Scholar Examines Medical Racism and the Dangers Black Women Face in Childbirth

November 1, 2019

Professor Dána-Ain Davis  discusses her new book, Reproductive Injustice, and how to address the issues it raises.

Dána-Ain Davis (Photo Credit: Alex Irklievski/GC)

Professor Dána-Ain Davis (GC/Queens, Anthropology/Urban Studies), director of the Center for the Study of Women and Society and of The Graduate Center’s M.A. Program in Women’s and Gender Studies, recently published a new book: Reproductive Injustice: Racism, Pregnancy, and Premature Birth.
The book analyzes how racism within the medical profession affects the lives and health of black American women who give birth to premature and low birth weight infants. Davis, who discussed her work at a November 5 book salon with Columbia University’s Vanessa Agard-Jones and Professor Lynn Roberts of CUNY SPH, spoke to The Graduate Center about some of her findings.
The Graduate Center: Recently we’ve seen some media attention on this issue: the inequality in care received by black women during their pregnancies and deliveries. How does your book differ in focus?
Davis: The book is part of the broader conversation around the concept of racial disparities. Where it makes a contribution lies in the fact that the analysis is linked to the concept of the afterlife of slavery. Many of the ways in which black women interpret the medical encounters they have during their pregnancies, deliveries, and postpartum are reminiscent of the practices and ideas that circulated about black women during the same time of enslavement.

GC: Another difference is that unlike many of the recent news stories and features, your book examines the experiences of professional black women, rather than low-income black women. Why did you choose to focus on professional black women?
Davis: When people focus on the birth outcomes of low-income women, they’re also subtly or not so subtly making a judgment about the behavior they associate with being a low-income patient, such as low-income women and smoking, and low-income women and not taking care of themselves nutritionally. It turns out these judgments are not as accurate as people think.
By looking at black women who are professional and have higher degrees of educational attainment I was hoping to shorten the bridge between these two groups of people. Black women with the highest degree of educational attainment and with access to health resources are more likely to have an adverse birth outcome or die from a pregnancy-related cause than white women with the lowest educational attainment. Which suggests that this is not about income or class, only, but that it’s about racism. Not about race; it’s about racism.
GC: That might seem surprising to readers – that, when it comes to pregnancy care, race “preempts” the social capital that usually comes with class benefits.
Davis: We see so much evidence of this, in the stories in the popular press. Like Serena Williams. We think of Kira Johnson, the woman in California whose mother-in-law is a well-known judge, or Shalon Irving, who was an epidemiologist at the CDC. Those latter two died.
Part of this is that the medical profession is simply not attuned to the concerns that black women have about their own bodies, and is much more dismissive to black women when they are talking about their concerns. Access to resources is not a protective mechanism when the institution deploying medical interventions services has in fact choreographed surgeries and experimented on black women’s bodies. There’s plenty of evidence from historians that many of the procedures used in obstetrics and gynecology, particularly in terms of surgeries, was conducted on enslaved black women.
GC: You note in the book that you've made an effort to cite research by black women.
Davis: Several years ago, there was a cite black women movement. It emerged from an article by anthropologist A. Lynn Bolles, “Telling the Story Straight: Black Feminist Intellectual Thought in Anthropology,” in which she described the need to describe, recognize and value the work of black scholars. Then in 2017 another bold scholar, Christen A. Smith, created Cite Black Women as a campaign to encourage people to engage in the radical praxis of citing black women’s intellectual production. It was, however, something I’ve always done. I think it’s fundamentally important to cite people who have been doing work for a really long time, and often receive too little credit for their theoretical contributions. In the academy, we know that a person, almost the entirety of their career, depends on the politics of citation. Since I also believe that the politics of citation is related to the politics of reproduction, what is it that I want to be reproducing in my work? I want to be reproducing a citational practice that pays honor to the people who have been doing work much longer than I have and to people who have just started.
GC: What is the most important change we can make to address this health issue?
Davis: The medical-technological complex needs to think more about how they can collaborate with birthing parents and try not to control the entirety of the process. Many people have argued that part of the reason for many adverse birth outcomes is there’s too much opportunity to suggest interventions that are not always necessary. There are unnecessary interventions in terms of C-sections; epidurals become the norm. I am a practicing doula, and I do assist people in birthing, and I see over and over again that medical professionals attempt to coerce parents to [agree to interventions] to hurry along the process. That can lead to adverse birth outcomes.

If the medical field works more in partnership with parents, we might end up with better outcomes. But more important, we need to have more birthing options. Not everyone needs to be in a hospital. Not everyone needs an obstetrician. Home births are good. Midwives are good. I think what we really need is to have the same reimbursement for a home birth and a birthing center and a hospital, as long as there’s no surgery involved. That’s pretty much what they do in Germany, which has some of the best birthing outcomes in the world.
GC: How does this research relate to your work as director of the M.A. Program in Women and Gender Studies?
Davis: One way that I’ve folded in this area of expertise is through the feminist research methods class that I taught last spring. I structured the class around reproductive justice issues. The students spent an entire semester learning about issues related to reproduction, the ways in which scholars write about reproduction, and methods, and engaged in research for a reproductive justice organization, called Ancient Song Doula in Brooklyn, one of the organizations that appeared in this book.
I also secured a $15,000 grant from the New York Women’s Foundation to send the students to a reproductive justice conference at Hampshire College, where one student presented, and will be sending more students this year, and to send students to the National Women’s Studies Association, of which I am co-chair this year and next year. There were nine students in the class and four of them are presenting at the National Women’s Studies Association conference