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The Pain Gap: How Sexism and Racism in Healthcare Kill Women
Explore real women’s tales of healthcare trauma and medical misogyny with this meticulously researched, in-depth examination of the women’s health crisis in America—and what we can do about it.
When Anushay Hossain became pregnant in the US, she was so relieved. Growing up in Bangladesh in the 1980s, where the concept of women’s healthcare hardly existed, she understood how lucky she was to access the best in the world. But she couldn’t have been more wrong. Things started to go awry from the minute she stepped in the hospital, and after thirty hours of labor (two of which she spent pushing), Hossain’s epidural slipped. Her pain was so severe that she ran a fever of 104 degrees, and as she shook and trembled uncontrollably, the doctors finally performed an emergency C-section.
Giving birth in the richest country on earth, Hossain never imagined she could die in labor. But she almost did. The experience put her on a journey to explore, understand, and share how women—especially women of color—are dismissed to death by systemic sexism in American healthcare.
Following in the footsteps of feminist manifestos such as The Feminine Mystique and Rage Becomes Her , The Pain Gap is an eye-opening and stirring call to arms that encourages women to flip their “hysteria complex” on its head and use it to revolutionize women’s healthcare. This book tells the story of Hossain’s experiences—from growing up in South Asia surrounded by staggering maternal mortality rates to lobbying for global health legislation on Capitol Hill to nearly becoming a statistic herself. Along the way, she realized that a little fury might be just what the doctor ordered.
Meticulously researched and deeply reported, this book explores real women’s traumatic experiences with America’s healthcare system—and empowers everyone to use their experiences to bring about the healthcare revolution women need.
When Anushay Hossain became pregnant in the US, she was so relieved. Growing up in Bangladesh in the 1980s, where the concept of women’s healthcare hardly existed, she understood how lucky she was to access the best in the world. But she couldn’t have been more wrong. Things started to go awry from the minute she stepped in the hospital, and after thirty hours of labor (two of which she spent pushing), Hossain’s epidural slipped. Her pain was so severe that she ran a fever of 104 degrees, and as she shook and trembled uncontrollably, the doctors finally performed an emergency C-section.
Giving birth in the richest country on earth, Hossain never imagined she could die in labor. But she almost did. The experience put her on a journey to explore, understand, and share how women—especially women of color—are dismissed to death by systemic sexism in American healthcare.
Following in the footsteps of feminist manifestos such as The Feminine Mystique and Rage Becomes Her , The Pain Gap is an eye-opening and stirring call to arms that encourages women to flip their “hysteria complex” on its head and use it to revolutionize women’s healthcare. This book tells the story of Hossain’s experiences—from growing up in South Asia surrounded by staggering maternal mortality rates to lobbying for global health legislation on Capitol Hill to nearly becoming a statistic herself. Along the way, she realized that a little fury might be just what the doctor ordered.
Meticulously researched and deeply reported, this book explores real women’s traumatic experiences with America’s healthcare system—and empowers everyone to use their experiences to bring about the healthcare revolution women need.
304 pages, Hardcover
First published October 26, 2021
171 people are currently reading
12500 people want to read
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Displaying 1 - 30 of 337 reviews
January 15, 2024
Interesting read but the description is completely misleading.
The Pain Gap by Anushay Hossain covers a wide range of traditional women's rights issues: abortion, childbirth, paid leave, women and pregnant women being excluded during vaccine testing, domestic violence, and unfair child rearing responsibilities.
Pros:
*Contains some interesting stories from women in their medical journey
*Touches on a multitude of hot topics in the realm of women’s rights
Cons:
*The target audience is not clear. The author spent a great deal of time discussing proposed policy issues and introducing a large number of organizations. This information was extremely boring. Women struggling with a health condition need help now, not wait for some policy which may or may not go into effect.
*The author spent considerable time on the issue of mental health and cited how women and WOC have such a high rate of depression. However, these statistics are greatly exaggerated because doctors overprescribe antidepressants. If a woman walks in with a difficult health problem, it is extremely easy to label her as “crazy” and write a script for an antidepressant.
*This book was billed as “The Pain Gap: How Sexism and Racism in Healthcare Kill Women.” However, most of the book did not cover this issue. Instead, it was a feminist manifesto (which I have absolutely no problem with) but it wasn’t as good as the book, White Feminism by Koa Beck.
Being through the health system this last year, I actually have put together my own list of tips that I will include at the very end of this review because the sick and dying can’t wait.
Overall, the author and I share many of the same ideologies; however, the book would have been better if the author had focused more on sharing the stories of women in their healthcare journey instead of a broad issue book covering nearly every women’s issue.
*Thanks, NetGalley, for a free copy of this book in exchange for my fair and honest opinion.
Tips For Your Healthcare Journey:
1) If you can afford it, hire a Private Patient Advocate. These are some of the things that my advocate has done for me:
a. Finds and schedules high quality doctors who are professional, respectful, and won’t stop until they find out what is going on.
b. Moves me up off the waitlists. Who can wait 2 years to see a doctor?
c. Reviews my medical records and prepares me for what to expect for my appointments.
d. She can get on the phone with my doctors and ask medical questions and let them know that they need a better plan and question if they have considered all alternatives.
2) You have to be your own doctor. Read as many health articles as you can. Stand your ground. Many, many doctors simply don’t care about your pain or how difficult your life is. However, if you quote medical articles to them, it is extremely difficult for them to brush you off as crazy.
a. Talk to other people on Reddit (ask questions and find support). Find out who the good doctors are and who to avoid like the plague.
3) If your doctor says that you are depressed or have a “Functional Neurological Disorder”, question that diagnosis.
4) Never give up on yourself. If you aren’t getting answers that make sense or you have a poor quality of life, see someone else (another doctor, nurse, physical therapist, acupuncturist).
5) Really inform yourself about labor if you are expecting because you can’t rely on the doctors being honest or explaining all of your choices. If you go to a large OB practice, there will be no continuity of care because you will see a new doctor at every appointment. Some of these doctors will literally schedule you for a 5-minute appointment. When you go into labor, you might end up with a doctor who you have never met before, and the doctor will only appear once the baby is crowning. At least with a midwife, they will take you through your entire labor, and you can be assigned to one person instead of being passed around like a hot potato to so many different doctors.
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The Pain Gap by Anushay Hossain covers a wide range of traditional women's rights issues: abortion, childbirth, paid leave, women and pregnant women being excluded during vaccine testing, domestic violence, and unfair child rearing responsibilities.
Pros:
*Contains some interesting stories from women in their medical journey
*Touches on a multitude of hot topics in the realm of women’s rights
Cons:
*The target audience is not clear. The author spent a great deal of time discussing proposed policy issues and introducing a large number of organizations. This information was extremely boring. Women struggling with a health condition need help now, not wait for some policy which may or may not go into effect.
*The author spent considerable time on the issue of mental health and cited how women and WOC have such a high rate of depression. However, these statistics are greatly exaggerated because doctors overprescribe antidepressants. If a woman walks in with a difficult health problem, it is extremely easy to label her as “crazy” and write a script for an antidepressant.
*This book was billed as “The Pain Gap: How Sexism and Racism in Healthcare Kill Women.” However, most of the book did not cover this issue. Instead, it was a feminist manifesto (which I have absolutely no problem with) but it wasn’t as good as the book, White Feminism by Koa Beck.
Being through the health system this last year, I actually have put together my own list of tips that I will include at the very end of this review because the sick and dying can’t wait.
Overall, the author and I share many of the same ideologies; however, the book would have been better if the author had focused more on sharing the stories of women in their healthcare journey instead of a broad issue book covering nearly every women’s issue.
*Thanks, NetGalley, for a free copy of this book in exchange for my fair and honest opinion.
