Opinion: Black maternal mortality crisis is a critical feminist issue
The week of April 11-17 is dedicated to raising awareness about the crisis of Black maternal mortality in the United States. Black women in the U.S. have a high maternal mortality rate, which is not only a health care crisis but also a critical feminist issue.
Feminism fights for gender equality and aims to dismantle structures that oppress women. However, feminists must recognize that women’s experiences are shaped by both their gender and race. Black feminist thought leaders such as Hooks and Collins emphasize that Black women are at the intersection of gender and race, and they face unique challenges and forms of oppression that are often overlooked within mainstream feminist discourse.
Black women are at a much higher risk of dying during childbirth compared to their white counterparts. In 2022, the Pennsylvania Maternal Mortality Review Committee reported an overall pregnancy-associated mortality ratio (PAMR) of 82 deaths per 100,000 live births in the state. The report also highlighted that Black women had the highest PAMR of 163 deaths per 100,000 live births! To understand the reasons behind these disparities in maternal outcomes, it is essential to examine the historical context.
The United States has a history of reproductive injustice against Black women, dating back to slavery and continuing through the eugenics movement and forced sterilizations. The practice of forced sterilization started in the early 20th century with the birth control movement and continued until the late 1970s. Influential figures who advocated for eugenics and the forced sterilization of Black women included Theodore Roosevelt, Andrew Carnegie and Margaret Sanger. Fannie Lou Hamer, who herself had been involuntarily sterilized in 1961, spoke out against coerced sterilization. Eugenic sterilization would affect thousands of women of color throughout the 20th century, including the Relf sisters, who were just 12 and 14 years old.
The history of exploitation, violence and medical experimentation against Black women has plagued our society for centuries. James Marion Sims, “the father of modern gynecology,” practiced many of his experimental surgeries on enslaved women without anesthetics during the 19th century. Such practices have perpetuated the crisis of Black maternal mortality, highlighting the deep-rooted racism within health care systems.
After accounting for risk factors such as educational attainment, obesity and neighborhood poverty levels, Black mothers continue to experience disproportionately higher rates of maternal morbidity and mortality. According to data from the Centers for Disease Control and Prevention, Black women with a college degree face pregnancy-related mortality rates that are five times higher than women with a similar education. A comprehensive report by ProPublica in 2019 revealed similar data in New York City. Regardless of education, obesity, or poverty status, Black mothers in the city face a heightened risk of harm compared to their white counterparts.
The racial inequities in maternal risk are not confined to the U.S. A report from the National Perinatal Epidemiology Unit at the University of Oxford in November 2019 revealed stark differences in maternal mortality rates in the United Kingdom, where Black women were five times more likely to die during childbirth than white women. Similar patterns emerge in other European countries. In France, for instance, African women experience a higher maternal mortality rate compared to white women. Additionally, this trend extends to Spain’s immigrant population, emphasizing that maternal mortality is not isolated to specific regions but is a global issue with deep-seated racial, class, and gender-based inequities. The fact that maternal mortalities are largely preventable events places these events in a human rights context as violations of Black women’s reproductive rights.
To address Black maternal mortality, a feminist approach should adopt a reproductive justice framework. It should prioritize birth equity — ensuring optimal birth conditions for all individuals. Achieving birth equity requires a sustained effort to address racial and social inequities on a global scale. By prioritizing reproductive justice and birth equity within the broader social justice framework, we can work toward a more equitable and inclusive health care system for all individuals.
Carline Crevecoeur is a retired OB/GYN and a State College Area School District board member.
