sick and tired: how racism impacts pregnancy outcomes

December 11, 2009 § 25 Comments

thanks to dou-la-la for this video.

how racism impacts pregnancy outcomes

notes from the video:

  • the biggest myth in dealing with race and infant mortality is that people think that it is the consequences of social economics
  • infant mortality rates among college grad white women is 3.7/1,000; among college grad black women is 10.2/1000
  • college grade black women have a worse infant mortality rate than white women without a high school education (9.9/1000), in other words black women lawyers, doctors, engineers have a higher infant mortality rate than white women who didnt finish college
  • life course perspective=that birth outcomes are not simply the product of the nine months of pregnancy, but are a consequence of a woc’s life experience
  • racism is a stress that causes wear and tear on the body’s systems to adapt, hormonal, inflammatory functions, metabolic infections which creates an overload on the system
  • everyday racism is like gunning the engine of a car without ever letting up
  • studies done where during the day white and black patients blood pressure would be the same but at night the white person’s blood pressure would drop but the black persons blood pressure would stay the same
  • there has been a lot done in terms of access to pre natal care to communities of color and yet have not seen a decrease in prematurity rates
  • we expect pre natal care in nine months to reverse the cumulative effects of a lifetime of exposure to inequities.  and that is probably expecting too much of pre natal care.
  • if we really want to do something about improving pregnancy outcomes we need to start taking care of women over the course of their lifetime starting from in the womb and throughout childhood, adolescence, adulthood, and motherhood.  taking care of women and families across their life course.

1  what really hit me about this video was the description of  the consequences of racism as a stress that causes wear and tear on the body throughout the lifetime.  this is what i find most difficult to describe to folks when they talk about ‘oh yeah, ive been discriminated too…for having freckles or kids used to tease me about my big ears…is that we are talking about apples and oranges.

the experience of day to day racism is continual trauma.  and like all traumas, racial traumas manifest themselves through the body.

fannie lou hamer: we are sick and tired of being sick and tired.  this is a visceral articulation of the experience of being a woman of color.  to be ‘sick and tired’.  to have one’s body constantly being revved up and never being able to bring it back down.  and that when the white and black person went home, the black person’s blood pressure stayed as high as when she had been out in the public world. to me this is a very important point.

why?  why didnt the blood pressure go back down when the black person arrived to the safety of her home.  at night.

in part, because racism is not simply about individual attitudes, but it is structural.  and by that i mean, the trauma of racism, is produced not simply by the racist attitudes and behaviours of ordinary folks in her day.  but also by the structures that define and limit her life.

in other words: going home does not stop her from being black.  furthermore, going home does not stop her from being conscious about being black.  and black is not a neutral term/identity in this world.  when we are triggered to be conscious of being black (or female), we trigger what is known as the stereotype threat.  and of course stress.

2  this is also why i think the whole–oh, these women who are having these birth outcomes, are just uneducated about birth, and once they hear and read about natural birth, take some lamaze classes, understand the value of colostrum, etc. then those women will make better choices and boom! problem solved–is really condescending to women of color.

well, here’s the thing as the video points out.  we already tried the whole educating marginalized women into better health outcomes.  that is what the whole ‘pre natal care is vital to your baby’s health’ came from.  and it hasnt worked.  not at all.

and it should be noted that–education is the answer–is a very middle class (yes, even black middle class) response to a problem.

education is pretty much useless to improve birth outcomes, if women of color are being traumatized by racism daily, and the ‘education’ is ignoring that she will be a woc during her pregnancy, and birth, and the rest of her life.

3  i wrote this a couple of months ago: smart tips and empowered births

and why are black mothers dying at twice the rate as white mothers…?  ill tell you my hypothesis.  its because black women live in black communities.  and in black communities the very air, the water, the grass, the houses.  are poisoned.  i think its environmental.  mixed with not having access to fresh foods.  and of course there is the stress of racism which is statistically deadly.

4  oh and just one more time: infant mortality rates among college grad white women is 3.7/1,000; among college grad black women is 10.2/1000–and–college grade black women have a worse infant mortality rate than white women without a high school education (9.9/1000), in other words black women lawyers, doctors, engineers have a higher infant mortality rate than white women who didnt finish college

i am not one to get into a ‘who has it worse’ racism vs. classism vs. homophobia vs. all the other structural oppression.  i just want to take a moment and let it seep into my bones the incredible impact that racism has on the body and the life.

but of course when talking about race and class.  it is important to note the wealth differential between white and black households.  on average a white household will own 10 times more wealth (net wealth=everything you own) than black families with the same income and education.