Tips For Your Healthcare Journey:
1) If you can afford it, hire a Private Patient Advocate. These are some of the things that my advocate has done for me:
a. Finds and schedules high quality doctors who are professional, respectful, and won’t stop until they find out what is going on.
b. Moves me up off the waitlists. Who can wait 2 years to see a doctor?
c. Reviews my medical records and prepares me for what to expect for my appointments.
d. She can get on the phone with my doctors and ask medical questions and let them know that they need a better plan and question if they have considered all alternatives.
2) You have to be your own doctor. Read as many health articles as you can. Stand your ground. Many, many doctors simply don’t care about your pain or how difficult your life is. However, if you quote medical articles to them, it is extremely difficult for them to brush you off as crazy.
a. Talk to other people on Reddit (ask questions and find support). Find out who the good doctors are and who to avoid like the plague.
3) If your doctor says that you are depressed or have a “Functional Neurological Disorder”, question that diagnosis.
4) Never give up on yourself. If you aren’t getting answers that make sense or you have a poor quality of life, see someone else (another doctor, nurse, physical therapist, acupuncturist).
5) Really inform yourself about labor if you are expecting because you can’t rely on the doctors being honest or explaining all of your choices. If you go to a large OB practice, there will be no continuity of care because you will see a new doctor at every appointment. Some of these doctors will literally schedule you for a 5-minute appointment. When you go into labor, you might end up with a doctor who you have never met before, and the doctor will only appear once the baby is crowning. At least with a midwife, they will take you through your entire labor, and you can be assigned to one person instead of being passed around like a hot potato to so many different doctors.
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April 21, 2022
A very important and broad topic but I feel like the book barely scrapes the surface.
Well written/good audiobook, still worth a read!
Well written/good audiobook, still worth a read!
April 29, 2024
Very vote blue no matter who vibes also Joe Biden is a rapist last time I checked so positing him as a feminist politician who cares about women’s rights is interesting…. American journalism is deeply suspect
December 4, 2021
This book starts off pretty strong and unfortunately devolves.
I think one of the issues with this book is that it’s marketed incorrectly. The majority of this book is centered on the COVID-19 pandemic, and feels almost TOO current. While the information in this book is definitely worth acknowledging and reading about, there are sections that seem like they may be irrelevant when the pandemic is over (if it ever truly ends).
Much of the information in this book is very necessary and needs to be talked about, especially the stories about specific women’s experiences.
My biggest complaint, however, is that this book comes across as very disorganized and jumbled, as well as having a lot of repeated information/anecdotes. The author constantly is referring back to her pregnancy experience, but never really adding to the original story she began with, just repeating the same story. There are other examples of repeating the same/similar anecdotes or information that comes across as being filler, rather than adding to the book.
Good idea, not the greatest execution, inaccurate marketing.
I think one of the issues with this book is that it’s marketed incorrectly. The majority of this book is centered on the COVID-19 pandemic, and feels almost TOO current. While the information in this book is definitely worth acknowledging and reading about, there are sections that seem like they may be irrelevant when the pandemic is over (if it ever truly ends).
Much of the information in this book is very necessary and needs to be talked about, especially the stories about specific women’s experiences.
My biggest complaint, however, is that this book comes across as very disorganized and jumbled, as well as having a lot of repeated information/anecdotes. The author constantly is referring back to her pregnancy experience, but never really adding to the original story she began with, just repeating the same story. There are other examples of repeating the same/similar anecdotes or information that comes across as being filler, rather than adding to the book.
Good idea, not the greatest execution, inaccurate marketing.
November 2, 2022
This was another audiobook I picked at random while browsing my library catalog but it instantly felt like it was something I’ll like reading. And it was an interesting mix.
I absolutely loved reading the personal stories - both of the author and her mom back in Bangladesh and the conditions of healthcare, especially for women. I felt very sympathetic to the situation because until a few decades ago, it was pretty much the same in India as well. But it was the chapters about how racism and misogyny drastically affects the health outcomes for women of color in America that hit me hard. Just like the author, I never expected that this was the reality in the richest country in the world, and though I’ve personally not experienced anything of such sort, it’s hard to digest that many women suffer so much just to get the right diagnosis or medication. I’ve read numerous horror stories from women on Twitter and this book reinforced the same. And I absolutely detested the chapter about the global gag rule and how US govt uses its monetary aid as a tool to impose its religious hegemony over the poor and destitute countries in the world, negatively impacting the thousands and millions of women who actually need that aid.
I didn’t realize that this book would include issues that women of color have faced during this pandemic. I guess I just didn’t see when it released. These were some heartbreaking stories. But many of the chapters then talk about the policy issues on a more broader level and it felt like a disconnect from the other half of the book which was about women’s stories. While I appreciate everything the author talks about policy changes that need to be made at the federal and state level to better the health outcomes of women of color, I also felt that it missed the point which the personal experiences in the book were making - any amount of policy changes can’t change the bias and prejudice and discrimination that exists in medicine and it’s practitioners because racism and misogyny is so entrenched in the system. It needs both a change at the education level to remove bias from the teachings at medical school, as well as a personal reckoning for all the doctors and other medical staff with their own prejudices. And the women advocating for their own health can definitely use some pointers in how to do it in a way that they are heard by the doctors and treated with the dignity and respect they deserve.
Overall, this was an informative but difficult read and I learnt quite a bit which I didn’t know. But I also thought it was a bit too broad for it’s short length and couldn’t cover everything it needed to in a succinct manner. However, I would still suggest you check it out if it’s a topic that interests you.
I absolutely loved reading the personal stories - both of the author and her mom back in Bangladesh and the conditions of healthcare, especially for women. I felt very sympathetic to the situation because until a few decades ago, it was pretty much the same in India as well. But it was the chapters about how racism and misogyny drastically affects the health outcomes for women of color in America that hit me hard. Just like the author, I never expected that this was the reality in the richest country in the world, and though I’ve personally not experienced anything of such sort, it’s hard to digest that many women suffer so much just to get the right diagnosis or medication. I’ve read numerous horror stories from women on Twitter and this book reinforced the same. And I absolutely detested the chapter about the global gag rule and how US govt uses its monetary aid as a tool to impose its religious hegemony over the poor and destitute countries in the world, negatively impacting the thousands and millions of women who actually need that aid.
I didn’t realize that this book would include issues that women of color have faced during this pandemic. I guess I just didn’t see when it released. These were some heartbreaking stories. But many of the chapters then talk about the policy issues on a more broader level and it felt like a disconnect from the other half of the book which was about women’s stories. While I appreciate everything the author talks about policy changes that need to be made at the federal and state level to better the health outcomes of women of color, I also felt that it missed the point which the personal experiences in the book were making - any amount of policy changes can’t change the bias and prejudice and discrimination that exists in medicine and it’s practitioners because racism and misogyny is so entrenched in the system. It needs both a change at the education level to remove bias from the teachings at medical school, as well as a personal reckoning for all the doctors and other medical staff with their own prejudices. And the women advocating for their own health can definitely use some pointers in how to do it in a way that they are heard by the doctors and treated with the dignity and respect they deserve.
Overall, this was an informative but difficult read and I learnt quite a bit which I didn’t know. But I also thought it was a bit too broad for it’s short length and couldn’t cover everything it needed to in a succinct manner. However, I would still suggest you check it out if it’s a topic that interests you.
March 3, 2022
Let me start by saying this is such an important topic, and one that I strongly believe needs to be discussed more. However, if someone were to ask me if I recommended this book to learn more about how racism and sexism affect people in healthcare, I would say absolutely not.
For starters, the synopsis is not entirely accurate. While the author does discuss racism and sexism in healthcare, there are so many tangents into different topics that it's not effective. It is also incredibly surface-level, and doesn't dive into the topic nearly as much as I hoped it would.
