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The Difference Between Life or Death: Racial Inequity in Maternal Healthcare
There was once a young lady who was nineteen years of age, pregnant with her first child,
and terrified at the prospect of becoming a parent. The young lady found a doctor and
during her first meeting with the doctor, he said to her that she was too young to have a
baby. The nurse that was in the room with the young lady and the doctor immediately spoke
up and stated that they had seen much younger girls come into their clinic. The young lady
would advance in her pregnancy and have symptoms that she didn't fully understand and
was timid when it came to speaking with the doctor because of their initial meeting. The
symptoms that the young lady was experiencing were those of high blood pressure. The
young lady was diagnosed with preeclampsia when she was seven months pregnant.
The doctor explained that the young lady could have seizures if her high blood pressure
was not controlled; however, instead of sending her to the hospital the doctor sent her
home on bed rest with no medical assistance just advising that she lay on her left side. The
young lady's water would break weeks later, and she would go into labor. She was eight
months pregnant. During the young lady's labor her blood pressure would rise to a level
that started to affect the baby's heart rate, so she was rushed into surgery, and her baby girl
was born via cesarean. The baby was placed in NICU as her lungs were not fully developed
and she also suffered from jaundice. The young lady's baby survived but has cerebral palsy
and is nonverbal. The young lady in this story was black; the doctor was not.
There was a video that went viral on social media in late 2025 that was the catalyst for this
essay and would later change my trajectory in education from Public Health to Nursing and
that is the story of Karrie Jones. Ms. Jones was a young mother who was in the end stages
of labor in a hospital. The nurse that was conducting intake procedures clearly
lacked empathy ignoring her anguished screams while asking redundant questions that
were already answered when she preregistered for the birth of her baby. After thirty long
minutes, Ms. Jones finally completed her intake and was allowed to go back to labor and
delivery where she gave birth 12 minutes later.
Racial bias in the health care system is rampant in the United States. Deaths of black
women from pregnancy-related complications are 3 to 4 times higher than those of white
women (Nisbeth). Shalon Irving worked for CDC in Atlanta, Ga. and was a Ph. D recipient.
Mrs. Irving had grave concerns regarding symptoms that she was experiencing after the
birth of her daughter. She returned to her doctor several times to report what she was
feeling and the changes within her body. Yet, her health concerns were dismissed. Mrs.
Irving died a few hours after her last visit to her doctor (Layne). Systemic racial biases
in the U.S. healthcare system significantly contributes to higher rates of death of Black
mothers and infants due to racial stereotypes, concerns being disregarded, and medical
provider's lack of empathy. The stories of the young lady and Mrs. Irving show that it
does not matter what the socioeconomic status is black women can still be discriminated
against within the medical system.
Racial stereotypes and the history of racial bias in the medical system are not new. It's
devastating origins can be traced back to the times of chattel slavery and the stereotypes
of black people in general during that time. Racial bias in the medical system started
during the time of chattel slavery when medical treatment was experimental. According to
Harriet A. Washington, "Toxic substances such as arsenic and mercury were commonly
used as methods of treatment and subsequently mercury would cross over into the
placenta barrier and concentrate in breast milk causing high black infant mortality as
well as birth defects" (Washington 28). Slaves were provided with these crude remedies
that would ultimately cause more harm than benefit. Nursing mothers would pass on the
toxic effects of the poisons onto their babies. The author would also go on to state,
"enslaved black Americans bore the worst abuses of these crudely empirical practices."
The worst practices were reserved for black bodies as they were not seen in the same light
or to have the same value as whites.
