Racism, Maternal Care, and the ‘Afterlife of Slavery’

A new book looks at adverse birth outcomes among black women in the context of racism and what the author calls the “afterlife of slavery.”

The book, Reproductive Injustice: Racism, Pregnancy, and Premature Birth, was written by Professor Dána-Ain Davis (Queens College, The Graduate Center). 

Data on maternal mortality in the U.S. reveals tremendous racial disparities. Pregnancy-related death rates are three times higher for black women, Native American women, and Alaska Native women than for white women, according to the Centers for Disease Control and Prevention.

Black women are also more likely to have C-sections, and they’re “three to four times more likely to give birth prematurely,” Davis told a recent standing-room-only crowd at a book talk at The Graduate Center. (Premature birth is a major cause of infant mortality.) 

Davis said she was “haunted” by these “persistent high rates of premature births” in light of the “proliferation of neonatal technology” at hospitals around the country. Why is there funding for technology, but not for preventive care? And while neonatal intensive care units save babies’ lives, they are also places where parents are judged, marginalized, and policed. 

Davis, who is an anthropologist, focused on the experiences of professional black women to show that race, not poverty, is the defining factor here. “Black women with the highest degree of educational attainment and with access to health resources are more likely to have an adverse birth outcome or die from a pregnancy-related cause than white women with the lowest educational attainment,” Davis said in an interview with The Graduate Center. That suggests the problem is not just about income or class, “but that it’s about racism.”

Black mothers told Davis that their concerns and preferences were routinely ignored on everything from pain management to symptoms. She attributes this to “obstetric racism as an expression of the afterlife of slavery.” A famous example: Serena Williams experienced a life-threatening postpartum episode when health care providers ignored her request for blood-clot treatment.

One form of activism in response to these issues is a growing network of doulas, who provide physical and emotional support for women during pregnancy, childbirth, and postpartum. Davis is a doula herself. 

Looking at these issues through the lens of slavery, and integrating historical data with contemporary experiences, she said, “makes it possible to talk about the continuation of racism in the medical management of black women’s reproduction.”