In the United States, social inequalities, including racial inequality, seems so stark and so universal, the stakes so high, and thus the problem so urgent, that the way forward seems obvious. Any non-criminal campaign is probably worth a try! And racism is often manifested in the acts and words of individuals, so the immediate response is clear – the condemnation and/or prosecution of those people.
In Britain and Ireland, things are more complicated because, while some individuals are still saying and doing racist things, we’re often dealing with discrimination by statistic rather than voluntary act. Black women are four time more likely to die in childbirth than white women (1), Asian women twice as likely, but the risk is still very small – 217 women in total, out of 2,235,159 births (with a further 349 women dying within a year.) between 2016 and 2018. So, dying in childbirth is not the common experience for either black or non-back women. Some commentators have speculated that black women are less likely to be listened to by doctors, but this is based on personal testimony and so is difficult to verify: many people, from all different ethnic backgrounds, feel that health care professionals can sometimes deal with them a little briskly and miss things: they are, after all, massively over-worked, under extreme time-pressure and are used to knowing better than their patients, who are likely to combine ignorance with hypochondria.
The Guardian article also points out that “women living in the most deprived areas were three times more likely to die than those in more affluent areas” and “almost all of those who died during or after pregnancy had multiple issues such as mental or physical health problems, were victims of domestic abuse, or were living in a deprived area. More than half of those who died were overweight or obese. Cardiac disease represents the largest single cause of indirect maternal deaths.” So, perhaps the most significant single factor is the limited life choices made available to immigrants by a begrudging indigenous population keen not to disadvantage themselves.
But if these factors increase susceptibility to childbirth mortality, they will affect anyone who suffers from them, irrespective of putative “race”. Race only appears causal if you organise your data-set by racial group. When organised into sub-sets based on weight or age or heart condition or income, they will be revealed as the culprits. This is significant, because you still have to be very unlucky to fall foul of the risk factors. It is only when you start working with incredibly large numbers that mortality is guaranteed and a bias becomes apparent. Which brings up the intriguing idea that if Britain was a smaller country, it wouldn’t appear to be systemically racist, because yearly statistics of mortality rates in pregnancy might not show any racial discrepancy. (You’d have to do macro-studies across several years to see the trend.)
“Systemic racism” becomes a useful term in this context. It allows us to understand these phenomena without having to resort to a sense of paranoid persecution or angry resentment. People haven’t taken against you personally, and you do not need to feel significantly more threatened than anyone else. Dying in childbirth is not the usual lived experience of women, of any racial group.
Unfortunately, the internet has ushered in an age where only personal experience, and our emotional response to it, are seen as having any validity. Everyone now has a voice to express themselves, but truth is increasingly easily falsified and thus mistrusted and dismissed. We are explicitly told to be angry, because that is seen as a powerful motivator, despite causing further conflict, antagonism and schism, and thus possibly doing more harm than good. (Is there any evidence that anger gets more constructive results than kindness and concern?)
In other words, we are told to take it personally. And that’s so easy to do, because everyone in a minority group will experience racism from time to time, and, unfortunately, it only takes one racist scumbag to make you feel vulnerable and unwelcome.
And then you start seeing it everywhere.
- “Black Women in the UK Four times more likely to die in Pregnancy or Childbirth” The Guardian, 15/01/21