5. and 1/3 of the us women population is of color.  and 4/5 of the global womens pop is of color.  and racism is global.

§ 25 Responses to sick and tired: how racism impacts pregnancy outcomes

  • […] Birth Outcomes Please go and read this brilliant post by Guerrilla Mama Medicine –> Sick and Tired: How Racism Impacts Pregnancy Outcomes. This is the first time I’ve seen the impact of racism on health laid out so clearly in […]

  • k. emvee says:

    Thank you thank you thank you for this post! We need more explicit talk about how racism affects pregnancy. Not just socioeconomic status – but racism independently of other co-factors.

  • Br00ke says:

    Saw this this morning and wondered what your take would be–one of my hbac groups posted this info for a study and I just felt weird about the participant criteria. It just seemed odd to me:

    Participants needed for a project about
    *Out of Hospital Birth Experiences*
    *Who can participate?* Women who gave birth in the last 5 years at a birth center, Or had a planned homebirth or a surprise (unplanned) out of hospital birth AND who have a history of childhood abuse and/or sexual trauma AND/OR are African-American

    I can see the correlation along the lines of ptsd–but why all lumped together?

    Thanks for the post.

    • Br00ke says:

      Oh and my question is more rhetorical–but I would like to hear people’s responses. Most folks on my group aren’t even reading it right–thinking you must be AA and abused–not that my comprehension is currently much better.

      • mama says:

        yeah that is just weird. i had to read it three times just to understand it. it would have been really helpful to me if they had posted *why* that was their criteria. like why afr-am and not latina or indigenous?

  • Derel says:

    I would imagine that a poisoned environment would also play heavily into infant mortality rates. I wouldn’t know how one could measure stress responses, and obviously higher stress caused by racism isn’t healthy, but I would wager that a poisoned environment plays a prominent role in infant mortality rates.

    • k. emvee says:

      Absolutely. I wonder if anyone knows of good explicit links between the reproductive justice and environmental justice movements? I see that they must be very connected – but haven’t kept up with either since I graduated college like I should have.

    • mama says:

      yes, i think there are strong environmental factors. but look. educated upper middle class black women are still having major differences in infant and maternal mortality than white women of the same education and socio economic status. we have to assume that those upper middle class black women are living in neighborhoods that are not plagued by the detritus of environmental racism. so it has to be deeper than environment.
      also, one measures stress responses – in this case – by measuring the blood pressure rates of white and black people who have similar lifestyles.

      • k. emvee says:

        I absolutely agree. And I think it’s all compounded – environmental issues, class issues, race issues. And that if it’s that bad for educated upper middle class black women, it’s hard to face what the realities are for uneducated, poor black women living in environmentally polluted and degraded areas.

  • Ash says:

    Thank you for this post. As a white student midwife, this is beyond helpful. I want all of the other students at my school to know this stuff too. What do you think about a petition or something to MEAC to encourage them to mandate education about these things to all MEAC approved schools?

    • mama says:


      yeah i do think its important that birth workers understand all of the major components that make up the pregnancy/birth/nursing experience. not simply the physiological ones. i know that there is a meme in the birth world that the physiological trumps all. but more and more we are seeing that that is an old and inadequate paradigm if our goal is to support women and their reproductive choices.
      are you not taught this in your schools? huh. i wonder why not… that is not a rhetorical question. i am really trying to figure out why wouldnt you be taught about how structural oppression impacts birth? i mean the research is out there…
      i used to be an antiracism trainer. and i dont do that anymore. but i could do a workshop on the ways that structural oppression, specifically racism and classism, affect the childbearing year. the workshop would have to be online…i dont know something to think about…

      • Ash says:

        I’m going to email you my reply.

      • k. emvee says:

        That would be just about the most amazing thing ever. Amongst MEAC-accredited schools there is an incredible dearth of discussion about race in general. There isn’t even good information about social justice work and the importance of being actively anti-racist let alone information about differential birth outcomes based on race and racism.

        We are so stuck in the second-wave feminism that the Seattle Midwifery School was formed in (and all other MEAC-accredited schools were based off of) where we have a universal woman (who also happens to be white, straight, Christian, and middle class) who understands the experiences of all women based on the virtue of her sex. We HAVE to move beyond this if we’re ever going to get anywhere.

