Reproductive Injustice: Racism, Pregnancy, and Premature Birth

Anthropologies of American Medicine: Culture, Power, and Practice Series

by Dána-Ain Davis

Winner, 2020 Senior Book Prize, given by the Association of Feminist Anthropology

Winner, 2020 Eileen Basker Memorial Prize, given by the Society for Medical Anthropology

Honorable Mention, 2020 Victor Turner Prize in Ethnographic Writing, given by the Society for Humanistic Anthropology

Finalist, 2020 PROSE Award in the Sociology, Anthropology and Criminology category, given by the Association of American Publishers


A troubling study of the role that medical racism plays in the lives of black women who have given birth to premature and low birth weight infants

Black women have higher rates of premature birth than other women in America. This cannot be simply explained by economic factors, with poorer women lacking resources or access to care. Even professional, middle-class black women are at a much higher risk of premature birth than low-income white women in the United States. Dána-Ain Davis looks into this phenomenon, placing racial differences in birth outcomes into a historical context, revealing that ideas about reproduction and race today have been influenced by the legacy of ideas which developed during the era of slavery.

While poor and low-income black women are often the “mascots” of premature birth outcomes, this book focuses on professional black women, who are just as likely to give birth prematurely. Drawing on an impressive array of interviews with nearly fifty mothers, fathers, neonatologists, nurses, midwives, and reproductive justice advocates, Dána-Ain Davis argues that events leading up to an infant’s arrival in a neonatal intensive care unit (NICU), and the parents’ experiences while they are in the NICU, reveal subtle but pernicious forms of racism that confound the perceived class dynamics that are frequently understood to be a central factor of premature birth.

The book argues not only that medical racism persists and must be considered when examining adverse outcomes―as well as upsetting experiences for parents―but also that NICUs and life-saving technologies should not be the only strategies for improving the outcomes for black pregnant women and their babies. Davis makes the case for other avenues, such as community-based birthing projects, doulas, and midwives, that support women during pregnancy and labor are just as important and effective in avoiding premature births and mortality.

Genres: Nonfiction, Feminism, Medicine, Anti Racist, Race, Womens, Health

272 pages, Hardcover

First published June 25, 2019

Reviews

[Jai · Rating 5 out of 5]

"We need to stop seeing birth as a risk but as a life experience," I absolutely loved this quote. The author gives so much information from her research that if you don't know about some of the subject matter it may be daunting. I came into reading the book as a black birth worker and someone who is knowledgeable about medical racism. However, this book discusses medical racism within the premature birth sphere. The author wrote this book based on several years of research which included shadowing at several hospitals across the country, talking to mothers/parents whose child was born prematurely. She also interviews several doctors on what their thoughts are on medical racism.

As I listened to this book I wondered how I/We in the birth worker community can change some of these outcomes and change medical racism. It all feels like it can't be done until racism in this country is fixed. I am confident that we have radical black doulas and midwives that are working with the black and Latinx communities to change that narrative.

[Kent Adams · Rating 5 out of 5]

So important and enlightening. A great look at medical racism and obstetric violence -- I highly recommend !!

[Colleen · Rating 5 out of 5]

More than any contemporary piece on reproductive issues, I think this text really drives it home that it’s not about class or level of affluence that fuels Black women's disproportionate rate of pregnancy-related deaths compared to white women. It’s about racism from a historically white-dominated, anti-black institution that has always viewed Black women as “intellectually inept, menacing, and generally incapable of mothering” since the time of their enslavement. The resulting neglect, misdiagnosis, violation, and even death are things no mother or child should ever have to contend with. If you doubt the American College of Obstetricians and Gynecologists’ statement that racial bias within the healthcare system is a contributor or that it’s even a factor at all, reading the narratives contained within this book will make your blood boil. Medical racism is very real and must be addressed.

[Ella · Rating 5 out of 5]

Incredible book no notes

[Kat Young · Rating 5 out of 5]

I got this ebook from NetGalley in exchange for an honest review.

What to say about this book? Let me just say that while I considered myself at least somewhat aware of some of these issues, I was not prepared for the heartache I would feel reading this. We have so far to go as a country. So far.

[Lucia Shen · Rating 5 out of 5]

Wow. This book was truly one of the most informative texts I have ever read and has given me so much context on an issue I knew very little about (the birthing experiences of and reproductive justice for Black birthing people in this country).

A big takeaway I had from this text is that the system (our healthcare system specifically but most other systems in the US as well), was never created to benefit Black birthing people. Even with all the fancy technological advances we have that are intended to improve birth outcomes in this country, the subtle (or sometimes blatant) racism towards and neglect of Black people in this country has long-term consequences on birthing people and their children.

Additionally, this text made me think a lot about how we discuss reproduction in general in this country. When we talk about birth in this country, we often discuss the pregnancy or the event of birth but do not seem to care much about the outcomes after. We want to “save” the babies by placing them in NICUs but think little about the long-term consequences of babies who experience traumatic events in the process of trying to “save” them.

There was so much in here that I will use in my own public health practice in terms of how to effectively communicate an issue while providing a wide range of necessary context (personal experiences, national data, organization perspectives, and more) and mobilizing readers toward action. I really enjoyed reading this book and can't wait to discuss it with Dr. Davis!

[Charlee Remitz · Rating 4 out of 5]

3.9*

I don’t know that I’m the best judge of this book. It’s very dense, which to me felt a little counterintuitive to bringing medical racism and reproductive injustice into focus for those of us laymen who want to address racism.