There was so much political talk in this book, and while that could have been incredibly productive to the topic, it was not used that way. It really boiled down to a lot of undeserved praise for Biden. For a book that talks about the importance of "believing women" it wasn't very convincing when she had so many positive things to say about our current president.
Lastly, there was inconsistent usage of inclusive language in this book. At certain points the author would use the term "pregnant people/person" and the rest of the time only used "pregnant women." Consistently using inclusive language would have been nice to see.
For starters, the synopsis is not entirely accurate. While the author does discuss racism and sexism in healthcare, there are so many tangents into different topics that it's not effective. It is also incredibly surface-level, and doesn't dive into the topic nearly as much as I hoped it would.
There was so much political talk in this book, and while that could have been incredibly productive to the topic, it was not used that way. It really boiled down to a lot of undeserved praise for Biden. For a book that talks about the importance of "believing women" it wasn't very convincing when she had so many positive things to say about our current president.
Lastly, there was inconsistent usage of inclusive language in this book. At certain points the author would use the term "pregnant people/person" and the rest of the time only used "pregnant women." Consistently using inclusive language would have been nice to see.
January 23, 2022
(3.25)
A good read, with smart points, arguments and statistics that I wasn’t familiar with before. Good approach to the intersectionality of racism, sexism and ableism. However, I’d highlight the feminism as the more prominent voice.
Didn’t know it would focus so much on covid-19, but makes sense that it does. It’s important to discuss the impact of this pandemic in healthcare systems, namely how it aggravates inequalities that existed before. The chapter that aimed to focus only on the gendered impact of the pandemic and lockdown was my favourite actually. I’m only disappointed that the following chapters became a little repetitive and didn’t bring many new arguments to the table, ending up repeating the same issues and pressing again on the covid issue.
As a woman with autoimmune and chronic illnesses I found this a necessary read and a good conversation starter.
A good read, with smart points, arguments and statistics that I wasn’t familiar with before. Good approach to the intersectionality of racism, sexism and ableism. However, I’d highlight the feminism as the more prominent voice.
Didn’t know it would focus so much on covid-19, but makes sense that it does. It’s important to discuss the impact of this pandemic in healthcare systems, namely how it aggravates inequalities that existed before. The chapter that aimed to focus only on the gendered impact of the pandemic and lockdown was my favourite actually. I’m only disappointed that the following chapters became a little repetitive and didn’t bring many new arguments to the table, ending up repeating the same issues and pressing again on the covid issue.
As a woman with autoimmune and chronic illnesses I found this a necessary read and a good conversation starter.
July 26, 2022
I’m so disappointed in the execution of this book. It is such an important topic that needs global attention. This however felt more like a personal rant on a few statistics that were looked at once.
So yes the topic is super important. I just would not recommend reading this book if you want to learn more on the subject.
So yes the topic is super important. I just would not recommend reading this book if you want to learn more on the subject.
January 26, 2023
Super important topic and definitely something I want to dive into, so for me a good book to start with. It introduces you to many of the problem women, people from the LGBTQI+ community and especially women of color face. It started out interesting with a lot of stories from different people, but in the end it started to repeat itself a bit too much. This topic is of course super broad and Hossain focuses mostly on maternal health especially during Covid-19. But the book is also a bit all over the place, from domestic violence to vaccinations to mental health problems during Covid-19, and it felt a bit messy. The books stays very on the surface and for that it's good as an introduction, but not for a deep dive into this topic.
3 stars
3 stars
August 8, 2025
everyone needs to read this! very well written and well researched! it’s heartbreaking and rage inducing but an important read. i learned SO MUCH from this book. it is infuriating to know this will continue to worsen under the current administration.
“Being a woman in America is already fraught; being a sick woman in America is doubly difficult. You aren’t believed, or you’re condescended down to. Your pain is treated as hysteria, your physical symptoms as signs of mental duress rather than authentic illness. For women who aren’t white, or straight, or upper middle class, the judgement is that much harsher and the consequences that much more serious.”
“As Americans, we have a responsibility to educate ourselves about how US foreign policy impacts women and girls globally because what happens here matters for women's rights around the world. When we vote in the United States, we are not only voting for ourselves. We are voting for women's rights globally. That's how powerful our politics and American policies are.”
"The American healthcare system is no different than any other American system," Moezzi told me in an interview. "It is a system that was designed to perpetuate broader societal values and biases, including racism, sexism, heteronormativity... It is a system intended to benefit some over others, because—like the American criminal justice and the educational systems—the American healthcare system does not value all lives equally... It is a system that values white, male, wealthy, straight, cisgender, able-bodied, neurotypical individuals above all others.”
“Being a woman in America is already fraught; being a sick woman in America is doubly difficult. You aren’t believed, or you’re condescended down to. Your pain is treated as hysteria, your physical symptoms as signs of mental duress rather than authentic illness. For women who aren’t white, or straight, or upper middle class, the judgement is that much harsher and the consequences that much more serious.”
“As Americans, we have a responsibility to educate ourselves about how US foreign policy impacts women and girls globally because what happens here matters for women's rights around the world. When we vote in the United States, we are not only voting for ourselves. We are voting for women's rights globally. That's how powerful our politics and American policies are.”
"The American healthcare system is no different than any other American system," Moezzi told me in an interview. "It is a system that was designed to perpetuate broader societal values and biases, including racism, sexism, heteronormativity... It is a system intended to benefit some over others, because—like the American criminal justice and the educational systems—the American healthcare system does not value all lives equally... It is a system that values white, male, wealthy, straight, cisgender, able-bodied, neurotypical individuals above all others.”
December 30, 2023
Ive had this book on my to read list ever since it came out. I knew there was medical care gap with women and POC, and I felt that if I was going to go into healthcare, I needed to be aware of it. Some of the chapters do not have easy fixes, but some are doable starting now. I also felt like the first couple pages of the book made it sound like it would be more politically charged than the majority of the book was. Unfortunately sex and race are just going to be considered political topics, but the majority of the book focused on medicinal barriers, especially those concerning pregnancy, birth, and postpartum discrepancies.
My two big takeaways:
- Women are often not believed. If they do not voice their discomfort and pain enough, many doctors assume that they are not in a lot of pain. If they voice their discomfort and pain too loudly, their reports often mark them as combative and aggressive. Not believing women increases in the amount of serious conditions that go undiagnosed.
- One of the main reasons we have a gap in womens health is because there is literally a gap in our knowledge of womens health. Until more recently (still an issue now), women and pregnant women have been excluded from clinical trials. A medication might work well for men, but that doesn’t mean it will work well for women. Male symptoms of heart conditions can be very different than women symptoms, which also increases the amount of undiagnosed issues.
My two big takeaways:
- Women are often not believed. If they do not voice their discomfort and pain enough, many doctors assume that they are not in a lot of pain. If they voice their discomfort and pain too loudly, their reports often mark them as combative and aggressive. Not believing women increases in the amount of serious conditions that go undiagnosed.
- One of the main reasons we have a gap in womens health is because there is literally a gap in our knowledge of womens health. Until more recently (still an issue now), women and pregnant women have been excluded from clinical trials. A medication might work well for men, but that doesn’t mean it will work well for women. Male symptoms of heart conditions can be very different than women symptoms, which also increases the amount of undiagnosed issues.
February 23, 2022
4.5. tragic and heartbreaking and angering and horrible and inspiring and real and validating.
Read
April 24, 2022Rating - N/A
The pain gap was a very eye opening book for me. The author, Anushay Hossain is clear about what she wants to discuss and bring out in this book.
