The Risks of Being Black and Pregnant


Serena Williams’ childbirth story was a true medical ordeal – one shared by far too many Black women – an emergency C-section.  If that wasn’t enough, blood clots caused a pulmonary embolism which was initially pooh-poohed by nurses and her doctor. The embolism made her cough so bad that her C-section wound opened.  And to top it off, the medicine she was given to prevent more blood clots caused a large hematoma in her abdomen.

From the outside it appeared that Serena had a lot going for a healthy pregnancy and childbirth.  She is incredibly fit. She has money and, presumably, health insurance. Her age (36) and her history of blood clots did add a level of risk to her pregnancy.  

But perhaps the greatest risk to her pregnancy was her race.  

The U.S. has a shameful rate of maternal death – the highest in the developed world.  And mothers of color die at nearly four times the rate of white mothers.  In North Carolina between 2006 and 2013, Black women had a maternal mortality rate twice that of white women.  

Black women are also disproportionately impacted by heart disease, stroke, diabetes, cervical cancer, fibroids, preterm birth, and sexually transmitted diseases.  And this is regardless of socioeconomic status, access to health care, or education.  

So, what’s going on?  Racism is what’s going on.  

I am a white woman and a mother.  It’s easy for me to see the connection between racism and access to health care or the bias of a health provider.  And it’s pretty easy to make a connection between poverty and discrimination and high blood pressure or inadequate nutrition.

But new research is increasingly suggesting that the impact of racism goes beyond what is easy to see:  the chronic stress of racism, along with sexism and classism, actually causes biological changes that result in poor health among black women – the Sojourner Syndrome.

Named after Sojourner Truth, the term describes the multiple roles of African American women; the ways in which they have adapted to resist, survive and thrive; and the impact on their health.

Common sense, personal experience, and research all confirm that African Americans experience more stress than their white counterparts – including poverty, discrimination in housing and employment, and having multiple caregiving roles.

As Fleda Mask jackson, an Atlanta researcher and member of the Black Mamas Matter Alliance, said in an interview with ProPublica, “It’s a chronic stress that just happens all the time – there is never a period where there’s rest from it, it’s everywhere, it’s in the air, it’s just affecting everything.”  

Despite the old adage, “black don’t crack”, stress actually ages black women faster than white women.  Researchers have coined the term “weathering” to describe how chronic stress wears away at the body. In one study of telomeres, the chromosomal markers of aging,  it was found that black women in their 40’s and 50’s were 7.5 years “ older” on average than their white counterparts.

What’s more, prolonged exposure to stress hormones can be toxic.  Chronic stress can increase inflammation which can take a toll throughout the body and contribute to everything from the common cold to heart disease to cancer and diabetes.   

Another study asked pregnant women what their biggest fears were.  White women said gaining weight and having a healthy child.  Black women said fear of bringing their child into this world and fear that their son might be killed because of the color of his skin.  Just imagine that level of chronic stress during the nine months of pregnancy!

Obviously, the solution is not an easy one.  For those of us who are white mothers, we need to be aware that our privilege, even when we are at our most stressed, means that we do not bear the stress of racism and its impact on our health and the health of our children.  

All of us need to work for racial equity and the empowerment of black women.  We need to support black women’s personal self-care. We need to advocate for public policy that supports low-income and working-class families.  We need to fight efforts to restrict access to women’s health services and advocate for programs that eliminate health disparities.

Let’s also remember that Sojourner’s Syndrome is not just about oppression.  As Shannon Shird says, it’s also about “Black women’s brilliance at resisting and persevering in the face of that.”


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