The American College of Obstetricians and Gynecologists acknowledges that racial bias within the health care system is contributing to the disproportionate number of pregnancy-related deaths among women of color. Providers spend less time with Black patients, ignore their symptoms, dismiss their complaints, and undertreat their pain.
Studies have noted that implicit bias influences patient-provider interaction and indicates that biases are likely to influence diagnosis and treatment decisions. This contributes to a higher allostatic load and adversely affects the health of the mother and fetus.
FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC medical ethics, 18(1), 19. doi:10.1186/s12910-017-0179-8
In a community meeting of Black mothers in San Diego in 2018, women noted implicit biases and racism during provider-patient interactions, feeling disrespected and judged by clinic and medical providers, with 80% of women feeling their provider did not care about them.
Data from State of California, Department of Public Health, Center for Health Statistics and Informatics, California Comprehensive Birth Files. Statistics prepared by the County of San Diego, Health and Human Services Agency, Public Health Services, Maternal, Child and Family Health Services.
In San Diego, Black infants are nearly 3 times more likely to die than White infants, are nearly 60% more likely to be born premature, and are nearly 2 times more likely to be born with low birthweight than White infants.
Based on comparison of African-American/Black and White 2013-2017 average infant mortality rates (8.3 vs. 2.9 deaths per 1,000 live births, respectively). Data from State of California, Department of Public Health, Center for Health Statistics and Informatics, Birth Cohort Statistical Master Files. Statistics prepared by County of San Diego, Health and Human Services Agency, Public Health Services.
California’s Black mothers are over 3 times more likely to die due to pregnancy or delivery complications than White mothers.
Based on comparison of African-American/Black and White 2014-2018 average maternal and late maternal mortality rates (55.2 vs. 16.5 deaths per 100,000 live births, respectively). Data from Centers for Disease Control and Prevention (CDC), National Center for Health Statistics, Division of Vital Statistics, Underlying Cause of Death 1999-2018 and Natality public-use data 2007-2018, on CDC WONDER Online Database. Accessed at http://wonder.cdc.gov on Jun 9, 2020.
During 2013-2017, preterm African-American infants were more than twice (2.2 times) as likely to die as preterm White infants (54.2 vs. 24.9 deaths per 1,000 live births, respectively).
These disparities persist irrespective of factors such as a mother’s income or education. An African-American woman with a college degree and a comfortable income still has a greater chance of giving birth prematurely than a White woman who didn’t graduate high school.