Furthermore, black women were used as human guinea pigs for obstetrics and gynecology
research and were said to have "thicker skin" and therefore do not feel pain in the same
way as white women. There was anesthesia available during chattel slavery; however, it
was not offered to black women. James Marion Sims, the father of modern obstetrics, was
said to have operated under the bigoted belief that "Black people did not feel pain"
(Holland). This egregious stereotype has had an insidious effect on the treatment of black
people in the medical system. Another stereotype was in the story of the young lady at the
beginning of the essay; her doctor told her that she was too young to have baby even
though she was nineteen years old. It feeds into the stereotype of teen mom. Another
destructive stereotype is what was said to Mrs. Shakima Tozay. Mrs. Tozay was six months
pregnant and visiting her doctor, while having the heart rate of her fetus checked, the
attending nurse referred to her baby as a "hoodlum". Her doctor would later downplay the
comment and the hospital later apologized for the nurse's comment. Mrs. Tozay would
later lament that the comment hurt her (Rabin). The nurse's own racial biases allowed her
to see an innocent fetus as a "hoodlum". The doctor gaslit Mrs. Tozay but downplaying the
remarks yet, the hospital saw the damage and to cover themselves, issued an apology.
As a result, racial bias has played a role in the health care system by way of communication
when concerns are disregarded and dismissed and the patient feels unheard.
Communication bias also occurs when physicians make clinical decisions without
addressing their patients' concerns. Unconscious bias in communication occurs when
providers believe that the patient's claims are exaggerated, this example of unconscious
bias leads to delayed treatment and poor quality of care. An example of this type of bias is
the story of renowned tennis player Serena Williams, who has a history of blood clots, after
the birth of her daughter, she began to feel short of breath. Signs that she knew to be signs
of blood clots. Mrs. Williams asked the medical staff to give her blood thinner, heparin, and
a CT scan (Layne). The medical staff ignored her request for medication and instead
ordered an ultrasound in place of the CT scan.
In fact, physicians do not ask the same questions to black mothers as they would to white
mothers missing out on key opportunities for details that would help to better make sound
clinical decisions in treatment. Studies show that about 1 in Black women report unfair
treatment by healthcare providers and staff due to racial bias. Ms. Williams had to
advocate for herself in her treatment in order to preserve her own life.
The consequences of racial bias in the maternal healthcare system are health risks due to
providers' lack of empathy due to unconscious bias. Assistant Professor at Duke University
Sarah M. Wilson stated, "The brain is wired to make decisions quickly... It uses cognitive
shortcuts that let bias seep in, especially when a person is uncertain, tired or stressed -
common circumstances in a busy practice or hospital...". Mrs. Wilson's quote gives
universal insight into how a provider in an impoverished area where that provider might be
the only one available to service a community can unknowingly behave in a way that is
racially biased as well as insight when that provider is in a city with many providers. Both
scenarios can lead to medical gaslighting and concerns being downplayed. Like in the
case of Mercedes Wells, in November 2025, Mercedes Wells was in active labor and
presented at Franciscan Health Crown Point Hospital where she remained for over six
hours without seeing a doctor. Mrs. Wells is a married black mother, and she felt as though
she was going to have her baby that day by her own admission. Yet, she was discharged
from the hospital in active labor, visibly in pain, with tears streaming down her face. She
and her husband were escorted out of the emergency department while her mother-in-law
filmed the disgraceful spectacle. Eight minutes after she left the hospital, she gave birth to
her daughter on the side of the road while in route to another medical center. Dana-Ain
Davis, PhD, MPH wrote: "Obstetric racism is a threat to maternal life and neonatal
outcomes. It includes, but is not limited to, critical lapses in diagnosis; being neglectful,
dismissive, or disrespectful; causing pain..." (Clouser). She spoke of the impact that racial
disparities have within the black community. What is blatantly clear is that no matter what
the socio-economic status is; whether the patient is married, unmarried, poor, college
educated, insured or uninsured, the treatment is the same if she is a person of color.
This issue could be addressed in the short term with physicians and healthcare staff
undergoing implicit bias training on a yearly basis. Addressing and understanding
conscious and unconscious bias in a clinical setting is a must. Cultural sensitivity is
addressed as mandatory during the hiring process with most facilities and is conducted on
a yearly basis, implicit bias training should be implemented the same way. A second short-
term solution is accountability for actions that cause severe harm and death. The physician
and the nurse that were involved in the case of Mercedes Wells both lost their jobs. This is
an appropriate start because both mother and child survived; however, there could have
been an adverse outcome because of that the consequence should be more severe by way
of license suspension. If the life of the mother or child is lost, then the punishment should
be termination of license.
