Breaking the Silence: Maternal Health and Black Disabled Women
A call to address systemic inequities in maternal care for Black disabled women and amplify their voices in the fight for justice.
By Kyanda Bailey
Content Warnings
- Racial Discrimination: This blog discusses systemic racism, specifically related to Black women’s experiences with healthcare.
- Ableism: The blog addresses ableism, including the discrimination disabled people face within healthcare systems.
- Reproductive Injustice: Topics such as forced sterilization and restrictions on reproductive rights are covered.
- Maternal Mortality and Health Complications: The blog discusses the disproportionately high maternal mortality rates for Black disabled women and related pregnancy complications.
- Historical Trauma: The blog touches on historical events such as forced sterilization and eugenics that may be disturbing or triggering.
- Health Inequities and Systemic Violence: It covers health disparities and the ongoing effects of systemic violence faced by marginalized groups.
Open discussions about maternal health can be found on almost any social media site. However, I often search for conversations centering the experiences of Black pregnant women — and find that discourse and literature about Black disabled pregnant women are far less common. For centuries, Black women’s bodies have been controlled, from forced sterilization to today’s fight for reproductive rights in a post-Roe v. Wade era. I am left wondering: where are the voices of Black disabled women in these critical conversations about maternal health?
Including Black disabled women in conversations about maternal health is essential to addressing their specific needs and challenges. Their experiences are often overlooked, but they must be centered in maternal health research and conversations to ensure equitable care and outcomes. By centering Black disabled women, we can identify systemic gaps, implement inclusive practices, and ensure that maternal healthcare reflects the needs of all individuals, fostering a more just healthcare system.
To address this gap, we need to look at how the intersecting realities of race, disability, and pregnancy create compounded challenges for Black disabled women. These overlapping identities expose them to systemic discrimination, inadequate healthcare access, and a lack of visibility in maternal health research. Black women in the U.S., including those with disabilities, face higher maternal mortality rates and other poor health outcomes. How do Black disabled women navigate pregnancy when both ableism and racism work against them? This question highlights the importance of understanding how race and disability magnify challenges during pregnancy.
Forced Sterilization: The Struggle for Disabled Black Women’s Reproductive Rights
Both ableism and racial discrimination interact to create a deeply unequal healthcare landscape for Black disabled pregnant women, a reality that has persisted for centuries. Between 1929 and 1974, thousands of Black women were forcibly sterilized in the U.S. under eugenics policies — removing their ability to have children — often without their consent. The Relf sisters are a striking example of sterilization abuse during this period. Simultaneously, disabled women, particularly those with intellectual disabilities, were also targeted for sterilization.
The 1927 Buck v. Bell Supreme Court decision confirmed the constitutionality of Virginia’s forced sterilization statute, targeting individuals deemed “unfit” to have children. Justifications for these practices included baseless claims like “menstrual management,” based on assumptions that disabled women could not cope with or manage their menstrual cycles. As Douglas Baynton explained in “Disability and the Justification of Inequality in American History,” disability was often used to justify societal control over disadvantaged groups. Women, in particular, were frequently depicted as hysterical or lacking emotional stability when they challenged societal norms. These stereotypes served as a basis for denying women control over their bodies and autonomy in all areas of life. For decades, the voices of women subjected to such injustices were unheard.
This legacy of reproductive control did not end with the eugenics movement; it evolved into more subtle but equally damaging forms of systemic control and neglect. For Black disabled women, the history of forced sterilization continues to shape systemic barriers to reproductive care today.
Continued Legacy
The Supreme Court’s decision to overturn Roe v. Wade disproportionately impacts Black disabled women. Black women in the U.S. face a maternal mortality rate three times higher than White women, while disabled women are at 11 times greater risk of maternal mortality. According to the National Institutes of Health, disabled women are more likely to face pregnancy complications, including preterm birth, hypertensive disorders, gestational diabetes, and cesarean delivery. One study found that Black disabled women reported higher rates of not having health insurance, inadequate social support, and diabetes. They also reported higher rates of stillbirth and labor costs compared to disabled White women.
Restrictive state abortion bans exacerbate these disparities, further limiting reproductive healthcare options and forcing Black disabled women to navigate unsafe and inaccessible alternatives. These bans increase the vulnerability of Black disabled women to harm and even death. Reproductive healthcare services — including maternal care, abortion care, and contraceptives — are often physically or financially inaccessible for people with disabilities. The systemic barriers resulting from these restrictions magnify long standing inequities and significantly endanger Black disabled women’s lives. The Supreme Court’s decision amplifies these disparities, underscoring the urgent need for systemic change to protect the reproductive rights and health of Black disabled women.