I agree with other reviews addressing the fact that the blurb did not justify the range of topics that this book covers. Hossain is primarily focused on maternal health and the healthcare system in America. However, she also focuses on other topics like racial prejudice that is still inherent and how it affects maternal health for women of colour, the effects that the pandemic has had on women in domestic settings, including mental health topics like depression, the stress caused by women forced into the role of primary caregiver in the family, as well as domestic violence which she calls the "shadow pandemic".
The stories and case studies she brings out in the book had me invested in the topic for the entirety of the book. However, the one drawback for me with this book was that I didn't find it very relatable as it mainly focuses on the issues faced in America.
I did read some reviews where they had warned me that the discussions that Hossain presents on the various policies in place as well as the ones that are being developed were boring. But i couldn't agree less with this kind of thought. I would rather say that the discussions on the major policies which the author hoped would change the situation were not relatable to me as I am not an American.
But these policies need to be highlighted and will probably be helpful for women or anyone who will benefit from it in America.
The author brings forth the following conversation anticipating that the topics she discusses in this book may not be very relatable to people from other countries, she noted : " But one woman asked me how a book on women's health in America would make any difference for a Bangladeshi woman. Her question gave me pause. Then I answered that if we can't rectify women's health and human rights in America, women in the rest of the world will effectively be 'screwed'. "
While this is a very condescending thought and I'm always sceptical about all this talk about - 'if the developed nations have it bad, the developing nations will have it worse', I would believe that anyone reading this book will no longer have the misconception that everything is the far west, the developed nations and America is perfect.
Hossain follows these thoughts by noting :
" I was reminded of how we are all connected......... Sisterhood is truly global, and if there has ever been a time for women to tap into our collective power, it is now because the need to revolutionize women's healthcare is urgent. "
This is a very good conclusion to this book as I believe that even if not everyone may relate to the problems from the first world countries, it is undeniable that women globally face many issues on a day to day basis and it is high time that we also speak up and prioritize women's healthcare and maternal healthcare.
The pain gap was a very eye opening book for me. The author, Anushay Hossain is clear about what she wants to discuss and bring out in this book.
I agree with other reviews addressing the fact that the blurb did not justify the range of topics that this book covers. Hossain is primarily focused on maternal health and the healthcare system in America. However, she also focuses on other topics like racial prejudice that is still inherent and how it affects maternal health for women of colour, the effects that the pandemic has had on women in domestic settings, including mental health topics like depression, the stress caused by women forced into the role of primary caregiver in the family, as well as domestic violence which she calls the "shadow pandemic".
The stories and case studies she brings out in the book had me invested in the topic for the entirety of the book. However, the one drawback for me with this book was that I didn't find it very relatable as it mainly focuses on the issues faced in America.
I did read some reviews where they had warned me that the discussions that Hossain presents on the various policies in place as well as the ones that are being developed were boring. But i couldn't agree less with this kind of thought. I would rather say that the discussions on the major policies which the author hoped would change the situation were not relatable to me as I am not an American.
But these policies need to be highlighted and will probably be helpful for women or anyone who will benefit from it in America.
The author brings forth the following conversation anticipating that the topics she discusses in this book may not be very relatable to people from other countries, she noted : " But one woman asked me how a book on women's health in America would make any difference for a Bangladeshi woman. Her question gave me pause. Then I answered that if we can't rectify women's health and human rights in America, women in the rest of the world will effectively be 'screwed'. "
While this is a very condescending thought and I'm always sceptical about all this talk about - 'if the developed nations have it bad, the developing nations will have it worse', I would believe that anyone reading this book will no longer have the misconception that everything is the far west, the developed nations and America is perfect.
Hossain follows these thoughts by noting :
" I was reminded of how we are all connected......... Sisterhood is truly global, and if there has ever been a time for women to tap into our collective power, it is now because the need to revolutionize women's healthcare is urgent. "
This is a very good conclusion to this book as I believe that even if not everyone may relate to the problems from the first world countries, it is undeniable that women globally face many issues on a day to day basis and it is high time that we also speak up and prioritize women's healthcare and maternal healthcare.
August 4, 2024
I was very excited to read this book and as I continued to read, the more disappointed I became. The main issue with this book is that’s it’s marketed incorrectly, it quite honestly should’ve been marketed as the effect COVID had on women.
The other issues is that the author discusses complex issues without giving proper exploration to the intersectionality of those issues. For example, she spends quite a bit of time complaining about how pregnant women weren’t included in COVID vaccine trials but just chalks it up to scientists being lazy. Perhaps it’s my bias in being in a healthcare graduate program, but it’s lazy to chalk it up to scientists being lazy. Research has a lot of hurdles to jump over in order to get approved. And with the COVID vaccine being in such high demand during the pandemic, I could only assume they wanted to eliminate as many of those hurdles as possible. One of the ways to do this is through not including vulnerable populations, which pregnant women currently fall under. I think a more interesting and better way to explore this in her book would’ve been to look into why that is, why do we label them a vulnerable population and what are the reasons to change that?
Finally, the author quotes a lot of research but then makes several claims that are not backed by research, is distracted easily and goes on several political tangents, and blames the government too much for things that are much more intersectional in nature. She also does a little too much partner/male blaming for things: for example, the way she writes about how she was the main caretaker for her children during COVID and then threatened to divorce her husband seemed very jarring and had me wondering where their open communication was throughout the whole process. It was an example, to me, not of sexism but of not communicating and just assuming with your partner.
She brings up valid arguments and interesting points such as in relation to women in the workforce and how COVID magnified the roles we give people. However, she missed the mark with what this book is marketed to be.
The other issues is that the author discusses complex issues without giving proper exploration to the intersectionality of those issues. For example, she spends quite a bit of time complaining about how pregnant women weren’t included in COVID vaccine trials but just chalks it up to scientists being lazy. Perhaps it’s my bias in being in a healthcare graduate program, but it’s lazy to chalk it up to scientists being lazy. Research has a lot of hurdles to jump over in order to get approved. And with the COVID vaccine being in such high demand during the pandemic, I could only assume they wanted to eliminate as many of those hurdles as possible. One of the ways to do this is through not including vulnerable populations, which pregnant women currently fall under. I think a more interesting and better way to explore this in her book would’ve been to look into why that is, why do we label them a vulnerable population and what are the reasons to change that?
Finally, the author quotes a lot of research but then makes several claims that are not backed by research, is distracted easily and goes on several political tangents, and blames the government too much for things that are much more intersectional in nature. She also does a little too much partner/male blaming for things: for example, the way she writes about how she was the main caretaker for her children during COVID and then threatened to divorce her husband seemed very jarring and had me wondering where their open communication was throughout the whole process. It was an example, to me, not of sexism but of not communicating and just assuming with your partner.
She brings up valid arguments and interesting points such as in relation to women in the workforce and how COVID magnified the roles we give people. However, she missed the mark with what this book is marketed to be.
This entire review has been hidden because of spoilers.
November 11, 2022
My thanks to NetGalley and Tiller/Simon and Schuster Element for an eARC of this book to read and review. My thanks to libro.fm and Simon and Schuster Audio for an advanced Audio of this book to listen to and review.
Other reviewers complained that the title and subtitle, what the reader is promised, is not what the reader is provided once a few chapters into the book. I would tend to agree. I got 75% of the way into the book and decided that police brutality had next to nothing to do with how sexism and racism in health care is killing women and DNF'd this.
That is sad, as this book had great potential to bring the difference between how women are treated by the medical establishment and how men are treated is incredibly different and how that difference is killing women.
I am ok with politics coming into play within the scope of the thesis expressed in the title, but I did not sign up for social justice/racism/police brutality too. Those things have their place, and that place does not seem to be this particular book. Yes, I know that the author has little say in what the title of the book is, but from her introduction, the title seemed to be the thesis. Then she got distracted and that is where she lost me.