One long term solution should be representation within the healthcare system, because
representation matters. Patients should be able to connect it medical staff that look like
them and represent the community that they reside in.
Currently black doctors make up about 5% of the physicians in the United States which is
an issue of systemic barriers within itself. When being treated by a physician that looks like
them, patients tend to experience better health outcomes (Sullivan). I decided to change
my major from Public Health to Nursing due to representation. I have seen, heard and
experienced having a nurse that lacked empathy or was racially biased in their treatment
toward me. President Trump has signed executive orders that eliminated DEI related
programs which play a role in the education and hiring of black and brown people to be
able to service their own communities which could also affect my long-term goal to
become a nurse and service my community.
Another long-term solution would be improvement in the way that hospitals report data on
maternal outcomes allowing that information to be tracked more efficiently and given to
states to improve legislative efforts to reduce maternal mortality. According to data from
the Centers for Disease Control and Prevention (CDC), Black women are more than
several times more likely to die from pregnancy related complications. Neel Shah,
assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical
School stated, "Maternal mortality has been going up for 25 years... one reason the
problem has not been addressed earlier is because we weren't systematically tracking it"
(Layne).
This fact is troubling. It's like being in a burning house and not being able to determine
where the fire is to put it out. If data is not tracked and compiled there is no way to
successfully back up claims that "the house is indeed on fire", there is no way to draw
attention to the problem. Marian MacDorman, research professor at Maryland Population
Research Center at the University of Maryland stated that the reporting gap "was a national
embarrassment" (Layne). As recently as March 2025 there have been executive orders that
have disrupted programs that affect maternal healthcare. Perhaps if there were strong
statistical data that could be shown to congress this may not have happened (Hill et al).
Ultimately, disparities exist. The reasons why they exist can be debated and attributed to
social conditions, economic status, racial bias etc. The truth is that all these multiple
explanations do play roles as to why these disparities exist and that fact cannot be denied.
It can also be argued how personal experiences are interpreted. Claims of discrimination
can be seen as miscommunication or differences in expectation regarding care. These
experiences, however, are evidence of implicit bias compounded with the fact that black
mothers and babies losing their lives at a higher rate than their white counterparts.
Terrence Sullivan passionately stated, "The maternal mortality rate for Black and brown
women is not just a healthcare issue; it is a matter of racial justice" reflects my own
opinion.
The young lady that I spoke of in the beginning of this essay is me.
That is my story. I didn't know how to advocate for myself. I was young and trying to
navigate a new chapter in my life. Instead of receiving guidance from a trusted professional
I was made to feel less than because I was pregnant at age nineteen. When I began to feel
lightheaded, when my limbs began to swell, I didn't feel safe bringing my concerns to him
because I didn't feel like my doctor cared or would listen to me anyway. During my research
for this essay, I came to learn that my story is "our story". So many black women
unfortunately, share this same story. This is not an issue that affects just black women but
women in general. My focus is on black women because we experience a higher rate of
death than any other race, so it is that much more serious for the black community. The
death rate for black women is 41.4 per 100,000 deaths while white women are 13.7 per
100,000 (Sullivan).
My hope is for this essay to bring attention to the importance of improving maternal
healthcare so that all women experience safe pregnancy outcomes. To accomplish that
There must be a change in the healthcare system via training, accountability,
representation, and legislature that ensures that concerns of black mothers are no longer
disregarded; providers are more involved in care and are empathetic to their black
patients, and the elimination of stereotypes that cause white providers to see
their black patients in a way that causes racial disparities and unconscious bias. To not
address and resolve these problems would continue be a matter of life and death for
mothers to be.
