Why the Idea of Motherhood Fills Me With Hope and Fear
And, What Implicit Bias Has to Do With It.
At 36, the thought of becoming a mother (one day) fills me with hope and fear. As a Black woman, the fear isn't just about the challenges of motherhood but the terrifying statistics that show Black women face disproportionately high maternal mortality rates. Despite advances in technology and healthcare, the maternal mortality rate for Black women in the United States stands at a staggering 49.5 deaths per 100,000 live births (Hoyert, 2022). In contrast, White women experience 19.0 deaths, Latinas 16.9 deaths, and Asian women 13.2 deaths per 100,000 live births.
The harsh reality is that our healthcare system fails Black women in critical moments. It's not just about access to technology but about the implicit biases permeating our healthcare practices. These biases lead to delayed diagnoses, dismissed symptoms, and inadequate care, resulting in preventable deaths. As healthcare providers, we must confront and address these biases head-on to ensure that every woman, regardless of race, receives the care she deserves.
Understanding Implicit Bias and Its Role in Maternal Mortality
As you may know, implicit biases are attitudes or stereotypes we unconsciously have that can affect our understanding, actions, and decisions. In healthcare, implicit bias can significantly impact the quality of care provided to patients, particularly Black women, during pregnancy and childbirth. Despite advancements in medical technology and practices, implicit bias continues to create barriers to equitable care.
Barrier 1. Delayed and Dismissed Symptoms
Black women often report that their symptoms are dismissed or underestimated by healthcare providers. This can lead to delayed diagnoses and treatments, which are critical during pregnancy and childbirth. For example, a Black woman experiencing severe pain may not receive the same level of attention and intervention as her White counterpart, leading to complications that could have been prevented.
Barrier 2. Mistrust in Healthcare Providers
Due to a history of discrimination, many Black women mistrust the healthcare system. This mistrust can result in delayed prenatal care or avoidance of necessary medical interventions. When Black women do seek care, they may not fully disclose their symptoms or concerns, fearing they will not be taken seriously.
Barrier 3. Communication Barriers
Effective communication between healthcare providers and patients is essential for quality care. Implicit biases can hinder this communication, leading to misunderstandings and inadequate patient education. Black women may feel less comfortable asking questions or advocating for themselves if they perceive their provider as biased.
Barrier 4. Systemic Inequities
Implicit bias is not just an individual issue but is also embedded in the policies and practices of healthcare institutions. This includes differences in the availability of resources, quality of facilities, and access to care. These systemic inequities further exacerbate the risks faced by Black women during pregnancy and childbirth.
Moving Towards Equitable Care
Therefore, we need a multifaceted approach to addressing implicit bias that involves self-awareness, education, and systemic changes. Recognizing our biases and actively working to mitigate them is crucial in providing equitable care to all patients. Therefore, there are actionable steps we can take as healthcare providers to move towards equitable care.
Step 1: Implicit Bias Training
Engage in regular training to understand and recognize implicit biases. These programs can provide valuable tools and strategies for reducing its impact in clinical settings.
Step 2: Patient-Centered Care
Foster an environment that prioritizes patient-centered care. Listen actively to your patients' concerns, validate their experiences, and involve them in decision-making.
Step 3: Advocate for Policy Changes
Advocate for policies that promote equity in healthcare. This includes ensuring equal access to resources, improving the quality of care for all, and holding institutions accountable for disparities in health outcomes.
Thus, implicit bias significantly contributes to the alarming rates of maternal mortality among Black women. As healthcare providers, we must acknowledge and address these biases to ensure every patient receives the care they deserve. By taking actionable steps towards equitable care, we can work towards reducing maternal mortality in the United States.
I invite you to join the Enhance Black Women's Health community. Together, we can make a difference. Subscribe to our newsletter to stay informed, gain valuable insights, and be part of a movement dedicated to promoting health equity. Your subscription is the first step towards transforming healthcare for Black women.
Reference
Hoyert, DL. Maternal Mortality Rates in the United States, 2022, NCHS Health E-Stats 2024. https://dx.doi.org/10.15620/cdc/152992
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Tomesha, thank you for writing about this. Someone I love is pregnant right now & there has unfortunately been some rare complications. I have been incredibly grateful that they have received high-quality care to address the complications, but the challenges of accessing that care have also left me thinking often about how much harder this is for Black mothers. What you outlined here is the root of that. I want a world where all women, and specifically Black women, can look forward to potential motherhood w/out fear. Thank you for your work on this one.