racism and doctors

in a recent article entitled: doctors in study prefer whites to blacks, the journalist, vanessa ho says:

Racial disparities have long been documented in health care, but a University of Washington study on doctors’ possible biases is validating the feelings of many African-American patients.

Released Tuesday, the study found that most doctors unconsciously prefer white people to black people. The exception was black doctors, who exhibited no preference for either race.

on this blog for the past year or so i have been documenting studies, articles, and first person accounts of the pervasive nature of racial bias within hospitals and medical establishment.  what i found interesting is the last line of this quote that black doctors exhibited no racial bias between white and black folks.  why dont black doctors have a detectable racial bias?  i am surprised.  i thought that through medical training, black doctors would likely also have a bias toward white patients.  maybe even medical training doesnt have to erase common sense about human beings and bodies.

considering the ways that birth culture require that women and children spend much more time with doctors than men, these studies do not bode well for the health care that women of color, and specifically black women receive.  unfortunately in my experience these same biases are represented among alternative health practitioners.  as i have stated before my home birth midwife insisted that i had gestational diabetes with little evidence to back up her claim other than ‘intuition’.  yes there is a history of diabetes in my family, but no history of gestational diabetes that i knew of.  and there is a major difference between the two.  but since, you know, black folks have some genetic disposition (sic) towards diabetes, she felt i needed to be extra careful about my diet.

the other thing that i found interesting is that the article is clear that:

“It’s important to not leave the impression that this necessarily affects behavior, because we really don’t know,” said Sabin, an assistant UW professor in medical education and training.

More research is needed, she said, to know whether bias affects care.

how could such a persistent bias not affect the care that black people receive?  if you believe that black people, by function of them being black, are less trustworthy, less intelligent, less responsible, etc.  how can that not affect how you, as a doctor, treat the person?  especially if you are not aware of these biases? especially when we look at the statistics of the limited choices that black folks are given in comparison to whites.  for instance:

A 2002 landmark report from the Institute of Medicine found that minorities receive poorer care than whites in many areas, from transplants to cancer to cardiovascular disease.

A Dartmouth study found that blacks in Seattle receive crucial blood tests at lower rates than whites, and undergo leg amputations — often caused by diabetes and vascular disease — more often than whites.

Studies that control for differences in income and education levels also have found racial disparities in care, Fleming said.

doulahood and DONA

this is from the ICTC (international center for traditional childbirthing) conference. unfortunately in birthing professional circles, seeing anything close to this many women of color is highly unusual.  the only reason that it is different here is because ICTC is the black midwives organization.  the only one of its kind that i know of.

BECOMING A DOULA

i began studying to be a doula while i was pregnant.  it was a perfect time to study to become a doula…the subject matter was very relevant to my life at the moment.  a doula named angela first inspired me to the vocation.  she was so cool and seemed to get ‘it’, the issues around race, gender, body issues, alternative identities, activism, ambition, etc.  i guess i just thought that all doulas were like her.  boy was i wrong.  they are relatively rare.  and i am do grateful for the mama luna doulas crew.

two months after i had aza, i started working as a doula with working class african american women in minneapolis.  i loved the work.   working on getting my certification with DONA.

MEXICO

when i went to mexico, i was ‘chatting’ with a southern california assistant midwife who suggested that since i had been traumatized by my birth i probably was not a good doula.  she worked with a clinic in san cristobal (that only had white midwives) that i hoped to volunteer as a doula for, but her entire attitude was condescending.  at one point she started in on a fake-ass chicana accent to prove that she was really down with women of color during birth.  she then told me that i should have been stronger in my birth.  she had never given birth.

a couple of weeks later the head midwife came over to our house to deliver a housemate’s child.  we sat around beside the fire for hours as my housemate was in the bathroom breathing through her contractions.  and the midwife started asking me to about my work as a doula and a mother.  at one point she stood up, flailed her arms to her side and yelled: no epidural! in response to my description of being a doula as similar to being an accompaniment worker.  i just shook my head.  that isnt accompaniment work and that isnt being a doula.  it was just a caracture.  and not a funny one at that.

later i found out that the head midwife at that san cris clinic was very apolitical toward birth.