Black women have the highest risk of pregnancy-related heart problems in the United States, according to a study released Wednesday, adding to a long list of disparate health outcomes they face as a group. But while the research may be new, Black women have long tackled these issues in community with one another.
Black women are at high risk of heart attacks, heart muscle weakness and more during and after pregnancy, according to the study, published in the Journal of the American Heart Association. Researchers reviewed hospitalization records for more than 46 million pregnant or postpartum women.
Compared to white women, pregnant Black women were found to be 23 percent more likely to have a heart attack and 71 percent more likely to develop heart muscle weakness, the researchers said.
“The magnitude of disparity was most alarming. We were very surprised by the persistent disparities irrespective of socioeconomic status,” said Dr. Samir R. Kapadia, senior author of the study and chair of the department of cardiovascular medicine at the Cleveland Clinic.
“When women have problems during pregnancy, they should be followed carefully after pregnancy and actions should be taken to prevent heart problems," he said.
The authors note that health professionals should take cultural factors into account when working with pregnant Black women. In recent years, the dire outcomes for Black pregnant women have consumed headlines, with researchers highlighting their alarming maternal mortality rates. Stars like Beyoncé and Serena Williams have made clear that medical racism is no respecter of class status.
But while data surrounding Black pregnancy may be new to many, many advocacy groups have been facing these disparities head-on for several years.
“The labor of caring for Black women in particular has been robustly taken up by both doulas and midwives who have a political and emotional commitment to ensuring that Black women have the kind of births that they want and to minimize the adverse outcomes,” says Dána-Ain Davis, a professor at Queens College in New York, a doula and the author of "Reproductive Injustice: Racism, Pregnancy, and Premature Birth."
“We do this by going through pregnancies with people, supporting them, educating them politically, educating them historically, and offering childbirth education," said Davis, who was not involved in the new research. "Some of the ways that we know work really well include group prenatal care. Black women benefit tremendously by being in community with other people during their pregnancies.”
Davis credits Kathryn Hall-Trujillo with starting the group practice years ago, noting that Davis uses group prenatal care in her own work as a doula. Hall-Trujillo founded Birthing Project USA, which pairs moms-to-be with volunteers who provide guidance and support throughout the pregnancy. Other groups doing similar work include the Black Mamas Matter Alliance, LOOM and Ancient Song Doula Services, a New York based doula-certification organization that serves birthing people of color and low-income families with culturally informed care.
These and similar groups have spent decades studying and experiencing the medical racism that makes pregnancy a hardship for many Black mothers. And community has been a common theme among these advocates. For example, the annual Momference in Washington, D.C., prioritizes this togetherness in a one-day conference for moms of color that “feels as intimate as a family reunion.”
The research found that while Black women are at highest risk of pregnancy-related heart issues, mortality and stroke have declined significantly among the group overall in recent years. Now, Davis said, it’s time for the conversation surrounding Black pregnancy to take a positive turn.
“A lot of the discussion around Black births and maternal mortality is really rooted in a politics of death and dying and bad outcomes. We do need a reproductive futurist perspective that is positive,” Davis said. “Focusing on the future of reproduction and the ways that communities might be able to participate in generating ideas about positive births, positive reproductive experiences, is a really important approach. Let’s utilize people’s knowledge and vision to create the kind of reproductive care systems that will generate not only better outcomes, but community commitment to those outcomes and the process.”
