In the last moments of George Floyd’s life, he called out for his mother. This invocation stands as a reminder of George’s humanity and reminds us of the sacred role mothers play in protecting and nurturing human life.
If the unjustified murder of Black men and women at the hands of police tasked with protecting our communities is one sign of the lifeblood of white supremacy, then the death of Black mothers at the hands of a medical system tasked with bringing life into this world is another sign of racial injustice. Black women are 3 to 4 times more likely to die in childbirth than white women and Black babies are more likely to die before they reach their first birthday than any other race of children. These are not just abstract numbers, they are events that often devastate people’s lives. The Perinatal Behavioral Health Service (PBHS) acknowledges and grieves these experiences alongside our patients.
Beyond these frequently cited statistics, PBHS routinely witnesses Black women’s voices—including their knowledge of their own bodies, their babies, and their physical and emotional pain—being dismissed, ignored, overpowered, and “managed” by the medical system. If medical and mental health providers and institutions demonstrate an inability to listen and respond to our patients, then healthcare is also a perpetrator of racial injustice. The time has come to slow down, take notice, and really listen and respond to what Black mothers are saying when they enter medical care.
As perinatal mental health providers, we are deeply concerned by and take responsibility for the inequalities present in our own field: According to the NIH, Black mothers are twice as likely to suffer from postpartum depression, but few of these women receive the necessary help to treat it. We are committed to listen to and partner with Black women during and after their pregnancies in order to challenge this disparity. Working in a medical setting, we are also called to intervene in a broader system that often fails these women. We believe that change should not only be born in protest on the streets but also should be made from within the system by those who are in position to implement processes and influence policy. These are some of the steps that PBHS is taking to oppose and end institutionalized racism in the medical system and in mental health care:
- Examining and challenging manifestations of racism and white supremacy within our own staff. We are especially concerned with fostering cultural norms that oppose racism and keep dialogue open. Our clinicians of color will continue to use their voices and personal experiences to bring to the forefront and normalize discussions of race and racism that challenge the white majority on the staff. Our white clinicians will listen openly to these concerns, and work to challenge how whiteness and racism shape their clinical encounters and their work with colleagues of color. At the same time, it is not the responsibility of Black clinicians to educate white clinicians or do all the work of bringing about change. White clinicians will educate themselves and consult over these matters, so that the responsibility for change does not continue to be shouldered by Black clinicians.
- PBHS seeks guidance from and will utilize organizations and resources that are led and/or sponsored by Black professionals leading the fight against maternal health racial disparities.
- PBHS will review our own polices on recruiting and training, in order to hire, retain, and support Black clinicians and foster clinical development.
- PBHS will continue to partner with Generate Health, the FLOURISH initiative, and other St Louis based organizations seeking to end the disparities in Black infant and maternal mortality. In addition to clinical work, we seek opportunities to enact policy change.
- PBHS staff will undertake additional training in order to continue to approach patients with awareness and sensitivity on matters of race and explore how racism contributes to the trauma our patients have endured. We are seeking treatment models that will acknowledge the racial and cultural experiences of our patients and foster their mental and emotional well-being.
- PBHS will reserve designated time for review and reflection to assess the fidelity to these steps and continue to hold ourselves accountable through ongoing program evaluation.
PBHS will listen to Black mothers, witnessing their trials and pain as well as their joy and celebrations.
We believe Black women are the experts in their own lives and, as such, pledge to advocate for these women in ways that ensure they are respected and treated with fairness and compassion as they seek care during and after their pregnancies. PBHS will support Black mothers as they continue to care for and protect themselves and their families from the continued, systemic, and sanctioned harm of Black people in the U.S. We say unequivocally: Black Lives Matter; Black Mothers Matter.