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How Racism Affects the Reproductive and Sexual Health in African American Women.

Aubrianna Cooper

California State University, Channel Islands

HLTH 499

Professor Ashley Winans

05 March 2021
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How Racism Affects the Reproductive and Sexual Health in African American Women.

Introduction

Racism is a longstanding public issue that has infected almost all aspects of life in

America. Racism is found in schools, workplaces, churches, and even in the healthcare system.

One of the safest places should be the healthcare system, you should be able to go to your doctor

and trust that you are being given the best care possible without question. Unfortunately, this is

not the case for many African American women when it comes to their reproductive and sexual

health. This discrimination and racism have followed African American women throughout

history and is still prevalent to this day. African American women tend to be more likely to be

discriminated against no matter their socioeconomic status, education level, or insurance

coverage.

Historical Background

Many preconceived stereotypes people have about African American women have been

passed down through generations of the past. This discrimination was established against African

women during slavery. Many African women that were enslaved had no say over their bodies or

their sexual health. During slavery, it was estimated that 58% of enslaved women were raped and

used for sexual and reproductive exploitation to benefit their slave owners. Many of the enslaved

women were raped and forced to be breeders (Prather et al., 2018, p. 251). Not only were

enslaved women sexually exploited they were also used for experimental reproductive surgeries,

this continued long after slavery was abolished and into the Jim Crow Era. These experimental

surgeries included cesarean sections and ovariectomies, which are still used to this day (Prather

et al., 2018, p. 251-252). For years after slavery ended many African American women still

faced sexual abuse. For years leading up to the Civil Rights movement of 1964, there was legal
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segregation in healthcare which allowed for federally funded reproductive procedures like

coerced sterilizations (Prather et al., 2016, p.7).

Impact on African American Women

Racism has a direct effect on African American women’s reproductive health. These acts

of racism have been present throughout history and continue to affect the quality of care these

women are receiving. Racism is considered a chronic psychosocial stressor in research, this

stress can affect cognitive, emotional, behavioral, and physiological responses, which leads to

poor health outcomes (Chambers et al., 2019, p. 485). Many African American women feel the

need to prove themselves to combat the preconceived discrimination which in turn leads to

“passive responses, include feeling powerless and hopeless (emotional), and ignoring, accepting

and not speaking up (behavioral)” (Chambers et al., 2019, p. 485). Studies have shown that

African American women are more likely to experience discrimination, receive sub-standard

medical care, and undergo unnecessary surgeries. They are also more likely to experience low

rates of maternal and infant outcomes, “between 1990 and 2015 the maternal mortality rate

increased from 16.9 to 26.4 percent” (Mehra et al., 2020, 484). They were more likely to

experience two to three times the rate of infant mortality and have infants who are born

prematurely with a low birth weight (Chambers et al., 2019, p. 213). Racism affects educational

access which has been linked to poor adherence to HIV treatment. Many African American

women who are living HIV have expressed mistrust in healthcare professionals (Prather et al.,

2016, p. 4).

Efforts for Improvement

Combating racism to improve reproductive health outcomes in African American women

is not going to be an overnight job. One study called The Saving Our Ladies from Early Births
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and Reducing Stress (SOLARS) is an Oakland California-based study that “aimed to describe

pregnant and early postpartum Black women’s experiences of stress, resilience, and coping”

(Chambers et al., 2019, p. 214). This study was able to expose the effects that racism has on

pregnant women in an attempt to combat racism. It was found that “data from this study support

the need to locally monitor and investigate the social determinants of health outcomes, such as

structural racism” (Chambers et al., 2019, p. 217). Specifically, focusing on systemic racism has

been found to be the best way to attempt to improve reproductive health outcomes for African

American women. In researching systemic racism measures it aids in efforts to improve

reproductive health outcomes among African American women (Alson et al., 2021, p. 56). There

needs to be a focus on health care and social service providers, in implementing anti-bias training

can aid in a decrease in discriminatory actions against African American women (Mehra et al.,

2020, p. 490).

Conclusion

There is no question that racism affects sexual and reproductive health outcomes in

African American women. While taking a look at the dark history that surrounds African

American women’s health, we were able to target where this issue began and identify why it is

still lingering today. The effects of racism on African American women’s reproductive health are

long-lasting and often extends to their children who are in turn also affected by poor health

outcomes. Targeting systemic racism will aid in improving health outcomes and reducing.

Whereas providing health care and social work providers with anti-bias training will help to

improve reducing discrimination thus improve health outcomes.

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References

Alson, Julianna G, Robinson, Whitney R, Pittman, LaShawnDa, & Doll, Kemi M. (2021).

Incorporating Measures of Structural Racism into Population Studies of Reproductive

Health in the United States: A Narrative Review. Health Equity, 5(1), 49–58.

https://doi.org/10.1089/heq.2020.0081

Chambers, B. D., Arabia, S. E., Arega, H. A., Altman, M. R., Berkowitz, R., Feuer, S. K.,

Franck, L. S., Gomez, A. M., Kober, K., Pacheco-Werner, T., Paynter, R. A., Prather, A.

A., Spellen, S. A., Stanley, D., Jelliffe-Pawlowski, L. L., & McLemore, M. R. (2020).

Exposures to structural racism and racial discrimination among pregnant and early post-

partum Black women living in Oakland, California. Stress and Health: Journal of the

International Society for the Investigation of Stress, 36(2), 213–219.

https://doi.org/10.1002/smi.2922

Mehra, R., Boyd, L. M., Magriples, U., Kershaw, T. S., Ickovics, J. R., & Keene, D. E. (2020).

Black Pregnant Women "Get the Most Judgment": A Qualitative Study of the

Experiences of Black Women at the Intersection of Race, Gender, and Pregnancy.

Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health,

30(6), 484–492. https://doi.org/10.1016/j.whi.2020.08.001

Prather, C., Fuller, T. R., Jeffries, W. L., 4th, Marshall, K. J., Howell, A. V., Belyue-Umole, A.,

& King, W. (2018). Racism, African American Women, and Their Sexual and

Reproductive Health: A Review of Historical and Contemporary Evidence and

Implications for Health Equity. Health Equity, 2(1), 249–259.

https://doi.org/10.1089/heq.2017.0045
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Prather, C., Fuller, T. R., Marshall, K. J., & Jeffries, W. L., 4th (2016). The Impact of Racism on

the Sexual and Reproductive Health of African American Women. Journal of Women's

Health (2002), 25(7), 664–671. https://doi.org/10.1089/jwh.2015.5637