Racism in Healthcare: What It’s Like Giving Birth As a Black Woman
A mother of one and a lawyer in Atlanta shares how racism in healthcare nearly killed her when she went into labor with her son and had health complications postpartum.
As protests against systemic racism continue across the United States, people of color are sharing more and more heartbreaking stories about how racism has impacted and even ended lives. Healthcare is a major, often overlooked, area of racism. Black and Brown people are less likely to have access to health insurance, less likely to be believed about their symptoms, less likely to receive proper treatment, and less likely to get healthcare overall, according to decades of research. Here, Yendelela Neely, a mother of one and a lawyer in Atlanta, shares how racism nearly killed her when she went into labor with her son and had postpartum health complications.
Joe Carlos Photography/Courtesy Yendelela Holston
Going into labor as a woman of color
By the time I was 39 weeks pregnant with my son I was ready to evict him. It had been great having a live-in roommate (literally) but it was time for him to move out. So I started doing everything I could to get labor going, eating all the spicy food and taking long swims. Apparently he was ready too because by the next morning I was in labor. I labored on my own until the contractions became regular and close together, finally heading to the hospital around 2:30 in the afternoon. I was in a lot of pain but so excited to finally meet my baby boy.
That excitement was squelched as soon as I arrived to check in. The nurse assigned to me took more than an hour to even examine me and when she finally did, it was a quick poke of my cervix and then, “You’re not dilated or effaced, you’re not in labor, go home.”
I knew my body and I knew I was in labor but she refused to listen. I refused to leave and she became annoyed. Exasperated, she called my OB/GYN who instructed her to admit me. The nurse came to the room where I was waiting and said, “She said to just induce you and get this over with since she is leaving the country tomorrow.”
A delayed labor induction
Excuse me, what? I was surprised by her attitude and getting more frustrated by the minute. (Being in agonizing pain every one to three minutes wasn’t helping either.) Was she like this with all her patients? Why did she have such disregard for my pain or my thoughts on my delivery of my baby? My race factors into most of my everyday experiences but I was not prepared for it to creep into this moment. I was in labor but, like so many times in my life, I didn’t have a choice whether or not to consider if my race was a factor.
My doctor arrived an hour later and entered my room with the nurse. “Have you induced her yet?” my doctor asked. The nurse sheepishly looked at the doctor and said “I was just about to,” even though she’d been stalling since the moment I’d been admitted. My doctor started to walk out of the room and then turned on her heels, deciding she would check my cervix herself. As soon as she did she exclaimed, “What are you talking about? She’s dilated to a seven and almost completely effaced. Not only is she definitely in labor but she’s almost done!”
The nurse left in a huff but because of her stalling, I wasn’t able to get a shot that I was told I’d need before my baby was born. Then my doctor broke my water and we discovered meconium in the amniotic fluid—a condition that can lead to lung problems or even death in infants. My sense of unease grew. Would my baby and I be able to get the care we needed—nay, deserved—at this hospital?
I gave birth to Joshua Bakari, the most perfect, beautiful baby I’d ever seen, just a few hours later. After he was born and my placenta had been delivered, I specifically asked the doctor “if she got it all.” Through all of my pregnancy readings, I had learned of the dangers of retained placenta. The doctor stated that the placenta was all out and intact. I finally felt like maybe I could relax and all of this would just be a story I’d tell my friends later.
Growing pains after birth as a woman of color
After delivering on Sunday, I was set to be discharged the following Tuesday but something didn’t feel right. My belly was swollen bigger than it had been immediately after I delivered Joshua. My doctor had to go out of the country and a nurse handled my discharge. I pointed out the size of my stomach and how it had grown. She assured me that it was fine, that I was fine, and that I should go home.
Struggles with breastfeeding
Things only got more stressful at home. I hadn’t been able to breastfeed in the hospital but I thought it would get better at home. Unfortunately, it seemed as if my efforts at breastfeeding were in vain. Despite all of my trying, my son always seemed hungry, like I was not feeding him. I visited my lactation nurse the following day and she stated that everything was fine and to keep trying. When it was not better by Friday, I made another appointment.
As soon as the lactation consultant saw me, she said, “Don’t worry about the baby, give him some formula, we need to worry about you!” My whole body was swollen; she insisted I go to the doctor immediately.
Postpartum swelling and a lack of care
Because my OB/GYN was not available, another doctor in her practice saw me. He, like the nurse at the hospital, seemed annoyed by my very presence. However, I overlooked it and explained to him that my son’s pediatrician’s office had sent me after concerns raised about my health by the lactation consultant. “Why are you here?” he demanded.
“This can’t be right,” I said to him, pointing to my swollen abdomen, legs, ankles, and even feet.
