By Darius Spearman (africanelements)

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Two recent viral videos have pulled back the curtain on a crisis centuries in the making. In Indiana, a Black mother named Mercedes Wells was forced to give birth on a highway after being sent home from a hospital while in active labor (people.com). In Texas, another Black mother nearly delivered her child in an emergency room waiting area as staff ignored her pain for over thirty minutes (now.org). These harrowing events are not random accidents; they are modern-day examples of systemic racism in maternity care, a problem with deep and painful roots in American history.

Health organizations and civil rights advocates highlight these cases as undeniable proof that Black women face elevated risks during childbirth because medical professionals often dismiss their pain and concerns (now.org). The experiences of these mothers are a direct consequence of a healthcare system built on a foundation of racial bias. To understand why a mother would be giving birth on the side of a road in the 21st century, we must look to the history that shaped the very rooms where she was denied care.

The origins of discriminatory practices in obstetrics trace back to the institution of chattel slavery, a system where enslaved people were legally treated as personal property (wikipedia.org). The birth of modern gynecology is tied to the horrific exploitation of enslaved Black women. Dr. J. Marion Sims, celebrated by some as the "father of modern gynecology," conducted experimental surgeries on enslaved women like Anarcha, Betsy, and Lucy without anesthesia in the mid-1800s (history.com).

Sims operated on the false and racist belief that Black people had a higher tolerance for pain than White people (deirdrecooperowens.com). This dangerous idea established a precedent of differential medical treatment that continues to harm Black patients today. During this era, the care of Black mothers was driven by economic motives, prioritizing the profit from enslaved bodies over their health and humanity (deirdrecooperowens.com). This historical abuse, furthermore, created a deep distrust of health institutions within the Black community that still lingers.

The legacy of these historical injustices manifests today as implicit bias and systemic racism. Systemic racism refers to the ways policies and practices within institutions, like hospitals, perpetuate racial inequality, often without any single person having racist intent (yipinstitute.org). It is a structure embedded in the very fabric of society that results in disadvantages for minority groups (yipinstitute.org).

Implicit bias is a direct descendant of these historical stereotypes (now.org). It involves unconscious attitudes that affect a person's understanding and decisions without their awareness (lifelongmedical.org). In a fast-paced hospital setting, a doctor or nurse's implicit bias can lead them to dismiss a Black woman's pain, misinterpret her symptoms, or offer a different standard of care (nih.gov). For example, providers influenced by stereotypes may take longer to respond to a Black patient's complaints or under-prescribe pain medication, believing they are exaggerating or have a higher pain tolerance (nih.gov).

Data shows deaths per 100,000 live births, highlighting a severe disparity in maternal outcomes (commonwealthfund.org).

The statistical data paints a grim picture of the crisis. In 2023, the maternal death rate for Black women was approximately 50.3 deaths per 100,000 live births (commonwealthfund.org). This rate is nearly 3.5 times higher than the rate for White women, which stands at 14.5 deaths per 100,000 live births (commonwealthfund.org). The Maternal Mortality Rate (MMR) is officially defined as the death of a woman while pregnant or within 42 days of the end of her pregnancy from a related cause (pbs.org).

This disparity persists regardless of income or education. A Black mother with a college education faces a 60% greater risk of maternal death than a White or Hispanic woman with less than a high school education (commonwealthfund.org). Shockingly, experts believe that over 80% of these maternal deaths are preventable, pointing to systemic failures in the healthcare system (cdc.gov). Limited access to quality care, implicit bias, and structural racism are all contributing factors (cdc.gov).

A CDC survey reveals that mothers of color report significantly higher rates of mistreatment during childbirth (cdc.gov).

The problem extends beyond mortality rates into the quality of care received. A survey from the Centers for Disease Control and Prevention revealed that one in five women reported mistreatment during maternity care (cdc.gov). This mistreatment was reported far more often by Black mothers (40%) and other mothers of color (cdc.gov). Common complaints include having requests for help ignored, being shouted at, and violations of physical privacy (cdc.gov).

Black women are also more likely to undergo procedures influenced by bias rather than medical need. They are 20% more likely than White women to have a C-section, even in non-emergency situations (commonwealthfund.org). Unnecessary C-sections are major surgeries that carry significant risks, including higher rates of infection, blood loss, and complications in future pregnancies like uterine rupture (nih.gov). These systemic failures are compounded by barriers to accessing care in the first place, with 65% of Black birthing people relying on Medicaid for their pregnancy care (commonwealthfund.org).

Historically, Black midwives were pillars of their communities, providing essential care during childbirth (cpr.org). However, as the medical profession grew in the early 20th century, a concerted effort was made to push them out. Racist campaigns were launched to delegitimize their practice, portraying Black midwives as unscientific, unclean, and ignorant (yale.edu). This propaganda aimed to promote physician-led hospital births as the only modern and safe option, effectively eroding a vital system of Black-led care (yale.edu).

The loss of community-based midwifery contributes to today's health disparities. The system that replaced it often leaves Black mothers navigating a world of limited access. Reliance on Medicaid can mean fewer available providers, longer wait times, and under-resourced facilities (commonwealthfund.org). This can lead to delayed diagnoses and inadequate management of pregnancy complications, thereby increasing the risk of preventable maternal deaths.

Black women are more than twice as likely as White women to receive late or no prenatal care (commonwealthfund.org).

The case of Mercedes Wells in Indiana is a stark illustration of these systemic failures. Despite being in active labor with her water broken, hospital staff dismissed her concerns and sent her home (people.com). She was checked at 3 centimeters dilation but was discharged without seeing a doctor (people.com). Just eight minutes later, her husband delivered their daughter on the side of a highway (revolt.tv). A week later, Wells was readmitted to a different hospital for severe pain and bleeding linked to the traumatic delivery (bet.com). The doctor and nurse involved were eventually fired (nurse.org).

In response to this incident, Representative Robin Kelly introduced the "Women Expansion for Learning and Labor Safety Act," known as the WELLS Act (people.com). The bill aims to require hospitals to establish "Safe Discharge Labor Plans" for patients showing signs of labor (revolt.tv). While the videos from Indiana and Texas are shocking, they represent a powerful call to action. They make it impossible to ignore the deadly consequences of a healthcare system that has historically devalued Black women's lives and continues to dismiss their pain.

Darius Spearman is a professor of Black Studies at San Diego City College, where he has been teaching for over 20 years. He is the founder of African Elements, a media platform dedicated to providing educational resources on the history and culture of the African diaspora. Through his work, Spearman aims to empower and educate by bringing historical context to contemporary issues affecting the Black community.