Commentary Race

Report: Racial Discrimination Severely Undermines Black Women’s Health

Elizabeth Dawes Gay

The stories of women who participated in focus groups led by SisterSong, included in a new report, convey the gross under-education and discriminatory treatment of Black women living in the South, in particular, where sexual and reproductive health education is nonexistent and stigma is rampant.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

On Wednesday, August 13, the United Nations Committee on the Elimination of Racial Discrimination begins a two-day review of the United States government’s efforts, or lack thereof, to address pervasive racial discrimination in law and practice. When the United States ratified the International Convention on the Elimination of All Forms of Racial Discrimination in 1994, it consented to a periodic review by human rights experts of its progress toward meeting the goals in the treaty. The last time such a review was conducted was 2008, when the committee expressed specific concern about persistent and worsening disparities in sexual, reproductive, and maternal health in the United States—particularly for Black women—and offered recommendations about how the country could reduce those disparities.

It’s no secret that Black women are more likely than others to experience negative maternal health outcomes, such as preterm birth or stillbirth, to suffer from conditions like preeclampsia, and to die at higher rates from pregnancy-related causes. A new shadow report, Reproductive Injustice: Racial and Gender Discrimination in U.S. Health Care, by the Center for Reproductive Rights, the National Latina Institute for Reproductive Health, and SisterSong Women of Color Reproductive Justice Collective shares some alarming data on maternal health outcomes as well as disturbing firsthand accounts of the racial discrimination experienced by Black women.

The stories of women who participated in focus groups led by SisterSong included in the report convey the gross under-education and discriminatory treatment of Black women living in the South, in particular, where sexual and reproductive health education is nonexistent and stigma is rampant. Women in the focus groups shared how they turned to friends or “the street” for information, but found it was often incorrect. When asking health-care providers for information, many were met with stigma about their sexuality and sexual decision making, and were lectured rather than offered helpful information. The women also encountered providers who made assumptions about their ability to utilize health information, undermining the quality of reproductive health care they received and jeopardizing their health.

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In one such interview, for example:

Aaliyah from Jackson [Mississippi] said her doctor had assumed she would not or could not effectively use contraception: “After I had the baby, and I went back for my checkup … [the doctor] told me, ‘I’ll see you in six weeks.’ I said, ‘Why?’ He said I’d be pregnant again.”

She sought the care she wanted to plan her family, but her provider refused to counsel her about contraceptive options and help her make an informed decision.

Tiffany, also from Jackson, Mississippi, tells the story of how she was forced to wait in a public hospital’s hallway during labor because there were no available beds, and how she was ignored until the baby crowned. Even then, she was told not to push until they could get her a room, endangering her health and the health of her baby.

Aaliyah, a Medicaid patient, explained how she received what can only be described as substandard prenatal care. A week before she was due, her doctor realized she had not received an ultrasound since she first found out she was pregnant. When an ultrasound was finally performed, they found low amniotic fluid and her labor was induced. Her baby suffered complications and remained on breathing tubes for three weeks.

These women are far from alone. Millions of women in the United States share these experiences and a million more suffer the consequences. While maternal deaths are rising all across the country, Black women are disproportionately affected. In rural Chicksaw County, Mississippi, the maternal mortality ratio is 595 women per 100,000 live births—worse than that of war-torn and developing nations like Kenya and Rwanda (400 and 320 per 100,000 live births, respectively). In Detroit, the ratio is 58 per 100,000 live births, although data shows the ratio in Michigan state could be as high as 391 per 100,000 live births among Black women who often experience a delay in receiving prenatal care.

This has not happened by chance. Rather, this is a direct result of political disinterest in helping the most vulnerable in our society, an unwillingness to acknowledge and address racial discrimination as a major factor in health outcomes, and a refusal to invest in health and well-being beyond insurance access to health care. Increased health care spending and newer technology hasn’t improved maternal health for all women in the United States, and definitely not for Black women.

Black women are victims of something much worse than stigma, judgment, and discrimination: We are victims of a system and society that abrogates our basic human rights, including the rights to health, life, and non-discrimination. It is apparent in stories of the women in the SisterSong focus groups who were fortunate enough to survive their pregnancies, and also reflected in data (some of which can be found here, here, here, and here) from the U.S. Department of Health and Human Services. The United States is the only industrialized nation to have an increase in maternal mortality over the past decade—now triple the rate of that in the United Kingdom. We’re sliding backward when we should be making progress, not just in science and medicine or the slow crawl toward health equity, but in achieving better health for all. Why is this?

