Maternal & Infant Health
Article

Medical bias, weathering and the deadly impact on Black mothers

Community Solutions Team
Transforming data into progress
Additional Contributors
No items found.
June 29, 2020
Read time:
Download Fact Sheets
Register now
Share this resource
Subscribe to our Newsletter
By subscribing you agree to with our Privacy Policy.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Download this as a PDF

For the past several years, The Center for Community Solutions has been committed to examining and improving maternal and infant health for families in our state. By analyzing disaggregated maternal mortality data, infant mortality reports and other critical statistics such as birth records, we’ve developed policy solutions to help combat an escalating maternal and infant health crisis. For example, Black women in Ohio are currently two and a half times more likely to die of a pregnancy-related death than white women. And in 2018, white infants in the state averaged 5.3 deaths per 100,000 live births, while Black infants averaged 15.6 deaths for 100,000 live births.[1] Our organization, and many others, have reached the tragic conclusion that African-American women and their babies are dying at alarming rates, especially compared to their white counterparts.

 Black women in Ohio are currently two and a half times more likely to die of a pregnancy-related death than white women.

Research suggests that even when controlling for education, income and health, the disparities remain. Race is a consistent factor threaded throughout the data, leading us to believe the driver of the inequality is racism.  

Medical bias occurs when people of color receive disparate care from medical professionals because of implicit biases they hold about particular populations, and myths about physical racial differences. This usually results in people of color’s health complaints being taken less seriously.  

Unfortunately, this bias is engrained from the beginning of medical training. A 2016 study of 418 medical students at the University of Virginia revealed that more than half of them endorsed at least one myth about physiological differences between Black people and white people, and that these false beliefs are related to racial bias in pain perception. Examples of endorsed myths, which were often used to justify slavery as appropriate, include whites have larger brains than Blacks, Blacks’ nerve endings are less sensitive than whites’ and Blacks’ skin is thicker than whites’.[2] As a result, Black people have suffered at the hands of trusted, licensed medical professionals for decades. A 2013 American Medical Association Journal of Ethics study that examined the racial disparities in pain management revealed that black and Latino people had their pain needs met less frequently and adequately than their white counterparts. This is despite the fact that white people are more likely to endanger themselves with the misuse of drugs.[3]

 When it comes to birth outcomes, medical bias tends to lend itself to more grave outcomes.

Famously, tennis star Serena Williams shared her excruciating postnatal, near death experience publicly after giving birth to her daughter in September 2017. Because of her history of blood clots, she became increasingly concerned that she was experiencing a pulmonary embolism after feeling short of breath following birth. Hospital employees did not act immediately on her concern. They instead performed unnecessary testing and brushed her off as being confused due to her pain medication.[4]  

She’s not alone, however, Black women across the country have died during or after childbirth due to medical bias for a long time. In 2016, Kira Johnson of Los Angeles died after giving birth from postpartum hemorrhage. After hours of her husband, Charles, letting hospital employees know that the catheter coming from her bedside was pink from blood, they finally made the decision to take her to surgery, where they found she had been bleeding internally for almost 10 hours.[5] In 2020, Amber Isaac of New York City suffered the same fate. Amber spent months pleading to see a doctor in-person in lieu of telehealth visits (due to COVID-19) because of her platelet levels. In late April she was admitted to the hospital after her condition worsened, where it was discovered she had hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and was thus induced more than a month early and rushed into an emergency C-section. She later died after giving birth.[6]

 Doctors complicate births when they do not listen to Black mothers.

A survey conducted by The National Partnership for Women & Families of California in 2018 drew the clear conclusion, doctors complicate births when they do not listen to Black mothers. Key findings included, that while 4 in 10 women overall reported that a health professional tried to induce labor by using medicine or other methods, Black women were more likely than white women to have a C-section, and Black women reported more frequent symptoms of anxiety and depression.[7]  

Another explanation for the disparities is weathering, a term used to describe how enduring constant racism, discrimination and stress leads to premature aging and poor health outcomes. Coined by Dr. Arline Geronimus, a public health researcher and professor at University of Michigan, who through research around genetics and stress physiology determined that discrimination exacts a significant toll on physical health.  

For Black women, weathering can manifest itself in mortality and morbidity rates for both mothers and infants. This can be seen throughout Geronimus’ research, i.e. observing that young Black women are more likely to have poor pregnancy outcomes if they are in their mid-20s than if they are in their late teens. This is the exact opposite outcome of their white counterparts.[8] Black women who wait a few more years to have a baby suffer poorer outcomes because their bodies are more weathered and biologically older than their age.  

Because the stressors of living in a race-conscious society that stigmatizes and disadvantages people of color are chronic and persistent throughout the entire lifespan, the body of a Black person – a Black mother -- wears at a much faster rate.

 Systemic and institutional racism is at the heart of why Black mothers are more at-risk while giving birth due to the wear and tear of discrimination.

While chronic stress is unhealthy for any person, for pregnant women it can be life threatening. Symptoms of stress such as loss of appetite and trouble falling asleep can significantly impact a growing fetus. High blood pressure, which chronic stress induces and exacerbates, can directly increase the chances of preterm labor as well as giving birth to a baby with low-birth weight.[9] While weathering research is focused primarily on infant outcomes, The Journal of Maternal-Fetal & Neonatal Medicine determined that the correlation of severe maternal morbidity and preterm birth is a strong one.[10]  

Systemic and institutional racism is at the heart of why Black mothers are more at-risk while giving birth due to the wear and tear of discrimination. While it is important that the state’s infant and maternal mortality rate continues to decline, until the gaps between white women and women of color are adequately addressed, the crisis will continue.

