Every woman deserves to give birth
and live to tell it with a healthy baby in her arms.

Check out our FACT SHEET on Unconscious Bias Training

Black women in Virginia dying roughly two and a half times more frequently than their counterparts. Eliminating these disparities necessitates addressing cultural competency and implicit bias in health care settings. Here are a few key biases that negatively impact health care delivery:

  • Racially biased science and medical education: Many biases stem from the history of misusing science to justify slavery and later racial discrimination. One wide-spread false claim perpetuated by physicians in the 1800s was that Black people are less sensitive to pain. In 2016, UVA Professor Sophie Trawalter, Ph.D. documented this false belief in medical students (source). Harm: Black patients are less likely to receive adequate pain treatment. Inadequate pain treatment when warranted could affect maternal morbidity; the use of epidurals in childbirth have been shown to reduce several maternal morbidity (source). Racial bias in pain perception has also been found to lead to underdiagnosis of endometriosis in Black women (source). Late diagnosis of endometriosis affects fertility which can necessitate assisted reproductive technology (ART) to conceive.  ART increases the risk of severe maternal morbidity and mortality. 

  • Adultification: Pervasive stereotypes of Black women that originated in the south during slavery impact how they are treated today. Implicit bias is evident starting at age five. When compared to White girls, starting at age five, Black girls are seen to need less protection, nurturing, support, and comfort. One of three common stereotypes that dates to the time of slavery portrays Black women as loud and aggressive (source). Harm: These negative perceptions contribute to stereotyping and dismissal of Black adult patients experiencing pain and symptoms in a clinical setting. An assertive Black patient who speaks up for their needs may be seen as aggressive or angry instead of an informed patient. The Georgetown Law Center on Poverty and Inequality is a great resource to learn more about Adultification Bias, https://www.endadultificationbias.org/.

  • Racial Bias and Drug Use: Black people are believed to have higher rates of drug use/misuse even though the evidence does not support this belief. HarmNumerous studies have identified racial bias in prenatal drug testing. Black women (not White women) are more likely to be drug tested even though Black patients have been found to have lower rates of positive tests (source). Racial bias that results in testing Black women more frequently harms White women. In Virginia, White women are more likely to have an accidental drug overdose (source). Removing bias from the decision making-process to assess and support pregnant individuals for drug use will help ALL birthing individuals.

Implicit Bias

The Virginia Maternal Mortality Review Team analyzed all cases of pregnancy associated deaths in Virginia and reported the following provider-related factors that contributed to maternal mortality:

  • delay in or lack of diagnosis
  • delay in or lack of treatment
  • delay in or lack of follow-up
  • failure to refer
  • failure to seek consultation