I fully believe and support her thesis, but we need clear and concise reasoning to have those who are on the fence or even opposed to that thesis to listen and maybe even understand, if not agree with it. But when tangents that have nothing to do with it are brought in, you lose even those who would follow you.
2, this had promise, stars.
Other reviewers complained that the title and subtitle, what the reader is promised, is not what the reader is provided once a few chapters into the book. I would tend to agree. I got 75% of the way into the book and decided that police brutality had next to nothing to do with how sexism and racism in health care is killing women and DNF'd this.
That is sad, as this book had great potential to bring the difference between how women are treated by the medical establishment and how men are treated is incredibly different and how that difference is killing women.
I am ok with politics coming into play within the scope of the thesis expressed in the title, but I did not sign up for social justice/racism/police brutality too. Those things have their place, and that place does not seem to be this particular book. Yes, I know that the author has little say in what the title of the book is, but from her introduction, the title seemed to be the thesis. Then she got distracted and that is where she lost me.
I fully believe and support her thesis, but we need clear and concise reasoning to have those who are on the fence or even opposed to that thesis to listen and maybe even understand, if not agree with it. But when tangents that have nothing to do with it are brought in, you lose even those who would follow you.
2, this had promise, stars.
This entire review has been hidden because of spoilers.
October 27, 2021
The Pain Gap illustrates the gap in medical care women in America, and more so women of color in America, face. It uses statistics and anecdotes from women who have experience poor medical care, particularly maternity care. It's a difficult read that tries to find balance between honestly illustrated the problem, without leaving the reader feeling hopeless. Hossain does a good job of balancing what individual women can do to advocate for themselves, while also acknowledging that systemic problems like the bias in maternal healthcare can't be fixed just by individuals advocating for themselves, but by systemic change.
February 24, 2023
Wasn’t a huge fan of this one. I feel like the reviews that said it was marketed wrong were correct. It wasn’t really about women’s pain and struggles with healthcare. Or I guess it sort of was… but it was so much about COVID that it wasn’t. Also we are passed the point this was written so many of her points were essentially irrelevant.
October 26, 2024
2.5 rounded downThis was fine, but I think somewhat skewed expectations prevented me from fully loving it. The focus here was overwhelmingly on pregnancy-related issues, and while I think that is absolutely a critical aspect of female health, I did wish it was less overwhelmingly the focus. Other type of pain and ways women interact with the medical system are mentioned, but somehow it always came back to pregnancy. Even in the conclusion when there's a section on how to advocate for yourself with medical professionals, almost every single one of the suggestions was specifically geared towards doing so in the context of pregnancy. As somebody who does not personally plan to become pregnant, I'd picked up this book hoping for a broader discussion of women's health, and I wish the subtitle had made it clearer that this really was mostly focused on the ways in which America's medical system specifically fails pregnant people, and not really so much women overall. This also came out in 2021 and feels very tied to COVID-19 and the various issues during the pandemic. While that stuff is still relevant, it did feel a little dated being so strongly tied to a very specific moment in time. Finally, there was a lot more overt political stuff than anticipated. Not a problem for me, but again, it ended up making it feel very dated given specific references to political candidates in office, etc. I think it weakens the book to be so specifically tied to particular years, because it makes it feel like, now that we are no longer in the same climate described in the book, is everything else still applicable? I thought this was OK, but it wasn't quite what I wanted.
November 5, 2021
If this doesn’t make you furious… I’m not sure what will. It’s time to stand up for what’s right!
The Pain Gap solidified I’m not alone, by exploring how sexism & racism in healthcare endanger and kill women, especially women of color, in America.
🙅🏻♀️I’m aware of this disparity. Many of us are. I’ve suffered from it tremendously. Friends of mine have too. But after reading this book, and the stories of SO MANY other women, the lack of adequate research and the vast absence of empathy in the American health system I’m not mad, I’m furious. I’m screaming mad. Crying hysterically mad… and if you’re a woman, or love a woman, you should be too.
🙅🏻♀️This book has content warnings galore. Racism. Sexism. Death. Maternal mortality. Medical trauma. Misogyny. But how could it not? If a nonfiction book is going to even dip a toe into the healthcare industry it wouldn’t be possible not to. Which is why this book is so important to read. Knowledge is power. We must arm ourselves with knowledge in order to stand up for ourselves and advocate for our health… and the heath of all women.
🙅🏻♀️Think I’m over exaggerating? Did you know in 1986 a study was conducted on a group of MEN to explore how obesity impacts breast and uterine cancer? For those in the back, men don’t have a uterus.
Hossain has done a fantastic job compiling a ton of information, both through research and anecdotal to tear down the veil and expose the disparities in our health system. She then discusses how to advocate for ourselves, loved ones, and for a real change in the medical industry itself. I do feel there could be a bit of an edit, some chapters do carry on a bit, and for the average reader a cleaner more precise focus would be more effective… but overall this was still a fantastic read that I recommend everyone to add to their TBR.
Thank you @anushayhossain @netgalley & @tillerpress for the eARC in exchange for my fair and honest review.
The Pain Gap solidified I’m not alone, by exploring how sexism & racism in healthcare endanger and kill women, especially women of color, in America.
🙅🏻♀️I’m aware of this disparity. Many of us are. I’ve suffered from it tremendously. Friends of mine have too. But after reading this book, and the stories of SO MANY other women, the lack of adequate research and the vast absence of empathy in the American health system I’m not mad, I’m furious. I’m screaming mad. Crying hysterically mad… and if you’re a woman, or love a woman, you should be too.
🙅🏻♀️This book has content warnings galore. Racism. Sexism. Death. Maternal mortality. Medical trauma. Misogyny. But how could it not? If a nonfiction book is going to even dip a toe into the healthcare industry it wouldn’t be possible not to. Which is why this book is so important to read. Knowledge is power. We must arm ourselves with knowledge in order to stand up for ourselves and advocate for our health… and the heath of all women.
🙅🏻♀️Think I’m over exaggerating? Did you know in 1986 a study was conducted on a group of MEN to explore how obesity impacts breast and uterine cancer? For those in the back, men don’t have a uterus.
Hossain has done a fantastic job compiling a ton of information, both through research and anecdotal to tear down the veil and expose the disparities in our health system. She then discusses how to advocate for ourselves, loved ones, and for a real change in the medical industry itself. I do feel there could be a bit of an edit, some chapters do carry on a bit, and for the average reader a cleaner more precise focus would be more effective… but overall this was still a fantastic read that I recommend everyone to add to their TBR.
Thank you @anushayhossain @netgalley & @tillerpress for the eARC in exchange for my fair and honest review.
March 9, 2023
I wish I could memorize this whole book to have this information readily available in my mind to tell people. It all made me so angry but also made so much sense. The fact that it also studied women during COVID was both fascinating and heartbreaking. Only read this when you're in an okay headspace about getting worked up by the material.
September 24, 2025
“It’s time for us to reclaim our hysteria” okay I’m sat!!!
WOMENS HEALTH IS IMPORTANT! START TAKING IT SERIOUSLY!
WOMENS HEALTH IS IMPORTANT! START TAKING IT SERIOUSLY!
April 14, 2022
Honestly, a rather depressing but necessary reading on a topic that on the surface seems not to exist but that unfortunately is reflected in a deficit in the attention that women receive and that seems to feel like something normal, when it shouldn't be.
May 29, 2022
This survey of differential treatment of women, and especially women of color, in United States healthcare presents stories and statistics that really should be shocking. Perhaps the saddest reality is that they are not, or at least won’t be to women of color and other readers who’ve followed the state of healthcare in this country. This book is just one more account of how bad things have become, blending a plethora of women’s personal stories with chilling statistics and accounts from non-profit leaders, other writers in the field, and healthcare professionals on the front lines.
