Black Women in Healthcare: Baby Steps to Equity

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Irelene Ricks

Urban One, Inc.

This essay is dedicated to our Black woman policy warrior, Lisa Ransom, who fought a good fight against uterine cancer and transitioned on January 19, 2023. Rest in Love.

The first Black female physician in the United States was Dr. Rebecca Lee Crumpler. Born during slavery on February 8, 1831, she grew up in the north in Pennsylvania, with an aunt who cared for the sick, giving Rebecca  first-hand field experience.  After attending a prominent private school, the West-Newton English and Classical School in Massachusetts, in 1852, she moved to Charlestown, Massachusetts, and continued her interest in medicine by working as a nurse. Eight years later, in 1860, she became the first Black woman to apply to medical school and was accepted into the New England Female Medical College, the first women’s medical college globally, according to American National Biography

Prior to Black Emancipation, there were no Black women who had been formally trained as medical doctors. Following in Dr. Crumpler’s footsteps, by 1920 there were 65 Black female doctors in the United States. This number may seem insignificant but at the time in which it occurred (i.e., post-Reconstruction, open disdain for women’s rights, Jim Crow), it is still quite an accomplishment. However, what is more troubling than this early twentieth century statistic is the fact that in 2021 Black women still represented only 2.8 percent of all U.S. doctors. 

The Birth of Black Maternal Child Health

Not content to just practice medicine, Dr. Crumpler was also the first Black female doctor to write a book on academic medicine that was published in 1883. Titled “A Book on Medical Discourses in Two Parts,” the book examines maternal child health and was dedicated to “mothers, nurses, and all who may desire to mitigate the afflictions of the human race.” Dr. Crumpler died in 1895, but her legacy of examining Black maternal child health lives on. Not long after Dr. Crumpler’s death, another Black woman doctor, Helen Octavia Dickens earned her medical degree in 1934 from the University of Illinois and was the only Black woman in her graduating class. Eleven years later, in 1945, Dr. Dickens became the first Black woman to receive board certification in obstetrics and gynecology (Ob-Gyn), setting the stage for what remains a small number of Black board certified Ob-Gyns in the U.S.

In 2023, more Black women die in childbirth or have serious negative consequences of childbirth (death or harm to the baby) than any other racial/ethnic group in the United States. According to the Centers for Disease Control (CDC), “In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women (19.1).” 

Unfortunately, the causes of maternal mortality (death) and morbidity (poor health outcomes) cannot be written off by the usual socioeconomic standards. Typically, people assume that low wealth mothers will suffer poor health consequences in a system that seems to favor wealthier women, but that hypothesis does not hold true in maternal health. Even Black wealthy, well-educated women (think of Serena Williams) experience life-threatening trauma during, or after, what should be normal deliveries.

What Can We Do About It?

Knowledge is power. Every April, Black Maternal Health week is celebrated from April 11-17. The theme of 2023’s Black Maternal Health Week is “Our Bodies Belong to Us.” This theme echoes the anger and frustration felt by women of all backgrounds after the Supreme Court’s rollback of Roe v Wade. As has already been proven with data, Black women are far more likely to suffer adverse health outcomes due to maternal and postnatal care than non-Hispanic white women, but legislators and judiciaries ignore these facts as they promote their own policy agendas on abortion. 

However, groups like Black Mamas Matter (the founders of Black Maternal Health week) have helped to center Black maternal health on the American policy stage. 

In their 2021 article, “Declines in the Proportion of U.S. Black Obstetrics and Gynecology Residents,” authors Nguyen, Mitchell-Chadwick, and Heyrana recommend several ways to increase Black ob-gyns in Black maternal care:  

  1. cultivating a diverse medical workforce starting from its earliest points of influence (e.g., facilitating health care and research experiences at the high school and undergraduate levels);
  2. identifying, tracking, and mentoring medical students and residents toward academic careers, (e.g., creating pipeline programs);
  3. creating inclusive and supportive workforce environments for underrepresented minority (URM) and physicians (e.g., promoting allyship to promote inclusivity, address implicit bias, and provide antiracism/antisexism training; creating diversity committees and initiatives);
  4. holding unprofessional and discriminatory behaviors accountable; and
  5. investing in the equitable compensation and promotion of URM faculty 

When giving life can also mean unexpected death for Black women, it is time for the medical community and policymakers to take a closer look at what is truly meant by “Right to Life.”  We owe Black women nothing less in our continued fight for health equity.