Part one of an Associated Press (AP) series exploring health disparities Black Americans experience from birth to death, examined just how dangerous it is for Black women to give birth in America.

Black women have the highest maternal mortality rate in the United States. They are three times more likely to die during pregnancy or delivery compared with white women, according to the Centers for Disease Control and Prevention (CDC). What’s more, Black babies are more likely to die and be born prematurely, according to the AP.

Due to socioeconomic struggles and structural racism, Black Americans often have less access to suitable medical care and as a result experience higher rates of chronic illness, including Alzheimer’s, asthma, high blood pressure and diabetes. In fact, a recent study found that between 1999 and 2020, there were 1.63 million excess deaths in the U.S. Black population compared with white people.

When it comes to childbirth, maternal sepsis is the leading cause of maternal mortality in America, and Black women are twice as likely to develop the condition compared with white mothers, according to the AP. Fever or pain in the infected area are some of the symptoms of maternal sepsis, which some medical providers may mistake for pregnancy symptoms. 

“Due to a lack of training, some medical providers don’t know what to look for. But slow or missed diagnoses are salso the result of bias, structural racism in medicine and inattentive care that leads to patients, particularly Black women, not being heard,” according to the AP.

Laura Riley, MD, chief of obstetrics and gynecology at Weill Cornell Medicine and New York–Presbyterian Hospital, told the AP that the impact of structural racism in maternal sepsis “is not being taken seriously” and that “delay in diagnosis is what leads to these really bad outcomes.”

The history of health disparities among Black people spans generations and can be traced to medical practices performed on enslaved and, later, freed Black people.

Furthermore, false beliefs about biological differences between Black and white people, such as that Black people have thicker skin, stronger bones and less sensitive nerve endings, may lead health providers to downplay Black patients’ pain and offer less relief.

Due to the long history of structural racism and neglect, communities of color have developed a distrust of health care institutions.

“We have to recognize that it’s not about just some racist people or a few bad actors,” Rana A. Hogarth, PhD, an associate professor of history at the University of Illinois, Urbana-Champaign, told the AP. “People need to stop thinking about things like slavery and racism as just these features that happened that are part of the contours of history and maybe think of them more as foundational and institutions that have been with us every step of the way.”

Experts emphasize the need for work to be done at all levels of government to eliminate racism and bias in health care.

In his 2024 fiscal year budget, President Joe Biden included $471 million in funding to reduce maternal mortality and morbidity rates and  expand maternal health initiatives in rural areas and implicit bias training overall.

To learn more about pregnancy risks among Black women, click #Pregnancy. There, you’ll find headlines such as “High Blood Pressure Common in Black Women of Childbearing Age,” “For Patients With Sickle Cell Disease, Fertility Care Is About Reproductive Justice” and “Hepatitis C Among Pregnant Women Has Risen 10-Fold.”