Racism: the Deadly Disease Sweeping the Healthcare Industry
While many believe that childbirth is a part of the “miracle of life” and is a beautiful process, implicit bias within the healthcare system can lead to disparities amongst women, resulting in the preventable deaths of many women of color. Statistics presented by the Centers for Disease Control and Protection (CDC) show that Black women, Native American women, and Alaskan Native American women have a mortality rate that is three or four times higher than the one of White women. According to nurse and midwife Yael Offer, a reproductive and birth justice activist, Black women are 12 times more likely to die due to childbirth in New York City alone. Nearly 60 percent of these pregnancy-related deaths are preventable.
Such disparities are extremely complex national problems. They even exist in cities with the lowest pregnancy-related mortality rates (PRMR) and among women with higher levels of education. The PRMR for Black women with a college degree was 4.5 times higher than their white counterparts. Pregnancy-related deaths per 100-thousand births for Black and Native American women older than 30 were three or four times higher than it was for White women. In the United States, the pregnancy mortality rate has been spiking since the 1990s and is now one of the highest in the developed world.
In a city-run hospital in Brooklyn, New York City, a 26-year-old Black woman, Sha-asia Washington, died during an emergency cesarean section. Washington was a few days past her due date when she went for a routine stress test and was kept overnight by the hospital to monitor her condition. Even though her blood pressure was abnormally high, they kept her there for two days without medication, which was something that would not have happened if she had been a White woman. Washington went into cardiac arrest shortly after receiving an epidural. Unconscious bias by healthcare officials in cases like this can easily result in the preventable deaths of many women. Black women are often stereotyped as more “emotional” and “dramatic,” which leads to many healthcare workers dismissing their concerns and labeling them as “fake.” In turn, this leads to serious problems going unnoticed, creating a higher mortality rate for pregnant Black women.
Some healthcare professions believe that institutional racist bias in healthcare is a result of doctors dismissing patients reporting health concerns. In a nursing textbook, Nursing: A Concept-Based Approach to Learning, a page in the book offered “advice” and “guidance” on how people of different races experience pain. This racist page stereotyped people according to the color of their skin, saying "Blacks often report higher pain intensity than other cultures," and "Native Americans usually tolerate a high level of pain without requesting pain medication." However, it does not talk about White people. Assumptions like these are not evidence-based and they encourage nurses to ignore what a patient is actually saying. Textbooks like these can lead to healthcare professionals not believing a patient if they tell them their pain level is high, as the book lists common behaviors as “culturally specific.” In turn, it can lead to higher mortality rates and a lower quality of care.
In response to these statistics, the CDC recommends hospitals implement standardized protocols in quality improvement initiatives, especially in facilities that serve disproportionately affected communities, and identify and address implicit bias in healthcare that will help improve health outcomes. However, this is not enough; in order to truly combat such disparities in healthcare—a field where a single mistake can lead to life or death—it is crucial that doctors, nurses, and other healthcare professions are taught to be unbiased and not stereotype their patients according to their race, gender, and more through seminars as well as workshops organized by hospitals and medical schools. While going to medical school or nursing school can teach people to save lives, it is vital that they also learn to treat everyone equally, no matter who they are.
In the future, when our generation starts to give birth to children, we need to ensure such disparities are not prevalent in society and that the treatment does not differ between people of different races and socioeconomic status. The future generation of doctors, who are currently in medical school learning how to put in an IV line and coach a pregnant woman through birth, must be taught to not discriminate against people. By implementing such changes, maternal mortality rates will decrease, especially for people who are Black, Native American, and those who do not earn as much money or access to viable healthcare as others.
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