The Difference Between Life or Death: Racial Inequity in Maternal Healthcare
There was once a young lady who was nineteen years of age, pregnant with her first child,
and terrified at the prospect of becoming a parent. The young lady found a doctor and
during her first meeting with the doctor, he said to her that she was too young to have a
baby. The nurse that was in the room with the young lady and the doctor immediately spoke
up and stated that they had seen much younger girls come into their clinic. The young lady
would advance in her pregnancy and have symptoms that she didn't fully understand and
was timid when it came to speaking with the doctor because of their initial meeting. The
symptoms that the young lady was experiencing were those of high blood pressure. The
young lady was diagnosed with preeclampsia when she was seven months pregnant.
The doctor explained that the young lady could have seizures if her high blood pressure
was not controlled; however, instead of sending her to the hospital the doctor sent her
home on bed rest with no medical assistance just advising that she lay on her left side. The
young lady's water would break weeks later, and she would go into labor. She was eight
months pregnant. During the young lady's labor her blood pressure would rise to a level
that started to affect the baby's heart rate, so she was rushed into surgery, and her baby girl
was born via cesarean. The baby was placed in NICU as her lungs were not fully developed
and she also suffered from jaundice. The young lady's baby survived but has cerebral palsy
and is nonverbal. The young lady in this story was black; the doctor was not.
There was a video that went viral on social media in late 2025 that was the catalyst for this
essay and would later change my trajectory in education from Public Health to Nursing and
that is the story of Karrie Jones. Ms. Jones was a young mother who was in the end stages
of labor in a hospital. The nurse that was conducting intake procedures clearly
lacked empathy ignoring her anguished screams while asking redundant questions that
were already answered when she preregistered for the birth of her baby. After thirty long
minutes, Ms. Jones finally completed her intake and was allowed to go back to labor and
delivery where she gave birth 12 minutes later.
Racial bias in the health care system is rampant in the United States. Deaths of black
women from pregnancy-related complications are 3 to 4 times higher than those of white
women (Nisbeth). Shalon Irving worked for CDC in Atlanta, Ga. and was a Ph. D recipient.
Mrs. Irving had grave concerns regarding symptoms that she was experiencing after the
birth of her daughter. She returned to her doctor several times to report what she was
feeling and the changes within her body. Yet, her health concerns were dismissed. Mrs.
Irving died a few hours after her last visit to her doctor (Layne). Systemic racial biases
in the U.S. healthcare system significantly contributes to higher rates of death of Black
mothers and infants due to racial stereotypes, concerns being disregarded, and medical
provider's lack of empathy. The stories of the young lady and Mrs. Irving show that it
does not matter what the socioeconomic status is black women can still be discriminated
against within the medical system.
Racial stereotypes and the history of racial bias in the medical system are not new. It's
devastating origins can be traced back to the times of chattel slavery and the stereotypes
of black people in general during that time. Racial bias in the medical system started
during the time of chattel slavery when medical treatment was experimental. According to
Harriet A. Washington, "Toxic substances such as arsenic and mercury were commonly
used as methods of treatment and subsequently mercury would cross over into the
placenta barrier and concentrate in breast milk causing high black infant mortality as
well as birth defects" (Washington 28). Slaves were provided with these crude remedies
that would ultimately cause more harm than benefit. Nursing mothers would pass on the
toxic effects of the poisons onto their babies. The author would also go on to state,
"enslaved black Americans bore the worst abuses of these crudely empirical practices."
The worst practices were reserved for black bodies as they were not seen in the same light
or to have the same value as whites.
