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Why black women fear the doctor

A history of their exploitation in reproductive healthcare in the U.S

Writing: Justin White

From Buzzfeed to the Guardian, or the GoFundMe pleas on Facebook and Twitter, we are all familiar with the extortionate cost of healthcare in the U.S. This alone is enough to put those uninsured, largely ethnic minorities off from visiting the doctor; yet for black women there exists a fear around reproductive health that extends beyond their finances. Nowhere is this more evident than in nativity, where black women are twice more likely to know what it feels like to give birth, but have no child to mother. Why? Like all race relations in the U.S., we look no further than 150 years ago to slavery to provide us with the answer.

At the time, scientific racism and social darwinism were both at the height of their relevance, reinforcing the idea that African Americans were an ‘other’ primitive species to the predominantly white population of the U.S. Due to this, a particular wonder was black women’s natural hyper-fertility. Belief was that black women possessed a narrower and deeper pelvis to those of ‘civilised’ white women, and therefore retained a hardiness to be “unaffected by the expected pains of labour and childbirth.” This naturally spread to medicine, and soon enough belief in a black primitive pelvis, obstetrical hardiness (relative immunity to pain during childbirth), and hyper-fertility was common practice. However, fast forward to the end of scientific racism and social darwinism’s influence in the 1950’s, and the same ideas continue to persist in modern medicine.

Time and time again, black patients are put through more extreme surgeries compared to their white counterparts, such as amputations, non-therapeutic hysterectomies (removal of all or a part of the uterus), vaginal surgeries, and contraceptive abuses, largely due to their ‘racial hardiness’ and better ability to tolerate pain. Furthermore, when it comes to the idea of their ‘primitive pelvis,’ equal disparities in prenatal care exist, as black women are far less likely to receive surgery for a pregnancy-related haemorrhage, and expected to be durable women, bearing the pain of contractions without advising their physicians. Combined with the fact that such treatments all come at a cost, black women’s fear of reproductive healthcare becomes evident. Yet even for black women who can afford to visit a gynaecologist and/or obstetrician, the same inequalities exist.

The International Organisation of Medicine found that middle class black women receive poorer healthcare than low income white women, and across insurance status, income, age, and severity of conditions ethnic minorities consistently receive lower quality healthcare than their white socio-economic equivalents. Therefore, physicians’ idea of black bodies, and all the preconceptions that come with it, can be seen as the sole cause for statistics such as black women dying from childbirth at three to four times the rate of white women, the disproportionate amount of extreme surgery black women undergo, and black women giving birth twice as often but having no child to mother. Yet certainly not every physician can perform his/her practice with racial bias?

Although a statistic does not exist (and nor would it do so accurately) representing the percentage of physicians that abide either consciously or subconsciously by these ideals left over from social darwinism and scientific racism, what must change in the U.S. is systematic racism. These harrowing statistics will not change until the system does, and evidently it hasn’t budged since the slave trade started some four centuries ago.

This article was based off Khiara Bridges work, “Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization” (University of California Press) and Yasmin Anwar’s article on “Why middle-class black women dread the doctor’s office” (University of California Berkeley News)

Image: Wiki Commons

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