The Black/African American Healthcare Experience: Understanding Maternal Health Through History and Lived Reality – Part II
Filed Under: Black / African American, Multicultural, Healthcare
Angela Roberts
Vice President, Administration & Project Support
Black Maternal Health Week was founded in 2018 by the Black Mamas Matter Alliance and formally recognized by the White House in 2021. Observed annually from April 11–17, it aims to deepen awareness, amplify Black women’s voices, and mobilize action to address the persistent inequities in maternal health outcomes. For our CultureBeat team, this moment provides an important opportunity to deepen the conversation that we’ve begun — grounding the discussion in purpose, history, and action.
During Black History Month, in Part I of this article, we paired data with personal stories to illustrate how historical realities and lived experiences continue to shape Black/African American maternal healthcare. In Part II, we move from understanding what happened to examining what it means today. For brands and market researchers across industries, these disparities reveal something important: a consumer experience crisis — an experience that directly influences how Black women and their families engage with brands, navigate systems, make decisions, participate in research, and build — or withhold — loyalty. Let’s now delve a little bit deeper into the confluence of factors that have led us to where we are today.
The Biological Toll of a Lifetime of Racial Stress
Historical context is essential to understanding today’s maternal health disparities. A deeper layer emerges when viewed through the lens of weathering, a term introduced by public health researcher Dr. Arline T. Geronimus. Weathering describes the cumulative deterioration of health experienced by many Black individuals due to lifelong exposure to social and economic stressors rooted in racism. Political stressors add additional complexity, where rollback of DEI initiatives and debates over racial justice milestones (e.g., affirmative action, voting rights protections, etc.) signal marginalization or devaluation of Black lived experiences.
Weathering is responsible for not only accelerating biological aging, but also for heightening vulnerability to mental illness and chronic conditions such as hypertension and diabetes — factors that directly shape maternal health outcomes and contribute to disproportionately high rates of maternal mortality among Black women. For expecting mothers, this accumulated stress can have life-or-death implications. The National Institutes of Health reports that weathering contributes to higher infant mortality rates, lower birth weight, and intrauterine growth restriction. These outcomes are not isolated; they reflect the compounding effects of chronic stress on the body. How Black women decide to navigate these realities provides useful insights for marketers.
Cultural Alignment in Maternal Care Becomes a Lifeline
Armed with historical knowledge and current statistics, many expecting Black mothers navigate maternal healthcare with a discerning eye. Some intentionally seek out Black obstetricians or providers who demonstrate genuine cultural competency. Others turn to doulas or midwives because they do not feel hospitals are safe or trustworthy.
When an expecting mother connects with her provider on a meaningful cultural level, it offers reassurance that she is in a safe space — one where she is heard, understood, and cared for by people who “get” her concerns and realities.
“Cultural affirmation is a safety signal.”
If you meet a Black midwife or a Black prenatal provider and they practice some of the same sacred cultural practices as you… there’s a level of safety… But when you enter into a healthcare system, no one practices your culture. No one affirms your culture. You immediately know: I’m an outsider. These are not my people.
Not Being Heard Becomes a Threat
According to the Pew Research Center, 55% of Black Americans report negative experiences with doctors. Among Black women under 50, that number rises to more than 70%. Many describe moments during childbirth where their concerns — especially about pain — were dismissed or ignored.
“Listening is caring.”
They kept asking if I wanted an epidural, and I kept saying yes… but they weren’t taking me seriously… By the time they came back, it was time to push. If they had listened to me… they would have known what I needed.
These experiences reinforce mistrust and highlight the critical role of listening as a form of clinical care.
The Need for Advocates Who Listen and Honor Birth Plans
Many mothers also express the need for advocates — often doulas or midwives — who genuinely listen and uphold their preferences throughout the birthing process. During labor, when pain and urgency can cloud decision-making, having someone who can articulate and defend their intentions becomes essential.
“Respect the birth plan = Respect the person.”
With all of my kids, I wanted a natural birth… but in the hospital, they very quickly call the anesthesiologist… There’s no conversation about waiting it out.
The need for advocacy extends well into the “fourth trimester,” a term coined by pediatrician Dr. Harvey Karp, referring to the postpartum period when most pregnancy-related deaths occur. And, as time goes on, Black women are becoming even more attuned to advocating for themselves. This is true across the culture where even high-profile individuals, like Serena Williams, for example, self-diagnosed life-threatening blood clots after giving birth, underscoring the importance of self-advocacy and being heard.
Black Families Deserve Better
The joy of expecting a child is profound — but for many Black mothers-to-be, it coexists with a very real sense of worry about navigating the healthcare system. One truth is clear: pregnancy and childbirth for Black women unfold within a landscape shaped by history, systemic inequities, and the ongoing risk of not being heard when it matters most.
Their decisions — seeking culturally aligned providers, partnering with doulas, crafting detailed birth plans, or remaining hyper-vigilant long after delivery — are not merely preferences. They are strategies for safety in a system that has not consistently earned their trust.
Understanding these experiences is crucial for anyone committed to improving maternal care. They illuminate not isolated challenges, but entrenched patterns that require urgent, thoughtful, and sustained action.
Why It Matters
This is bigger than healthcare — it’s a trust crisis.
The maternal healthcare experiences Black women face shape how they assess all systems and institutions. When safety, listening, and respect are absent in moments that matter most, skepticism carries into how brands are judged, trusted, and chosen across categories.
Consumer decisions are increasingly shaped by lived experience, not brand intent.
Black women and families bring heightened discernment into every interaction — research participation, product adoption, loyalty, and advocacy. Brands outside healthcare should recognize this vigilance as a signal, not a barrier, and design experiences that prove trustworthiness through action.
Cultural alignment functions as a safety signal across industries.
Just as culturally affirming providers offer reassurance in maternal care, brands that reflect cultural understanding in language, imagery, service design, and research practices communicate respect and belonging.
Exclusion carries long-term business consequences.
When communities feel unheard or unsafe, they opt out — of care, research, feedback loops, and brand relationships. Brands risk losing insight, relevance, and credibility if they fail to address the root causes of disengagement.
What brands can do now: design for dignity, not assumptions.
Invest in inclusive research practices, build teams with cultural fluency, co-create with Black consumers, and audit experience touchpoints for bias or dismissal. Brands that actively reduce friction, affirm lived realities, and honor consumer voice won’t just earn loyalty — they’ll help repair trust where it’s been broken.
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