We could blame the problems for being too complex, for the multiple factors that feed into these outcomes, and for solutions that require levels of coordination and partnership that seem daunting. But, are these problems insurmountable? I believe, as many of you might, that although the problems that lead to negative health outcomes for Black women are certainly complex and undoubtedly challenging, they can be overcome by investing appropriate attention and resources. The U.S. government’s own report to the committee acknowledges that more can be done, but it doesn’t outline a plan for changing the situation.

Fortunately, the Reproductive Injustice report offers some key recommendations, which include providing comprehensive sexual education, addressing racial and gender stereotypes that promote stigma, improving the quality of maternal health services for women relying on the public health system, providing paid parental leave, and ensuring access to remedies for those who experience discrimination. These recommendations mirror those included in Amnesty International’s report, Deadly Delivery: The Maternal Health Care Crisis in the USA, and there is little doubt that women and families will benefit when these recommendations are fully implemented. For example, researchers have proven the benefits of high-quality prenatal and maternal health care for both mother and baby.

Finally, international organizations have identified political commitment as a precondition for reducing maternal mortality and improving health outcomes. Clearly, change will not happen without political will and thoughtful decision making at the federal, state, and local levels, and in all levels of government. The United States made a commitment to address racial disparities, but it hasn’t followed through. Now we need answers, not excuses. It’s time for lawmakers to act. The lives of women across the nation depend on it. 

News Abortion

Reproductive Justice Groups Hit Back at RNC’s Anti-Choice Platform

Michelle D. Anderson

Reproductive rights and justice groups are greeting the Republican National Convention with billboards and media campaigns that challenge anti-choice policies.

Reproductive advocacy groups have moved to counter negative images that will be displayed this week during the Republican National Convention (RNC) in Cleveland, while educating the public about anti-choice legislation that has eroded abortion care access nationwide.

Donald Trump, the presumptive GOP nominee for president, along with Indiana Gov. Mike Pence (R), Trump’s choice for vice president, have supported a slew of anti-choice policies.

The National Institute for Reproductive Health is among the many groups bringing attention to the Republican Party’s anti-abortion platform. The New York City-based nonprofit organization this month erected six billboards near RNC headquarters and around downtown Cleveland hotels with the message, “If abortion is made illegal, how much time will a person serve?”

The institute’s campaign comes as Created Equal, an anti-abortion organization based in Columbus, Ohio, released its plans to use aerial advertising. The group’s plan was first reported by The Stream, a conservative Christian website.

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The site reported that the anti-choice banners would span 50 feet by 100 feet and seek to “pressure congressional Republicans into defunding Planned Parenthood.” Those plans were scrapped after the Federal Aviation Administration created a no-fly zone around both parties’ conventions.

Created Equal, which was banned from using similar messages on a large public monitor near the popular Alamo historic site in San Antonio, Texas, in 2014, did not respond to a request for comment on Thursday.

Andrea Miller, president of the National Institute for Reproductive Health, said in an interview with Rewire that Created Equal’s stance and tactics on abortion show how “dramatically out of touch” its leaders compared to where most of the public stands on reproductive rights. Last year, a Gallup poll suggested half of Americans supported a person’s right to have an abortion, while 44 percent considered themselves “pro-life.”

About 56 percent of U.S. adults believe abortion care should be legal all or most of the time, according to the Pew Research Center’s FactTank.

“It’s important to raise awareness about what the RNC platform has historically endorsed and what they have continued to endorse,” Miller told Rewire.

Miller noted that more than a dozen women, like Purvi Patel of Indiana, have been arrested or convicted of alleged self-induced abortion since 2004. The billboards, she said, help convey what might happen if the Republican Party platform becomes law across the country.

Miller said the National Institute for Reproductive Health’s campaign had been in the works for several months before Created Equal announced its now-cancelled aerial advertising plans. Although the group was not aware of Created Equal’s plans, staff anticipated that intimidating messages seeking to shame and stigmatize people would be used during the GOP convention, Miller said.

The institute, in a statement about its billboard campaign, noted that many are unaware of “both the number of anti-choice laws that have passed and their real-life consequences.” The group unveiled an in-depth analysis looking at how the RNC platform “has consistently sought to make abortion both illegal and inaccessible” over the last 30 years.

