Bettye Jean Ford was in her second trimester when the pressure she had been feeling in her abdomen for weeks turned to excruciating pain. She rushed to a Los Angeles emergency room, where she was diagnosed with a urinary tract infection and sent home with antibiotics. Still cramping severely, the first-time expectant mother spent the next 24 hours trying to sleep.
The next morning, her obstetrician found her dilated and sent her to the hospital next door where an ultrasound confirmed she was in labor. Rather than being admitted, she was sent back to the clinic with paperwork to finish.
Finally, at 23 weeks and six days, Ford gave birth to a premature baby girl while a nurse told her to close her mouth so as not to scream while pushing. After delivery, the new mother was sedated; her child, whom she had named Kally, had died by the time she awoke.
That was 2006. Since then, California has worked hard to improve health care for pregnant women—so hard, in fact, that the state is now often held up as a national success story in improving maternal outcomes.
But for African American mothers, that improvement has remained elusive. Statewide as well as nationally, black women are substantially more likely than white women to suffer life-threatening complications during pregnancy, give birth prematurely, die in childbirth and lose their babies.
Mortality rates among black infants in California are triple those of white infants, according to state birth records. California Department of Public Health statistics show the rate of preterm births among black mothers to be nearly twice that of white mothers, and the rate of maternal mortality to be quadruple, in part because of complications from underestimated or undiagnosed cardiovascular conditions.
A host of factors underlie this health gap, but studies consistently point to an ugly one: the persistence of racial bias in perinatal care for women of color.