When LaTasha Williams learned she was pregnant in fall 2021, one of the first things she felt was fear.
She hadn’t planned to have another child. Her husband, Willie, was on a waitlist to have a vasectomy in a few months. They were raising four children already and were mid-move from a suburb of Portland to Vancouver, Washington.
If only there were some way pregnancy could have been avoided.
As 2022 began, LaTasha battled familiar health challenges that she had faced during her last pregnancy: high blood pressure, gestational diabetes, and a shortened cervix. But this time, she delivered a healthy baby boy, Mekai, born a month early, but who spent only a few hours in the neonatal intensive care unit.
The difference, LaTasha said, was the care she received. In her son’s case, she was treated and monitored carefully by a Black OB/GYN, kept on bed rest, and assisted by a certified doula who advocated for her before, during, and after the birth.
But was the certified doula Black as well? Because the race of LaTasha’s healthcare providers is obviously Very Important.
…Black mothers are three times as likely as white women to die in childbirth, and Black fetuses and infants die at rates far outpacing those of nearly every other race. Oregon mirrors these trends: Black infants are more likely to be born underweight, and both they and their mothers have a lower chance of surviving that first year of life than white and Hispanic ones.
So are we arguing here that the US healthcare system is systemically racist? Yes, we are:
A variety of factors drives the disparities, and research indicates race touches many aspects of the care Black mothers receive before, during and after birth. Black women experience higher rates of uncontrolled blood pressure and diabetes, cardiac disease and other comorbidities that heighten the risk of poor outcomes during pregnancy and birth. Social determinants of health that are shaped by systemic racism, including food insecurity and health care access, play a role in those conditions. Even so, Black women are less likely to receive follow-up care after giving birth.
Nutrition deficiencies, a horrible diet, and obesity are hard to blame on the medical system. At some point free will is involved, and frankly, it’s a lot easier to believe that people are out there making terrible choices than it is to believe that the entire US medical system—all those doctors, nurses, support staff—are racist against Black women.
Higher socioeconomic status is no guarantee of a better birth outcome for Black and Native women: Those who are highly educated and wealthier still face worse outcomes than white women with less education and wealth.
What about Asian women? How about Hispanic women? Man, I hate how doctors and nurses play racial favorites.
This article is a push for legislation for expanded doula care in Oregon. Depending on cost, that could be a good thing for all pregnant women and for society. Throwing a racial lens over it only obscures its value—is this something needed by other races?—and that makes this article self-defeating.