Furthermore, black women were used as human guinea pigs for obstetrics and gynecology
research and were said to have "thicker skin" and therefore do not feel pain in the same
way as white women. There was anesthesia available during chattel slavery; however, it
was not offered to black women. James Marion Sims, the father of modern obstetrics, was
said to have operated under the bigoted belief that "Black people did not feel pain"
(Holland). This egregious stereotype has had an insidious effect on the treatment of black
people in the medical system. Another stereotype was in the story of the young lady at the
beginning of the essay; her doctor told her that she was too young to have baby even
though she was nineteen years old. It feeds into the stereotype of teen mom. Another
destructive stereotype is what was said to Mrs. Shakima Tozay. Mrs. Tozay was six months
pregnant and visiting her doctor, while having the heart rate of her fetus checked, the
attending nurse referred to her baby as a "hoodlum". Her doctor would later downplay the
comment and the hospital later apologized for the nurse's comment. Mrs. Tozay would
later lament that the comment hurt her (Rabin). The nurse's own racial biases allowed her
to see an innocent fetus as a "hoodlum". The doctor gaslit Mrs. Tozay but downplaying the
remarks yet, the hospital saw the damage and to cover themselves, issued an apology.
As a result, racial bias has played a role in the health care system by way of communication
when concerns are disregarded and dismissed and the patient feels unheard.
Communication bias also occurs when physicians make clinical decisions without
addressing their patients' concerns. Unconscious bias in communication occurs when
providers believe that the patient's claims are exaggerated, this example of unconscious
bias leads to delayed treatment and poor quality of care. An example of this type of bias is
the story of renowned tennis player Serena Williams, who has a history of blood clots, after
the birth of her daughter, she began to feel short of breath. Signs that she knew to be signs
of blood clots. Mrs. Williams asked the medical staff to give her blood thinner, heparin, and
a CT scan (Layne). The medical staff ignored her request for medication and instead
ordered an ultrasound in place of the CT scan.
In fact, physicians do not ask the same questions to black mothers as they would to white
mothers missing out on key opportunities for details that would help to better make sound
clinical decisions in treatment. Studies show that about 1 in Black women report unfair
treatment by healthcare providers and staff due to racial bias. Ms. Williams had to
advocate for herself in her treatment in order to preserve her own life.
The consequences of racial bias in the maternal healthcare system are health risks due to
providers' lack of empathy due to unconscious bias. Assistant Professor at Duke University
Sarah M. Wilson stated, "The brain is wired to make decisions quickly... It uses cognitive
shortcuts that let bias seep in, especially when a person is uncertain, tired or stressed -
common circumstances in a busy practice or hospital...". Mrs. Wilson's quote gives
universal insight into how a provider in an impoverished area where that provider might be
the only one available to service a community can unknowingly behave in a way that is
racially biased as well as insight when that provider is in a city with many providers. Both
scenarios can lead to medical gaslighting and concerns being downplayed. Like in the
case of Mercedes Wells, in November 2025, Mercedes Wells was in active labor and
presented at Franciscan Health Crown Point Hospital where she remained for over six
hours without seeing a doctor. Mrs. Wells is a married black mother, and she felt as though
she was going to have her baby that day by her own admission. Yet, she was discharged
from the hospital in active labor, visibly in pain, with tears streaming down her face. She
and her husband were escorted out of the emergency department while her mother-in-law
filmed the disgraceful spectacle. Eight minutes after she left the hospital, she gave birth to
her daughter on the side of the road while in route to another medical center. Dana-Ain
Davis, PhD, MPH wrote: "Obstetric racism is a threat to maternal life and neonatal
outcomes. It includes, but is not limited to, critical lapses in diagnosis; being neglectful,
dismissive, or disrespectful; causing pain..." (Clouser). She spoke of the impact that racial
disparities have within the black community. What is blatantly clear is that no matter what
the socio-economic status is; whether the patient is married, unmarried, poor, college
educated, insured or uninsured, the treatment is the same if she is a person of color.
This issue could be addressed in the short term with physicians and healthcare staff
undergoing implicit bias training on a yearly basis. Addressing and understanding
conscious and unconscious bias in a clinical setting is a must. Cultural sensitivity is
addressed as mandatory during the hiring process with most facilities and is conducted on
a yearly basis, implicit bias training should be implemented the same way. A second short-
term solution is accountability for actions that cause severe harm and death. The physician
and the nurse that were involved in the case of Mercedes Wells both lost their jobs. This is
an appropriate start because both mother and child survived; however, there could have
been an adverse outcome because of that the consequence should be more severe by way
of license suspension. If the life of the mother or child is lost, then the punishment should
be termination of license.
