Tracing Black Women’s Pain and the Impacts on Black Maternal Health Today
Author: Stephanie Awotwi-Pratt BSc., BA, MA | Editors: Romina Garcia de leon, Janielle Richards (blog coordinators) Reviewer: Tashi Stampp
Note to the readers: This blog discusses difficult subject matter such as sexual violence and enslavement.
Colonialism and the Lasting History of Black Women’s Lives
In the enslavement era, Black women were thought not to experience pain, such that white physicians like Dr. James Marion Sims who founded the field of obstetrics operated on Black enslaved women without pain medication or local anesthesia. Additionally, many white physicians of the 18th and 19th centuries believed that Black women inherently lacked civility thus used enslaved women as sites of medical experimentation.
Also considered “medical superbodies” or medical guinea pigs, the Black enslaved body was hypersexualized and viewed as a living cadaver for white physicians to dissect and extract knowledge used to treat white women of the time. The prevailing assumption by physicians at the time was that enslaved women did not feel “physical pain” in comparison to the civilized white women of the colonial era.
Scholars write about how pregnant enslaved women suffered harsh working conditions and extreme physical labour tasks regardless of their physically vulnerable conditions. The economy of slave production was at the cost of the lives of Black women who were consistently raped to produce free slaves for their white colonial masters, some of which were physicians like James Marion Sims. Sims, who also owned Black slaves at the time, operated on enslaved Black women who often developed a vesicovaginal fistula (VVF), a condition where an opening is formed between the bladder and vagina causing urine to spill into the reproductive tract inducing symptoms of extreme pain and discomfort, impairing their ability to conceive successfully.
Black enslaved women were treated for these conditions without anesthesia or consent. White physicians treated these conditions to ensure enslaved women continued to serve their slave masters. Sims profited from the pain of enslaved women he viewed as medical experiments to bolster his career and facilitated the creation of the modern speculum used today in clinical practice.
Effects on Black Women’s Pain Treatment in Reproductive Healthcare Settings
Today, evident in the results of emerging research in the U.S. and Canada, my research included highlighting Black women and infants experiencing higher incidences of complications and mortality rates. Scholars identify how myths about the Black body and its higher pain threshold are purely “socially constructed” and used to delegitimize the disproportionately high rates of healthcare providers’ dismissal of Black patients’ pain during labour, delivery, and postpartum.
Also known as “obstetric hardiness” Black women are thought to be able to deliver children painlessly. This racist logic that Black women are intrinsically predisposed to make children and endure pain, originates from the colonial justification of sexual violence against Black women which permeates medical systems today. Obstetric racism is the major contributor and reason why medical care providers unconsciously dismiss Black women’s pain if they are trained to believe race-based taken-for-granted truths about the Black maternal body.
How Can the Past Continue to Shape the Future?
My master’s and undergraduate research findings were gathered from 25 qualitative one-on-one interviews. A consistent finding was that Black women feel unheard and dismissed by healthcare providers who perceive Black women to have higher pain tolerances. Despite the participant’s socioeconomic background, occupation, and knowledge of the healthcare system, Black Canadian women continue to receive inadequate and inappropriate pain medications to manage their birth and postpartum. Therefore, the past informs the future.
The torture and treatment of enslaved Black women continue to shape the assumptions providers make about Black women in North America, evidence being the high mortality rates and race-based data gathered in America. For instance, the U.S. Centre for Disease Control and Prevention (CDC) reported that Black women are three times more likely to die of pregnancy-related causes than white women. Maternal health research and continued awareness of the historical legacies of oppression that reinforce medical practices that harm Black women today are prevalent.
Awareness must be drawn on the micro and macro levels of patient and provider interactions that perpetuate dismissal of Black women’s pain in Canada. Equity begins when medical interventions, providers, and medical systems all work together to create safe spaces for Black women to seek care without judgment and adequate maternal health interventions.
Amplifying and developing awareness for the ways Black women have been historically and perpetually marginalized in maternal health spaces directly contributes to addressing systemic and implicit biases. Further action is required with continued research on Black maternal health in Canada, acknowledgement of historical oppression, and future community-driven initiatives that centre Black women’s voices in medicine.
