Stratified Reproduction and Black Women
Stratified reproduction is a social scientific concept that explains the disparities in the ability of people to successfully deliver and care for their children based on inequalities related to race, ethnicity, class, and other defining factors. Healthy labor and delivery should be at the very base of healthcare in Western societies, but there has been an alarming increase of infant in maternal mortality. Today in the United States, the rate of women who die as a result of pregnancy or childbirth is worse than it was 25 years ago (Villarosa, 2018). These statistics are frightening and do not align with the advanced medicine and the supposed abundance of federally funded resources and programs in our day and age.
In 1995, eugenic legislation was introduced to regulate and intervene in reproduction (Dikötter, 1998). The goal was — and maybe still is — to make sure those considered “inferior” or less than ideal do not reproduce children that may also be considered the same. While this law is an infringement upon human and reproductive rights, tendencies in society and across different industries continue to perpetuate these paradigms in a less obvious but more ominous way. Outside of scientific and academic research, empirical evidence shows that minority, queer, poor, young, unmarried people have stories and experiences with medical professionals that undermine their health and disseminate the assumption and narrative that they are unaware of their bodies and cannot advocate for their own health or wellbeing. On social media, we are flooded with first-hand accounts of people dying or suffering just because doctors would not listen to them. Even though so many people suffer from the effects of stratified reproduction, I am focusing on Black women in this assignment.
For this news commentary, I chose to highlight an article featured in the New York Times that focuses on a young Black mother in New Orleans that experienced stratified reproduction and discrimination on more than one occasion. Simone Landrum, a young mother of 2 at the time, became pregnant in 2016. After continuously advocating for herself to her doctor and expressing concern over the emergence of health problems, she was rushed into the hospital. What her physician wrote off as headaches and normal discomfort ended up being her placenta ripping away from her uterine wall. Not only did her doctor put her life at risk by ignoring her cries for help by only recommending she take Tylenol, he even suggested a cesarean surgery because he would be on vacation in the upcoming weeks. What started as an inconvenience for this doctor and his office resulted in the death of her daughter, Harmony. Usually, those who are highlighted as casualties and victims of stratified reproduction come from low-income households. However, Black women of all socio-economic demographics have shared their horror stories. Serena Williams — arguably the best athlete of our time and household name — also lived through the detrimental results of stratified reproduction. After giving birth to her daughter through a cesarean delivery, she experienced a pulmonary embolism. An artery in her lung was blocked by a blood clot. Blood clots are a common side effect of cesareans and Serena Williams had a history of the disorder and could barely breathe regularly. Her symptoms of an untreated side effect of labor were untreated and resulted in her having multiple surgeries and a new understanding of the disparity between the way medical professionals view and interact with Black women despite money, education, and even fame.
This came as a surprise to me. I would assume that in the United States of America, those who had access to the best doctors and resources would have little to no trouble giving birth and the after-effects. But Linda Villarosa explained it perfectly:
“For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions — including hypertension and pre-eclampsia — that lead directly to higher rates of infant and maternal death. And that societal racism is further expressed in a pervasive, longstanding racial bias in health care — including the dismissal of legitimate concerns and symptoms — that can help explain poor birth outcomes even in the case of black women with the most advantages.”
As a result of her horrific experience and the preventable death of her daughter, Simone Landrum decided to accept the help and support of a licensed doula. Doulas are trained reproductive professionals who provide guidance to individuals regarding the stimulation of healthy physical reproductive health and mental support related to stillbirth, miscarriage, and other counterproductive incidences. Not only did the inception of the doula’s presence give Landrum the ability to have someone else advocate for her in the delivery room, but she also had someone to talk to about her fears, stressors, and hopes. Her doula also provided holistic care. Since Landrum’s body and mind were still healing from the effects of her last labor, she needed to be in the hands of specialized care from someone who actually listened to her rather than imposing what they believe. During this time, her fourth time giving labor, a probable assumption would be that all of the healthcare professionals helping her deliver would be precautious so that she and her child’s lives are not at risk. But this was not the case. Simone was repeatedly asked if she had children before, resulting in her becoming more anxious at the thought of the past repeating itself. Luckily this time, she had her doula — who is also a Black woman — to advocate for her and explain to the staff that the continuation of questions that should already be in her medical records and communicated through the team is contributing to her already rising state of anxiousness. One of the most important roles that doulas play is as an advocate in the medical system for their clients. “At the point a woman is most vulnerable, she has another set of ears and another voice to help get through some of the potentially traumatic decisions that have to be made,” says Dana Davis — the director of the Center for the Study of Women and Society at the City University of New York (Villarosa, 2018).
A 2016 study by researchers at the University of Virginia aimed to understand why African-American patients are given sparse treatments for pain in comparison to white patients and outlines stated by the World Health Organization (Villarosa, 2018). This study found that white medical students and residents believed false information regarding the anatomical and physiological makeup of Black people. “…many thought, falsely, that blacks have less-sensitive nerve endings than whites, that black people’s blood coagulates more quickly and that black skin is thicker than white” Villarosa, 2018). These findings don’t prove that these medical professionals are racist or have individual prejudices toward Black people, but it shows how stereotypes ingrained in the foundation of many institutions and systems across the world have long-lasting and detrimental effects on the people they are meant to serve.
For Simone Landrum, the inherent and unintentional perpetuation of prejudices placed on minorities in America caused her to lose her child. In her labor following this loss, it resulted in healthcare professionals giving her the wrong dose of anesthesia — resulting in her losing all feeling in her legs, it resulted in her being made fun of and censured for asking “too many questions”, and it caused her to not even receive any follow-up appointments or check-ins months after her delivery.
This entire class is about the reproductive justice movement and what needs to be done to correct inequalities. Stratified reproduction is at the core of this. Black women do not receive the same level of empathy or standard of care in most medical situations — but especially regarding reproduction. Black women are four times more likely to die from pregnancy-related illnesses than white women (American Heart Association, 2019). And even when they do give birth successfully, there are so many obstacles that threaten their children’s lives every day. In order for stratified reproduction to be corrected, there must be equality for all — yes, even Black women.
Resources:
Reading the Body: Genetic Knowledge and Social Marginalization in The People’s Republic of China — Frank Dikötter