One long term solution should be representation within the healthcare system, because
representation matters. Patients should be able to connect it medical staff that look like
them and represent the community that they reside in.
Currently black doctors make up about 5% of the physicians in the United States which is
an issue of systemic barriers within itself. When being treated by a physician that looks like
them, patients tend to experience better health outcomes (Sullivan). I decided to change
my major from Public Health to Nursing due to representation. I have seen, heard and
experienced having a nurse that lacked empathy or was racially biased in their treatment
toward me. President Trump has signed executive orders that eliminated DEI related
programs which play a role in the education and hiring of black and brown people to be
able to service their own communities which could also affect my long-term goal to
become a nurse and service my community.
Another long-term solution would be improvement in the way that hospitals report data on
maternal outcomes allowing that information to be tracked more efficiently and given to
states to improve legislative efforts to reduce maternal mortality. According to data from
the Centers for Disease Control and Prevention (CDC), Black women are more than
several times more likely to die from pregnancy related complications. Neel Shah,
assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical
School stated, "Maternal mortality has been going up for 25 years... one reason the
problem has not been addressed earlier is because we weren't systematically tracking it"
(Layne).
This fact is troubling. It's like being in a burning house and not being able to determine
where the fire is to put it out. If data is not tracked and compiled there is no way to
successfully back up claims that "the house is indeed on fire", there is no way to draw
attention to the problem. Marian MacDorman, research professor at Maryland Population
Research Center at the University of Maryland stated that the reporting gap "was a national
embarrassment" (Layne). As recently as March 2025 there have been executive orders that
have disrupted programs that affect maternal healthcare. Perhaps if there were strong
statistical data that could be shown to congress this may not have happened (Hill et al).
Ultimately, disparities exist. The reasons why they exist can be debated and attributed to
social conditions, economic status, racial bias etc. The truth is that all these multiple
explanations do play roles as to why these disparities exist and that fact cannot be denied.
It can also be argued how personal experiences are interpreted. Claims of discrimination
can be seen as miscommunication or differences in expectation regarding care. These
experiences, however, are evidence of implicit bias compounded with the fact that black
mothers and babies losing their lives at a higher rate than their white counterparts.
Terrence Sullivan passionately stated, "The maternal mortality rate for Black and brown
women is not just a healthcare issue; it is a matter of racial justice" reflects my own
opinion.
The young lady that I spoke of in the beginning of this essay is me.
That is my story. I didn't know how to advocate for myself. I was young and trying to
navigate a new chapter in my life. Instead of receiving guidance from a trusted professional
I was made to feel less than because I was pregnant at age nineteen. When I began to feel
lightheaded, when my limbs began to swell, I didn't feel safe bringing my concerns to him
because I didn't feel like my doctor cared or would listen to me anyway. During my research
for this essay, I came to learn that my story is "our story". So many black women
unfortunately, share this same story. This is not an issue that affects just black women but
women in general. My focus is on black women because we experience a higher rate of
death than any other race, so it is that much more serious for the black community. The
death rate for black women is 41.4 per 100,000 deaths while white women are 13.7 per
100,000 (Sullivan).
My hope is for this essay to bring attention to the importance of improving maternal
healthcare so that all women experience safe pregnancy outcomes. To accomplish that
There must be a change in the healthcare system via training, accountability,
representation, and legislature that ensures that concerns of black mothers are no longer
disregarded; providers are more involved in care and are empathetic to their black
patients, and the elimination of stereotypes that cause white providers to see
their black patients in a way that causes racial disparities and unconscious bias. To not
address and resolve these problems would continue be a matter of life and death for
mothers to be.
