Researchers from George Mason University spent 13 years analyzing 1.8 million hospital births in the state of Florida and have published the troubling results of their study: Black babies are three times more likely to die when they are cared for by white doctors. The mortality rate of Black babies decreases by 39% to 58% when Black babies are cared for by Black doctors.
This latest study offers more evidence to what Black mothers have been trying to tell the rest of us for years: pregnant Black women and their children are often less safe — and even at greater risk of dying — when they are cared for in hospitals by white doctors.
Co-author Rachel Hardeman explained the findings on Twitter:
"Our study provides the first evidence that the Black-White newborn mortality gap is smaller when Black MDs provide care for Black newborns than when White MDs do, lending support to research examining the importance of racial concordance in addressing health care inequities."
She continued, "Black babies have been dying at disproportionate rates since as long as we've collected data. The time is now to change this and to ensure that Black infants are afforded the opportunity to thrive."
Many doctors and health care providers already know that Black babies die at a higher rate than white babies, but this latest finding sheds even more insight into the unjust medical systems in place in the United States.
Earlier this year, the US Centers for Disease Control and Prevention published its own study that proved Black infants still die at a higher rate than white infants. This research appears to agree with the study published today.
The authors of the study note, "Strikingly, these effects appear to manifest more strongly in more complicated cases, and when hospitals deliver more Black newborns. The findings suggest that Black physicians outperform their White colleagues when caring for Black newborns."
Rather than speculating about why Black babies are suffering at the hands of white physicians, the authors instead call for an overhaul of the system: "Taken with this work, it gives warrant for hospitals and other care organizations to invest in efforts to reduce such biases and explore their connection to institutional racism."
Their hope is that such changes could take place across the board, throughout the entirety of each and every hospital where babies are born:
"Reducing racial disparities in newborn mortality will also require raising awareness among physicians, nurses, and hospital administrators about the prevalence of racial and ethnic disparities."
The maternal mortality rate for Black mothers in the United States is equally grim. In 2017, NPR published a story about the death of Shalon Irving, an epidemiologist at the CDC. Shalon died from complications associated with high blood pressure just three weeks after giving birth.
The CDC's own report on maternal mortality in the country indicates that Black mothers are 243% more likely to die from pregnancy and childbirth-related complications than white mothers.
In some parts of the United States, the disparity between Black mothers and white mothers is only growing. For example, in New York City, Black mothers experienced a risk of death due to pregnancy or childbirth-related complications at a rate of seven times higher than white women between 2001 and 2005. In 2017, Black mothers were dying at a rate of 12 times higher.
Research indicates that this difference is owing to improvements that have a positive impact on the lives and health of white mothers but show no marked improvement on the lives and health of Black mothers.
There are a lot of structural reasons why many Black women enter into motherhood at a significant disadvantage. These include the fact that Black women are more likely than white women to be uninsured prior to becoming pregnant. If they are enrolled in Medicaid, the mothers will often have to wait several weeks before their coverage begins, and it's likely they will lose that coverage shortly after giving birth.
Many Black women also usually deliver babies at hospitals that were historically segregated and that experience much higher rates of fatal birth-related complications.
But Black mothers are still dying even when they have health insurance, when they have a steady income, and when they have access to better hospitals and have more support at home. Shalon Irving was a brilliant scientist who held an undergraduate degree, two master's degrees, and a dual-subject PhD. She worked at one of the most highly respected institutions in the world. Her insurance was incredible, and her family supported her fully. And yet she still died from a preventable childbirth-related complication.
Others have studied the reasons why Black women are dying at such disproportionate numbers and have come up with a stark conclusion: Unconscious biases are deeply embedded in the medical system in the United States, and those biases harm Black women and infants every day.
It its report about Shalon's death, NPR noted that its team collected more than 200 interviews with Black women who reported feeling undervalued and unprotected while they were pregnant.
"There was the new mother in Nebraska with a history of hypertension who couldn't get her doctors to believe she was having a heart attack until she had another one. The young Florida mother-to-be whose breathing problems were blamed on obesity when in fact her lungs were filling with fluid and her heart was failing. The Arizona mother whose anesthesiologist assumed she smoked marijuana because of the way she did her hair. The Chicago-area businesswoman with a high-risk pregnancy who was so upset at her doctor's attitude that she changed OB/GYNs in her seventh month, only to suffer a fatal postpartum stroke."
Hakima Payne, a former labor and delivery nurse and mother of nine children, agrees that the cultural divide is real and it's significant.
"The nursing culture is white, middle-class and female, so is largely built around that identity. Anything that doesn't fit that identity is suspect." She continued, describing "the conversations that took place behind the nurse's station that just made assumptions; a lot of victim-blaming — 'If those people would only do blah, blah, blah, things would be different.'"
