Photo taken by Domo of the belly of a Black pregnant person available on Unsplash

Reflections on Black Maternal Health Week

By Yolonda P. Harrison

Earlier this week, a workshop attendee asked me if I thought that implicit bias workshops were still needed in 2023.  Considering this was a workshop for a health care organization and at the start of Black Maternal Health Week, I couldn’t help but pause to think about how deeply bias in health care impacts me and other Black women.  Although I’ve had plenty of experiences with bias in the workplace, my experiences with bias in health care have impacted me the most. 

In 2018, Black Maternal Health Week was originated by the Black Mamas Matter Alliance (BMMA) to build awareness, activism, and community surrounding the health disparities and maternal health outcomes among Black women in the United States.  Black Maternal Health Week not only shines a light on the need for access to better and more holistic maternal care but on harsh realities such as the lack of prioritization of Black patients by health care institutions and the higher likelihood that Black women will be terminated, forced to resign, or forced to return to work too soon after giving birth or facing a health crisis.  In 2021, the first Proclamation on Black Maternal Health Week was issued.

In general, women and birthing people in the United States are way too likely to die from preventable pregnancy-related causes, however, Black women bear the brunt of this disparity.  Since the 1990s, maternal mortality rates among Black women have continually increased and those numbers drastically worsened between 2019 and 2021.  According to the CDC, Black women are three times more likely to die from pregnancy-related causes than those who are white.

For over 20 years now, research has shown that BIPOC patients encounter bias and experience a lower quality of care when receiving or attempting to receive health services.  However, due to intersectionality and stereotypical tropes facing Black women, the bias encountered when seeking health care can be deadly.  For example, Black women are typically characterized as “difficult,” “challenging,” “high-strung,” “non-compliant,” or even “scary,” for simply asking questions or seeking transparency.  All of which are rooted, in the “angry Black woman” trope.  This characterization too often leads to Black women being dismissed, discounted, or ignored in most settings, including in the workplace and when seeking medical care.  

Today’s Black maternal mortality rates continue to demonstrate the disrespect, neglect, and lack of protection that exists for Black women in America (and it’s been nearly 61 years since Malcolm X initially uttered these words).  The impact of institutional, systemic, and structural racism prevents many Black women and birthing people from having access to equitable health care, housing, food, water, education, and employment in this country.  Therefore, large-scale initiatives such as diversifying the workforce to better reflect the population, expanding access to perinatal and mental health care, and pursuing environmental justice for BIPOC communities need to be prioritized.  However, educating individuals about bias and convincing them to work on themselves — to disrupt the biases that many Black women encounter daily is also important.  

How can our systems, institutions, and organizations become more equitable if the individuals running them don’t realize, don’t care, or don’t work to stop the harm they cause on an interpersonal level?  To this day, I encounter individuals working in health care who do not understand what “implicit bias” is, or if they understand the concept theoretically, they believe it does not apply to them.  Many of these people are directly causing harm to BIPOC patients and, until they do the work to change their behavior, they will continue to do so. 

In this year’s Proclamation, the President called upon “all Americans to raise awareness of the state of Black maternal health in the United States by understanding the consequences of institutional racism; recognizing the scope of this problem and the need for urgent solutions; amplifying the voices and experiences of Black women, families, and communities; and committing to building a world in which Black women do not have to fear for their safety, their well-being, their dignity, or their lives before, during, and after pregnancy.” 

Thus, when asked if implicit bias workshops still matter in 2023, I shared that as a Black woman, bias impacts my life daily in countless ways from hair discrimination to the Black maternal mortality crisis.  I concluded my anecdote with “How do your actions contribute to or detract from the well-being of the Black women you treat and work with?”  I didn’t receive an answer, but workshop participation picked up moving forward.

*Photo by Domo. on Unsplash