So if I give birth, I could just…die?
As a Black woman in America, it's unfortunately possible.
It was a cold, rainy Wednesday morning during the second semester of my sophomore year of college when my fellow sophomores and I filed into the basketball practice gym of our school. As part of the humanities courses we were required to take that year, we had to participate in something called a poverty simulation.
As someone who grew up in a quite poor town, I found it a little funny that the school set up something like this to show these sheltered, formerly-homeschooled Christian kids how the other half lived when I knew the realities of it. As we sat down at tables, we were assigned to "families" and given laminated cards that had our roles on them. In the simulation, I was a seven-year-old boy whose only task was to go to "school" while my "parents" worked, paid bills, and did other adult things.
At this "school" with the other "children", we were told a list of facts about poor people in the state of Mississippi. Truthfully, I don't remember most of them. To be honest, unlike my actual seven-year-old self, I was immediately bored of this whole operation and just wanted "school" and this simulation to be over so I could go back to my dorm and play RimWorld or something to pass the time until my next class. However, one fact I was told did stick out to me.
Rather matter-of-factly, the lady giving us the facts about the poor of Mississippi told us that Black women specifically were more likely to die after childbirth that White women in this state, and just…moved on to the next fact, with no elaboration. At that point, my still half-asleep mind snapped awake. What do you mean Black women just die after giving birth? Before I could even think about questioning it, "school" was over, and I had to go "home". However, being that my "family" was poor and still "working" by that time, leaving me "home" alone, I — a seven-year-old boy in this simulation, mind you — was arrested and sent to "juvy", which consisted of a soccer net in the corner of the court.
As I did my hard time in that soccer net, I couldn't help but go over that tidbit of information in my mind. At the time, it just struck me as odd. I know that it happens now, but…why does it happen? Are Black women just genetically really bad at delivering babies? At 19, I knew that couldn't possibly be the truth. However, before I could mull over it for too long, the simulation was over. I went back to my cold dorm room and played RimWorld, waiting for my next class to start, mostly forgetting about the rather uneventful simulation, rejoicing in the fact that next semester, I wouldn't be taking nearly as many credit hours.
Sometime after the simulation, I would come to learn that tennis superstar Serena Williams had talked about her near-death experience after giving birth to her daughter, Olympia, and I was reminded of that morbid little factoid nonchalantly delivered in the gym that day. In the account, Serena says that she experienced a whole host of problems after an easy pregnancy and uncomplicated c-section delivery, and if it weren't for her doctors and nurses, she wouldn't be alive today. So, once again, I wondered: maybe Black women just are genetically predisposed to post-birth complications. Still, I knew that just could not be true. After all, how genetically different can a Black person be from a White person, aside from some melanin and coily hair?
As it happens, postpartum complications are very common among American women, and the rate of them has actually gone up. In 2018, 16.9 women per 1000 in America experienced some kind of childbirth complication, from 14.8 four years prior. And, to add on to that already startling statistic, Black women are indeed staggeringly more likely to die after giving birth than non-Black women, and the issue isn't down to genetics at all.
According to the World Health Organization, women living in poverty and farther away from health facilities are more likely to die during pregnancy or childbirth. And, when you realize that Mississippi does not offer postpartum Medicare coverage, it starts to come together: It all boils down to medical racism.
There is a long-held belief that Black people have a higher pain tolerance than Whites, which originated during slavery. From a 2016 paper from Hoffman et al:
In the 19th century, prominent physicians sought to establish the “physical peculiarities” of blacks that could “serve to distinguish him from the white man” (23). Such “peculiarities” included thicker skulls, less sensitive nervous systems, and diseases inherent in dark skin (20, 21, 23). Dr. Samuel Cartright, for instance, wrote that blacks bore a “Negro disease [making them] insensible to pain when subjected to punishment” (20). Other physicians believed that blacks could tolerate surgical operations with little, if any, pain at all (22, 25).
This belief, while verifiably false, still informs how doctors treat their Black patients:
Extant research has shown that, relative to white patients, black patients are less likely to be given pain medications and, if given pain medications, they receive lower quantities (1–10). For example, in a retrospective study, Todd et al. (10) found that black patients were significantly less likely than white patients to receive analgesics for extremity fractures in the emergency room (57% vs. 74%), despite having similar self-reports of pain.
Pregnancy is personally my nightmare scenario, for a myriad of reasons — money, independence, the fact that some women have metamorphosed into being solely their children's mother and not their own person, and of course, the fact that I simply have never had the desire. Now, though, the reality that I could just up and die after giving birth is among those reasons.
Mississippi is kind of a nightmarish hellscape when it comes to being a woman of childbearing potential. In school, you get insufficient education about sex and its potential ramifications. You might witness your high school classmates becoming pregnant and having their lives upended. If you do become pregnant — even when you actually want to and are ready to — there is a chance your doctor will just refuse to listen to you about your health concerns. As stated before, if you're poor, you can say goodbye to your Medicare coverage once you give birth. And, if you never wanted to become pregnant to begin with, you might be coerced into keeping it anyway in the exam room of one of the state's many pregnancy "choice" centers where the only choice you have is carrying a fetus to term. And, even if you do live in Jackson and have access to The Pink House, their days may be numbered.
As most couples trying for kids will attest to, it may be quite difficult to become pregnant even if you want to. But all these factors, combined with my own personal reasons for not wanting kids, is enough to make me exceptionally anxious about becoming pregnant and wary about even letting a man near me. The sad reality is that in the state of Mississippi where I currently reside, if I give birth, I could just die, for no reason other than the fact that the system seems to hate Black women. And none of this even takes COVID into consideration.
This is what we mean by dismantling systemic racism. In order to do that, though, we can't just trim the plant. We'll have to uproot the entire diseased bush, and with a legislative body more fickle than a two year old presented with the choice of spaghetti or chicken nuggets, that's likely never going to happen. Maybe not even in my lifetime — and I'm only 22. I try to stay optimistic about these things. But it's hard when the realities of life are so harsh.
