- Jess, a Black OB-GYN, recalls racist comments against Haitian patients at a former workplace.
- In part due to biased beliefs about their bodies, she said the patients were commonly deprioritized.
- Black people are more likely to suffer pregnancy-related complications and death than white people.
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Jess’s patient was undergoing an emergency C-section when she went into cardiac arrest. The woman had a high-risk pregnancy and needed chest compressions to survive.
And yet, Jess’s supervisor, the attending physician, wasn’t concerned. He was a white male, and the patient, a Creole-speaking woman from Haiti, was Black. “You can’t kill a Creole,” Jess, an OB-GYN of Afro-Caribbean descent who was a resident at the time, told Insider she heard him say.
Jess was appalled and “extremely uncomfortable.” Without looking away from her computer, she said, “Not cool, guys.” As she expected at the hospital with no people of color in leadership and only a few on staff, the small group of clinicians continued to chuckle.
It wasn’t the only time Jess, whose identity is known to Insider but who asked to use a pseudonym to speak openly about such incidents, said she heard comments like that at the hospital in Florida, where people from a wide range of races and ethnicities sought care.
She said the Haitian patients were uniquely discriminated against, including when compared to other non-native English speakers and other people of color, perhaps because, as Jess said she perceived, white clinicians sometimes held openly biased beliefs about their bodies.
For instance, when Haitian pregnant patients developed pre-eclampsia, a potentially life-threatening blood pressure condition, clinicians frequently seemed to tend to them with less urgency than their white patients with the same condition, Jess said.
"I would hear comments such as, 'She's Creole, they do this all the time' or, 'She's Haitian, she'll be fine' or, 'this is what their babies do,' without any further cause for concern," said Jess, who no longer works at the hospital.
Insider has corroborated Jess's account with a former colleague, who recalled the same incident and similar comments.
In the US, maternal mortality rates are at least 2.5 times higher in Black women than white women. It's not genetics or education or merely issues of access. It's experiences like Jess's that may help illustrate why.
"What I expected [when I entered the profession] was hypervigilance and person-centeredness, for us all to do our part to reduce the racial and ethnic disparity of maternal mortality," she said. "Instead, I was met with the harsh reality of obstetric racism."
Black women in the US are far more likely to develop pre-eclampsia and die than white women
In the US, Black women are at least two and a half more likely to die in pregnancy, childbirth, or immediately postpartum than white women. Other statistics show pregnancy-related deaths for Black, American Indian, and Alaska Native women over 30 years old are four to five times as high as they are for white women.
Black women with at least a college degree are at even greater risk, dying from pregnancy-related complications at 5.2 times the rate of white women, data out of the Centers for Disease Control and Prevention, has found.
Dr. Chaniece Wallace, a pediatric chief resident at Indiana University School of Medicine who died in childbirth after her daughter was born prematurely via C-section, was one of those tragedies.
She had pre-eclampsia, which causes women to develop high blood pressure and usually protein in their urine, and can also lead to swelling in their legs, hands, face, or whole body, according to Harvard Medical School. If it develops into eclampsia, women experience seizures and may be at higher risk of stroke.
While most women and their babies in the developed world "survive just fine," the Harvard website says, as many as 14% of women with the conditions in developing countries die. Black women in America are on an island in between.
Their rates of pre-eclampsia and eclampsia are about 60% higher than white women, and they're also more likely to experience poor outcomes from the condition, one 2017 report out of the US Agency for Healthcare Research and Quality found.
Beyoncé has spoken openly about her experience with pre-eclampsia while pregnant with twins, who were delivered via emergency C-section. "I was in survival mode and did not grasp it all until months later," she wrote in Vogue. "Today I have a connection to any parent who has been through such an experience."
Kevork Djansezian/Getty Images for NARAS
Some doctors falsely believe Black people perceive pain differently, leading to inappropriate care
Doctors and researchers have pointed to a variety of factors that could help explain the disturbing disparities in maternal health, including socioeconomic status and access to prenatal treatment. But those explanations implicate patients, not the healthcare professionals who are subconsciously delivering substandard care.
One 2016 study, for instance, found that about half of white medical students and residents endorsed false beliefs about biological differences between Black and white people, like that Black people's nerve endings are less sensitive and their skin is thicker. In turn, they rated Black patients' pain as lower and made less accurate treatment recommendations.
"To this day, Black people are less likely to get the same treatment in terms of pain medication, they're more likely to wait longer in the ER, they're less likely to be taken seriously - it's a holdover from the days of slavery," Dr. Jennifer Lincoln, an OB-GYN, said on TikTok in response to the death of Nicole Thea, a London-based social media star, who died July 11 along with her unborn child at 8 months pregnant.
Sayida Peprah, a psychologist and doula, previously told Insider implicit bias in the medical system can also play out when a Black mother is dismissed when she raises a concern, a Black father is dissuaded from asking questions because the healthcare providers perceive him as hostile, or a clinician puts less effort into caring for a Black infant or mom due to "unconscious influences around the lack of value of their lives."
Even before Black patients enter healthcare settings, they're at a disadvantage due to their daily experiences.
"Structural racism faced in the daily lives of Black people leads to fewer opportunities for the achievement of optimal health statuses, and microaggressions and acts of racism in daily life contribute to chronic stress causing poorer physical and psychological health," Jess said.
'The medical community needs to work to rebuild trust'
Jess's patient who went into cardiac arrest "astonishingly" survived, she said, but living through childbirth as a Black person in the US shouldn't be astonishing.
"It is time for us to be advocates for all of our patients, especially our Black patients, creating a space for all to feel safe to share their concerns and be heard, not just listened to," Jess said.
"The medical community needs to work to rebuild the trust that our Black communities lost in us generations ago due to decades of legal injustices," she continued. "Finally, we must stop spreading offensive and absurd phrases such as 'you can't kill a Creole' because our nation's maternal health data says otherwise."
Are you a healthcare professional who's witnessed racist treatment on the job? Email [email protected] to share your story; your identity will be protected.