The Under-Treatment of Black Women's Pregnancy Pain: A Critical Healthcare Gap

The Under-Treatment of Black Women's Pregnancy Pain: A Critical Healthcare Gap

Date: 07 August, 2023 | Blog | Birth Injury | By: Sanga Turnbull

Introduction

It's an unsettling and distressing reality: in the United States, Black women are disproportionately likely to experience severe maternal morbidity and mortality. They are three to four times more likely to die from pregnancy-related complications than their white counterparts. While numerous factors contribute to this grim statistic, one particular issue requires urgent attention—the tendency for the healthcare system to dismiss or under-treat the pain and discomfort reported by Black women during pregnancy. This oversight can lead to catastrophic outcomes such as untreated infections, hemorrhaging, and other severe complications.

Historical Context and Implicit Bias

The dismissal of Black women's pain and discomfort is not an isolated issue but rooted in systemic racial bias that has permeated healthcare institutions for centuries. Stereotypes, misconceptions, and implicit biases about pain tolerance and emotional expression can, consciously or unconsciously, affect the medical care Black women receive.

The infamous 'pain gap' manifests itself in various forms. Sometimes it's as simple yet damaging as the prescribing physician doubting the patient's account of their symptoms. In other instances, it's the hesitation to administer appropriate pain medication or conduct thorough diagnostic tests, perhaps due to unfounded assumptions about the likelihood of drug misuse. These implicit biases compromise not only the quality of care but also the fundamental trust between patient and provider.

Medical Consequences

When a pregnant woman's complaints of pain or discomfort are dismissed, under-treated, or inadequately managed, the medical consequences can be severe, even fatal.

• Untreated Infections: Untreated urinary tract infections (UTIs) are one example. These are relatively common during pregnancy and can lead to more severe conditions like kidney infections if not properly treated. Yet, the pain and discomfort associated with UTIs are often overlooked or misattributed, particularly in Black women.
• Hemorrhaging: Similarly, ignoring complaints related to abdominal or back pain can be deadly if they signal issues like placental abruption, where the placenta detaches from the uterus. This can lead to hemorrhaging—a leading cause of maternal death—and yet it is a condition that can often be managed effectively if caught early.
• Lack of Follow-Up and Monitoring: Inconsistent or poor follow-up for chronic conditions like hypertension or gestational diabetes, which require regular monitoring and medication adjustment, can also lead to severe complications. Here, too, the pain or discomfort expressed by Black women is often not taken as seriously, leading to inadequate follow-up and heightened risks.

BEING YOUR OWN PATIENT ADVOCATE

Addressing this issue necessitates a multi-faceted approach:

1. Awareness and Training: Medical professionals must undergo rigorous sensitivity and implicit bias training.
2. Policy Changes: Institutions should implement clear guidelines for diagnosing and managing pain during pregnancy, including mandatory second opinions for severe cases.
3. Patient Advocacy: Equipping Black women with information, resources, and support networks can empower them to advocate for better care.
4. Research: More comprehensive research must be conducted to understand the nuances of how racial bias affects healthcare delivery during pregnancy.

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