer. Representation says that from the images seen on screens and print (film, television, news, magazines, videos), we make meaning. And the meaning that has been made about who Black women are in a country like ours has been dubious at best.

The "strong black female" title has been one that Black women have claimed as their own. But did you know that being strong, black, and female was a white construction created in mediated images long before many of us were born? In the context of a racist and white supremacist culture, even seemingly positive labels can work to our disadvantage. What proves to be most dangerous are the internal, unspoken perceptions people have of Black women. The danger of purporting strength as a Black woman in a racist country is that she can be perceived as having a higher tolerance for pain than other women.

So now that it is out that medical professionals are not trusting the word of Black women when they alert them to their health concerns or problems, it is important to also air out the reasons why.

Film scholar, Donald Bogle says that since the beginning of American film, two primary caricatures have represented Black women: mammy and the tragic mulatto. Their characteristics are familiar. Mammy is strong but loyal. The tragic mulatto is alluring but untrustworthy. Throughout American film history, Black female representation was mostly one or the other. But toward the end of the 20th century, with iconic and historic characters like those of Pam Grier and Teresa Graves, Black feminine representation became a mashup of both mammy and mulatto. She was strong and deceitful…prime conditions for the perceptions Dr. Shah speaks of in his research.

Now well into the 21st century, Black female representation is even more prevalent. From news stories of police excessive force and the women who are left to pick up the pieces, to the stars of reality television and contemporary movies, our presence has gone mainstream in old and new ways. Black female lead characters like Olivia Pope (Scandal), Annalise Keating (How to Get Away with Murder), Issa Rae (Insecure), and Yara Shahidi (Grown-ish) have been written into scripts more than they have ever been. And yet, in a country that continues to racialize Black beauty and Black presence, a country where Michelle Obama, is an "ape in heels," Maxine Waters is called "crazy" and chided for "her James Brown wig,” and Omarosa Manigault is called a "dog" by the President of the United States, Black women in 2018 still contend with biased labels of the past that seek to keep them as caricatures and to rob them of their humanity...even to the point of death.

The link between long-held stereotypes and perceptions about Black women’s tolerance for pain and their credibility, can all be difficult to process. It can seem like a stretch to underline the impact of these titles and the way they have seeped into the consciousness of everyday people. But I am hard pressed to find any other reason why medical professionals wouldn’t treat us like any other patient.

Damned if we do. Damned if we don't.

Because no matter how bright we shine, in our intelligence, in our beauty, in our nobility, in our resilience, in our dignity, civility, or success, the labels continue to work to contain us. Racism continues to skew our representation to fit into undying stereotypes and caricatures that have been set into the American consciousness.

I appreciate Dr. Shah for boldly speaking the truth about what is happening in America’s hospitals as it relates to Black women. His truth exposes other truths that are less discussed, like how harmful ideologies continue to play themselves out in new generations of people and in real-life data.

Mammy, mulatto, strong Black female, whichever way our presence is interpreted, Black women  are first and foremost human. Wiping the slate clean and ridding the American mindset of the lie that we are anything but remains to be the challenge.

What do you think about the reasons behind the high rate of black maternal death?
Dawn has a Master of Arts in Media and Cinema Studies and holds down a day job in academia. She is a freelance writer from Chicago who has written for The Chicago Defender, NBC5 Chicago, and Caramel Lattes and Stilettos. Read more of her works here.

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