Tag Archives: medical racism

Medieval Medicine Used Against Pregnant Women Today

from Women En Large: Images of Fat Nudes copyright laurie toby edison

Laurie and Debbie say:

No matter how low you believe the anti-abortion zealots can sink, you find a lower bottom. As ProPublica (invaluable as always!) reports, doctors all over America are using the “lung float test” to determine if babies born at home were stillborn or alive at birth.

[Dr. Christopher] Milroy, [a forensic pathologist who teaches at the University of Ottawa], has studied the test and its history and has found references to its use in the 17th century, when witch trials were still occurring. But by the late 1700s, its reliability was questioned by doctors and lawyers.

The analogy to witch trials is both chilling and inescapable: we know that witches were tested by attempting to drown them: if they drowned, they were innocent but dead, if they didn’t drown, they were witches and killed otherwise. That was not a test; it was a mechanism to control and/or eliminate women, and that’s exactly what’s happening here.

The test’s reliability has been continuously questioned ever since, and consistently found wanting. Physicians for Human Rights says:

Despite its being deemed for decades by dozens of authoritative pathologists and forensic experts as wholly unreliable and inaccurate, the test is still being used as a part of routine practice. Reflecting the clear consensus among forensic medical experts that the test is highly inaccurate and should not be used — certainly never as the only test when performing a postmortem assessment of a deceased neonate — prosecutors and judges must refrain from relying on these tests as determinative in prosecuting crimes related to conduct in pregnancy.

So the only conclusion is that the people using it care far more about punishing women than about finding the “truth,” and they certainly don’t care about the pain of delivering a baby stillborn at home, or the pain of delivering a baby who takes two breaths before it dies.

Of course, the test — which should never be applied at all, and certainly not in legal cases — is not applied equitably.

Yveka Pierre, senior litigation counsel with the reproductive justice nonprofit If/When/How, said the people who are prosecuted for their pregnancy outcomes are typically from marginalized communities. They’re Black, like [Latice] Fisher; or they’re brown, like Purvi Patel, an Indiana woman who was sent to prison for feticide after self-inducing an abortion, a charge that was later vacated; or they face financial hurdles, like Akers.

“Some losses are tragedies, depending on your identity, and some losses are crimes, depending on your identity.” Pierre said. “That is not how we say the law should work.”

Fisher’s story is in the ProPublica article. She was convicted of second-degree murder, and served only a short part of her term before a coalition of attorneys and abortion advocates came to her defense, got her out of jail, and convinced the Mississippi district attorney to vacate the original grand jury. A second grand jury failed to indict her. The “positive” outcome here is insufficient: she should never have been charged or convicted in the first place, and it shouldn’t take an army of activists to change her story.

No agency currently tracks how often the lung float test is used in criminal cases. But the 11 cases ProPublica identified are likely an undercount because some cases weren’t covered in news reports, and plea deals and acquittals often create less of a public record.

This story–and this test–represent only a tiny margin of the ways the system attacks women, especially women of color. At the same time, this is simultaneously such an unconscionable approach to stillbirth, and so viscerally intense, that separating it out for examination feels right. And if even 11, or even 5, women are spared criminal charges and potential jail time because this test is eliminated from use, that counts.


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Various Thoughts about Medical Racism

America's History of Medical Misogynoir, with stylized images ofo women with skin tones ranging from very dark to very light
picture from DocumentWomen

Debbie says:

I listen to a lot of podcasts, many of them about race and racism issues, but the idea for this post came from The Allusionist, which is about words. Host Helen Zaltzman interviewed Moya Bailey, who coined the term “misogynoir” when she was doing work on racism in the medical community. As part of the conversation, Bailey relates the story of Dr. Susan Moore, a Black physician who died of COVID-19 in 2020. Despite her profession, Dr. Moore received woefully inadequate treatment for the virus because she was perceived as a “drug-seeker,” undoubtedly because of the color of her skin.

Examples like Dr. Wood’s are legion; perhaps more is to be gained from looking at the theory and practice of medical racism than the horror stories. This brings me to two things I’ve learned recently from Pod Save the People. First, race correction. When I heard the term, I thought (naively), “Wow! Sounds like a way to do evidence-based work on the medical issues that disproportionately affect the Black and Brown communities. I couldn’t have been more wrong.

Race correction, which is in use today, is the misuse of what author Cathy O’Neil calls “weapons of math destruction” against the health of (especially) Black people. Jacque Smith and Cassie Spodak wrote about it for CNN.

The New England Journal of Medicine article “Hidden in Plain Sight” [link requires registration] includes a partial list of 13 medical equations that use race correction. Take the Vaginal Birth After Cesarean calculator, for example. Doctors use this calculator to predict the likelihood of a successful vaginal delivery after a prior C-section. If you are Black or Hispanic, your score is adjusted to show a lower chance of success. That means your doctor is more likely to encourage another C-section, which could put you at risk for blood loss, infection and a longer recovery period.

[Dr. Samuel] Cartwright, the racist doctor from the 1800s, also developed his own version of a tool called the spirometer to measure lung capacity. Doctors still use spirometers today, and most include a race correction for Black patients to account for their supposedly shallower breaths.

Turns out, second-year medical student Carina Seah wryly told CNN, math is as racist as the people who make it.

On a somewhat more encouraging note, Pod Save the People also hosted Dr. James Wood, a Black orthopedic surgeon. I was especially pleased to hear Dr. Wood address fatphobia and medical bias against fat people in the context of medical racism:

And there’s bias against obese patients because patients who are very obese– everybody wants to blame whatever disease that is on the body habitus. But there’s new study and new research now on obesity that’s talking about people in their best body. I see people who are obese by any standard.

They walk in, their BMI, 38-40. But then their best body, these are the same people that can run five miles. They can hike. They can ride bikes at 20-30 miles, in great shape. It just big people, doing their best body. So being able to really have people understand this and respect this is something else that’s coming on new in the future.

So people who’ve been fat shamed and other things like that– and this is happening. It has happened to doctor’s office where they walk in and say, well, you’re too fat. I can’t take care of you. Or you’re too fat, you’ve got to do that, so you could take care of your diabetes or your hypertension or your arthritis in the joints. Being more cognizant of what the conversation is now about obesity would be very helpful as well, just as an example.

I’m not sure what research Dr. Wood is citing on this “best body” concept, and I will keep looking. In the interim, it was genuinely exciting to hear a medical professional talking about medical bias and using terms like “fat shamed,” which I tend only to hear in body image circles.

I’ll close with a comment from Moya Bailey which applies both to misogynoir and medical racism:

“I’m hoping that this is perhaps the flourishing before the end. If we talk about it a lot now, perhaps that means we’ll get to a place where we can actually transform and get rid of it.”


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