Racism Is The Root, Sustaining Cause Of Black Infant Mortality
Jose Luis Pelaez Inc/Getty Images

Joia Crear-Perry <> Nov,
12, 2018

The life or death fear of childbirth for Black women is generations old, as
we have believed it to be something that was innate to us and unchangeable.
Premature birth, or a baby born before 37 weeks gestation, is by far the
leading cause of infant death in the United States. Black babies, however,
are two to three times more likely to die from all causes, including
prematurity, than white babies in the United States.

It was exciting to see Serena Williams
adding her critical voice to this conversation. And November 17th, World
Prematurity Day, is an opportunity for Black women and our allies to
continue calling out the true cause of the inequities in infant
mortality—the impact of anti-Black white supremacy on Black women’s
bodies—and then work to create policy and cultural changes to end this
persistent and grave injustice.

There is a dangerous hierarchy of human value, based solely upon skin
color, embedded into how we provide and research healthcare. This has been
the case for 600 years. Some researchers hold the belief that these
inequities are too entrenched to fix, but that callous lack of investment
is detrimental for Black women and their children.

Addressing why women die in childbirth, and supporting policies like paid
leave and equal pay that would mitigate these deaths, is critical, but I
learned early that I couldn’t educate, work, or earn myself to a risk-free
childbirth. When I was a 25-year-old 3rd year medical student, my son was
born weighing 445 grams when I was 22 weeks pregnant. At the time, I was
married and had no medical issues. I was average weight *and* I initiated
prenatal care at 8 weeks pregnant. I also took folic acid while
intentionally trying to get pregnant.

While in medical school in 1995, I was taught that my genes and therefore
my race were tied together, which was the reason my son was in the NICU. I
believed that I was genetically doomed to have my son too early because I
was Black.

Why was I taught that?

Because the foundation of medicine in the United States was built and
continues to rest on a racist framework. From the earliest beginnings,
medical schools have propagated Dr. Samuel Morton’s
<> racist
theory of differential skull size and intelligence; so, it makes sense
that, even today, it is relatively easy to channel millions of dollars into
researching genetic causes of premature birth, while ignoring inequality
and racism as factors. Dorothy Roberts calls this race-based medicine

Researchers and eugenicists
<> have used race
as a rough proxy for many things like poverty and lack of insurance.
Blackness is not the problem, though; white supremacy is.

We can discuss cortisol
<>, epigenetics
and telomeres
sure. But my response in every meeting and lecture when they want me to
keep giving them scientific data
<> that racism is
<> is
always the same:

How much data, and how many more sources, do we have to present before
people accept that racism is harmful? And when we keep spending money for
research on genetic causes or cortisol or telomeres, it begs the question:
To what end?

Even if we identify the exact cortisol blocker to decrease prematurity, are
we going to leave racism in place? White folks’ frustration with me saying
the root cause is racism is only overshadowed by my frustration in their
not believing it—or looking for a pill or shot to fix it.

Without equivocation, race was made up to harm—and it works.

Understanding that racism
personally mediated, and internalized, as well as implicit bias,
<>causes inequities in
birth outcomes and maternal morbidity is imperative. Once we start with
some historical truths, that Black women were enshrined in the U.S.
Constitution with explicit devaluation based on race and gender, we can
build policy and culture that, finally, values us all.

*Joia Crear-Perry, MD, FACOG Founder & President of the National Birth
Equity Collaborative. <>*