A Conversation About the Healthcare Inequities of Black Women and Miscarriages

The U.S. healthcare system is hurting Black women in a myriad of ways, including when it comes to obstetrical and prenatal care. In a 2013 study, it was reported that the risk of miscarriage is greater among Black women than that of white women. In the seven years since that study, this issue is still as pertinent as ever and Black women are still not getting the healthcare they deserve. 

As Dr. Jamila Perritt, an OB-GYN and provider at Planned Parenthood of Metropolitan Washington, DC, points out, that particular study named the disparities in healthcare between Black women and white women without an examination of the causes. “Black women experience a number of inequitable health outcomes, including the risk of miscarriage,” Dr. Perritt notes. 

Why Are Black at Higher Risk for Miscarriage Than White Women?

While it’s difficult to point to one specific thing that can lead to miscarriage, Dr. Perritt says that what is clear is that a woman being Black is not what puts her at risk, rather, “the racialized experience of being Black in this country.” 

She continues that it’s the structural and environmental manifestations of racist systems, including healthcare, that are the driving forces for these adverse outcomes like miscarriages. 

Pregnancy complications and miscarriages don’t exist in a vacuum,” Dr. Perritt points out, adding, “These outcomes aren’t determined once you get pregnant.” Instead, it’s a myriad of lifelong factors, including access to quality healthcare, healthy communities (including access to clean water and healthy food) and overall support. 

A System Rooted in Racism

While there are a broad range of factors, Dr. Perritt says once these systems that are inherent in our society are identified, then the work can actually begin. No structure in this country, not even healthcare, has not been touched by white supremacy. “We have all been cultured in this society that is grounded by racism,” Dr. Perritt points out. 

And while things like sensitivity training and intrinsic bias courses are out there for those in the medical profession, Dr. Perritt says there has to be conversations and a deep understanding that racism is the root cause for these health outcomes, like miscarriages for example. 

Healthcare professionals not only have to face the ways white supremacy shows up in their line of work and that they are not immune to racism, but Dr. Perritt says they must understand “what it means to provide holistic, community-grounded care.” 

How Can We Ensure Black Women Have the Healthcare They Deserve?

Another key factor to making steps towards change, she says, is to move the conversation away from disparity framing, and instead discuss the preventable inequities in health outcomes in communities. 

Still, as the world tries to catch up with history and make changes towards improving society as a whole, Black women need to get the healthcare they deserve. “It can be hard to navigate our healthcare system and even more challenging for Black women and other women of color who share their racial and ethnic backgrounds,” Dr. Perritt points out. 

Because the proportion of providers of color does not align with how many patients of color there are, this can be a difficult hurdle. “The power dynamic in our medical system is real, and it can feel disempowering. Black women are less likely to be listened to, their pain is more likely to be ignored.” 

The relationship with a healthcare provider should be a mutual one, Dr. Perritt says, and just because someone has all the medical training in the world, doesn’t necessarily mean they are the right fit for you. 

Dr. Perritt encourages that if women can, they search for the right healthcare provider who is not only compassionate and caring, but listens to your needs and points of view and sees you as a whole person. After all, she says, “You are the expert in your own life.” 

Having a compassionate healthcare provider can be especially important when it comes to miscarriage, which can be a painful and traumatic experience for many women. Dr. Perritt reminds women that not only are miscarriages a common occurrence, but they are not your fault. These reassurances can be extremely helpful to a woman coping with the trauma of miscarriage. 

Finding a Support System

Finding a support system, whether it’s from a doula or a therapist that specializes in maternal mental health, can be crucial to the healing process. Dr. Perritt acknowledges that seeking out those services can be difficult in and of itself, as “there’s a lot of stigma that comes with miscarriage.” 

But, as Dr. Perritt points out, the more you talk about it, whether it’s with other women in your community or with a compassionate healthcare provider, the less alone you may feel. And feeling less alone and disregarded when it comes to health and care is something that is long overdue to Black women and women of color in this country. 

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  • Perhaps I am naive. As a white woman, I think a better term, as least as it applies to me, is white privilege, not white supremacy. When I think of White Supremacy I think of the KKK, Proud Boys, and misogyny, not the thousand small stressors that make up the black and POC experience from my white privilege. These last few weeks have been illuminating about what I take for granted and expect that black and POC cannot and how slowly real change has occurred. I never considered myself or believed I was a racist. I always tried to treat people as individuals and rarely made (ar at least) voiced stereotyped assumptions, but I have rarely been an anti-racist. I pledge moving forward to be a more observant and responsive anti-racist. I can do this by being more observant of the conversations and actions of others, in-person and online, and questioning the reason for their words and acts. I will do this in the hope of bringing them some understanding of why their words or deeds are offensive or at least to plant seeds for change.


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