In 2004, black women were nearly four times as likely to die in childbirth as white women nationwide, and had a maternal death rate of 34.7 per 100,000 live births compared to 9.3 deaths per 100,000 live births for white women.
I’ve talked about maternal mortality before, and how the US is at the bottom of the rankings for the developing world. You also probably already know that women of color face disproportionately high rates of infant mortality, low birth weights and maternal mortality. This article discusses how a new set of reports called the Safe Motherhood reports try to delve deeper into understanding why these risk factors vary. There are the obvious ones we could come up with (no MPH degree necessary) like poverty, lack of access to prenatal care, stress and racism. But these studies are finding something more puzzling:
But one chart shows that black women with adequate prenatal care died at a rate comparable to that of white women with inadequate prenatal care — which hints at a medical mystery a small field of researchers are trying to explain. While some analysts emphasize a lack of health care and poverty to explain high maternal mortality rates among black women, newer studies have indicated that regardless of a black woman’s income and education levels, black women are more likely to die having a baby than white and Latina women.
When we discuss health disparities it’s super important to talk about RACISM. Why? Because a fact like that one above can easily lead to conclusions about the genetic predisposition to maternal mortality, for example. So instead of furthering delving into an understanding of how racism and poverty might affect these women (even if it’s not the poverty that they themselves are currently living under), one could argue that black women are simply predisposed to risk factors that can increase the risk of maternal mortality.
Similar arguments are being made about things like heart disease, or diabetes, for the Black community as well as Latinos. I think we need to be clear about what these health disparities tell us: that racism exists and has a serious and LASTING effect on the experiences of people of color. This effect is so powerful that not even improving ones class status via income or education can erase it. That’s one side of it. The other side of it is that even educated, wealthy women of color still experience the effects of racism on their health and wellbeing. And when I say racism, I don’t just mean prejudice between individual people. I also mean institutional racism, which establishes systems that favor certain racial groups over others. Like the prison industrial complex. Or the public education system. These things have an impact on the overall health of a community.
I could get into a whole diatribe (similar to ones I’ve gotten into around gender difference) about the social construction and lack of biological link to race difference. But I won’t, because I think overall we are beyond that. Doesn’t mean sometimes these things don’t sometimes need restating. To conclude: it’s important to study health disparities and race, so we can document where more work needs to be done. But the point is not to make essentializing statements about the differences between the races. Definitely not.
Note: the above article did a good job of talking about the social factors affecting this, I just used it as an opening to talk more about this issue.
Radical Doula 
It’s interesting – prenatal care has also not been demonstrated as an effective way to reduce maternal mortality in developing countries, either. So – although I fully agree with you that racism is the true cause of the health disparities between women of color and white women in the United States – the study finding that prenatal care is not the keystone to maternal mortality for African American women is still important.
Personally, I think public health scientists overlook racism because it’s not easily measured… and the prevailing logic among university public health researchers seems to be that if you can’t turn it in to a number, it must not exist. (Grr.) I took a course in health disparities last year, and was so frustrated by the research. Public health researchers seem to be unable to think out of the “traditional epidemiological study” box. And although our course instructors agreed that all of our research models were limited, they were unable to offer any other models for actually conducting “respectable” public health research on disparities that really have a social justice underpinning.
And of course, even though it’s been drilled into my head that public health must be “evidence based,” I am always asking “how much evidence do we really need to take action on something!?” One of the interesting theories that I have read is Geronimus’ “weathering” theory – that the lifelong experience of consistent racism takes a physical toll that amounts to adverse health outcomes on a population level.
Anyhow – enough public health babble! Thanks for your writing – I enjoy your blog. I’m in year 2 of an MPH program in Maternal & Child Health, and I’m a good friend of Crabby’s over at http://crabgrass.wordpress.com/ and Mr. Kate at http://theambiguouscitizen.wordpress.com/. Keep up the good work!