Black Women and OBGYN Care: What the Data Shows and What History Explains

23 hours ago
4 min read

You can’t talk about OBGYN care and Black women today without looking at what is still happening in the numbers, and the truth is, not much has changed in the ways that matter most.

In the United States, Black women are about three times more likely to die from pregnancy-related causes than white women, and in some areas that number is even higher depending on access to care, location, and provider bias. Infant mortality follows the same pattern, with Black infants dying at more than twice the rate of white infants, even when controlling for income and education.

The United States also has one of the highest maternal mortality rates among developed countries, despite spending more on healthcare overall, and at the same time maintains a C-section rate around 30 to 32 percent, which is higher than many other high-income nations that report better outcomes for both mothers and babies. Countries like the Netherlands, Norway, and Japan tend to have lower intervention rates and more consistent integration of midwifery care, longer postpartum support, and a system that does not rely as heavily on surgical birth.

When you look at all of that together, it doesn’t feel like a mystery, and it doesn’t feel like something that can be explained away by individual choice or isolated cases. It reflects patterns that have been building over time.

And when you understand the history, those patterns start to make sense.

In the 1840s, Dr. J. Marion Sims performed repeated experimental surgeries on enslaved Black women in Alabama, including Anarcha, Betsey, and Lucy, and these procedures were done without anesthesia at a time when pain relief existed but was not used on them. Anarcha endured more than 30 surgeries, Lucy nearly died from infection, and these women had no ability to consent or refuse what was being done to their bodies.

Those experiments contributed to what is now considered foundational knowledge in gynecology, and Sims later became president of the American Medical Association, which means the system itself was built, in part, on practices that treated Black women as expendable.

That mindset did not stay in the 1800s.

The belief that Black women feel less pain was taught, repeated, and reinforced over generations, and as recently as 2016, research published in the Proceedings of the National Academy of Sciences found that some medical trainees still held false beliefs about biological differences between Black and white patients, including pain tolerance and physical characteristics, which directly affects how symptoms are treated and how seriously concerns are taken.

Henrietta Lacks is another name that cannot be separated from this conversation. In 1951, her cells were taken without her knowledge or consent while she was being treated for cervical cancer, and those cells became one of the most important tools in medical research, used for decades in developing treatments and vaccines, while her family remained largely unaware of what had been done.

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Again, the pattern is not new.

The Tuskegee Syphilis Study continued from 1932 to 1972, allowing Black men to go untreated for decades even after penicillin became available, and these decisions were not accidents, they were choices made within a system that consistently placed research and advancement over the lives of Black patients.

So when people ask why there is hesitation, why there is questioning, why there is a return to midwives, herbalists, and community-based care, the answer is not confusion, it is awareness.

Black midwives, often called granny midwives, delivered generations of babies safely within their communities, working from knowledge passed down through experience, observation, and apprenticeship, understanding how the body changed over time and how to support it through pregnancy and birth without relying on constant intervention. These women were trusted not because of formal credentials, but because of outcomes, consistency, and care.

In the early 20th century, licensing laws and regulatory changes pushed many of these midwives out, not because they were ineffective, but because the system shifted who was allowed to practice and who was recognized as legitimate.

At the same time, access to hospitals was not equal, not always safe, and not always available, which meant that for many families, plant knowledge and home-based care were not alternative options, they were necessary.

This idea is not new, and it is not outside of Scripture either.

In Exodus, when the Egyptians were commanded to kill Hebrew male babies, the midwives did not follow those orders. They feared God and preserved life instead, choosing obedience over compliance, and in doing so, they protected an entire generation. That moment is often read as a story of courage, but it is also a reminder that there are times when care must be kept close, when responsibility cannot be handed over without discernment, and when protecting life requires wisdom and action at the household level.

Reclaiming herbal medicine and midwifery awareness today is often misunderstood because it is framed as rejection of modern medicine, when in reality it is about understanding it fully.

It is about knowing where medicine has helped and where it has failed.

It is about asking better questions, paying attention to patterns, and making decisions that are informed, not assumed. When you look at the data and the history together, the outcomes we see today are not surprising, they are consistent. Understanding that is what allows you to move forward with clarity, not fear, and to care for your household with both awareness and responsibility.

If this is a conversation you’ve never really heard broken down this way,

that’s not by accident.

Most of us were never taught how to look at women’s health, history, and the body together, which is why so many questions go unanswered or get brushed aside.

Inside The Women’s Health Class Bundle Replay, we go deeper into how the body actually works across different stages, what to look for, and how to support it with more clarity and less guesswork.