What I Didn't Know

The lifelong accumulated experiences of racial discrimination by African American women constitute an independent risk factor for preterm delivery.

Does this surprise you? It did me. This was the conclusion of a 2004 study on very low birthweight in African American Infants.

Of course I learned in nursing school that African American women and infants had worse outcomes than their white counterparts. I had been taught that this was a function of largely (if not exclusively) socioeconomic factors or social determinants of health. 

 Image courtesy of Claudia Booker, CPM.

Image courtesy of Claudia Booker, CPM.

Sherry Payne set me straight. I met Sherry at the MANA conference last fall. Sherry, has a Masters in Nursing, is a certified lactation consultant, nursing educator, doula, and is studying to be a midwife. She is also a co-founder of Uzazi Villiage and the mother of nine. Sherry knows something about the experience of birth in the African American community and she isn't shy about educating you if you don't.

I went to the talk she presented titled, What You Don't Know Hurts Us: Racism, White Privilege and Perinatal Health Inequities. (You can click here to purchase an audio recording of the session.) 

It was there that I first heard about the idea that the accumulated stress resulting from racial discrimination itself was a factor in the disparities we see in African-American babies and mothers. 

Not surprisingly, racial discrimination is affecting more than just birth outcomes. PBS did a documentary series called Unnatural Causes all about how inequalities are affecting population health. Episode 2 focuses specifically on perinatal outcomes, When the Bough Breaks.

If you still think the disparities are socioeconomic, here are two important facts. Black women with a college education have higher rates of infant death than white women with a high school diploma and that recent immigrants from Africa have infant mortality rates that more closely match their white counterparts. Clearly socioeconomic and racial differences alone do not account for the disparity. 

Organizations like Black Women Birthing Justice, Mamatoto Villiage, Uzazi Villiage, and others are innovating ways to support women and families of color. Still, I am painfully aware that as long as Black women encounter even subtle racism in their every day lives the disparities we see in maternal and infant death rates will persist. 

 A dynamic group of Black women in Oakland, CA. These doulas and advocates are committed to birthing justice in their community. 

A dynamic group of Black women in Oakland, CA. These doulas and advocates are committed to birthing justice in their community. 

So what does this mean for me? As Sherry recently told me, "Racism doesn't just land on Black women from the air." How are my unexamined biases and actions or inaction contributing to the current systemic inequalities?

I'm not an expert when it comes to racial reconciliation, but there are a few things I've done as a result of these conversations.

One is to examine my implicit biases.  We all have them. Take the test if you think you don'tIf I am aware of mine, I'm more likely to be able to consciously challenge them and change my behavior. 

Another is to seek out communities of color who are working to reduce disparities and become involved. I'm not talking about taking over or inserting myself where I am not needed or wanted, but listening and supporting, becoming an ally. 

In her essay, White Privilege and Male Privilege: A Personal Account of Coming to See Correspondences Through Work in Women's Studies, Peggy McIntosh puts it this way:

If we raise our daily consciousness on the perquisites of being light-skinned. What will we do with such knowledge? As we know from watching men, it is an open question whether we will choose to use unearned advantage, and whether we will use any of our arbitrarily awarded power to try to reconstruct power systems on a broader base.

As a woman, I find this correspondence useful. As a white woman I can promote racial equality the same way I expect men to promote gender equality.

I love the way midwives (mostly white women) have rallied to support the #blacklivesmatter campaign. At first I didn't see the connection, but then it became so clear. Racism and inequality affects everything.

Before black babies are born their mothers carry the stress of generations of racism and discrimination in their bodies. Too often babies suffer as a result.

If you care about these issues, sign up and support the work of Jennie Joseph and the National Perinatal Task Force. I'm planning to visit next month and to some shooting for the film. More about that here


Thanks for staying with me. I know this stuff can feel overwhelming. If that's where you are, then here are a few simple steps. 

Today, in honor of Martin Luther King Jr. I invite you to examine your own biases. Challenge those biases, then seek out communities of color working for change and listen. 

Talk to your friends. Engage in the conversation. It's not fair to leave all the work to men and women of color.

We are all connected. When one community suffers we all suffer, but together we can make the world a safer place for every man, woman, and child, regardless of the color of their skin. 

 Thanks to  Claudia Booker  for sharing this beautiful image!

Thanks to Claudia Booker for sharing this beautiful image!

Special thanks to all the Black women who have shared their experience with me and who have taught me things I didn't know, especially Claudia Booker, Jennie Joseph, and Sherry Payne.