Focusing primarily on maternal health, most of the challenges this book shares are not new, but the need for awareness is as crucial as ever and presented here specifically through the lens of the COVID-19 pandemic. Hossain offers an important reminder that the US is unnecessarily the worst Global North country when it comes to maternal mortality, that women’s pain is routinely dismissed by doctors with horrifying consequences, and that race and gender intersect to make the statistics particularly abysmal for women of color.
While I’ve read a fair bit about the horrors of hospital birth in this country and have personally experienced the way doctors dismiss feminized pain, I still had some of my own assumptions challenged. For example, I learned that pregnant women aren’t prescribed most drugs not because of known risks but rather because it’s expensive and inconvenient to include pregnant women in clinical trials. This is just another example both of how profit dominates healthcare in the US and birthing parents are objectified as carriers of the all-important future child, rather than treated as humans capable of making choices and in need of consideration. Though current narratives around choice center the imminent reversal of Roe v. Wade, it’s also important to understand that denial of choice in pregnancy is about the autonomy to make all medical care decisions, not only the choice of whether to carry to term.
While privilege is a huge factor in medical outcomes, readers may be surprised to read stories of even wealthy women of color in leadership positions, including women who are doctors themselves, being denied care and harassed by male staff. Hossain uses these examples and confirming statistics to show that while access to care is an important issue, racism alone creates massive disparities and status saves no one. Racist beliefs about Black women having higher pain tolerance and a greater likelihood of abusing pain medication, for example, remain common among medical professionals.
Hossain interviewed over a hundred women for the book, and you’ll find heartbreaking stories of women of color being ignored in emergency rooms while bleeding to death, shouted at to shut up while in excruciating pain during childbirth, and “dismissed to death” when experiencing pain they intuitively recognize as a major warning signal. In Louisiana, for example, 59% of Black maternal deaths were found to be preventable compared to 9% of white deaths. It’s hard to miss that this isn’t just about sexism or even access—it’s about systemic racism.
Hossain covers women of color’s experiences with refreshing specificity. She highlights issues for individual communities including the dramatic impact of the pandemic on Filipino nurses in New York, how maternal depression disparately impacts Black women experiencing cultural pressure against therapeutic support, and how Asian-American victims of domestic violence may find it even harder to access care in the fact of racist beliefs about the virus. Hossain also considers the anti-Black history of banning community midwives, questioning the norm of hospital birth, and points out that early pandemic policies disproportionately affected Black women, who often need a doula to advocate against medical racism and were not allowed to have both a doula and a partner present.
Hossain does make a strategic choice not to focus exclusively on racialized women, though they form the center of her narrative. As she points out from her own experience lobbying for the Feminist Majority Foundation, policy conversations in DC are exceedingly white, and white policymakers frankly tend not to care about issues framed as a “Black woman’s problem” or a woman-of-color problem. I personally worked for several years in this space, and while I’m not sure I ever met Hossain I suspect we were in some of the same rooms (full disclosure, several of the folks she interviewed were colleagues, including my first boss in DC). I made similar observations, noting that the folks in the room (especially senior leaders) tended to be white and that discussions of women’s health frequently placed racial disparities as a sidebar to issues that affect all women. It’s a sad fact, but treating women of color as canaries in a coal mine that white women should pay attention to for their own self-interest really is likely the most effective strategy at the federal level.
Hossain makes an effort to show that healthcare issues are part of a much broader problem of systemic sexism and racism. COVID in particular has shown how the US model of “no support systems, women as the backup” can be devastating. She points out that even successful career women are staying home in droves so higher-earning male partners can earn an income while the kids are at home, with many essentially sacrificing their careers. Women with abusive partners not only found it harder to leave during lockdown, but often experienced greater violence given the mental health impact of lockdown on those partners, and continue to risk infection in shelters. And of course frontline workers (largely women of color) have no choice but to risk serious illness and death, with no safety net if they do contract the virus. While these aren’t new issues, Hossain’s hope is that their exacerbation during this crisis is waking more US residents up to how bad things really are.
The author’s personal lens is somewhat unusual, as her interest in maternal mortality stems from the shock of having her own pain dismissed and barely surviving childbirth in a country she’d seen as the gold standard growing up in Bangladesh. She makes a direct comparison in telling the story of a beloved nanny who died in childbirth and was only even able to access healthcare due to luck—something that we might see as a “development issue,” but is in fact very similar to the US, where positive birth experiences are more about luck of the draw than American prosperity or superiority.
I found Hossain’s writing compelling and accessible on the whole, if a little unfocused at times. I think the book would have been served by limiting the scope to maternal health, as its overall flow doesn’t build as clearly as it could towards the conclusion that birth justice is a crucial part of the fight against systemic racism. Readers expecting broader coverage of the issues women of color face in healthcare may be confused and frustrated by the fact that maternal health is the primary focus of the book, since that’s not fully evident from the title or introductory chapters.
As written, chapters are a little uneven and the reader may occasionally get slightly lost. It might have served the flow of the book to introduce up front some of the broader context including police brutality, the history of medical experimentation on Black subjects, and how female subjects are excluded from medical research even around gender-specific health conditions before going into examples. I needed to make certain connections across chapters on my own—for example, how the theme of women’s choices connects the global gag rule, the tough decision pregnant people had to make around getting vaccinated in the absence of any medical guidance, and the tendency of hospitals to mandate unnecessary C-sections and other procedures. I expect most readers will ultimately draw the necessary conclusions, but the “hit” isn’t as strong as it could be with more guidance.
That said, I really appreciated how towards the end Hossain brings things back to the fundamental need to believe women of color. She calls this a “radical” proposal, highlighting the connections between #MeToo, medical denial of female pain, and the larger problems of systemic racism. But she also frames justice as “possible and so within our reach,” and suggests that COVID has created an opportunity by shining a spotlight on “parallel pandemics” including racism, police brutality, maternal health, and domestic violence.
The specific solutions she proposes to get there vary, and what’s challenging is that we have to admit as one expert does in the solutions chapter that women of color often simply don’t have options. Self-advocacy can be framed as drug-seeking or rebellious behavior, while silence leads to abuse. Hossain attempts to reframe “hysteria,” the term used for thousands of years to dismiss women’s frame, as a powerful collective voice with potential for change, but the political establishment is still largely white and male and that’s a larger problem to solve.
In my view, what we’re talking about here is major systemic overhaul of US institutions at every level, not traditional party politics, and so I found Hossain’s trust in the Biden administration overly optimistic. Perhaps the most intriguing to me was the story of a birth center in Florida that’s virtually training clinicians in its patient-centered model, drastically improving outcomes for Black pregnancy. Community solutions may be the best way forward while books like these continue to raise awareness of a system that is well and truly broken.
(ARC provided through NetGalley.)
Focusing primarily on maternal health, most of the challenges this book shares are not new, but the need for awareness is as crucial as ever and presented here specifically through the lens of the COVID-19 pandemic. Hossain offers an important reminder that the US is unnecessarily the worst Global North country when it comes to maternal mortality, that women’s pain is routinely dismissed by doctors with horrifying consequences, and that race and gender intersect to make the statistics particularly abysmal for women of color.
While I’ve read a fair bit about the horrors of hospital birth in this country and have personally experienced the way doctors dismiss feminized pain, I still had some of my own assumptions challenged. For example, I learned that pregnant women aren’t prescribed most drugs not because of known risks but rather because it’s expensive and inconvenient to include pregnant women in clinical trials. This is just another example both of how profit dominates healthcare in the US and birthing parents are objectified as carriers of the all-important future child, rather than treated as humans capable of making choices and in need of consideration. Though current narratives around choice center the imminent reversal of Roe v. Wade, it’s also important to understand that denial of choice in pregnancy is about the autonomy to make all medical care decisions, not only the choice of whether to carry to term.
