One Way to Reduce Premature Births? Believe Women

Imagine that six months into a pregnancy, you experience intolerable pain. You rush to the highly regarded hospital your OB/GYN is associated with, where you plan to ultimately give birth. But although you know your own body, how it should feel, and when to be worried about yourself and about your unborn child, the medical personnel meet your report of pain with skepticism.

Rather than determine what is wrong and do everything possible to make you comfortable and protect you and your baby, the doctors turn you away. They assume you are addicted to painkillers and that your visit to the hospital is nothing more than drug-seeking behavior. The pain, caused by pregnancy complications or by a health condition that needs to be addressed, causes a premature birth.

That scenario is all too common to Black women in the United States, where racist attitudes and prejudices constrict medical care to the point of affecting how many babies are brought to full term. According to a January 2021 article published by the Population Research Bureau, 14 percent of Black women have premature births, as compared to 9 percent of white women. The disparity is not due to socioeconomic factors or health habits: being a non-smoker and having a college degree does not assure giving birth to a full-term, healthy baby.  Rather, stressors accruing from racism – such as not being listened to in a doctor’s office – can affect the fetus and trigger premature labor.

Linara Davidson Greenidge, Associate Dean for Communication Strategy, Development and Alumni Affairs here at the Columbia School of Social Work, knows this scenario all too well. Now the mother of two, during her first pregnancy she was denied pain medication for fibroid tumors – a condition she knew she had and knew how to manage – and subjected to unnecessary tests. The pain triggered premature labor. “My son was born at 29 weeks weighing 2 pounds, 14 ounces,” she wrote in a 2021 article for The Grio. “I gave birth early because of malpractice.”

Sociologist Tressie McMillan Cottom, a professor at the University of North Carolina – Chapel Hill, recounted a similar experience in a 2019 essay. Bleeding and in pain four months into her pregnancy, she was put off for three days by her seemingly competent obstetrics office “on the white, wealthy side of town.” There the medical staff blamed her weight, constipation, and indigestion, withholding pain meds and not recognizing that she was in labor. Once she finally was brought to the delivery room, her baby daughter died almost immediately after birth.

“Everything about the structure of trying to get medical care had filtered me through assumptions of my incompetence,” Cottom concluded.

“The games the medical field plays on the bodies of Black women to make us hold the blame is astounding,” says Davidson Greenidge. “I know my body better than the most qualified OB/GYN, and their practice of medicine will only be successful with my partnership.”

Babies born prematurely face a higher risk of death, disability, and chronic disease. Premature birth can also create enduring emotional and economic hardship for the entire family.

No doubt, many of the solutions to the health crisis of premature birth are complex, requiring years of research and testing, great medical skill, and millions of dollars in grant money and development.

But one major solution could not be simpler and costs nothing: Believe women. And in particular, believe Black women.