The other morning I was drinking my coffee, easing into the morning after a couple of long days at work. I opened up the New York Times and was riveted by this article by Linda Villarosa on maternal and infant mortality among black women in the United States. There were so many things about this article that resonated, angered and saddened me that I felt both exhausted and inflamed after I read it.

From 2010 to 2014, I worked as a early intervention and school physical therapist in and around Durham County, North Carolina. In a country where African Americans make up about 13% of the population, Durham County is 40% black. Working in that community, I remember asking one of my mentors why so many of my patient's histories included maternal hypertension and preeclampsia. (Preeclampsia is linked to birth complications, including prematurity, the biggest risk factor for cerebral palsy.) It was then that I learned these conditions are more prevalent in African American women. As Villarosa describes in her article, however, the popular ideology used to be that these differences were due to genetics or socioeconomic conditions, maybe both. This made sense in the context of my work. Many of the families I worked with were on public assistance and dealt with the demoralizing hardships of poverty: unstable and, at times, unsafe living conditions, insecure work, transportation issues, limited education and healthcare issues.

In sharing research from the last decade, though, Villarosa reveals that infant and maternal morbidity and mortality rates are, in fact, higher in well-educated, affluent black women than they are in white women with only eighth grade education, making a powerful and disturbing case that the cause of these conditions not poverty-related (she also debunks the genetics argument), but rather the accumulated stress of a lifetime of contending with racism--a phenomenon known as weathering.

photo by Kiana Bosman

This disproportionate burden on well-educated women struck a chord with me, not only because of the African American women I know and work with, but also because it echoes a sad note in the world of child care. 

As I mention in the "About Me" section of this blog, I became interested in child care in a deep way once I had children of my own. I experienced so many mornings leaving crying kids at daycare, often crying myself, that I came to work one day and went to PubMed (a huge database of research articles) and started reading up on how childcare impacts children. I haven't stopped since.  

Although I'm a pediatric physical therapist, I also started reading about childcare teachers and about how childcare impacted families, personally and professionally. What strikes me over and over again in this research--when I learned how girls begin to be less active than boys as early as preschool; when I learned that even in one of the most progressive countries in the world--Denmark--mothers did seventeen times more housework and childcare than fathers; when I learned that most childcare providers (95% of whom are female) earn so little they couldn't even pay for the daycare they provide--was how childcare was in so many ways an emblem of our society and its attitudes toward women.

Often, reading these articles, I didn't know whether to laugh or cry. It was both comforting and infuriating to know that women all over the world were battling the same pressures (many, I fully admit, so successfully indoctrinated they've become self-inflicted): pressure to be smart, successful, financially secure, a star worker, a fantastic mother; a supportive spouse; and that my hair also look good (though I've mostly given up on this one)--and because doing all these things at once is impossible, and because there's very little real support for working parents in the United States--feeling like I was always failing at everything. There are many days when it occurs to me, with no surprise, that heart disease is a leading killer of women. Most days, I feel like I'm sprinting from about 6 am to 9 pm (and those are improved hours, since my son started sleeping through the night). 

I get the pressure of being a woman trying to do it all, and I would still take it over dealing with the gnawing insecurity of poverty or an earlier time when I wouldn't have been afforded the educational and work options I have today (Thank you, Ladies of Yesteryear). Nevertheless, I feel pretty sure that every man I work with makes more money than I do, and that fills me with just a tiny bit of rage every day I walk in to work. What I don't experience is walking into a work party and, as one of my African American colleagues did, being asked when the food would arrive (the trustee who made the comment assumed she was a food service worker). If I feel moments away from a heart attack some days, I can only imagine how I'd feel if I were also contending with racism.

Villarosa's article is about many things, one of them being unconscionable disparity. But, at root, it's also about an experience that joins all mothers, and for that, it is a call to action for all mothers and all who value children and families.

This article has so much important information that I haven't even touched on here--about some amazing doula organizations (Birthmark and Black Mamas Matter, the latter from which I adapted the title of this post) that are serving African American women and--on the other side of things--some chilling facts and figures about racism and bias in healthcare. It is deeply disturbing and absolutely worth the read.

Did you read Villarosa's article or do have a related experience? Start the conversation below.