Bearing the Burden of Injustice: Black Maternal Mortality

Mother and babyWhen it comes to maternal mortality, American women don’t all live in the same country. While white women live in Qatar, black women live in Mongolia.

Maternal mortality is death related to complications from pregnancy or childbirth. Most of us don’t come from a time or place where the prospect of dying in childbirth is a tangible possibility — in the past century, as medicine has advanced, maternal mortality rates have plummeted.


To raise healthy families, we need access to general and reproductive health care, including preventive care, prenatal care, and maternity care.


The United States, though, hasn’t come as far as would be expected. Although its wealth should have put it on par with other developed nations like Canada, the United Kingdom, Australia, Japan, and those in Scandinavia, women in these countries fare far better than those in the United States. So do women in Libya, Bosnia and Herzogovina, Bulgaria, and Kazakhstan, indicating that national priorities — and not necessarily national wealth — are key to ensuring maternal health.

The United States’ high maternal mortality rate is heartbreaking no matter how you look at it, but is even worse for women of color. African-American women are 3.5 times more likely to die as a result of pregnancy or childbirth than white women. Between 2011 and 2013, the maternal mortality rate for white women was 12.7 deaths per 100,000 live births. Comparing that to 2015 data from the World Health Organization (WHO), that rate puts white women’s maternal mortality on par with mothers in Qatar and Bahrain, two wealthy Persian Gulf nations. African-American women, however, suffered 43.5 deaths per 100,000 live births, putting their maternal mortality on par with those of Turkmenistan, Brazil, and Mongolia. Continue reading

STD Awareness: The HIV Epidemic at Home

In the United States, we understand HIV — the virus that causes AIDS — using a common narrative, one that gives us the impression that its deadliest chapters belong in decades past or distant places. It goes like this:

The disease emerged in the 1980s, cutting down young gay men in their primes and blindsiding scientists as they scrambled to unravel the virus’ mysteries. While AIDS initially whipped up mass hysteria among the general public, LGBTQ folks demanded equality, pushing to find treatments and a cure. AIDS activism and scientific research eventually led to the development of antiretroviral drugs, which tamed the plague by turning a death sentence into a chronic disease. Now, with the right medication, people with HIV can live long, healthy lives. The hysteria has died down, as most people realize viral transmission is preventable, and the infection is manageable.

One thing hasn’t changed, however: Just as it was in the 1980s, AIDS is still thought of as a disease of the “other.” Back then, it was a disease of gay men, a population cruelly marginalized by the general public. Today, it’s thought of as a disease of sub-Saharan Africa, where HIV prevalence is highest.

That narrative, however, doesn’t tell the whole story. Right here in our own backyards, the HIV epidemic continues to spread in the face of chilling indifference from those not affected. African-American MSM — men who have sex with men, who may or may not self-identify as gay or bisexual — have an HIV prevalence that exceeds that of any country in the world. In Swaziland, for example, 27 percent of adults are living with HIV/AIDS, but if current transmission rates hold steady, half of African-American MSM are projected to be diagnosed with HIV in their lifetime. Instead of taking this projection as a wake-up call to invest in lifesaving health policies, however, state and federal responses are poised to let it become a self-fulfilling prophecy.

Contrary to racist and homophobic stereotypes, data show that black MSM aren’t more likely to engage in risky sexual behavior, use drugs and alcohol, or withhold their HIV status from partners. So why are they burdened with higher HIV rates? The answer lies beyond mere behavior, embedded in policies and practices that disproportionately harm people based on race, sexuality, and geography. Continue reading

STD Awareness: Gardasil and Gendered Double Standards

male female teens largeDespite the fact that it’s been approved for males for years, Gardasil is still largely seen as a vaccine for girls, and human papillomavirus (HPV) is still thought of by many as a virus that only impacts the female population. The fact of the matter is that HPV can have serious consequence for boys and men, and Gardasil is an important tool in protecting their sexual health. Why, then, does the association between girls and Gardasil persist?


Let’s stop thinking of Gardasil as the cervical cancer vaccine. Gardasil is a cancer vaccine, period.


Before Gardasil’s introduction, the pharmaceutical company Merck launched an HPV-awareness campaign to get a buzz going for their upcoming vaccine. Their talking points could be boiled down to one simple fact: HPV causes cervical cancer. Outside of the medical field, HPV was a little-known virus, and Merck strove to connect HPV and cervical cancer in the public’s mind so that, after it hit the market, Gardasil’s value would be easily recognized.

So the origins of the association between girls and Gardasil lie in its marketing — and the fact that the Food and Drug Administration (FDA) initially only approved its use in females. From its introduction in 2006 until 2009, Gardasil was only FDA-approved for use in girls and women, and its routine use in males was not recommended by the Advisory Committee on Immunization Practices until December 2011.

While Gardasil’s website is currently gender neutral, archives show that before FDA approval for males, it contained photos of young women and female-specific language. This initial focus on female recipients could have “feminized” Gardasil, entrenching its association with girls and women in the cultural imagination. Some scholars say that, by only recommending it for one sex, the FDA implicitly assigned liability for HPV transmission to females, and advertisers framed the woman as a disease vector in taglines targeting females, such as “spread the word, not the disease.” Although a male’s sexual history is a major predictor of a female partner’s HPV status, girls and women were assigned sole responsibility for their HPV status while boys and men were not similarly burdened. Such messages downplayed the male role in HPV transmission as well as HPV’s effect on males. Continue reading

The Feminine Mystique in Retrospect: An Interview With Stephanie Coontz, Part 1

Award-winning author Stephanie Coontz has published a long list of books and articles about the history of family and marriage. She has written about the evolution of those two institutions from prehistory to today, in works that have been widely praised for their intelligence, wit, and insight. In her most recent book, A Strange Stirring: The Feminine Mystique and American Women at the Dawn of the 1960s (Basic Books, 2012), Coontz takes us back 50 years to a breakthrough that changed the role of women in American households.


“Equal marriages require more negotiation than unequal ones.”


In 1963 it was clear that a revolution was beginning. After its approval by the FDA at the beginning of the decade, 2.3 million American women were using the birth control pill, the oral contraceptive that Planned Parenthood founder Margaret Sanger had been instrumental in pioneering. And on February 19, 1963, 50 years ago today, Betty Friedan published The Feminine Mystique, a book that sold millions of copies in its first three years. It quickly became the object of both derision and acclaim for awakening women to aspirations beyond what discrimination and prejudice had long defined for them. If oral contraceptives were the breakthrough in medicine that finally enabled women to plan their reproductive lives around their educational and career goals, Friedan’s landmark book was the breakthrough in consciousness that gave many the resolve to do it.

Friedan was a magazine writer whose experience surveying women at a college reunion was the spark that drove her to uncover “the problem that has no name.” She was referring to the dissatisfaction and depression she found widespread among housewives, not just at the reunion but in many other encounters she had with them as a writer. Convinced that it would help married women — and their marriages — if they sought their own identities outside of the home, Friedan synthesized a wealth of research to make her case in The Feminine Mystique. Stephanie Coontz’s A Strange Stirring is a social history of The Feminine Mystique that takes readers from an era of far-reaching sex discrimination in the early 1960s when Friedan made her breakthrough, to the contemporary era when many of Friedan’s appeals have been realized but new challenges hinder equality. Continue reading