  • Br00ke says:

    I’m pretty well informed about pregnancy and birthing not only because I’ve done it a few times, but also had a strong interest in being a midwife. So I’ve had friends ask why I start using midwifery services so soon into my pregnancy when I tell people that it’s not really necessary unless that’s what they want–I’ll go before the test comes back positive if I could! I fully admit, it’s therapy for me. Or at least theraputic. Lots of issues come up during pregnancy and even though I may not address these things head on while at a prenatal appointment, I am still really open and questioning and go home and read more stuffs, so I do learn a lot about the holistic nature of ME. Now as you’ve said before, I woc would not be able to be that open without fearing very typical and likely repercussion.
    A friend of mine (woc and immigrant with noticeable accent and headscarf) recently had her second bebe through a midwife (white) and although the experience was considerably different than her first in a hospital setting–better–she was still no where near as comfortable with her midwife as I have been and felt that her midwife wasn’t either. Isms are not going to dissipate at prenatal appointments and births–not even with touchy-feely, crunchy, liberal white midwifes. That sucks.

    • mama says:

      ha ha ha. the funny thing is: i like granola. really. especially with maple syrup. and some soy milk. i think that is part of my response to the natural birth culture. is that…if it wasn’t for the race/class thing…the crunchy midwives would love me. for instance, on the phone i sound white. so, i would call midwives on the phone and they would ‘love’ me and feel connected and everything would be cool. and then after meeting (seeing) me–you could just see the look on their face trying to figure out how i was the same girl they met on the phone. after the first couple of times, i started telling midwives on the phone that i was black, so they could get a ‘heads up’.

      • Ash says:

        I’m still putting together my response to your other point, but I wanted to respond to this.

        Your experience with midwives on the phone is inexcusable, but it doesn’t surprise me a bit. If I were the ambassador of crunchy white women, I would apologize on our behalf. The problem is that even most white leftist midwives (and most white leftist people in general) still have a 3rd grade understanding of racism. You know- where you celebrate Martin Luther King day and everybody talks about how great it is black people can vote and we freed the slaves and then we all pat ourselves on the back for being colorblind.

        How many white midwives and doulas have read “unpacking the invisible knapsack” or anything by Cornel West/Tim Wise? Conversations about racism as a systemic phenomenon that is all pervasive in society, affecting women of color of all socioeconomic classes, are not had very often at all. And they need to happen, especially in midwifery training.

        I don’t know what the solution to this. I think it would start with MEAC mandating all approved schools have some sort of antiracist training that included the effects of racism on women of color in the childbearing years, preferably taught by WOC.

        I think presentations on this subject need to be seen at the big midwifery conferences when they happen, also taught by WOC.

      • k. emvee says:

        Ash, you and I should talk. Let’s start a revolution. I’m also a student-midwife, just starting out on my journey. (Some of my initial thoughts and musings.)

        I think most white midwives (and most DEMs are white) have never even heard about Cornel West or Tim Wise, let alone ever thought about the concept of white privilege. And that in and of itself is a problem.

        I have hopes that Jennie Joseph’s new school down in Florida will be different and will be the start of a real education for midwives. She’s the only midwifery educator I’ve come across who has a real grasp on the interactions of race and class and midwifery.

      • mama says:

        ash meet k. emvee! yes. the two of you should definitely get together. i have a feeling though that looking at radical women of color–audre lorde, june jordan, angela davis—would be more fruitful than west or wise. i dislike wise’s method and feel that it lacks integrity–but that is just imho. also looking at: andrea smith, patricia hill collins
        just to name a few

      • k. emvee says:

        That has always been my personal preference – I’d rather read Angela Davis than Tim Wise any day. But I struggle with recommending books, authors, and thinkers that I think will change people’s lives and viewpoints vs. those I think they will read because they believe them to be more accessible. As usual, I don’t have any easy answers around that.

      • mama says:

        i saw the video on your site of –i think–jennie joseph. if so that was an amazing short talk she gave.

      • k. emvee says:

        That was indeed of Jennie Joseph. I’m glad you checked it out!

  • […] to educate myself about racism and privilege. Learn the ways racism affect the body physically and birth outcomes negatively. Continue to oppose and undermine racism, educate others, and in […]

  • mamabella says:

    Let us concern to the unity, no racism anymore. So our generation will love one another and every woman during pregnancy fell safe and comfort.

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