Do pregnant black women receive worse medical treatment than whites?

In America, data consistently shows that black women experience the highest rates of maternal and infant mortality compared to other ethnicities.

An estimated 2 maternal deaths occur daily among black women in America, according to an Amnesty International report, which also considered that disparities in health outcomes are driven by unequal access to health services.

However, pregnancy and childbirth in America remains a relatively safe experience compared to other world regions. Of the 1000 women who die daily from preventable pregnancy-related causes, 99 percent die in developing countries. Similarly, most neonatal deaths occur in developing countries.

Yet, this safety is not seen in data among black women. Black women in America also have the poorest pregnancy-related outcomes.

The Centers for Disease Control (CDC) encourages research to understand the reasons for ethnic disparities in pregnancy-related outcomes. But evidence as to whether, and how much, racism plays a role in determining these disparities is not readily available.

"African-American women are often made to feel marginalized, stigmatized, and stereotyped because of racism practiced against them," the authors of a paper on African-American women's childbirth preparation argue. "Especially important is identifying ways to decrease racism's negative impact on childbearing families and their preparation for birthing."

Academic literature describing how black American women prepare for childbirth remains very limited, say some researchers.

For black women in Oregon, poor treatment from health providers during pregnancy is suggested as a contributor to poor pregnancy outcomes in preliminary results from the International Center for Traditional Childbirth (ICTC) and Portland State University.

"Many [women] are in the public health care system. They don't have access to or support to take birthing classes or maintain breastfeeding. They often give birth alone with no support besides hospital staff. And, some expressed fear during their time in the hospital based on their treatment," said Shafia Monroe, CEO of ICTC.

ICTC's mission is to increase the number of midwives, doulas, and healers of color, and to empower families in order to reduce maternal and infant mortality.

New findings released this year show the risks and benefits of home birthing in America. The data was compiled from over 2 million live births and presented at the 2012 Society for Maternal-Fetal Medicine.