NARAL Pro-Choice Ohio last week began an online newspaper campaign that placed messages in the Cleveland Plain Dealer via Cleveland.com, the Columbus Dispatch, and the Dayton Daily News, NARAL Pro-Choice Ohio spokesman Gabriel Mann told Rewire.

The ads address actions carried out by Created Equal by asking, “When Did The Right To Life Become The Right To Terrorize Ohio Abortion Providers?”

“We’re looking to expose how bad [Created Equal has] been in these specific media markets in Ohio. Created Equal has targeted doctors outside their homes,” Mann said. “It’s been a very aggressive campaign.”

The NARAL ads direct readers to OhioAbortionFacts.org, an educational website created by NARAL; Planned Parenthood of Greater Ohio; the human rights and reproductive justice group, New Voices Cleveland; and Preterm, the only abortion provider located within Cleveland city limits.

The website provides visitors with a chronological look at anti-abortion restrictions that have been passed in Ohio since the landmark decision in Roe v. Wade in 1973.

In 2015, for example, Ohio’s Republican-held legislature passed a law requiring all abortion facilities to have a transfer agreement with a non-public hospital within 30 miles of their location. 

Like NARAL and the National Institute for Reproductive Health, Preterm has erected a communications campaign against the RNC platform. In Cleveland, that includes a billboard bearing the message, “End The Silence. End the Shame,” along a major highway near the airport, Miller said.

New Voices has focused its advocacy on combatting anti-choice policies and violence against Black women, especially on social media sites like Twitter.

After the police killing of Tamir Rice, a 12-year-old Black boy, New Voices collaborated with the Repeal Hyde Art Project to erect billboard signage showing that reproductive justice includes the right to raise children who are protected from police brutality.

Abortion is not the only issue that has become the subject of billboard advertising at the GOP convention.

Kansas-based environmental and LGBTQ rights group Planting Peace erected a billboard depicting Donald Trump kissing his former challenger Sen. Ted Cruz (R-Texas) just minutes from the RNC site, according to the Plain Dealer.

The billboard, which features the message, “Love Trumps Hate. End Homophobia,” calls for an “immediate change in the Republican Party platform with regard to our LGBT family and LGBT rights,” according to news reports.

CORRECTION: A version of this article incorrectly stated the percentage of Americans in favor of abortion rights. 

Commentary Sexuality

Auntie Conversations: Black Women Talk Sex, Self-Care, and Illness

Charmaine Lang

These auntie conversations were just as much about me as they were about my aunts and mama. I really want to know what to expect, what to anticipate, and perhaps, even, what not to do as I age and grow in relationships so that I, too, can have a fulfilling and healthy partnership.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

“You’re just being nosy,” one of my aunts said, after I asked her if she enjoyed having sex with her husband. I assured her this was all part of a research project on the intimate lives of Black women. She relented a bit, but still gave me the side-eye.

I’ve been engaged in archival research for the last year. While the personal letters of Black women writer-activists and the newspapers of the Third World Women’s Alliance are remarkable and informative, they provide little insight into the intimate lives and sexual desires of Black women. After all, sex improves our mood and alleviates stress: That immediate gratification of pleasure and release is a way to practice self-care.

So on a recent trip home to Los Angeles, I asked my aunties to share their stories with me at a little gathering they threw in my honor.

And they did.

I asked them: “What’s your sex life like?” “Do you want to have sex?” “Are you and your husband intimate?” “You know … does he kiss you and hold your hand?” And I learned that contrary to tropes that present us as either asexual mammies or hypersexual jezebels, the Black women in my life are vulnerable and wanting love and loving partners, at all stages of life.

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Between 1952 and 1969, my maternal grandmother had six daughters and one son. All of them grew up in South Central Los Angeles, witnessing white flight, the Watts riot of 1965, and the crack epidemic. At the same time, the women have kept the family intact. They are the ones who always plan big dinners for the holidays and organize food drives for their churches. And they arranged care of their mother toward the end of her life. I’ve always wondered how they were able to prioritize family and their own desires for intimacy.

So I asked.

My 57-year-old aunt who is a retired customer service representative living in Pomona, California, told me: “My lifetime of sex consisted of first starting off with getting to know the person, communicating, establishing companionship. Once that was done, the sex and intimacy followed. When you’re younger, you have no frets. You experiment all the time.”

I wanted to know more.

