April 19, 2022
Public health research has generated increasingly sophisticated theories and methods for linking the biological to the social, and for understanding how historical and current forms of discrimination, trauma and injustice find expression in health outcomes. Stark racial disparities in maternal mortality and severe maternal morbidity are particularly appropriate for this exploration because women's sexuality and reproduction has always been a crucial battleground for social control of disadvantaged groups, for assertions of biomedical dominance and professional hierarchies, and for humiliation—and selective celebration—of individuals to further promote specific gender and racial ideologies.Yet, simultaneously, women's sexuality and reproduction has also provided the setting for women to assert their personhood, express their community and cultural solidarity, and define and demand their political and social citizenship. Over the last four decades, women of color have built social movements to link this profound understanding of the personal and political meaning of reproduction to the wider struggle for social justice across a broad range of social institutions where racism finds different forms of expression–schools, police and courts, voting rights and political representation, media and social discourse. The recent surge of attention to what advocates, scholars, politicians and journalists now routinely call the "Black maternal health crisis" helps to create an important opportunity for research to link to action, indeed for research to be action.This report is just one step towards recognition of the role of racism in maternal health. It describes findings from an exploratory, qualitative research study of Black women's experiences during pregnancy and childbirth in Atlanta, which was conducted in 2018 in partnership between Black Mamas Matter Alliance (BMMA), the Averting Maternal Death and Disability (AMDD) program of Columbia University Mailman School of Public Health, Center for Black Women's Wellness (CBWW), and other local community-based organizations. This was part of a larger study conducted in New York City in 2017 (Freedman et. al., 2020). Specifically, the study in Atlanta sought to understand Black women's perceptions of the disrespect and abuse they experienced during pregnancy and childbirth. By focusing on disrespect and abuse during childbirth, the study links to a wider global movement that is mobilizing around the concept of respectful maternity care (Armbruster et. al., 2011). It also constitutes initial steps in pursuit of a wider agenda led by BMMA and women of color organizations that seek to transform knowledge and how it is generated, and by doing so, build power and shift culture, bending the arc of history toward social justice (Aina et. al., 2019).