When we hear the phrase medical racism, it's easy to think of history—to imagine something that happened generations ago and has little relevance today.
But for many women, particularly Black women and other marginalized communities, the effects of that history are still felt in exam rooms, labor and delivery units, and doctors' offices across the United States.
To understand why trust in healthcare can be complicated, we first have to understand how we got here.
The Origins of Modern Gynecology
This section would carefully cover:
- J. Marion Sims
- Anarcha, Lucy, and Betsey
- Vesicovaginal fistula surgery
- Lack of consent under slavery
- Why this history matters
I'd be careful to avoid oversimplification. Sims' surgical innovations are part of gynecologic history, but so is the exploitation of enslaved Black women whose bodies were used without the ability to give meaningful consent. Modern organizations such as ACOG explicitly acknowledge this history and its ongoing impact on the field.
Racism Didn't End—It Changed
Move into modern medicine.
Important point: Race is not a biological risk factor.
Instead: Racism creates unequal outcomes.
That distinction is emphasized by ACOG, which states that racism—not race—is what drives many inequities in obstetric and gynecologic outcomes.
The Myth That Black Patients Feel Less Pain
This deserves its own section.
Cover:
- historical origins
- modern physician studies
- undertreatment of pain
- why these myths persist
This is one of the most striking examples of how historical stereotypes can influence clinical care today. ACOG notes that false beliefs about biological differences in pain tolerance originated during slavery and continue to affect pain assessment and treatment.
Pregnancy Shouldn't Be More Dangerous Because of Your Race
Discuss:
- maternal mortality
- severe maternal morbidity
- postpartum care
- listening to patients
Use CDC/NIH/ACOG data.
Current NIH-supported research has found maternal mortality among non-Hispanic Black women to be approximately 3.5 times that of non-Hispanic White women.
Why Trust in Healthcare Can Be Complicated
Topics:
- historical trauma
- sterilization
- discrimination
- medical mistrust
Important distinction:
Explain that mistrust is not irrational.
It often develops from personal experience, community experience, and documented historical injustices.
Where Do We Go From Here?
I wouldn't want readers leaving angry.
I'd want them leaving hopeful.
Discuss:
- implicit bias education
- diverse clinical trials
- listening to patients
- informed consent
- shared decision making
- patient advocacy
Understanding this history isn't about assigning blame to today's clinicians.
It's about recognizing that medicine, like every institution, evolves.
By acknowledging where we've fallen short, we create space to build a healthcare system where every woman is believed, respected, and receives equitable care.
Sources:
American College of Obstetricians and Gynecologists
https://www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2025/racism-in-obstetrics-gynecology
ACOG Committee Statement
https://www.acog.org/clinical/clinical-guidance/committee-statement/articles/2024/09/racial-and-ethnic-inequities-in-obstetrics-and-gynecology
CDC
https://www.cdc.gov/womens-health/features/maternal-mortality.html
PNAS
https://www.pnas.org/doi/full/10.1073/pnas.1516047113