While privilege is a huge factor in medical outcomes, readers may be surprised to read stories of even wealthy women of color in leadership positions, including women who are doctors themselves, being denied care and harassed by male staff. Hossain uses these examples and confirming statistics to show that while access to care is an important issue, racism alone creates massive disparities and status saves no one. Racist beliefs about Black women having higher pain tolerance and a greater likelihood of abusing pain medication, for example, remain common among medical professionals.
Hossain interviewed over a hundred women for the book, and you’ll find heartbreaking stories of women of color being ignored in emergency rooms while bleeding to death, shouted at to shut up while in excruciating pain during childbirth, and “dismissed to death” when experiencing pain they intuitively recognize as a major warning signal. In Louisiana, for example, 59% of Black maternal deaths were found to be preventable compared to 9% of white deaths. It’s hard to miss that this isn’t just about sexism or even access—it’s about systemic racism.
Hossain covers women of color’s experiences with refreshing specificity. She highlights issues for individual communities including the dramatic impact of the pandemic on Filipino nurses in New York, how maternal depression disparately impacts Black women experiencing cultural pressure against therapeutic support, and how Asian-American victims of domestic violence may find it even harder to access care in the fact of racist beliefs about the virus. Hossain also considers the anti-Black history of banning community midwives, questioning the norm of hospital birth, and points out that early pandemic policies disproportionately affected Black women, who often need a doula to advocate against medical racism and were not allowed to have both a doula and a partner present.
Hossain does make a strategic choice not to focus exclusively on racialized women, though they form the center of her narrative. As she points out from her own experience lobbying for the Feminist Majority Foundation, policy conversations in DC are exceedingly white, and white policymakers frankly tend not to care about issues framed as a “Black woman’s problem” or a woman-of-color problem. I personally worked for several years in this space, and while I’m not sure I ever met Hossain I suspect we were in some of the same rooms (full disclosure, several of the folks she interviewed were colleagues, including my first boss in DC). I made similar observations, noting that the folks in the room (especially senior leaders) tended to be white and that discussions of women’s health frequently placed racial disparities as a sidebar to issues that affect all women. It’s a sad fact, but treating women of color as canaries in a coal mine that white women should pay attention to for their own self-interest really is likely the most effective strategy at the federal level.
Hossain makes an effort to show that healthcare issues are part of a much broader problem of systemic sexism and racism. COVID in particular has shown how the US model of “no support systems, women as the backup” can be devastating. She points out that even successful career women are staying home in droves so higher-earning male partners can earn an income while the kids are at home, with many essentially sacrificing their careers. Women with abusive partners not only found it harder to leave during lockdown, but often experienced greater violence given the mental health impact of lockdown on those partners, and continue to risk infection in shelters. And of course frontline workers (largely women of color) have no choice but to risk serious illness and death, with no safety net if they do contract the virus. While these aren’t new issues, Hossain’s hope is that their exacerbation during this crisis is waking more US residents up to how bad things really are.
The author’s personal lens is somewhat unusual, as her interest in maternal mortality stems from the shock of having her own pain dismissed and barely surviving childbirth in a country she’d seen as the gold standard growing up in Bangladesh. She makes a direct comparison in telling the story of a beloved nanny who died in childbirth and was only even able to access healthcare due to luck—something that we might see as a “development issue,” but is in fact very similar to the US, where positive birth experiences are more about luck of the draw than American prosperity or superiority.
I found Hossain’s writing compelling and accessible on the whole, if a little unfocused at times. I think the book would have been served by limiting the scope to maternal health, as its overall flow doesn’t build as clearly as it could towards the conclusion that birth justice is a crucial part of the fight against systemic racism. Readers expecting broader coverage of the issues women of color face in healthcare may be confused and frustrated by the fact that maternal health is the primary focus of the book, since that’s not fully evident from the title or introductory chapters.
As written, chapters are a little uneven and the reader may occasionally get slightly lost. It might have served the flow of the book to introduce up front some of the broader context including police brutality, the history of medical experimentation on Black subjects, and how female subjects are excluded from medical research even around gender-specific health conditions before going into examples. I needed to make certain connections across chapters on my own—for example, how the theme of women’s choices connects the global gag rule, the tough decision pregnant people had to make around getting vaccinated in the absence of any medical guidance, and the tendency of hospitals to mandate unnecessary C-sections and other procedures. I expect most readers will ultimately draw the necessary conclusions, but the “hit” isn’t as strong as it could be with more guidance.
That said, I really appreciated how towards the end Hossain brings things back to the fundamental need to believe women of color. She calls this a “radical” proposal, highlighting the connections between #MeToo, medical denial of female pain, and the larger problems of systemic racism. But she also frames justice as “possible and so within our reach,” and suggests that COVID has created an opportunity by shining a spotlight on “parallel pandemics” including racism, police brutality, maternal health, and domestic violence.
The specific solutions she proposes to get there vary, and what’s challenging is that we have to admit as one expert does in the solutions chapter that women of color often simply don’t have options. Self-advocacy can be framed as drug-seeking or rebellious behavior, while silence leads to abuse. Hossain attempts to reframe “hysteria,” the term used for thousands of years to dismiss women’s frame, as a powerful collective voice with potential for change, but the political establishment is still largely white and male and that’s a larger problem to solve.
In my view, what we’re talking about here is major systemic overhaul of US institutions at every level, not traditional party politics, and so I found Hossain’s trust in the Biden administration overly optimistic. Perhaps the most intriguing to me was the story of a birth center in Florida that’s virtually training clinicians in its patient-centered model, drastically improving outcomes for Black pregnancy. Community solutions may be the best way forward while books like these continue to raise awareness of a system that is well and truly broken.
(ARC provided through NetGalley.)
July 23, 2024
This wasn’t about women’s healthcare. It was all complaining about Covid.
Mislabeled. A shame for such an important topic.
It was on topic till chapter 5.
Mislabeled. A shame for such an important topic.
It was on topic till chapter 5.
January 10, 2024
thanks to netgalley & tiller press for the review copy in exchange for an honest review.
The Pain Gap: How Sexism and Racism in Healthcare Kill Women is just okay. As other reviewers have pointed out, the marketing is a bit off. The title and description should have made it more clear that Hossain's dominant focus is sexism and racism within maternity healthcare. Most of the stories, policies, statistics, and suggestions related specifically to maternal health which is just one aspect of women's health and a facet that many women do not experience! She's also notably focused specifically on cisgender women's experience; at no point are there stories or reference points that introduce how anti-trans bias affect women's healthcare (or, on the flip side, care related to pregnancy).
There's also no substantive exploration of how either anti-fat bias affects healthcare access for women or women of color, especially black women. This is a huge point of health inequity and there are resources available to address it; it's a glaring omission and weakens the overall introduction and analysis of the topic. The primary mention of it was towards the end when she quotes Regen Chastain's advice about avoiding anti-fat bias at the doctor's office (which just amounts to ... look up doctor's ahead of time? lmao). For a more helpful resource for this specifically, I really recommend What's Wrong with Fat?.
Finally, there's very little exploration of how financial inequity within healthcare and how that negatively impacts women and women of color. Again, really surprising especially given that she correctly identifies and highlights how much the United States underperform when it comes to maternity health. But believing women and women's pain isn't the only point of inequity within women's healthcare. The prohibitive cost of healthcare in the United States is part of the inequity that is almost completely ignored in The Pain Gap.
If this book were to serve as an introduction to the topic, it would be missing major facets of the issue. I wouldn't recommend it, unfortunately. I had much higher hopes!
