Reproducing while Black: the crisis of Black maternal health, obstetric racism and assisted reproductive technology

Abstract

Black women bear the burden of a number of crises related to reproduction. Historically, their reproduction has been governed in relation to the slave economy, and connected to this, they have been experimented upon and subjected to exploitative medical interventions and policies. Even now, they are more likely to experience premature births and more likely to die from pregnancy-related complications. Their reproductive lives have been beleaguered by racism. This reality, as this article points out, shapes the use of assisted reproductive technology (ART) by Black women. Using the framework of obstetric racism, I suggest that, in addition to the crisis of adverse maternal health outcomes, such as premature birth, low-birthweight infants and maternal death, Black women also face the crisis of racism in their medical encounters as they attempt to conceive through ART. Obstetric racism is enacted on racialized bodies that have historically experienced subjugation, especially, but not solely, reproductive subjugation. In my prior work, I delineated four dimensions of obstetric racism: diagnostic lapses; neglect, dismissiveness or disrespect; intentionally causing pain; and coercion. In this article, I extend that framework and explore three additional dimensions of obstetric racism: ceremonies of degradation; medical abuse; and racial reconnaissance. This article is based on ethnographic work from 2011 to 2019, during which time I collected narratives of US-based Black women and documented the circumstances under which they experienced obstetric racism in their interactions with medical personnel while attempting conception through ART.