The Persistent Crisis of Maternal Mortality for Black Women: A Systemic Failure

Dr. Bayo Curry-Winchell, a physician herself, knew what to expect after her 2016 cesarean section. Yet, something felt wrong. Dizziness and a dull stomach pain prompted her to voice concerns to the nurse who had wheeled her into the delivery room. The response, "Bayo, you look fine. Everything looks fine," proved tragically inaccurate. Despite her medical expertise and hospital access as a medical director, Curry-Winchell’s internal bleeding was initially dismissed. Her obstetrician, alerted by her persistence, intervened just in time.

Curry-Winchell’s experience highlights a disturbing reality: Black women in the United States face a disproportionately high risk of maternal mortality. Their mortality rates are 3.5 times greater than those of their white counterparts. This disparity, while partially attributable to factors like limited access to quality prenatal care, comprehensive insurance, and nutritious food, persists even when socioeconomic factors are controlled. A 2023 study from the National Bureau of Economic Research, focusing on childbirths in California, revealed that these disparities exist regardless of income and education levels, indicating deeper, systemic issues at play.

Dr. Kisha Davis, chief health officer for Montgomery County, Maryland, and a board director for the American Academy of Family Physicians, points to unconscious bias among healthcare providers as a significant contributor to this "medical paradox." She emphasizes the feeling of many women that their pain isn’t acknowledged. Their symptoms are dismissed and their concerns brushed aside. They lack comfort asking questions. "It’s really critical to make sure we check these biases at the door," she urges.

Research unveils a disturbing legacy of racial bias embedded within the medical community. A 2016 study shockingly found that nearly half of first- and second-year medical students harbored the misconception that Black people possess a higher pain tolerance, thicker skin, and experience less pain than white patients. Such ingrained biases can profoundly impact treatment decisions, leading to inadequate pain management, delayed diagnoses, and ultimately, poorer outcomes for Black women.

The effects of these medical biases extend beyond physical health, impacting mental health treatment as well. Forty percent of Black women experience maternal mental health symptoms, yet up to half of these women don’t receive the support they desperately need. The March of Dimes, a nonprofit dedicated to improving maternal and infant health, highlights this critical gap in care. Mental health conditions are now the leading cause of maternal mortality in the U.S., making it imperative that healthcare providers address the mental and emotional well-being of pregnant and postpartum women.

Dr. Davis calls for a fundamental shift in the doctor-patient relationship. "Doctors need to do a better job of listening to our patients and helping them feel safe. Our patients need to push us to make sure that we are respecting them and respecting their care," she asserts. This requires acknowledging the systemic nature of the problem and taking active steps to dismantle the biases that perpetuate disparities. "The challenge is on us to make the system better," she emphasizes.

One promising avenue for improvement is increasing the representation of Black doctors within the healthcare workforce. Research consistently demonstrates that patient outcomes improve when providers share similar backgrounds and cultural understandings as their patients. Katherine Sacks, associate director of health economics at the Milken Institute, highlights the importance of having a provider who "listens and understands and has a good relationship with you." This connection is crucial not only for reducing maternal mortality but also for ensuring a positive birthing experience. "Birth trauma is very real for a lot of people who survive," she notes, underscoring the lasting impact of negative experiences during childbirth.

Curry-Winchell’s personal trauma fueled her commitment to healthcare advocacy. Her mission is to equip patients with the knowledge, tools, and strategies they need to advocate for themselves within the healthcare system. She encourages patients to prepare questions in advance of appointments and to bring a trusted friend or family member who can speak up on their behalf if necessary.

Curry-Winchell’s advocacy is driven by the hope that other women can avoid the trauma she endured. Almost a decade after her near-fatal experience, she remains dedicated to empowering patients and transforming the healthcare system. "That’s what really fuels my desire to continue to help as many people as possible," she says. "Your health is truly your most prized possession." It is a possession that should be equally protected and valued, regardless of race or socioeconomic status.

The high maternal mortality rate among Black women in the United States is a complex problem rooted in systemic failures, unconscious biases, and a lack of adequate access to quality care. Addressing this crisis requires a multi-pronged approach, including dismantling biases within the medical community, increasing the representation of Black healthcare providers, improving access to prenatal and postpartum care, and empowering patients to advocate for themselves. Only through sustained effort and a commitment to equity can we ensure that all women have a safe and healthy childbirth experience.

The story of Dr. Curry-Winchell is a reminder that even those with medical knowledge and access can fall victim to a system that often fails to prioritize the health and well-being of Black women. It is a call to action for healthcare providers, policymakers, and communities to work together to create a more just and equitable healthcare system for all.