Challenges for Black Disabled Pregnant Women
Racist and ableist biases rooted in systemic discrimination create compounded challenges for Black disabled women. Issues such as inaccessible transportation to medical appointments and a lack of accommodations for disabled patients persist in healthcare systems. Disabled women, including those who are pregnant, often face attacks on bodily autonomy — a remnant of the eugenics movement.
Black women with disabilities may struggle to find competent care during pregnancy. According to Generate Health, “Not only do many Black women face racial discrimination while seeking healthcare during their pregnancies; many providers also lack knowledge and confidence in managing a pregnancy that may be affected by a physical, intellectual, or emotional mental disability” (para. 4). This underscores the urgent need for systemic changes to address both racial bias and the lack of disability competence among providers.
Recognizing that Black disabled pregnant women deserve informed providers and equitable health outcomes is just the first step toward providing better care.
Essential Steps for Equity in Black Disabled Maternal Health
The challenges faced by Black disabled pregnant women require urgent attention and action. To fully understand their experiences, additional data is essential, which could guide the development of equitable policy recommendations. A strong push for culturally competent care and protections against systemic harm is also necessary.
Centering intersectional frameworks, such as reproductive justice and disability justice, is a vital step forward. These frameworks emphasize fundamental human rights, including the right to make decisions about one’s body and raise children in safe, dignified conditions. Both frameworks advocate for accessible, stigma-free healthcare and community support.
Disability justice, in particular, addresses the historical injustices faced by disabled people and people of color, such as forced sterilization, institutionalization, and persistent barriers to receiving competent, respectful care. These frameworks are crucial for addressing the unique needs of Black disabled pregnant women and amplifying their voices in the fight for systemic change.
Black disabled women have long been excluded from maternal health discussions. Their intersecting identities subject them to compounded forms of discrimination. Elevating their stories is vital for creating a healthcare system that serves everyone. Acknowledging these barriers is not enough. It is time for action to ensure Black disabled women’s voices and needs are prioritized in maternal health conversations, policy-making, and research.
The first step in this process is funding targeted research that addresses the intersection of race and disability. Institutions must be held accountable for creating inclusive and equitable healthcare practices. Prioritizing the well-being of Black disabled women and upholding their fundamental rights to safe and dignified maternal care must be non-negotiable.
Definitions/Explanations of Key Terms
- Ableism: Discrimination or prejudice against individuals with disabilities, typically rooted in assumptions about their abilities, which often leads to exclusion, inequality, and a lack of accessibility.
- Eugenics: A set of beliefs and practices aimed at improving the genetic quality of the human population, often through unethical methods such as forced sterilization, particularly targeting people considered “unfit” (e.g., disabled people and people of color).
- Maternal Mortality: The death of a woman during pregnancy or within 42 days following the end of pregnancy, regardless of the cause. This term is particularly relevant to discussions about the disproportionate maternal mortality rates among Black disabled women.
- Intersectionality: The interconnectedness of social categories such as race, class, and disability, which can create overlapping systems of discrimination and disadvantage, making it harder for people to navigate multiple forms of oppression.
- Reproductive Justice: A framework that emphasizes the fundamental rights of all women, including the right to have children, the right to not have children, and the right to care for their children in a safe and healthy environment. It focuses on ensuring access to equitable reproductive health services and protecting these rights from systemic harm.
- Disability Justice: A framework that works to dismantle systemic discrimination against people with disabilities by advocating for inclusivity, accessibility, and respect in all areas of society, recognizing the historical injustices faced by disabled people.
- Health Disparities: Differences in health outcomes and access to healthcare services, often influenced by factors such as race, disability, and socioeconomic status. These disparities can result in significant gaps in care and unequal health outcomes for marginalized groups.
- Systemic Discrimination: Discrimination that is embedded within the systems, policies, and institutions of society, often affecting individuals based on their race, gender, disability, or other characteristics. This form of discrimination is often invisible or normalized, making it harder to recognize and address.
Kyanda Bailey was a Fall 2024 intern with the Center for Racial and Disability Justice through the American Association of People with Disabilities (AAPD) internship program. During her internship, she contributed significantly to advocacy and research efforts aimed at addressing disparities — particularly healthcare disparities — at the intersection of race and disability.
The Northwestern Pritzker Law Center for Racial and Disability Justice (CRDJ) is a first-of-its-kind center dedicated to promoting justice for people of color, people with disabilities, and individuals at the intersection of race and disability.
Learn more about CRDJ by visiting the Center for Racial and Disability Justice webpage.
