My professor said maybe it has something to do with stress. But for me, that stress, what we knew about stress at the time was more like, “Oh, I’m stressed out.” It’s not a kind of long-term, toxic stress that we later found out was associated with preterm birth, low birth weight and infant mortality.
Then in 1996, when I got pregnant with my first kid, I was surprised that I had something called intrauterine growth restriction [“a condition in which the unborn baby is smaller than expected for his or her gestational age”]. I was eating right. I was exercising. I was publicly talking about good health. I had a really good doctor. I had great health insurance. So I was very surprised when I had a condition that is usually associated with someone that is maybe using drugs and alcohol. I was sent to a perinatologist, a really high-end person, who right away was asking me questions. Do you drink? Do you smoke? Do you use illicit drugs? And I’m looking at her like, are you kidding? No. And because this was such a rare condition, my baby was born right at term, just the day of term. And she was four pounds, 13 ounces. She could fit in the palm of my hand.
I remember thinking back to that low birth weight study and wondering, does this have something to do with that toxic stress that I read about in the earlier research? Since then, I have heard about so many Black women who have had the same condition.
Grose: Along with the toxic, cumulative stress of racism on the health of Black Americans that you talk about in the book, you cataloged so many instances of casual and aggressive disrespect from medical providers, especially toward Black women, during pregnancy and birth. How does it affect Black mothers and babies as they’re experiencing this?
Villarosa: Birth for anyone is difficult, but if you’re being treated unkindly, if you’re not being listened to, if you are meeting your doctor for the first time — which disproportionately happens to Black women — then it makes the birth harder. It makes the birth more difficult and more dangerous. And we’ve seen that. We look no further than Serena Williams. She is someone who should have had every advantage, and also every kind of knowledge about her body, because she’s a professional athlete. But she wasn’t listened to during the birthing process. [In a 2018 profile of Williams, Vogue reported that she experienced shortness of breath while at the hospital recovering from an emergency C-section and worried it was related to her history of blood clots. When she spoke up, a nurse thought that Williams’s pain medication was making her confused. After telling a doctor she needed a CT scan, not the ultrasound that was initially performed, blood clots were found in her lungs and she was put on the heparin drip she had asked for all along.]
If she can’t get this kind of care, then how are average people, average Black women, supposed to get good care in a medical system that, evidence shows, doesn’t always treat us fairly?