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The reasons for the black-white divide in both infant and maternal
mortality have been debated by researchers and doctors for more than two
decades. But recently there has been growing acceptance of what has largely
been, for the medical establishment, a shocking idea: For black women in
America, an inescapable atmosphere of societal and systemic racism can
create a kind of toxic physiological stress, resulting in conditions —
including hypertension and pre-eclampsia — that lead directly to higher
rates of infant and maternal death. And that societal racism is further
expressed in a pervasive, longstanding racial bias in health care —
including the dismissal of legitimate concerns and symptoms — that can help
explain poor birth outcomes even in the case of black women with the most
advantages.

“Actual institutional and structural racism has a big bearing on our
patients’ lives, and it’s our responsibility to talk about that more than
just saying that it’s a problem,” says Dr. Sanithia L. Williams, an
African-American OB-GYN in the Bay Area and a fellow with the nonprofit
organization Physicians for Reproductive Health. “That has been the missing
piece, I think, for a long time in medicine.”

https://www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html
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