“You just gave birth, what do you expect?” he snapped. He then looked at me as if to say you can leave. When I did not, he huffed and listened to my breathing with his stethoscope. He then declared I was fine, told me to go home and left, without even looking below my waist or otherwise examining me. Again, there was the unnecessary rudeness, not to mention a lack of appropriate care. As I walked painfully back to my car I realized his true priorities when he beat me to the parking lot where I saw him tossing his golf clubs in the back of his car, before speeding off. He clearly valued his golf game over my life.
Passing a blood clot
The next morning, just six days after giving birth, I passed a blood clot the size of a softball while trying to pump milk for my son. Now I knew something was desperately wrong. Unfortunately, Dr. Golf Clubs was the doctor on call and he told me to meet him at the hospital. After my experience the day before, he was the last person I wanted to treat me. However, I never even made it to him; I didn’t even make it past the driveway. As soon I walked out of the house, I started hemorrhaging so badly I actually thought that I might die. My husband called an ambulance and in between going in and out of consciousness, I wrote a good-bye note to my son, telling him that I loved him and I was so sorry I wasn’t going to be there to raise him.
Another delayed treatment
At the hospital they left me in an exam room, bleeding out, for over four hours while I just tried to stay conscious. Something in me felt that if I let myself go to sleep I wouldn’t wake up. Why were they taking so long to help me?
Later, my husband would tell me that he’d overheard the doctors discussing different treatment options, based on what we could pay. They assumed I didn’t have health insurance and were surprised to find that I did and it came back approved. This one was easy: Black people are less likely to have access to health insurance and they’d clearly judged me based on my skin. Even when I showed them my insurance card.
At that point, they finally decided to take me into surgery. By this point, my distrust of the medical community was so high that I refused to allow them to give me general anesthesia for the surgery. I wanted to be awake; I need to know what was happening at all times. I had to be able to advocate for myself. The anesthesiologist finally agreed to a local anesthetic.
Retained placenta surgery
During the surgery, they discovered that a bit of the placenta had been missed during the delivery and had remained attached to my uterus. My body had thought it was still pregnant and kept pumping blood to the “placenta,” which explained my swelling and bleeding. This condition, called retained placenta, affects about three percent of pregnant women and is extremely serious, leading to death if not treated. The surgeon was able to successfully remove it but she told me she’d never seen someone lose as much blood as I had and still survive. I was right, I had been dying.
I would later learn one more fact that made my blood boil: Not having breastmilk come in is an early warning sign of retained placenta. Dr. Golf Clubs was not only rude and negligent but he nearly cost me my life and my ability to be a mother. And, yes, I do think it was because I’m Black.
LWA/Dann Tardif/Getty Images
Racism in healthcare
Here’s why: Black women are four times more likely to die from pregnancy or childbirth, according to the Centers for Disease Control. We are more likely to have pregnancy complications including preeclampsia and gestational diabetes, and more likely to have problems after birth, like hemorrhaging.
It gets worse. Modern obstetrics and gynecology was founded by J. Marion Sims, a doctor who used live, unanesthetized, enslaved women to experiment on because he didn’t think they could feel pain. And that’s not an idea that got left in the last century with using cocaine for baby teething pain. Today, people of color are more likely to have their symptoms dismissed or ignored by medical professionals and are less likely to receive pain medication, according to a 2012 study published in the American Journal of Public Health. Alarmingly, a separate 2016 study published in PNAS found that half of the medical students reported believing one or more health myths about Black people including “Black people’s nerve endings are less sensitive than white people’s” and “Black people’s skin is thicker than white people’s.” And these are people training to be doctors!
Dismissal of concerns about racism in healthcare
I’ve heard a lot of people dismiss concerns about racism in American healthcare by pointing out the connection between being black and being poor. They argue that not having money is the real reason for not getting good healthcare. (As if that makes it better.) Well, I want you to know something else about me: I’m an attorney with a law degree from Duke. I made partner at my large, international firm in 2013, while I was on maternity leave from having my son. Money, education, resources, none of that was an issue for me. And yet I was still treated horribly.
I wish I could say this was the last time I’ve encountered racism in the healthcare industry. Unfortunately, I’ve had to confront it over and over again as I’ve sought to get an accurate diagnosis and appropriate treatment for my son’s vision problems. And I’m sure there will be more incidents in the future.
As this country reexamines how it treats people of color, I hope we include the healthcare system. Doctors are supposed to take care of us, they even swore an oath to do so, yet black women have learned the hard way that many of them won’t even listen to us, much less give us good care. And we’re dying because of it.
—As told to Charlotte Hilton Andersen
- American Pregnancy Association: "Retained Placenta"
- Centers for Disease Control: "Pregnancy-related death"
- The Atlantic: "The surgeon who experimented on slaves"
- American Journal of Public Health: "The Influence of Implicit Bias on Treatment Recommendations for 4 Common Pediatric Conditions: Pain, Urinary Tract Infection, Attention Deficit Hyperactivity Disorder, and Asthma"
- PNAS: "Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites"