Jallicia A. Jolly
Like many other women in the final stages of childbirth, there was a time when I knew I needed medication to help manage my pain. So I ordered an epidural and an anesthesiologist arrived within minutes.
But the doctor seemed in a hurry, which made me nervous. So, as he prepared to insert his needle into my spine, I asked him if he could explain the process to me. My nurse reiterated my request for informed consent. The anesthesiologist ignored our pleas, demanded that I stay still, and made an unsuccessful first attempt to administer the epidural.
I cried out in pain. He berated me. I felt his blue eyes stare at my black body. My nurse and my husband huddled and held me. I cried again. Sensing my deep anxiety and devastation, my nurse interrupted the process and called another anesthesiologist.
The irony, if that’s what you call it, is that I’m a maternal health and equity researcher. I knew I could run into such problems as a 28 year old black mother for the first time. I am an educator in reproductive justice. A teacher of black women’s health. I also have top notch health insurance and no pre-existing conditions.
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Yet even with these privileges and knowledge, I was not prepared to face the possibility of my own untimely death, as childbirth during the three COVID-19 pandemics, anti-black violence and the crisis of black maternal health meant that I had to reckon with my own mortality just as I was celebrating a new life.
A horrible and deadly reality
The realities of pregnant black women in the United States are of course gruesome. Black women are three to four times more likely to die from pregnancy-related causes than white women. The increased risk of pregnancy-related death for black women spans income and education levels. The inadequate care that black women often receive is rooted in unconscious and conscious prejudices, structural racism, and gender discrimination.
Studies have also shown that systemic and societal racism can create psychological stress, leading to chronic illnesses such as hypertension and preeclampsia, two of the leading causes of maternal death. It’s about excessive “vigilance,” or the chronic stress and psychological burden of anticipating racism. (High blood pressure is just one of the measurable health risks that stem from structural racism, alongside poor neighborhoods, mass incarceration, and high unemployment.) The experience of living with it and witnessing racial violence only increases the physical and mental impacts of racism and violence.
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Additionally, the research I recently conducted and intend to publish on the relationship between gender, class, racism, and black maternal health outcomes also reveals that experiences of reproductive coercion of black women increase the emotional and physical toll of medical racism, neglect and prejudice at the hands of medical providers.
Coercion alone is one of the abusive behaviors that can be difficult to follow. It often involves verbal abuse and condescending behavior, attempts to control a person’s reproductive health and decision-making, forced medical procedures, and a rejection of self-advocacy. Although there is growing awareness of the maternal health crisis in the United States, the aggravated trauma of navigating multiple forms of violence during pregnancy often goes unnoticed.
And while reproductive coercion is one of the underlying causes of racial disparities in maternal health outcomes, it seems clear that anti-black racism and COVID-19 are only making things worse.
The COVID-19 pandemic has simply laid bare these pre-existing inequalities. Describing these overlapping disparities in August 2020 as “the perfect storm,” a Harvard TH Chan School of Public Health researcher predicted that maternal mortality among black women in the United States would increase during the pandemic. She cited the already disproportionate maternal mortality rates among black women and the burden of COVID-19 in black communities.
Data on black pregnancies and maternal outcomes in the past year are not yet available, but the circumstances are unfavorable for black women.
Say their names
Even as our awareness of the premature death of black women from COVID-19, pregnancy-related complications and police brutality grows, we know little about the cumulative impacts of these traumas and their experiences. Current interventions in black maternal health are incomplete and short-sighted because they do not sufficiently include their voices. The exclusion of black women’s experiences limits a deeper understanding of the tangible and intangible ways in which black women deal with trauma and racism throughout and beyond the clinical encounter.
Thinking back to my own experience giving birth to my healthy daughter, I remember stories of black women who have received substandard care in health systems and whose needs are deprioritized – and have not lived through. to tell their own stories.
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There was Sha-asia Washington, a 26-year-old black woman who died after giving an epidural during childbirth. Shalon Irving, a 36-year-old black epidemiologist, collapsed and died of complications from high blood pressure three weeks after giving birth, even after repeatedly telling her health care providers that she was not did not smell well. And there was Amber Rose Isaac, 26, who died on her own after a cesarean emergency. Before her death, she tweeted about her experience of “dealing with incompetent doctors”.
Taking a hard and honest look at the life and death of these black women who have been victims of structural violence means embracing disease, inequality and violence while dealing with pregnancy, childbirth and the collective life-sustaining work. black. It means disrupting a notorious legacy of racial violence, gender discrimination and medical racism.
Say the names and tell the stories of Sha-asia Washington, Shalon Irving and Amber Rose Isaac. Think about my experiences giving birth to my daughter, as they are far from rare.
Sharing these stories means confronting the realities of today, and doing so is the first step in effectively addressing the embodied effects of structural conditions that undermine the holistic well-being of black women today.
Jallicia A. Jolly is a postdoctoral fellow and new Assistant Professor of American and Black Studies at Amherst College. She is a researcher on transnational politics of race, gender, sexuality and reproductive justice across the African diaspora. Jolly is also a writer for Dr. Shalon’s Maternal Action Project (DSMAP), an Atlanta-based non-profit organization established in honor of Shalon Irving that aims to raise awareness of the black maternal health crisis. Follow her on Twitter: @jallicia