“You’re not just trying to get in our business? You’re actually going to write something, right?” was my mother’s response.

When asked about the state of her sex life, my 59-year-old aunt, a social worker, said: “I am a married woman without a physical sex life with my husband. His illness has a lot to do with this, along with the aging process.”

My Pomona aunt went into more detail about how as we get older our ability and desire changes.

“You try to keep pace with pleasing your partner, and he tries to please you. But it is hard when you are a full-time worker, wife, and mother, and you commute to work. You’re tired. Hear me: You’re tired; they are not. You grow older, gain weight, and get sicker. You start to take medicine, and all that affects your ability and desire to perform.”

“For me, in a nutshell, [sexual activity] feels like work: I don’t feel excited. When it happens, it happens,” she said.

I learned the combination of energy spent on wage work, domestic labor, and mothering is draining, dissipating the mood for sex or intimacy. A husband who does not have the same domestic responsibilities has more energy for sex. The unbalanced load equates to differences in desire.

I wondered: Did my aunts talk to their partners about this?

Illnesses, such as diabetes and cancer, can cause anxiety, depression, and fatigue, which interrupt lovemaking. Talking to a partner can help to create a new normal in the relationship.

However, as my social worker aunt made clear, “It takes two to talk openly and honestly, which I find very difficult most of the time.”

“To be vulnerable is hard because I do not want to get hurt emotionally, so I protect my heart from harm,” she explained. “[My husband and I] can be harsh and curt to each other at times, which leads to me shutting down and not expressing my true feelings. My husband can be prideful and unwilling to admit there are issues within the relationship.”

Aunt April, a 47-year-old Los Angeles teacher, had some things to share too. “My love life is complicated. After suffering an overwhelming and devastating loss in 2011 of my husband and mate of nearly 20 years, I’m very hesitant to fully try again.”

She hasn’t dated since 1991. After much counseling, grieving, and encouragement from her 12-year-old daughter, she decided to give it a try.

“I have been seeing someone, but I have a lot of fear that if I relinquish my heart to him, he will die. So, I think about sabotaging the relationship so that I don’t have to get to know him and start worrying about his well-being and wondering if he feels the same way I do. In my mind, it’s easier to be casual and not give too much of my heart,” she said.

Intimacy, then, is also about being vulnerable in communicating how one feels—and open to all possibilities, even hurt.

As a 34-year-old queer Black woman figuring out my dating life, my aunt’s words about communication struck me. At times I can be guarded, too, fearful of letting someone get close. I started to ask myself: “What’s my sex life like?” and “What role does intimacy play in my life as I juggle a job and doctoral studies?”

These auntie conversations were just as much about me as they were about my aunts and mama. I really want to know what to expect, what to anticipate, and perhaps, even, what not to do as I age and grow in relationships so that I, too, can have a fulfilling and healthy partnership.

“I enjoy sex more now then I did before,” my mama, Jackie, said. Now 55, she remarried in 2013. She lives in Gilbert, Arizona, and works in the accounting and human resource field. “My husband loves me unconditionally; with him, I’m more comfortable. It’s more relaxing.”

My mama expressed her ability to enjoy herself with her husband because of the work she put into loving herself and prioritizing her needs.

I always talk to my mama about my dating life: heartbreaks and goals. She always says, “Learn to love yourself first.” It really isn’t what I want to hear, but it’s the truth. Self-love is important and central to the success of any relationship, especially the one with ourselves. My social worker aunt often takes trips to the spa and movies, and my aunt April is an avid concertgoer. They have found ways to have intimacy in their lives that is not informed by their relationship status.

The journey to self-love can be arduous at times as we discover parts of ourselves that we don’t like and want to transform. But with much compassion and patience, we can learn to be generous with the deepest parts of ourselves and each other. And isn’t that a necessary part of intimacy and sex?

The stories shared by my womenfolk reveal a side of Black women not often seen in pop culture. That is, Black women older than 45 learning how to date after the loss of a partner, and finding love and being intimate after 50. Neither mammies nor jezebels, these Black women, much like the Black women activists of the 1960s and 1970s I study, desire full lives, tenderness, and love. My aunts’ stories reassure me that Black women activists from decades past and present have intimate relationships, even if not explicit in the body of literature about them.

The stories of everyday Black women are essential in disrupting dehumanizing stereotypes so that we can begin to see representations of Black women that truly reflect our experiences and dynamic being.