The problem of racism and bias in Black maternal and infant health

Why Irth’s digital platform is critical to ending the Black maternal mortality and morbidity crisis.

By Kimberly Seals Allers


Racism and unconscious bias have been directly linked to the unconscionably high rates of Black maternal mortality and morbidity, as well as the racial disparities in infant deaths.

Last year, a study put a horrifying number to the epidemic: Black people in America are over three times more likely to die from pregnancy-related causes than white people, the Centers for Disease Control and Prevention reported. More recently, the tragic deaths of Sha-Asia Washington and Amber Isaac led to a spate of heart-wrenching news stories decrying the racist disparity.

Compelling research from Stanford University and others demonstrates that implicit bias, concerning your race, class, gender identification, marital status or even sexual orientation can impact the care and treatment you receive. In the most recent Listening to Mothers national childbearing survey, 21% of black mothers and 19% of Hispanic mothers hospitalized for childbirth reported their perceptions of poor treatment due to race, ethnicity, cultural background, or language.

According to the Centers for Disease Control and Prevention (CDC), Black women and birthing people in America are over three times more likely to die from pregnancy-related causes than white people. More recently, last year, the tragic deaths of Sha-Asia Washington and Amber Isaac led to a spate of heart-wrenching news stories decrying the racist disparity.

Meanwhile, the evidence of literal bias in treatment is compelling and conclusive. White physicians are less likely to educate their Black patients about preventative care; they’re less likely to offer preventative testing; and they’re less likely to refer them to “state-of-the-art” specialty facilities, according to a 2013 meta-analysis performed by sociological researchers at Texas A&M University.

The other piece is in how we birth. Black women are more likely to be given cesarean sections than other races, even in low-risk pregnancies. (In 2018, over 30% of Black women with low-risk pregnancies delivered via C-section, compared to under 25% of white women.) And a 2008 review found that the race-based discrepancy in C-section rates persisted even after adjusting for the fact that Black people are more likely to have preexisting conditions that might necessitate the procedure. Many maternal deaths occur due to complications from C-sections.

To address this ongoing and deadly issue, hospitals and even governments have mandated anti-bias trainings for physicians and healthcare professionals. These are helpful, but there is no public accountability for the care of Black women receive and we have no way of knowing how someone like us experienced a particular health care provider.

This is why Irth is so important. On the front end, we give Black women and birthing people a platform to leave and see reviews from other moms of color just like them. Think of it as the “Yelp-like” platform that every Black woman or birthing person of color needs. Check Irth to see prenatal reviews of Ob/gyns, reviews of birthing hospitals, postpartum appointment reviews and reviews of pediatricians for infants up to one year old. We have tremendous power as consumers to let providers know we will publicly share where we are receiving good care and where we are not.

Irth features a special icon to indicate that a doula (a trained birth support professional) has left a review—doulas attend multiple births at a given hospital and have an incredible and powerful perspective on care. Our “Amber’s Rose” icon indicates whether a maternal death has been reported by a user in the last three years. Our “Forever Footprint” lets you know if an infant death has been reported. We need to make that information public!

On the back end, Irth turns your qualitative experiences into quantitative data to push for change. We pool the collective experiences and generate data to help institutions see the specific behaviors and patterns that cause harm, feelings of disrespect, and ultimately death. This is how we push for change—inform and protect ourselves and then use our collective power to use consumer forces to disrupt an industry that has been slow to change.

Together, we can!


Kimberly Seals Allers is the founder of Irth. A five-time author, award-winning journalist and former senior editor at Essence, her first childbirth experience inspired her to pivot to maternal and infant health strategy and advocacy. Since then, she has led community-centered, participatory research projects in Detroit, New Orleans, Philadelphia, and five other U.S. cities all designed to understand the lived experience of birth and breastfeeding for Black and brown people. Learn more at Follow @iamKSealsAllers on Twitter, Instagram and Facebook.



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