In every corner of this country, black and brown mamas are hustling to survive. The ends rarely meet for countless women of color, to the extent that it’s become an exhaustive refrain to talk about the obvious reasons why: the longstanding systems of inequality towards Black and Latinx citizens and immigrants, aftermaths of slavery, unequal pay, division of families, etcetera etcetera. It is the song that doesn’t end.
Perhaps that is why not enough people have discussed the compounding effects that 2019 will have on generations of non-white mothers who have been subject to centuries of pre and post-natal abuse and atrocity. The burial of slavery’s atrocities have robbed America’s collective memory and current consciousness of one fact in the midst of today’s anti-abortion landscape: non-white women have always been brutalized in pregnancy to protect white power and supremacy.
Pregnant Black slaves were beaten and lynched — their unborn babies cut from their womb. As late as the 1970s, Black, indigenous, and immigrant women were being forced into sterilization by the government. These were regular unceremonious abortions performed by the very people whose descendants would later leverage the practice as “cruel” when it offered them a continued foothold on oppressive power. The irony is not lost on those of us who have studied the history books.
So why then, has the conversation about abortion in America not progressed into a conversation about the terror our nation’s systems inflict upon non-white mothers?
There is a clear line between mothers of color who have been routinely misdiagnosed, ignored, and sometimes killed during pregnancy and child labor and the women whose lives will be upended by the recent uptick in rigid anti-abortion laws. According to Forward Together, a nonprofit fighting to dismantle society’s marginalization of many identity groups, “Latinas, in particular, have the lowest rate of health insurance coverage of women of any other racial or ethnic group,” which means their access to proper care and healthy pregnancies remains severely limited. Despite a meaningful correction in dismally low Latinx insurance rates provided by the Affordable Care Act, the crisis ensues. Forward Together points out that Latinx people still struggle with innumerable threats to a healthy pregnancy, labor, and delivery — including fear of apprehension by immigrant enforcement and lack of culturally appropriate care.
Karina Valunzuela Quinn, a Colombian nurse who practiced at Children’s National Hospital in Washington, D.C., explained potential inequities women of color face when pregnant — particularly as they relate to cultural differences.
“Discrimination can happen, often in subtle ways that we have become so accustomed to that, we no longer notice. Staff may often assume a woman of color is uneducated and unmarried. They may also not expect her to ask questions, because the expectation is that she will blindly follow what has been prescribed or diagnosed. The expectation is also that she will be more docile, because of the perception that she lacks education. The truth is everyone has a right to ask about the treatment they are receiving, and if they don’t understand they deserve multiple explanations if necessary.”
Improper medical treatment of pregnant women of color, though, cannot be solved with money or education. Countless Black celebrity women have spoken out about harrowing labor experiences — from Beyoncé to Serena Williams to Judge Hatchett, who lost her daughter-in-law to medical negligence after doctors allowed her to internally bleed to death following a C-Section. A cautionary tale, these instances emphasize how money and fame do not stand up to white supremacist systems of racial bias and discrimination.
Historical precedent explains these incidences too. Coined the “Father of Gynecology,” a History Channel report showed that James Marion Sims pioneered the industry by testing techniques and practices on Black slave women without anesthesia. His painful early gynecology experiences often led to prolonged suffering of the women, but similarly to the implicit bias of many modern practitioners he operated “under the racist notion that black people do not feel pain.” He also believed Black people were innately less intelligent than white people, due to their skull structure. After running countless excruciating experiments on black bodies, he eventually perfected his craft and began operation on white women — this time using anesthesia. Up until January 2018, a statue celebrating Sims stood proudly in New York City.
Given the history, it is much easier to understand how Serena Williams — one of the strongest athletes in history with yet a highly-documented history of blood clots — almost died from blood clots after giving birth.
The history also informs the risk even more women suffer in the present. While conceptualizing how even the “greatest” of women-of-color will suffer from the impact of racial bias in maternity wards, imagine what those without resources will experience.
“Teen moms and women of color are probably the lowest on the hierarchy of patient care when it comes to hospital treatment,” Quinn explains. “New abortion laws will inevitably only put this most vulnerable population at risk. Moms of color should know that they may need to speak up a little louder than usual. Unlike any other service industry, you, as the healthcare consumer, are on someone else’s turf. The doctors and nurses recognize their responsibility to get as many people as possible safely through the delivery process, but that may not necessarily incorporate what is best for your personal situation.”
The line between women of color who do not receive adequate treatment during pregnancy and anti-abortion laws is not dotted, nor does it take a roundabout route. Non-white women will suffer the most, and they will suffer often as they carry out pregnancies and labor in spaces that feel more like execution rooms than new life centers. The National Women’s Health Network shared that “the rates of abortions for African-American women and Latinas are disproportionately higher than their white counterparts based on their overall population size” and “Black women are three times as likely as white women to experience an unintended pregnancy; Hispanic women are twice as likely.”
Politicians have tried to come up with solutions. Elizabeth Warren suggested a financial bonus for hospitals that work to improve health outcomes for new Black mothers. While the thought is nice, the reality is this most likely wouldn’t work or really do much to prevent Black mothers from dying. Corey Booker and Ayanna Pressley introduced legislation that would expand Medicaid coverage for pregnant women and new mothers. While it could help, it’s still not enough, especially when we see women with money and power like Serena Williams and Beyonce almost dying while giving birth. The issue is much larger than the resources.
Until America has prepared to discuss the treatment of the mothers who are disproportionately affected by anti-women laws and systems, we are only fighting for white women’s rights. For women of color looking to advocate for themselves in the hospital, Quinn offers strong recommendations.
“The most eye-opening part of my own labor was my lack of control in the entire situation,” she says. “It wasn’t until my husband mentioned to one of the nurses that I was a nurse that my concerns were given the validity they deserved. Doulas have become so popular these days, because, in a highly emotionally-charged situation, they are someone calm to advocate for the mother.”
“For a person not very familiar with healthcare terminology, the best thing you can do is ask the doctor or nurse for a few minutes to think before making a decision. Taking a step back and forcing the staff to step back can allow time for the patient to be viewed individually,” Quinn adds. “This also can give you a true indication of the severity of the situation, because if it is a true emergency the healthcare staff will not allow for this time. But if it isn’t, the patient won’t be completely pressured into a decision.”