“If the numbers were reversed and white women were dying at the rate black women are dying, there would be political will to address this problem.”
That's how Katrina Anderson, senior counsel for the Center for Reproductive Rights, describes the discrimination and enormous disadvantages faced by black mothers, who are far more likely than white mothers to die from complications during pregnancy, delivery and post-delivery.
Although the problem is complex, many experts say the principal cause can be summed up in a single word: racism.
A new Fusion documentary, The Naked Truth: Death by Delivery, featuring journalist Nelufar Hedayat, looks at the difficulties encountered by mothers of color in states like Georgia – which has the worst rate of maternal mortality – and New York.
A pregnancy or delivery that ends in the mother's death is an indicator not only of poverty but also of gender inequality and social injustice. The United States has one of the highest rates of maternal mortality among developed countries, and the numbers have been rising since 1987.
The most recent figures from the Centers for Disease Control and Prevention show 17 such deaths out of 100,000 births.
Sick before even becoming pregnant
The documentary puts a face to the devastating numbers. It tells the story of Gale, 42, an African American who has two children and is pregnant with a third. Her house is one hour from the nearest health center in Augusta, Georgia.
“I don't know what I'm going to do if I have an emergency. That's very disturbing. There's nothing they can do for me here,” said Gale, who suffers from gestational diabetes, high blood pressure and weight problems – all factors in high-risk pregnancies.
Her case reflects how structural racism affects women of color. They face more complications during pregnancy, delivery and post-delivery as well as limitations on access to quality health care. They are also more likely to live in poor communities with fewer services and resources and less access to healthy food and exercise – all factors critical to a healthy life.
“These injustices affect women's health before they even become pregnant," said Dr. Deborah Kaplan, an assistant commissioner with the New York City Health Department. "If you are already a victim of racism and you suffer chronic stress, trauma or another health problem, that significantly reduces the possibility of a healthy pregnancy.”
Data shows that African American women fare worse than white women, no matter their salaries or level of education. The places where they live and work can directly impact their pregnancies. And those same factors can cause death.
Groups of activists, like the Black Mamas Matter Alliance, offer counsel on how to prevent maternal mortality and agree that the root of the problems is racism.
“Black women are treated differently because of the color of their skin,” psychologist and researcher Fleda Jackson said in the documentary. “Many don't know their rights and suffer abuses, and they don't have insurance. And they also suffer from sexism. They are black and they are women. There is no rest for them in these circumstances.”
The case of New York City
In New York City, African American women are more likely to die from a complication during pregnancy or birth than the U.S. national average. Between 2006 to 2010, they were 12 times more likely than white women to die.
“We have a very segregated city, and that didn't happen overnight. That's the result of years and years of policies to exclude and oppress women of color in general,” Kaplan told Univision Noticias.
“We have to take into account the issues that most affect them: the homes, the food, the security of their streets, the violence they are exposed to and that can impact their health and increase the probability of chronic diseases and stress, which keep them from having a healthy pregnancy,” she added.
A study by the New York City Health Department found that even black women with higher levels of education, such as university studies, showed a worse health picture than white women who had not graduated from high school.
“The United States is the only country with an advanced economy where maternal mortality rose in the last decade,” said Anderson. “We don't see this as an issue of resources, but where those resources are invested. It is not helping the poorest women.”
To confront the crisis, New York City has established a review committee of doctors, administrators and community residents and leaders to determine solutions.
“Through our Healthy Start program we are also focusing on the neighborhoods that have the highest severe maternal morbidity rates in North and Central Brooklyn", explained Dr. Kaplan. “We're also supporting the prenatal care programs that help to reduce preterm births. We must talk about this injustice. We have a great opportunity to make a difference.”