A few weeks after my 20th birthday I made an important decision: if I were to have children in the future, I’d deliver them at home with the help of a doula. The hospital would be my last resort, in the case of an emergency. My choice was rooted in and shaped by the rampant neglect and discrimination that Black women face in doctor’s offices and hospitals throughout the US. Too many Black women have died, or had near-death experiences, because they were disregarded by their healthcare professionals.
Amber Rose Issac was one of these women.
Twenty-six year old Amber Rose Issac was pregnant with her first child earlier this year. In February, Issac informed her doctors (in virtual appointments) that her blood platelet count was dropping. Despite her concerns, the medical team tending to Issac’s pregnancy at Montefiore Medical Center in New York dismissed and ignored her distress. Issac was eventually admitted to the hospital where doctors realized that she had developed HELLP syndrome. This complication causes low blood platelet counts among other life-threatening problems. The doctors induced labor but after delivering her son, Issac passed away.
The neglect of Issac’s doctors cannot be fully attributed to their increased and urgent workloads due to COVID-19. Black women have experienced a lower quality of care in medicine for years that is evidenced in our high mortality rate during childbirth. Black women are 3 to 4 more times likely to die during childbirth than white women. Racism and bias contribute greatly to this disparity. Racism has been and continues to be entrenched in the medical field.
Science has never been neutral. It has long been a vital instrument in the oppression of Black women and other disadvantaged communities.
Eugenics is a prime example. This pseudoscience was first proposed in 1883 by Charles Darwin’s cousin Sir Frances Galton. Eugenics was focused on enhancing the world’s gene pool by weeding out individuals with undesirable characteristics. Unsurprisingly, ‘undesirables’ were marginalized groups like Black, Jewish and disabled peoples. Beginning in the early 20th century,federally-funded eugenics programs were commonplace, resulting in the widespread forced sterilization of Black women in America. Civil rights activist Fannie Lou Hamer was forcibly sterilized without her consent in 1961, less than 75 years ago.
What was done to Hamer could have happened to any of the older Black women that you know. What was done to Hamer could have been done to my grandmother, my best friend’s great aunt or your next door neighbor. In recent American history, thousands of Black women were subjected to non-consensual hysterectomies ‘for the good of the country’.
Even the field of gynecology was founded on the bodies of Black women. J. Marion Sims, dubbed the ‘father of gynecology’, experimented on enslaved women. The reverberations of these racist ‘scientific’ beliefs and experiments can still be felt in modern day medicine.
Racism within the healthcare field begins in medical school with a curriculum that incorrectly portrays or completely excludes Black folk. A majority of medical textbooks only illustrate what illnesses and symptoms look like on light, white skin. Consequently, once students are medical professionals they may be unable to identify, diagnose and properly treat Black patients because they are unfamiliar with what certain diseases look like on darker skin.
Medical textbooks are also guilty of including information that perpetuates racial stereotypes. Just a few years ago, there was a scandal with a Pearson textbook that “explained” how certain racial and ethnic groups respond to pain differently because of their biological makeup. Pearson has since removed the chapter but it goes without saying that, in the 21st century, it should not have made it to print in the first place. This is a prime example of the resilience of scientific racism.
Such literature contributes to and legitimizes implicit bias that is already present in many medical students. According to a survey from 2016, 40% of first and second year medical students believed that Black people had a higher pain tolerance than whites and did not experience pain in the same way. This belief, in addition to stereotypes about Black people’s relationship with drugs, contributes to the under-prescription of pain medication for Black patients. White patients are 22% more likely to receive pain meds than their Black counterparts.
Compounding the bias ingrained in medical school, Black women’s intersecting racial and gender identities put us in a uniquely vulnerable situation. From the moment we step into health care settings we are battling stereotypes about both our race and our gender. All too often we are disregarded and ignored by the very medical professionals who are supposed to care for us, which places our lives at higher risk.
Amy Mason-Cooley experienced this a few months ago.
Mason-Cooley went to the hospital in June with debilitating pain that prevented her from walking. She has sickle cell, a disease that primarily impacts the Black community. After spending a full day in the hospital, Mason-Cooley was still in pain but her doctor took her off her medication. He did so against her wishes and pleas. Mason-Cooley’s blood count dropped after she was taken off her meds and she did not stabilize until other medical staff came in and began administering her medication again. Her interaction with health care professionals is exemplary of the way that Black women’s voices are dismissed time and again in medical settings. Who are we to turn to when our own health care providers don’t value our voice? Who can we trust?
There are some people working to dismantle systemic racism within the medical field itself. Medical students have been advocating for the integration and centering of anti-racism in their curriculum. One medical student, Malone Mukwende, is publishing a handbook that illustrates what certain symptoms and illnesses look like on darker skin. These individual actions are commendable but we need system-wide action and we need it now.
If there’s anything this past year has revealed to us, it is that 2020 can be a turning point in this country. We are in the midst of a racial reckoning and medical emergency. There is no better time to come to terms with the reality of medical racism than right now. There is no better time to begin adopting anti-racist medical frameworks and approaches than right now. We need to address just how much racism contributes to health disparities in the US and that Black women are bearing the brunt of the consequences, as we have for centuries.
COVID-19 has re-energized conversations about health and access to healthcare as a human right. These are conversations that are hopeful and excite me. But I also want to know that when I, and other women who look like me, have access to this healthcare, that we will receive the same caliber and quality of care as our white counterparts. I want to know that if I decide to have my future child in a hospital, I won’t be one of the thousands of Black women who die from preventable complications simply because I wasn’t listened to.
It shouldn’t take the death, or near-death experience, of a Black woman for her voice to matter. Black women matter all the time. Black women should be believed all the time. Especially in the doctor’s office.