Yes, Black Women Are in Pain. Why Don’t You Believe Us?
Reflections from an intimate conversation about birth care with Synclaire Warren and Elaine Welteroth, Founder of Birthfund
Women know the feeling of being disbelieved well. Our jobs, education level, expertise, stories, even hobbies are picked and prodded for authenticity. I have a “yes, really” locked and loaded every time someone asks me what I do and I mention computer programming. Yes, really. But once we subsume other social categories along with our gendered disbelief, consider: race or class, disbelief becomes more than a question that can be answered with my, “yes, really”. It evolves into a condition that deprives communities of resources, and in the case of Black Maternal Health we must consider that disbelieving Black women is deadly.
Picture this: I’m in a warmly lit beautiful conference room in the middle of Midtown Manhattan for Clinton Global Initiative 2025. Shifting in my cream boucle chair across from Reproductive Rights creator, Synclaire Warren and BirthFund founder, Elaine Welteroth who are deep in a conversation about Black Maternal Health outcomes. As the founder of Birthfund Elaine
Welteroth champions families from highly impacted communities by funding their 1:1 midwifery care. Synclaire Warren also uses her platform as a Doula to advocate for safe births for Black women. And the specific focus on Black women and birthing is essential, with maternal death rates dropping for every racial group except Black women, “who continue to face alarming disparities in maternal health outcomes,” according to the Policy Center for Maternal Health.
As they spoke, I started to wonder what it’d feel like to be disbelieved in the doctor’s office. My mind wandered to the mothers whose concerns and cries went discredited and untreated, and wondered how a medical system that feels so precise could fail so many people. A world where, “the pregnancy-related death rate for Black women is more than three times the rate for mothers of other racial and ethnic groups,” as reported by Axios, didn’t make sense to me. When Elaine shared the phrase “Medical Gaslighting” with us, I was instantly transported in time to my sixteen year-old self who’s fibroids were just erroneously diagnosed as appendicitis, so my surgeon mistakenly removed my appendix (yes, really!!!!!!!!!), and it hit me.
By the time I was 19 years old I only had my period a handful of times and about half sent me to the hospital. The menstrual pain I was going through felt like the shock of accidentally touching a too recently-lit stove burner except I couldn’t take my hand off it for days. The initial pain shocked me like a ghost-sighting and it would leave me curled in a ball on the cool bathroom floor until the cycle was complete. Sometimes, I’d even pass out right there on the floor, thus warranting a trip to the ER. After several hospital visits and doctor’s appointments with countless nurses insisting that I was either pregnant, even though I asserted that would require immaculate conception which seemed unlikely, or simply anxious, I felt a sense of relief upon the discovery of my faux appendicitis.
That relief was taken from me when upon completion of the appendectomy, as I’m doped up on morphine, the surgeon shared that the surgery went great and there was only one problem: I didn’t have appendicitis. “He must be joking. Or I must be hallucinating.” I remember myself hoping as I stared at him lifeless. I was already as deflated as you’d imagine a 16 year old girl on morphine who’d just had the first surgery of her life to be, and the news of my misfortune only made me sink further. I had returned to the uphill battle that was, getting literally any medical professional to take my reproductive health seriously. And above all, I had to face the devastating fact that medical gaslighting, when healthcare professionals dismiss, minimize, or invalidate a patient’s legitimate medical concerns as defined by The American Journal of Medicine, started stealing from my body. Despite how personally I took this adversity, the experience isn’t mine alone. There’s a trail of evidence throughout history that suggests a very harmful association between medical gaslighting and the Black community.
Take the Tuskegee Syphilis Experiment as a pretty literal example, one I assume to be widely known, but in reality the tragedy continues to be under-taught. The study aimed to examine the debilitating STD, Syphilis, and targeted poor Black men “who were eager for medical treatment.” According to the Equal Justice Initiative, “They enlisted 600 black men, 399 of whom had syphilis, by concealing the experiment’s purpose and the infected men’s diagnosis.” Participants in the study experienced medical gaslighting en masse, and in this case the gaslighting was very intentional. These men were told they were receiving care, but in reality they deliberately went untreated, in some cases for up to 40 years when just 17 years into the study the treatment to Syphilis was discovered.
You should also consider another chilling example; Mississippi Appendectomies. Believe it or not, America is no stranger to forced sterilization. Throughout the 60s, 70s and 80s, Black women consented to receive one medical procedure at the doctor’s office, but often unknowingly left with two: whatever they consented to plus a complete hysterectomy. In accordance with WashU, “The practice of unwanted sterilization via complete hysterectomy by medical professionals on unknowing Black patients was so common that it was coined by Fannie [Lou Hammer, famed Civil Rights Activist] as the “Mississippi Appendectomy”.” As Dorothy E. Roberts reports in Killing the Black Body, “During the 1970s sterilization became the most rapidly growing form of birth control in the United States, rising from 200,000 cases in 1970 to over 700,000 in 1980... Teaching hospitals performed unnecessary hysterectomies on poor Black women as practice for their medical residents.” In this case, doctors deceiving and lying to their patients, effectively gaslighting them, robbed Black women of their own bodily autonomy. Today medical gaslighting continues to contribute to adverse Black maternal health outcomes, and in too many cases, is robbing Black mothers of their lives.
Decades after these horrific events, the racial bias Black patients face might not look like an unethical research study, or forced sterilization (although honestly, it might), but it can be as simple as your doctor not believing that you’re in pain. The Proceedings of the National Academies of Science found that, “trainees who believed that black people are not as sensitive to pain as white people were less likely to treat black people’s pain appropriately.” This means, “From birth to death, regardless of wealth or social standing, [Black Americans] are far more likely to get sick and die from common ailments.” How do you prove your pain to a medical system that uses and discards your personhood in order to adhere to frameworks of race-based medicine? This unjust yet seemingly constant occurrence of disbelief in the doctor’s office results in wide-ranging failures across the network, none more glaring than the Black Maternal Health crisis, where so many Black women die because doctors don’t believe them, as published by AP.
Despite being the most affected by adverse maternal health outcomes, Black women are leading the charge to find solutions. Birthfund lays the statistics bare, “The U.S. maternal mortality rate is 10x higher than other high-income countries and nearly half of new moms label their births ‘traumatic’.” And where policy makers, insurance or even doctors might fail, Welteroth believes midwifery can step in to protect and advocate for patients at risk. “Midwifery-led care could avert about 2/3 of deaths among women and newborns, and under midwife care, there is an average 13% decrease in obstetric interventions. But only 12% of births in the U.S. were attended by a midwife in 2021 due to a lack of access,” according to Birthfund. Co-care for Black mothers could mean finally seeing a decrease in maternal death rates for Black mothers, giving them the justice and dignity they deserve.
It was truly enlightening to see how Elaine’s own birthing experience directly influenced her mission to make birthing more safe and equitable for every woman. Similarly, Sinclaire’s work as a Doula to create a co-care environment for mothers was similarly inspired by her personal experience with reproductive healthcare. It seems like so many Black women around me have personal experience with adverse reproductive health outcomes, and although many of us are searching for and finding our own solutions, I want to leave you with an important statement that Elaine ended our conversation with: “This is not a Black women’s problem to fix. And when we address the problem for the most vulnerable, we fix it for everybody.”