  1. https://www.dispatch.com/news/20181206/ohio-infant-deaths-fall-overall-but-rate-for-black-babies-increases
  2. https://www.pnas.org/content/pnas/113/16/4296.full.pdf
  3. https://journalofethics.ama-assn.org/article/pain-and-ethnicity/2013-05
  4. https://www.vogue.com/article/serena-williams-vogue-cover-interview-february-2018
  5. https://www.cnn.com/2020/02/21/health/maternal-mortality-fathers-grief/index.html
  6. https://people.com/health/26-year-old-woman-dies-giving-birth-peak-covid-19-family-says-it-was-preventable/
  7. https://www.chcf.org/wp-content/uploads/2018/08/ListeningMothers2018.pdf
  8. https://www.npr.org/sections/codeswitch/2018/01/14/577664626/making-the-case-that-discrimination-is-bad-for-your-health
  9. https://www.nichd.nih.gov/health/topics/preconceptioncare/conditioninfo/stress
  10. https://www.tandfonline.com/doi/abs/10.1080/14767058.2019.1628941?journalCode=ijmf20
Download Fact Sheets

District 10

Download

All Council Districts 2024

Download

District 4

Download

District 2

Download

District 11

Download

District 9

Download

District 8

Download

District 5

Download

District 7

Download

District 1

Download

District 3

Download

District 6

Download

West Boulevard

Download

University

Download

Union-Miles

Download

Tremont

Download

Stockyards

Download

St.Clair-Superior

Download

Old Brooklyn

Download

Ohio City

Download

North Shore Collinwood

Download

Mount Pleasant

Download

Lee-Seville

Download

Lee-Harvard

Download

Kinsman

Download

Kamm's Corners

Download

Jefferson

Download

Goodrich-Kirtland Park

Download

Glenville

Download

Fairfax

Download

Euclid-Green

Download

Edgewater

Download

Downtown

Download

Detroit Shoreway

Download

Cudell

Download

Collinwood-Nottingham

Download

Clark-Fulton

Download

Central

Download

Buckeye-Woodhill

Download

Buckeye-Shaker Square

Download

Brooklyn Centre

Download

Broadway-Slavic Village

Download

Bellaire-Puritas

Download

All Neighborhoods 2024

Download

West Boulevard Factsheet

Download

University Neighborhood Factsheet

Download

Union-Miles Neighborhood Factsheet

Download

Tremont Neighborhood Factsheet

Download

Stockyards Neighborhood Factsheet

Download

St. Clair-Superior Neighborhood Factsheet

Download

Old Brooklyn Neighborhood Factsheet

Download

Ohio City Neighborhood Factsheet

Download

North Shore Collinwood Neighborhood Factsheet

Download

Mount Pleasant Neighborhood Factsheet

Download

Lee-Seville Neighborhood Factsheet

Download

Lee-Harvard Neighborhood Factsheet

Download

Kinsman Neighborhood Factsheet

Download

Kamm's Neighborhood Factsheet

Download

Jefferson Neighborhood Factsheet

Download

Hough Neighborhood Factsheet

Download

Hopkins Neighborhood Factsheet

Download

Goodrich-Kirtland Park Neighborhood Factsheet

Download

Glenville Neighborhood Factsheet

Download

Fairfax Neighborhood Factsheet

Download

Euclid-Green Neighborhood Factsheet

Download

Edgewater Neighborhood Factsheet

Download

Downtown Neighborhood Factsheet

Download

Detroit Shoreway Neighborhood Factsheet

Download

Cuyahoga Valley Neighborhood Factsheet

Download

Cudell Neighborhood Factsheet

Download

Collinwood-Nottingham Neighborhood Factsheet

Download

Clark-Fulton Neighborhood Factsheet

Download

Central Neighborhood Factsheet

Download

Buckeye-Shaker Square Neighborhood Factsheet

Download

Brooklyn Centre Neighborhood Factsheet

Download

Broadway-Slavic Village Neighborhood Factsheet

Download

Bellaire-Puritas Neighborhood Factsheet

Download

All Neighborhoods 2016

Download

District 2

Download

District 1

Download

Ohio Women Statewide

Download

All Women Fact Sheets

Download

Wyandot Women

Download

Wood Women

Download

Williams Women

Download

Wayne Women

Download

Washington Women

Download

Warren Women

Download

Vinton Women

Download

Van Wert Women

Download

Union Women

Download

Tuscarawas Women

Download

Trumbell Women

Download

Summit Women

Download

Stark Women

Download

Shelby Women

Download

Seneca Women

Download

Scioto Women

Download

Sandusky Women

Download
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Download report

Subscribe to our newsletter

5 Things you need to know arrives on Mondays with the latest articles, events, and advocacy developments in Ohio

Explore the fact sheets

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique.

No Related Fact Sheets

Explore Topics

Browse articles, research, and testimony.

Poverty & Safety Net
Article

The Jedi public health approach and four more ways to address weathering

Natasha Takyi-Micah
October 7, 2024
Poverty & Safety Net
Article

Community Solutions supports annual Glenn Leadership Forum, October 18

Tara Britton
October 7, 2024
Poverty & Safety Net
Article

Data Days: Using data for civic engagement, social justice, and advancing policy 

Jason Kluk-Barany
October 7, 2024
Poverty & Safety Net
Article

Current state of Ohio’s state budget

Tara Britton
September 30, 2024
Poverty & Safety Net
Article

Populations growing and shrinking in Cleveland, by age

Emily Muttillo
September 30, 2024