The Pain Gap: How Sexism and Racism in Healthcare Kill Women is just okay. As other reviewers have pointed out, the marketing is a bit off. The title and description should have made it more clear that Hossain's dominant focus is sexism and racism within maternity healthcare. Most of the stories, policies, statistics, and suggestions related specifically to maternal health which is just one aspect of women's health and a facet that many women do not experience! She's also notably focused specifically on cisgender women's experience; at no point are there stories or reference points that introduce how anti-trans bias affect women's healthcare (or, on the flip side, care related to pregnancy).
There's also no substantive exploration of how either anti-fat bias affects healthcare access for women or women of color, especially black women. This is a huge point of health inequity and there are resources available to address it; it's a glaring omission and weakens the overall introduction and analysis of the topic. The primary mention of it was towards the end when she quotes Regen Chastain's advice about avoiding anti-fat bias at the doctor's office (which just amounts to ... look up doctor's ahead of time? lmao). For a more helpful resource for this specifically, I really recommend What's Wrong with Fat?.
Finally, there's very little exploration of how financial inequity within healthcare and how that negatively impacts women and women of color. Again, really surprising especially given that she correctly identifies and highlights how much the United States underperform when it comes to maternity health. But believing women and women's pain isn't the only point of inequity within women's healthcare. The prohibitive cost of healthcare in the United States is part of the inequity that is almost completely ignored in The Pain Gap.
If this book were to serve as an introduction to the topic, it would be missing major facets of the issue. I wouldn't recommend it, unfortunately. I had much higher hopes!
April 3, 2023
I think this was one of the hardest books for me to read because I didn't think I would be able to relate, but unfortunately, found my own stories on many of these pages. I went into this book believing that I had always had positive experiences in healthcare as a woman, but the testimonials in The Pain Gap made me reflect on times when I could not advocate for myself. I've spent a lot of time since thinking about moments where I wasn't believed, didn't feel comfortable advocating for myself as a woman, and was told "it's not that bad" in response to my symptoms and/or pain. This book is incredibly well-researched and flushed out in its subject matter, including the chapters discussing the impact of COVID-19 on women and mothers.
As stomach-churning and horrific as these stories and statistics are, this is a must-read. Please research trigger warnings before diving into this book, but the information in The Pain Gap that Anushay Hossain shares are crucial to women's safety and well-being. The Pain Gap sheds light on the horrors faced by expecting mothers, women who undergo surgeries and wellness exams, BIPOC women, and the history of racism within healthcare, and what we can do to advocate and keep ourselves safe in doctor's offices. I really appreciated the alternatives and evidence to support the choice of at-home births, midwives, and doulas. I highly recommend this book to anyone, whether you or a loved one who has been impacted by sexism and/or racism in healthcare.
As stomach-churning and horrific as these stories and statistics are, this is a must-read. Please research trigger warnings before diving into this book, but the information in The Pain Gap that Anushay Hossain shares are crucial to women's safety and well-being. The Pain Gap sheds light on the horrors faced by expecting mothers, women who undergo surgeries and wellness exams, BIPOC women, and the history of racism within healthcare, and what we can do to advocate and keep ourselves safe in doctor's offices. I really appreciated the alternatives and evidence to support the choice of at-home births, midwives, and doulas. I highly recommend this book to anyone, whether you or a loved one who has been impacted by sexism and/or racism in healthcare.
December 21, 2021
It’s the ultimate SMDH book. Except it’s SMHS, shake my head sadly. Heartbreaking stories that are all too familiar, at least from a chronic pain patient perspective.
The worst, “You should have said something!” she scolded.
Or
“…well, it turns out I have a really high threshold for pain,“ yup. Docs are impressed how well I take huge steroid shots into tender spots. Imagine how much pain I deal with every day when that seems pretty negligible. This was Padma Lakshmi about endometriosis. I related to this a LOT.
I hate lupus.
When she asked for an epidural she had to prove she was in enough pain first. How do you prove you’re in enough pain? Several people reported doctors making them do this. I wonder if any of those doctors were people who’d given birth?
“Women should act more, not less, “hysterical“ when it comes to our well-being, and that begins by telling our stories loudly.“
She reported that even though 70% of chronic pain patients are women, but 80% of pain studies continue to be on men or male mice.
The worst, “You should have said something!” she scolded.
Or
“…well, it turns out I have a really high threshold for pain,“ yup. Docs are impressed how well I take huge steroid shots into tender spots. Imagine how much pain I deal with every day when that seems pretty negligible. This was Padma Lakshmi about endometriosis. I related to this a LOT.
I hate lupus.
When she asked for an epidural she had to prove she was in enough pain first. How do you prove you’re in enough pain? Several people reported doctors making them do this. I wonder if any of those doctors were people who’d given birth?
“Women should act more, not less, “hysterical“ when it comes to our well-being, and that begins by telling our stories loudly.“
She reported that even though 70% of chronic pain patients are women, but 80% of pain studies continue to be on men or male mice.
November 10, 2022
*Libro.fm*
I’m really happy I read this book, only because the topic is important and underrated! While reading it, I was noticing sexism and racism in healthcare in the other books that I was reading at the same time and also while discussing with women around me. I was always thinking “oh but that happened because of the pain gap!”, being the only one to understand.
However, the book was so repetitive. Sometimes the sentences and statements were so alike that I was looking at my screen thinking I went back to an earlier part of the audio (but nope). I also think it could have been more engaging, with more anecdotes and clear chapters. It felt like listening to a way too long speech!
7.5/10
I’m really happy I read this book, only because the topic is important and underrated! While reading it, I was noticing sexism and racism in healthcare in the other books that I was reading at the same time and also while discussing with women around me. I was always thinking “oh but that happened because of the pain gap!”, being the only one to understand.
However, the book was so repetitive. Sometimes the sentences and statements were so alike that I was looking at my screen thinking I went back to an earlier part of the audio (but nope). I also think it could have been more engaging, with more anecdotes and clear chapters. It felt like listening to a way too long speech!
7.5/10
July 1, 2022
(3.9) i think this is a great book to really grasp the maternal problem we have in this issue. i especially appreciated the stories from women, which is crucial in the process of listening and believing women.
however, i wish the book discussed more thoroughly the systemic issues of maternal health. while she does discuss the lack of trust of women and dismissing us as “hysterical” (which i have experienced personally), i want to know more about *why* doctors are trained to still think like this even after a whole decade of medical training. also, the book lacks a thorough guide on the ways we can address these issues. towards the end, Hossain talks about the different solutions and bills being put in place. But, we need more systemic solutions, specifically in the medical field. for example, how do we tackle implicit and unconscious bias in the medical field?
overall, great beginner book! i still recommend it, but many questions are left unanswered.
however, i wish the book discussed more thoroughly the systemic issues of maternal health. while she does discuss the lack of trust of women and dismissing us as “hysterical” (which i have experienced personally), i want to know more about *why* doctors are trained to still think like this even after a whole decade of medical training. also, the book lacks a thorough guide on the ways we can address these issues. towards the end, Hossain talks about the different solutions and bills being put in place. But, we need more systemic solutions, specifically in the medical field. for example, how do we tackle implicit and unconscious bias in the medical field?
overall, great beginner book! i still recommend it, but many questions are left unanswered.
March 12, 2022
I think that this book covered a lot of topics in the span of 300 pages, I would even say too many as they were all barely covered and honestly, you could say a lot more about each of them.
The title, I would say, is also very broad as it doesn't; just touch upon the sexism and racism of the world but as well the pandemic, health problems, pregnancy and a whole other variety of things.
I would recommend this purely because you can get a glimpse of what is happening in the world, but I would research more into the topics provided.
The title, I would say, is also very broad as it doesn't; just touch upon the sexism and racism of the world but as well the pandemic, health problems, pregnancy and a whole other variety of things.
I would recommend this purely because you can get a glimpse of what is happening in the world, but I would research more into the topics provided.
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