In the words of Nira Yuval-Davis, “...one cannot dichotomize between ‘natural’ and ‘controlled’ reproduction: all so-called natural biological reproduction takes place in the specific social, political, and economic contexts which construct it.” (2) For African American women, political climates and power dynamics have always had a significant impact on reproduction.
Historically, the white, male, slave-holding elite exercised population control on African American communities through rape and other coercive means, in an effort to force black women to produce as many future slaves as possible. However, following the abolition of slavery, white men could no longer benefit economically from the creation of black infants. As a result, the direction of population control shifted. The government employed forced sterilization and other economic and social disincentives in order to stifle the growth of the African American population.
Clearly, the United States has a consistent and horrific history of disregarding the health and personal autonomy of African American women and infants. However, African Americans still experience devaluation at the hands of the state. In the year 1850, the first year that the United States government began to document infant mortality by race, the black infant mortality rate was placed at 340 per 1,000 live births. The white infant mortality rate that same year was 217 per 1,000 live births. In modern America, those numbers have dramatically reduced, however, the racial disparity has not. Today, the black infant mortality rate is 11.3 per 1,000 live births, compared to 4.9 per 1,000 live births for white infants. Modern African American women are three to four times more likely to die in childbirth than their white counterparts. (Villarosa) Activists have called for reforms to the treatment of pregnant women of all races across the United States for decades. As of January 2018, United States ranked 45th in the world in terms of maternal mortality, an abysmal score for one of the wealthiest modern nations. (Taylor) However, while American maternity care in general requires dramatic improvement and women of all races suffer from poor treatment; the issue is exacerbated by underlying racism which permeates every aspect of American society.
Most members of the medical community have acknowledged the racial divide in maternal and infant mortality for decades. However, the driving forces behind this troubling trend have, until recently, remained largely obscured. Many erroneous theories have sought to explain the phenomena of high black maternal and infant mortality. Most, predictably, placed the blame on black women. For example, many popular theories stressed poor decision making on the part of African American mothers, claiming that African American women use drugs during pregnancy at higher rates than white women, that African American women consume less nutritious diets while pregnant, and that African American women seek prenatal care at lower rates than white women. All of these theories sought to frame the debate surrounding black maternal and infant mortality in terms of individual choice, in order to erase any state responsibility for the suffering of minority communities. Attention has also focused on the economic disadvantages that African Americans face, citing class as a key indicator of infant and maternal mortality. (Villarosa)
In actuality, African American women smoke and drink during pregnancy at lower rates than their white counterparts. Even when women of color seek prenatal care, they still suffer from preterm births at alarming rates. The fact that African American college graduates are more likely to lose their babies than white women without high school diplomas refutes the notion that class can primarily account for the racial divide in maternal and infant mortality. (Villarosa)
Research has indicated that the key factor in high infant and maternal mortality in the African American community lies in the systemic racial discrimination people of color encounter on a daily basis. A survey which polled pregnant women found the highest levels of preterm birth in mothers who reported experiencing racial discrimination. (Villarosa) The stress black women experience due to discrimination leads to higher rates of hypertension and preeclampsia and lower infant birth weights. In seventy-two percent of infant mortality cases, low birth weight is to blame. Since the maternal and infant mortality disparity held true across class lines, this indicates that the primary form of discrimination causing maternal and infant deaths is racial, not classist. (Chatterjee, Rhitu, and Davis)
The constant anxiety African American women experience as a result of living in a discriminatory state is compounded by rampant racism in the medical community. Studies have shown that African Americans receive poor quality treatment compared to their white counterparts. In 2002 a study of race in the health-care system, found that, among other issues, people of color were less likely to be given the right medications for issues like heart disease, and African American women are forty percent more likely to undergo an unnecessary C-section. C-sections can lead to serious medical complications and can make African American women feel disempowered in a hospital setting. (Nelson) Clearly, a great deal of evidence points to systemic racism deeply rooted in both the state and the medical community as the primary cause of the maternal and infant mortality divide.
Although African Americans has cited unfair treatment at the hands of the state and the health care system, their collective voices went ignored. In the United States the white male patriarchy often frames debates about important issues, like the maternal and infant mortality divide, in ways that justify the current order. This led to the advancement of inaccurate claims that black women cause their own deaths, and the deaths of their infants, through poor decision making. Due to their disadvantaged status in society, African American women have had trouble presenting their experiences and refuting this problematic narrative. (Collins, 749) As a result, discrimination as a pivotal factor in the lives of pregnant African American women went unexamined for decades, and black women and infants paid the ultimate price for society’s refusal to listen.
Chatterjee, Rhitu, and Rebecca Davis. “How Racism May Cause Black Mothers To Suffer The Death Of Their Infants.” NPR, NPR, 20 Dec. 2017, www.npr.org/sections/health-shots/2017/12/20/570777510/how-racism-may-cause-black-mothers-to-suffer-the-death-of-their-infants.
Collins Patricia, “The Social Construction of Black Feminist Thought.” Signs, Vol. 1, No. 4 (Summer 1989, 745-773)
Jordan June, “Report from the Bahamas, 1982.” Meridians: feminism, race, transnationalism. Vol. 3, No. 2 (2003), 6-16.
Kiss Elizabeth, “Alchemy or Fool’s Gold? Assessing Feminist Doubts about Rights” in Reconstructing Political Theory: Feminist Perspectives, eds. Mary Lyndon Shanley and Uma Narayan, University Park, PA: The Pennsylvania State University Press, 1997, 1-24.
Nelson, Alan. “Unequal Treatment.” Journal of the National Medical Association, Aug. 2002, doi:10.17226/10260.
Schneider Anne and Ingram Helen, “Social Construction of Target Populations: Implications for Politics and Policy,” The American Political Science Review, Volume 87, No. 2 (June 1993) 334-347
Taylor, Jamila. “Maternal Mortality and the Devaluation of Black Motherhood.” Center for American Progress, 12 Apr. 2018, www.americanprogress.org/issues/women/news/2018/04/11/449405/maternal-mortality-devaluation-black-motherhood/.
Villarosa, Linda. “Why America's Black Mothers and Babies Are in a Life-or-Death Crisis.” The New York Times, The New York Times, 11 Apr. 2018, www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html.
Yuval-Davis Nira, “Women and the Biological Reproduction of the Nation” (all) and “Theorizing Gender and Nation” (pages 19-22) from Gender and Nation. London: Sage Publications, 1997.