However, I took much away from this read. I found myself realizing that, in a lot of ways, addressing racism addresses myriad issues in our neoliberal society, where intervention is king and prevention is a sore in the backside of capitalism. NICUs, ultrasounds, and other saving technologies are money makers. In much the same way medical providers deflect when asked to address racism, a grand veil has been pulled over the eyes of western humanity. Is it so strange to want to have control over your birth? I felt extraordinary rage reading the stories in these pages. The women who experienced medical racism from the antebellum period and on into the afterlife of slavery. Black women whose partners experienced racism in the delivery room. Black women who were punished for prioritizing natural birth over medicalization.

This is not a class issue. This is racism. Found in every nook and cranny, unaddressed and rampant. I love the idea presented near the end: when seeking medical care, place your emphasis on the care. We could all take something away from this read.

ACAB. Black births matter. And Black women and birthing people matter.

[Caralyn · Rating 5 out of 5]

This book was essential in understanding Black premature births in America. Using the Black Mothers’ perspective in combination with a framework that seeks to understand medical racism in the context of the afterlife of slavery, this book provides a much needed quantitative and qualitative analysis of racialized birth. What really stuck out to me was the emphasis placed on how economic status was an insufficient explanation of the high rates of premature birth rates in Black women, which further emphasized and clarified the separation of class. Davis is a great writer and articulated her points extremely well, it was a very interesting read.

[Nikoya · Rating 5 out of 5]

This was required reading for my Sociology class. Dana-Ain Davis is an accomplished writer and Anthropologist. This was a 7-year journey as she tried to answer why black women are 2 to 3x likely to have a premature birth. Traveling to NICUs, interviewing, scientists, doctors, nurses, and parents. This book should be required reading for any class that is Sociology and truly want to know about how black women and children are suffering. It is important to know how medical racism is thriving in this country.

[babygotbooks · Rating 5 out of 5]

wow...just wow. Dána did an amazing job at illustrating how socioeconomic status and education level don't serve as a buffer from medical racism being experienced by Black women. i think it was also crucial of Dána to have prematurity be one of the books focal points, being that it is one of the leading causes of infant mortality amongst Black women. such a wonderful book. i'm gearing up to become a doula and i would say this book is required reading for those interested in getting involved in birth work.

[Lacy · Rating 5 out of 5]

This is a well written, well researched account on the history of racism as it plays out in pregnancies and premature births. Using historical research alongside personal accounts from people (mostly women) who have experienced various forms of racism during and after their pregnancies.
I recommend for anyone who is interested in this subject. Note: this is more like a textbook, so keep that in mind.

[Sally Kenney · Rating 3 out of 5]

I learned a lot from this book, particularly about the history of the March of Dimes and race. Much of the other information I already knew. The accounts of medical professionals'--doctors and nurses--dismissiveness and retaliation is horrifying, but not unfamiliar.

[Saira · Rating 5 out of 5]

Used this book for my intro to medical anthropology class. The author came to my campus for a book conversation and talk. My students enjoyed speaking to her, the advice she gave, and reading this book.

[Emilee · Rating 5 out of 5]

An important book written by a Black woman using research conducted by Black women about Black women. Eye opening, detailed, sharp in her assessment of the medical industrial complex and the racist implications of the afterlife of slavery within the medical field.

[DM · Rating 4 out of 5]

Read for Med Anth.

[Mandy · Rating 4 out of 5]

A heartbreaking story of the racism women face when being pregnant and having their babies in the NICU.

[Jess · Rating 5 out of 5]

This book makes me want to change careers. 10 stars.

[Leslie · Rating 4 out of 5]

Such interesting and important topics, but challenging to read due to the academic style.

[BooksAreFun · Rating 4 out of 5]

Insightful and educational.

[Sophie Schott · Rating 3 out of 5]

Solid read for AWT project. I wish there was more empirical data but overall helpful read.

[April A · Rating 4 out of 5]

Good, but have read more in-depth coverage of this topic that were better calls to action

[Shaylah · Rating 5 out of 5]

So informative

[Willow Brown · Rating 3 out of 5]

really just bc i had to read this for class and it’s an ethnography which is not my preferred form of book. interesting tho

[Sabrina · Rating 5 out of 5]

another anthro class read. i really enjoyed the historical perspective this took

[Cristie Underwood · Rating 5 out of 5]

This is a book that everyone needs to read, as it is well-researched and gives in-depth information on an issue that many of us think that we know about. Trust me, you don't know half the story. I was shocked at some of the information that was presented. It breaks my heart to know that so many women are treated so unjustly. We need to do better as a Country and reading this book and becoming familiar with this issue is an excellent first step.

[Kaitlyn Nichols · Rating 5 out of 5]

Davis sheds light on the complex issue of prematurity as experienced by Black women. In Part 1, she shows how adverse birth outcomes disproportionately affect Black women in the Afterlife of Slavery by presenting statistics and sharing the birth stories of several Black mothers. In Part 2, Davis provides insight into the strategies implemented to address prematurity and medical racism and critiques their success.

[Monica · Rating 4 out of 5]

Using qualitative interviews, the authors tells the stories of women’s experiences with medical racism and how these experiences have affected the women’s pregnancy outcomes. She also discusses various strategies that could be employed to address health disparities in birth outcomes for BIPOC women.