A few years ago, I sat in an exam room with my OB/GYN and my husband. I was in my mid-thirties, and this was my third pregnancy. We had fostered three children and had adopted one. Each of my pregnancies had triggered a new (and permanent) health condition. Our “surprise” pregnancy was no different—except that the health condition kicked in three months early. I spent the last trimester as an insulin dependent diabetic with polyhydramnios. By the end of the pregnancy, I was in the clinic 3-4 times a week for monitoring, and the doctor had told us that if our baby got too big (a risk of gestational diabetes), that they may have to break his shoulder during delivery. I requested a tubal ligation following delivery. Another pregnancy could prove fatal.

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must only hit the message boards to learn that countless women are repeatedly denied what is considered a “permanent” form of birth control by health care providers. They are often forced to wait until they have met certain criteria such as being over the age of 30, having given birth to multiple children, and/or having had a life-threatening reproductive health crisis. Some, like me, even after multiple high-risk pregnancies and meeting all gender-biased criteria, are still required to have a spouse’s signed permission in order for the medical provider to approve the procedure.

Women go to the doctor more than men do (McMillon), but a little digging into the dynamics of women’s healthcare gives one pause and prompts the question of whether or not women go to the doctor more because it takes longer for doctors to diagnose and treat illnesses in women correctly, (especially when the illness directly correlates with women’s biology)? Additionally, women are still significantly underrepresented in the medical field (Bailey), thereby causing diagnostic criteria to lean heavily towards how Disease is manifested in biological male bodies and interpreted by male doctors.

This disparity is only amplified when one considers the fact that, not only are the majority of healthcare providers male but “out of a population that’s 13 percent Black only 5.7 percent of U.S. physicians are African American” (Stallings). With that in mind, we are compelled to ask, not only what does it mean to be a woman in need of healthcare in America; but, what does it mean to be a Black woman in need of healthcare in America?

Psychologist and Theologian Chanequa Walker-Barnes writes,

The mythological strength of Black women often masks the very real vulnerabilities of their lives. There is a largely ignored health crisis confronting Black women in America. Black women are experiencing epidemic rates of medical conditions such as obesity, diabetes, hypertension, and HIV/AIDS. And they have higher morbidity and mortality rates than any other racial-gender group for nearly every major cause of death (Too Heavy a Yoke: Black Women and the Burden of Strength 5).

As most readers understand, the egregious disparities that exist in the American health care system pre-existed the Covid-19 pandemic. The virus merely spotlighted the profound ways that the Black community, and, for the purpose of this article, Black women in particular, are impacted by a critically biased and increasingly open racialized system.

Below are a few examples to consider. Please note, that all of these numbers are pre-pandemic numbers. Early data suggests that Covid-19 has “significantly impacted the reproductive health of women,” (Phelan) but it is still too early to know exactly what the long-term impact will be. It should also be noted that poor health in any body system will impact the health of both the pregnant mother and the unborn infant.

In the United States…

• More women will die giving birth than in any other “developed” country in the world (Schlanger).
• Black women are three to four times more likely to die giving birth in the United States than white women (Schlanger) and “Maternal mortality and injury rates are higher for Black females, irrespective of income or education level” (Beim).
• Women are 10% more likely to die of cardiovascular disease than men (BOGATAJ) and “High blood pressure and cardiovascular disease are two of the leading causes of maternal death…” (Villarosa)
• “…pre-eclampsia and eclampsia (both related to blood pressure and cardiovascular disease)… are 60 percent more common in African-American women and also more severe” (Villarosa) and “Black women are significantly underrepresented in key biomedical research datasets” (Beim).
• Health insurance costs are higher for women regardless of maternity coverage (McMillon).
• Black women are twice as likely to be uninsured as white women (National Partnership for Women & Families) and Black babies are twice as likely to die as white babies (Ely).

However one feels about the Supreme Court’s recent decision to overturn Roe vs. Wade and the varied responses of individual state’s legislative bodies, we should understand that the ruling is already having, and will continue to have, an overwhelming impact on women’s healthcare in this country. Moreover, we need to understand that the healthcare challenges that all women experience within our system are significant, and often fatally amplified for BIPOC women.

By Naphtali Renshaw

References

Bailey, Susan R., MD. “Despite advances, gender disparities persist in medicine.” 20 September 2020. American Medical Association. <https://www.ama-assn.org/about/leadership/despite-advances-gender-disparities-persist-medicine&gt;.

Beim, Piraye. “The Disparities in Healthcare for Black Women.” 6 June 2020. August 2022. <https://www.endofound.org/the-disparities-in-healthcare-for-black-women&gt;.

BOGATAJ, MARIE. “Women vs. men: is there a health equality gap?” 17 June 2019. August 2022. <https://www.axa.com/en/magazine/women-vs-men-is-there-a-health-equality-gap&gt;.

Ely, Danielle M. , Ph.D., and Anne K. Driscoll, Ph.D. “Infant Mortality in the United States, 2018: Data.” National Vital Statistics Reports 16 July 2020. <https://www.cdc.gov/nchs/data/nvsr/nvsr69/NVSR-69-7-508.pdf&gt;.

McMillon, James. “Insurance Rates Male vs. Female.” n.d. August 2022. <https://pocketsense.com/insurance-rates-male-vs-female-6684278.html&gt;.

National Partnership for Women & Families. “Black Women Experience Pervasive Disparities.” April 2019. National Partnership for Women & Families. August 2022. <https://www.nationalpartnership.org/our-work/resources/health-care/black-womens-health-insurance-coverage.pdf&gt;.

Phelan, Niamh et al. ““The Impact of the COVID-19 Pandemic on Women’s Reproductive Health.”.” Frontiers in endocrinology vol. 12 642755. (2021). <https://pubmed.ncbi.nlm.nih.gov/33841334/&gt;.

Schlanger, Zoë. “Should a pregnant person ever go to prison?” 6 April 2019. Quartz. August 2022. <https://qz.com/1587102/what-its-like-to-give-birth-in-a-us-prison/#:~:text=With%20a%20present-day%20prison%20population%20of%20more%20than,rate%20more%20than%20twice%20that%20of%20white%20infants.&gt;.

Stallings, Ericka. “The Article That Could Help Save Black Women’s Lives.” October 2018. Oprah.com. September 2021. <https://www.oprah.com/health_wellness/the-article-that-could-help-save-black-womens-lives#ixzz5VRnkBHiz&gt;.

Villarosa, Linda. “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis.” 11 April 2018. https://www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html. August 2022. <https://www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html&gt;.

Walker-Barnes, Chanequa. Too Heavy a Yoke: Black Women and the Burden of Strength. Kindle Edition. Eugene: Cascade Books – An Imprint of Wipf and Stock Publishers, 2014.