Author: Tate Fonda*
What does it take for a country founded on the principles of inequality to dismantle the systemic racism that persists into the present? Now that the long-silenced voices of the advocates for equal rights have erupted into a recent collective scream for black equity, what does it take to dismantle the systemic racism that persists through our society, especially within the work of those who should be saving all lives? A medically preventable problem all-too-often hidden to those who do not face the struggles of the outcome, particularly in the United States, has caused black expecting mothers across the states to fear for life itself before, during, and after pregnancy. Doctors who question the level and seriousness of pain felt by black women in the United States has not only generally petrified expecting mothers, but, in many instances, led to otherwise preventable excruciatingly painful experiences, elevated stress during a time that should be calm and celebratory, and in many extreme cases, the death of their children or
In an all-too-long trial of censorship that has continued in the post-slavery and post-civil rights movement eras, created primarily by both continued manipulation by those in seats of power and white guilt, among other discrepancies, black women have long silently suffered the turmoil of discrimination-- adjusting their daily lives to the troubles that would not face a white woman, and especially not a white man. Headlines may cast their stories into the light on occasion, only to disappear into the vast sea of information on the following days. Justice is advertised, maybe spoken about, and put to rest, in a vicious cycle of teased justice. The dangers particularly posed to the black population by the justice system, a profession created to “protect” that has not fairly withheld its mission, carry parallels into the medical field, particularly to black women. The professions that should dispense justice and protection such as
civil servants, doctors, and surgeons alike all carry a generally alarming similarity: many employees don’t properly understand their discriminatory attitudes, causing them to administer unfair treatment in life or death exchanges. Those who understand their discriminatory attitudes are even more overtly dangerous. Whether explicitly known of, denied, or held obliviously in, these attitudes shape the personalities of the employees of our most arguably important professions-- holding missions to maintain safety. While brutality, unlawful arrests, and court discrimination are dangers facing black Americans in the field of justice, excruciatingly painful experiences, elevated stress during a time that should be peaceful, and in extreme cases, the death of children, plague black expecting mothers as worries to expect of the medical system. These issues are massive in scale. According to a study conducted on racial bias in assessment in
pain levels and their treatments by several University of Virginia psychologist researchers, out of these three misconceptions: “Black people’s nerve endings are less sensitive than white people’s.” “Black people’s skin is thicker than white people’s” and “Black people’s blood coagulates more quickly than white people’s”, half of the group of students training to become doctors, including residents, believed that one or more false statement was true. A jarring 40% of the group believed in the most common misconception studied of the three: that “black people’s skin is thicker than white people’s”(Hoffman). This is a dangerous and unfounded misconception that reveals only the surface of internalized racist treatment given by prospective doctors, and in terms of reasonable extrapolation, practicing doctors.
For Black women, who already suffer the fate of undermined pain levels by discriminatory doctors both aware and unaware of their prejudice, pregnancy has been made a time of fear instead of comfort. One of these women was Brandi Jordan, a pediatric care specialist who planned on having her third baby via a hospital birth. Stumbling into the department of the hospital where she worked for five years in labor pains, telling the doctor her water had broken, he simply replied that she “may have peed”. When she brushed off the comment and restated that she was in labor, the doctor shut her down, saying “It doesn’t matter that you think you’re in labor. What matters is when I think you’re in labor.” Ghast with pain, and fully aware of her state, Brandi was denied admittance into the hospital and was given a small closeted room next to the waiting room where her wails of labor pain were heard by all who were waiting. The stripping of her privacy, the denial of her pain, and the dangerous delivery of her child were all treated as consequences of the color of her skin-- a trouble that all too many black women face in their journeys to delivery. Brandi, while recounting her story as a guest on the Duncan Trussell Family Hour Podcast, remarks on a protest sign that spoke to her, reading, “Doctors do to Black Women What Police do to Black Men”(Trussell).
Brandi’s case is in no way isolated. According to a CDC study titled “How Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths”, pregnancy-related deaths per 100,000 live births for black and women older than 30 was four to five times as high as it was for white women. Beyond the threat of overt racism, death threatens these women as a result of preventable malpractice. The PRMR (pregnancy-related mortality ratio) for black women with at least a college degree was 5.2 times that of their white counterparts. It can be soundly concluded that there are no other factors at play aside from a history of racial prejudice that persists into the present within the medical field, scaring black expecting mothers away from a time that is generally more peaceful for white women.
What does it take for a country founded on the principles of inequality to dismantle the systemic racism that persists into the present? It begins with the recognition that has begun to penetrate the surface of society as we see it today. Protest. Education. Diffusion of resources. The social agenda has paved way for the medical field and all Americans concerned with their practices to take accountability and seek remedy to the cases of discrimination that they are both aware and unaware of. The answer lies within equity; extending a ladder to those who cannot reach the highest branch. Catering to pregnant black women when they state they are in pain, and throughout the process of their maternal journey, would allow for a system of equity to enter the playing field of hospitals across the nation. Training doctors to rule out common racially-biased misconceptions with mandatory classes would not be an overextension of their work-- and may help fill in gaps of understanding, educating those who may not be aware of their practiced prejudice. Upon completion of these classes, doctors would receive a certification of Racial Bias Training, one that would be needed to practice. To ensure there are no cracks in the process, doctors would attend yearly workshops, evolving in terms of curricula based on the needs of the current social climate, in the Administration of Fair Practices, to upkeep their certification. Normalizing a lack of racial bias and an understanding of the need for equity to be a characteristic of a doctor would not only ensure equalization of treatment for black and white women, but for other minorities who suffer a similar fate. Normalizing these necessary characteristics would encourage level minded individuals to stay in the profession and become the majority. Overtly racist doctors would drastically increase in number, disarming their dangerous practices from the profession.
It will not be easy to dismantle the history that haunts us into the present. There will be no quick fix. But a slow plan allows us to look towards the end of the tunnel of racial discrimination towards black expecting mothers. If we require classes in racial bias to be a part of the curricula for new doctors, strictly upkeeping their required certification in Racial Bias Training, we can introduce the characteristics of racial fairness in a field that so desperately needs it. Aside from on-the-paper scientific methods, a truly good doctor must be able to have an understanding of how to fairly treat all patients, a promise that should’ve been kept when every practicing employee took the Hippocratic Oath.
Hoffman, Kelly M., et al. “Racial Bias in Pain Assessment and Treatment Recommendations, and
False Beliefs about Biological Differences between Blacks and Whites.” PNAS, National
Academy of Sciences, 19 Apr. 2016, www.pnas.org/content/113/16/4296.
“Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths.” Centers for Disease
Control and Prevention, Centers for Disease Control and Prevention, 6 Sept. 2019,
Trussell, Duncan. “390: Brandi Jordan.” Duncan Trussell Family Hour, 10 July 2020.
This article is the 1st place winner of our first ever MedSoc Talk Article Competition. The prompt was, "What is the biggest problem that the medical field faces and what is your solution to it?"